Is Malting Barley Better Feed for Cattle than Feed Barley?

Barley grain from a combined intermediate and advanced barley breeding trial was assessed for grain, feed and malt quality from two sites over two consecutive years, with the objective to ascertain relationships between these traits. Results indicated there were genetic effects for both malt (hot water extract and friability) and “feed” traits (as measured by hardness, acid detergent fibre, starch and in-sacco dry matter digestibility). The feed trait values were generally independent of the malt trait values. However, there were positive relationships between friability, hardness and protein, as well as a negative relationship between extract and husk. Extract also had a positive relationship with test weight but appeared to be independent from the feed traits. Test weight also showed little relationship to the feed traits. Heritability values ranged from low to high for almost all traits. This study details where both malt and cattle feed parameters have been compared and the results indicated that while malt and feed traits do not correlate directly, malt cultivars can exhibit excellent feed characteristics, equal to or better than feed cultivars. This data highlights the benefit of selecting for malt quality even if a breeding program would be interested at targeting specific feed quality.

Validating economic and environmental sustainability of a short-term summer forage legume in dryland wheat cropping systems in south-west Queensland.

The present study set out to test the hypothesis through field and simulation studies that the incorporation of short-term summer legumes, particularly annual legume lablab (Lablab purpureus cv. Highworth), in a fallow-wheat cropping system will improve the overall economic and environmental benefits in south-west Queensland. Replicated, large plot experiments were established at five commercial properties by using their machineries, and two smaller plot experiments were established at two intensively researched sites (Roma and St George). A detailed study on various other biennial and perennial summer forage legumes in rotation with wheat and influenced by phosphorus (P) supply (10 and 40 kg P/ha) was also carried out at the two research sites. The other legumes were lucerne (Medicago sativa), butterfly pea (Clitoria ternatea) and burgundy bean (Macroptilium bracteatum). After legumes, spring wheat (Triticum aestivum) was sown into the legume stubble. The annual lablab produced the highest forage yield, whereas germination, establishment and production of other biennial and perennial legumes were poor, particularly in the red soil at St George. At the commercial sites, only lablab-wheat rotations were experimented, with an increased supply of P in subsurface soil (20 kg P/ha). The lablab grown at the commercial sites yielded between 3 and 6 t/ha forage yield over 2-3 month periods, whereas the following wheat crop with no applied fertiliser yielded between 0.5 to 2.5 t/ha. The wheat following lablab yielded 30% less, on average, than the wheat in a fallow plot, and the profitability of wheat following lablab was slightly higher than that of the wheat following fallow because of greater costs associated with fallow management. The profitability of the lablab-wheat phase was determined after accounting for the input costs and additional costs associated with the management of fallow and in-crop herbicide applications for a fallow-wheat system. The economic and environmental benefits of forage lablab and wheat cropping were also assessed through simulations over a long-term climatic pattern by using economic (PreCAPS) and biophysical (Agricultural Production Systems Simulation, APSIM) decision support models. Analysis of the long-term rainfall pattern (70% in summer and 30% in winter) and simulation studies indicated that ~50% time a wheat crop would not be planted or would fail to produce a profitable crop (grain yield less than 1 t/ha) because of less and unreliable rainfall in winter. Whereas forage lablab in summer would produce a profitable crop, with a forage yield of more than 3 t/ha, ~90% times. Only 14 wheat crops (of 26 growing seasons, i.e. 54%) were profitable, compared with 22 forage lablab (of 25 seasons, i.e. 90%). An opportunistic double-cropping of lablab in summer and wheat in winter is also viable and profitable in 50% of the years. Simulation studies also indicated that an opportunistic lablab-wheat cropping can reduce the potential runoff+drainage by more than 40% in the Roma region, leading to improved economic and environmental benefits.

Impacts of grazing management options on pasture and animal productivity in a Heteropogon contortus (black speargrass) pasture in central Queensland. 4. Animal production.

Steer liveweight gains were measured in an extensive grazing study conducted in a Heteropogon contortus (black speargrass) pasture in central Queensland between 1988 and 2001. Treatments included a range of stocking rates in native pastures, legume-oversown native pasture and animal diet supplement/spring-burning pastures. Seasonal rainfall throughout this study was below the long-term mean. Mean annual pasture utilisation ranged from 13 to 61%. Annual liveweight gains per head in native pasture were highly variable among years and ranged from a low of 43 kg/steer at 2 ha/steer to a high of 182 kg/steer at 8 ha/steer. Annual liveweight gains were consistently highest at light stocking and decreased with increasing stocking rate. Annual liveweight gain per hectare increased linearly with stocking rate. These stocking rate trends were also evident in legume-oversown pastures although both the intercept and slope of the regressions for legume-oversown pastures were higher than that for native pasture. The highest annual liveweight gain for legume-oversown pasture was 221 kg/steer at 4 ha/steer. After 13 years, annual liveweight gain per unit area occurred at the heaviest stocking rate despite deleterious changes in the pasture. Across all years, the annual liveweight advantage for legume-oversown pastures was 37 kg/steer. Compared with native pasture, changes in annual liveweight gain with burning were variable. It was concluded that cattle productivity is sustainable when stocking rates are maintained at 4 ha/steer or lighter (equivalent to a utilisation rate around 30%). Although steer liveweight gain occurred at all stocking rates and economic returns were highest at heaviest stocking rates, stocking rates heavier than 4 ha/steer are unsustainable because of their long-term impact on pasture productivity.

Development of profitable milk production systems for northern Australia: a field assessment of the productivity of five potential farming systems using farmlets.

Farmlets, each of 20 cows, were established to field test five milk production systems and provide a learning platform for farmers and researchers in a subtropical environment. The systems were developed through desktop modelling and industry consultation in response to the need for substantial increases in farm milk production following deregulation of the industry. Four of the systems were based on grazing and the continued use of existing farmland resource bases, whereas the fifth comprised a feedlot and associated forage base developed as a greenfield site. The field evaluation was conducted over 4 years under more adverse environmental conditions than anticipated with below average rainfall and restrictions on irrigation. For the grazed systems, mean annual milk yield per cow ranged from 6330 kg/year (1.9 cows/ha) for a herd based on rain-grown tropical pastures to 7617 kg/year (3.0 cows/ha) where animals were based on temperate and tropical irrigated forages. For the feedlot herd, production of 9460 kg/cow.year (4.3 cows/ha of forage base) was achieved. For all herds, the level of production achieved required annual inputs of concentrates of similar to 3 t DM/animal and purchased conserved fodder from 0.3 to 1.5 t DM/animal. This level of supplementary feeding made a major contribution to total farm nutrient inputs, contributing 50% or more of the nitrogen, phosphorus and potassium entering the farming system, and presents challenges to the management of manure and urine that results from the higher stocking rates enabled. Mean annual milk production for the five systems ranged from 88 to 105% of that predicted by the desktop modelling. This level of agreement for the grazed systems was achieved with minimal overall change in predicted feed inputs; however, the feedlot system required a substantial increase in inputs over those predicted. Reproductive performance for all systems was poorer than anticipated, particularly over the summer mating period. We conclude that the desktop model, developed as a rapid response to assist farmers modify their current farming systems, provided a reasonable prediction of inputs required and milk production. Further model development would need to consider more closely climate variability, the limitations summer temperatures place on reproductive success and the feed requirements of feedlot herds.

Impacts of grazing management options on pasture and animal productivity in a Heteropogon contortus (black speargrass) pasture in central Queensland. 3. Diet composition in autumn

The diet selected in autumn by steers fistulated at the oesophageous was studied in a subset of treatments in an extensive grazing study conducted in a Heteropogon contortus pasture in central Queensland between 1988 and 2001. These treatments were a factorial array of three stocking rates (4, 3 and 2 ha/steer) and three pasture types (native pasture, legume-oversown native pasture and animal diet supplement/spring-burning native pasture). Seasonal rainfall throughout this study was below the long-term mean and mean annual pasture utilisation ranged from 30 to 61%. Steers consistently selected H. contortus with levels decreasing from 47 to 18% of the diet as stocking rate increased from 4 ha/steer to 2 ha/steer. Stylosanthes scabra cv. Seca was always selected in legume-oversown pastures with diet composition varying from 35 to 66% despite its plant density increasing from 7 to 65 plants/m(2) and pasture composition from 20 to 50%. Steers also selected a diet containing Chrysopogon fallax, forbs and sedges in higher proportions than they were present in the pasture. Greater availability of the intermediate grasses Chloris divaricata and Eragrostis spp. was associated with increased stocking rates. Bothriochloa bladhii was seldom selected in the diet, especially when other palatable species were present in the pasture, despite B. bladhii often being the major contributor to total pasture yield. It was concluded that a stocking rate of 4 ha/steer will maintain the availability of H. contortus in the pasture.

Impacts of grazing management options on pasture and animal productivity in a Heteropogon contortus (black speargrass) pasture in central Queensland. 2. Population dynamics of Heteropogon contortus and Stylosanthes scabra cv. Seca.

The dynamics of Heteropogon contortus and Stylosanthes scabra cv. Seca populations were studied in a subset of treatments in an extensive grazing study conducted in central Queensland between 1988 and 2001. These treatments were 4 stocking rates in native pasture and 2 of these stocking rates in legume oversown and supplement/spring burning treatments. For the 1999-2000 summer, population data for H. contortus in 5 of these native pasture and supplement/burning treatments were compared with those for an additional burnt treatment. Seasonal rainfall throughout this study was below the long-term mean and mean annual pasture utilisation ranged from 24 to 61%. Increasing stocking rate from 5 to 2 ha/steer in native pasture reduced H. contortus plant density. Increasing stocking rate reduced seedling recruitment as a result of its effect on soil seedbanks. Seedling recruitment was the major determinant of change in plant density, although some individual H. contortus plants did survive throughout the study. Burning in spring 1999, particularly at light stocking rate, promoted seedling recruitment above that in both unburnt native and legume oversown pasture and resulted in increased H. contortus plant density. In the legume oversown treatments, S. scabra cv. Seca density increased rapidly from 15 plants/m2 in 1988 to 140 plants/m2 in 2001 following a lag phase between 1988 and 1993. This increased S. scabra density was associated with an eventual decline in H. contortus plant density through reduced seedling recruitment. It was concluded that H. contortus population density is sustainable at stocking rates of 4 and 5 ha/steer (30% pasture utilisation) and that spring burning at light stocking rate can promote H. contortus populations. Increasing densities of S. scabra need to be managed to prevent its dominance.

Issues and advances in the integrated control of sheep lice.

Ongoing pressure to minimise costs of production, growing markets for low residue and organic wool and meat, resistance to chemicals in louse populations, and the deregistration of diazinon for dipping and jetting have contributed to a move away from routine annual application of lousicides to more integrated approaches to controlling lice. Advances including improved methods for monitoring and detection of lice, an expanded range of louse control products and the availability of a web-accessible suite of decision support tools for wool growers (LiceBossTM) will aid this transition. Possibilities for the future include an on-farm detection test and non-chemical control methods. The design and extension of well-constructed resistance management programs to preserve the effectiveness of recently available new product groups should be a priority.

Zebrafish as a model of Parkinson's disease

Parkinson’s disease (PD) is the second most common neurodegenerative disease among the elderly. Its etiology is unknown and no disease-modifying drugs are available. Thus, more information concerning its pathogenesis is needed. Among other genes, mutated PTEN-induced kinase 1 (PINK1) has been linked to early-onset and sporadic PD, but its mode of action is poorly understood. Most animal models of PD are based on the use of the neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). MPTP is metabolized to MPP+ by monoamine oxidase B (MAO B) and causes cell death of dopaminergic neurons in the substantia nigra in mammals. Zebrafish has been a widely used model organism in developmental biology, but is now emerging as a model for human diseases due to its ideal combination of properties. Zebrafish are inexpensive and easy to maintain, develop rapidly, breed in large quantities producing transparent embryos, and are readily manipulated by various methods, particularly genetic ones. In addition, zebrafish are vertebrate animals and results derived from zebrafish may be more applicable to mammals than results from invertebrate genetic models such as Drosophila melanogaster and Caenorhabditis elegans. However, the similarity cannot be taken for granted. The aim of this study was to establish and test a PD model using larval zebrafish. The developing monoaminergic neuronal systems of larval zebrafish were investigated. We identified and classified 17 catecholaminergic and 9 serotonergic neuron populations in the zebrafish brain. A 3-dimensional atlas was created to facilitate future research. Only one gene encoding MAO was found in the zebrafish genome. Zebrafish MAO showed MAO A-type substrate specificity, but non-A-non-B inhibitor specificity. Distribution of MAO in larval and adult zebrafish brains was both diffuse and distinctly cellular. Inhibition of MAO during larval development led to markedly elevated 5-hydroxytryptamine (serotonin, 5-HT) levels, which decreased the locomotion of the fish. MPTP exposure caused a transient loss of cells in specific aminergic cell populations and decreased locomotion. MPTP-induced changes could be rescued by the MAO B inhibitor deprenyl, suggesting a role for MAO in MPTP toxicity. MPP+ affected only one catecholaminergic cell population; thus, the action of MPP+ was more selective than that of MPTP. The zebrafish PINK1 gene was cloned in zebrafish, and morpholino oligonucleotides were used to suppress its expression in larval zebrafish. The functional domains and expression pattern of zebrafish PINK1 resembled those of other vertebrates, suggesting that zebrafish is a feasible model for studying PINK1. Translation inhibition resulted in cell loss of the same catecholaminergic cell populations as MPTP and MPP+. Inactivation of PINK1 sensitized larval zebrafish to subefficacious doses of MPTP, causing a decrease in locomotion and cell loss in one dopaminergic cell population. Zebrafish appears to be a feasible model for studying PD, since its aminergic systems, mode of action of MPTP, and functions of PINK1 resemble those of mammalians. However, the functions of zebrafish MAO differ from the two forms of MAO found in mammals. Future studies using zebrafish PD models should utilize the advantages specific to zebrafish, such as the ability to execute large-scale genetic or drug screens.

Technical highlights: Invasive plant and animal research 2009-10

Technical highlights 2009–10, with detailed progress reports on the latest invasive plant and animal research undertaken by Biosecurity Queensland, a service unit of the Department of Employment, Economic Development and Innovation.

Technical highlights: Invasive plant and animal research 2008-09

Technical highlights 2008–09, with detailed progress reports on the latest invasive plant and animal research undertaken by Biosecurity Queensland, a service unit of the Department of Employment, Economic Development and Innovation.

Technical highlights: Invasive plant and animal research 2007-08

Technical highlights 2007–08, with detailed progress reports on the latest invasive plant and animal research undertaken by Biosecurity Queensland, a service unit of the Department of Primary Industries and Fisheries.

Expression and function of angiotensins in the regulation of intraocular pressure - an experimental study

Glaucoma is a multifactorial long-term ocular neuropathy associated with progressive loss of the visual field, retinal nerve fiber structural abnormalities and optic disc changes. Like arterial hypertension it is usually a symptomless disease, but if left untreated leads to visual disability and eventual blindness. All therapies currently used aim to lower intraocular pressure (IOP) in order to minimize cell death. Drugs with new mechanisms of action could protect glaucomatous eyes against blindness. Renin-angiotensin system (RAS) is known to regulate systemic blood pressure and compounds acting on it are in wide clinical use in the treatment of hypertension and heart failure but not yet in ophthalmological use. There are only few previous studies concerning intraocular RAS, though evidence is accumulating that drugs antagonizing RAS can also lower IOP, the only treatable risk factor in glaucoma. The main aim of this experimental study was to clarify the expression of the renin-angiotensin system in the eye tissues and to test its potential oculohypotensive effects and mechanisms. In addition, the possible relationship between the development of hypertension and IOP was evaluated in animal models. In conclusion, a novel angiotensin receptor type (Mas), as well as ACE2 enzyme- producing agonists for Mas, were described for the first time in the eye structures participating in the regulation of IOP. In addition, a Mas receptor agonist significantly reduced even normal IOP. The effect was abolished by a specific receptor antagonist. Intraocular, local RAS would thus to be involved in the regulation of IOP, probably even more in pathological conditions such as glaucoma though there was no unambiguous relationship between arterial and ocular hypertension. The findings suggest the potential as antiglaucomatous drugs of agents which increase ACE2 activity and the formation of angiotensin (1-7), or activate Mas receptors.

Nutritional intake of opioid replacement therapy patients in community pharmacies: A pilot study

Aim: Opioid replacement therapy (ORT) is an established therapy for a patient group that has been associated with nutrition-related comorbidities. This paper aims to assess the nutritional intake and supplementation in ORT patients, determine the extent of nutritional/dietary advice supplied to ORT patients and to briefly examine patients' perception of pharmacists' provision of nutritional advice. Methods: The nutritional intake of ORT patients receiving treatment in community pharmacies within the Australian Capital Territory was assessed via a 24-hour recall survey. Food intake data were analysed via nutrient analysis software and compared with Australian Nutrition Reference Values and the nutrient intakes of the Australian population. Patients were surveyed to determine supplement use and perceptions of nutritional advice gained by pharmacists. Results: Potential insufficient intake of various macronutrients and micronutrients was observed in both sexes. Less than 25 of patients recorded supplement use. Fifteen percent of males and 21 of females stated that they had approached a pharmacist with a nutrition-related query. All patients who received nutritional advice followed the advice. Conclusions: ORT patients dosing at community pharmacies appear to have poor nutritional intake. ORT patients appear to be receptive to pharmacist's advice. Community pharmacists can potentially increase the beneficial health outcomes in this population through the proactive supply of accurate nutritional advice.

The scientific basis and development of a matrix metalloproteinase (MMP) -8 specific chair-side test for monitoring of periodontal health and disease from gingival crevicular fluid

Matrix metalloproteinase (MMP) -8, collagenase-2, is a key mediator of irreversible tissue destruction in chronic periodontitis and detectable in gingival crevicular fluid (GCF). MMP-8 mostly originates from neutrophil leukocytes, the first line of defence cells which exist abundantly in GCF, especially in inflammation. MMP-8 is capable of degrading almost all extra-cellular matrix and basement membrane components and is especially efficient against type I collagen. Thus the expression of MMP-8 in GCF could be valuable in monitoring the activity of periodontitis and possibly offers a diagnostic means to predict progression of periodontitis. In this study the value of MMP-8 detection from GCF in monitoring of periodontal health and disease was evaluated with special reference to its ability to differentiate periodontal health and different disease states of the periodontium and to recognise the progression of periodontitis, i.e. active sites. For chair-side detection of MMP-8 from the GCF or peri-implant sulcus fluid (PISF) samples, a dip-stick test based on immunochromatography involving two monoclonal antibodies was developed. The immunoassay for the detection of MMP-8 from GCF was found to be more suitable for monitoring of periodontitis than detection of GCF elastase concentration or activity. Periodontally healthy subjects and individuals suffering of gingivitis or of periodontitis could be differentiated by means of GCF MMP-8 levels and dipstick testing when the positive threshold value of the MMP-8 chair-side test was set at 1000 µg/l. MMP-8 dipstick test results from periodontally healthy and from subjects with gingivitis were mainly negative while periodontitis patients sites with deep pockets ( 5 mm) and which were bleeding on probing were most often test positive. Periodontitis patients GCF MMP-8 levels decreased with hygiene phase periodontal treatment (scaling and root planing, SRP) and even reduced during the three month maintenance phase. A decrease in GCF MMP-8 levels could be monitored with the MMP-8 test. Agreement between the test stick and the quantitative assay was very good (κ = 0.81) and the test provided a baseline sensitivity of 0.83 and specificity of 0.96. During the 12-month longitudinal maintenance phase, periodontitis patients progressing sites (sites with an increase in attachment loss ≥ 2 mm during the maintenance phase) had elevated GCF MMP-8 levels compared with stable sites. General mean MMP-8 concentrations in smokers (S) sites were lower than in non-smokers (NS) sites but in progressing S and NS sites concentrations were at an equal level. Sites with exceptionally and repeatedly elevated MMP-8 concentrations during the maintenance phase were clustered in smoking patients with poor response to SRP (refractory patients). These sites especially were identified by the MMP-8 test. Subgingival plaque samples from periodontitis patients deep periodontal pockets were examined by polymerase chain reaction (PCR) to find out if periodontal lesions may serve as a niche for Chlamydia pneumoniae. Findings were compared with the clinical periodontal parameters and GCF MMP-8 levels to determine the correlation with periodontal status. Traces of C. pneumoniae were identified from one periodontitis patient s pooled subgingival plaque sample by means of PCR. After periodontal treatment (SRP) the sample was negative for C. pneumoniae. Clinical parameters or biomarkers (MMP-8) of the patient with the positive C. pneumoniae finding did not differ from other study patients. In this study it was concluded that MMP-8 concentrations in GCF of sites from periodontally healthy individuals, subjects with gingivitis or with periodontitis are at different levels. The cut-off value of the developed MMP-8 test is at an optimal level to differentiate between these conditions and can possibly be utilised in identification of individuals at the risk of the transition of gingivitis to periodontitis. In periodontitis patients, repeatedly elevated GCF MMP-8 concentrations may indicate sites at risk of progression of periodontitis as well as patients with poor response to conventional periodontal treatment (SRP). This can be monitored by MMP-8 testing. Despite the lower mean GCF MMP-8 concentrations in smokers, a fraction of smokers sites expressed very high MMP-8 concentrations together with enhanced periodontal activity and could be identified with MMP-8 specific chair-side test. Deep periodontal lesions may be niches for non-periodontopathogenic micro-organisms with systemic effects like C. pneumoniae and possibly play a role in the transmission from one subject to another.

Routine Measurement of Health-Related Quality of Life in Assessing Cost-Effectiveness in Secondary Health Care

Aims: The aims of this study were 1) to identify and describe health economic studies that have used quality-adjusted life years (QALYs) based on actual measurements of patients' health-related quality of life (HRQoL); 2) to test the feasibility of routine collection of health-related quality of life (HRQoL) data as an indicator of effectiveness of secondary health care; and 3) to establish and compare the cost-utility of three large-volume surgical procedures in a real-world setting in the Helsinki University Central Hospital, a large referral hospital providing secondary and tertiary health-care services for a population of approximately 1.4 million. Patients and methods: So as to identify studies that have used QALYs as an outcome measure, a systematic search of the literature was performed using the Medline, Embase, CINAHL, SCI and Cochrane Library electronic databases. Initial screening of the identified articles involved two reviewers independently reading the abstracts; the full-text articles were also evaluated independently by two reviewers, with a third reviewer used in cases where the two reviewers could not agree a consensus on which articles should be included. The feasibility of routinely evaluating the cost-effectiveness of secondary health care was tested by setting up a system for collecting HRQoL data on approximately 4 900 patients' HRQoL before and after operative treatments performed in the hospital. The HRQoL data used as an indicator of treatment effectiveness was combined with diagnostic and financial indicators routinely collected in the hospital. To compare the cost-effectiveness of three surgical interventions, 712 patients admitted for routine operative treatment completed the 15D HRQoL questionnaire before and also 3-12 months after the operation. QALYs were calculated using the obtained utility data and expected remaining life years of the patients. Direct hospital costs were obtained from the clinical patient administration database of the hospital and a cost-utility analysis was performed from the perspective of the provider of secondary health care services. Main results: The systematic review (Study I) showed that although QALYs gained are considered an important measure of the effectiveness of health care, the number of studies in which QALYs are based on actual measurements of patients' HRQoL is still fairly limited. Of the reviewed full-text articles, only 70 reported QALYs based on actual before after measurements using a valid HRQoL instrument. Collection of simple cost-effectiveness data in secondary health care is feasible and could easily be expanded and performed on a routine basis (Study II). It allows meaningful comparisons between various treatments and provides a means for allocating limited health care resources. The cost per QALY gained was 2 770 for cervical operations and 1 740 for lumbar operations. In cases where surgery was delayed the cost per QALY was doubled (Study III). The cost per QALY ranges between subgroups in cataract surgery (Study IV). The cost per QALY gained was 5 130 for patients having both eyes operated on and 8 210 for patients with only one eye operated on during the 6-month follow-up. In patients whose first eye had been operated on previous to the study period, the mean HRQoL deteriorated after surgery, thus precluding the establishment of the cost per QALY. In arthroplasty patients (Study V) the mean cost per QALY gained in a one-year period was 6 710 for primary hip replacement, 52 270 for revision hip replacement, and 14 000 for primary knee replacement. Conclusions: Although the importance of cost-utility analyses has during recent years been stressed, there are only a limited number of studies in which the evaluation is based on patients own assessment of the treatment effectiveness. Most of the cost-effectiveness and cost-utility analyses are based on modeling that employs expert opinion regarding the outcome of treatment, not on patient-derived assessments. Routine collection of effectiveness information from patients entering treatment in secondary health care turned out to be easy enough and did not, for instance, require additional personnel on the wards in which the study was executed. The mean patient response rate was more than 70 %, suggesting that patients were happy to participate and appreciated the fact that the hospital showed an interest in their well-being even after the actual treatment episode had ended. Spinal surgery leads to a statistically significant and clinically important improvement in HRQoL. The cost per QALY gained was reasonable, at less than half of that observed for instance for hip replacement surgery. However, prolonged waiting for an operation approximately doubled the cost per QALY gained from the surgical intervention. The mean utility gain following routine cataract surgery in a real world setting was relatively small and confined mostly to patients who had had both eyes operated on. The cost of cataract surgery per QALY gained was higher than previously reported and was associated with considerable degree of uncertainty. Hip and knee replacement both improve HRQoL. The cost per QALY gained from knee replacement is two-fold compared to hip replacement. Cost-utility results from the three studied specialties showed that there is great variation in the cost-utility of surgical interventions performed in a real-world setting even when only common, widely accepted interventions are considered. However, the cost per QALY of all the studied interventions, except for revision hip arthroplasty, was well below 50 000, this figure being sometimes cited in the literature as a threshold level for the cost-effectiveness of an intervention. Based on the present study it may be concluded that routine evaluation of the cost-utility of secondary health care is feasible and produces information essential for a rational and balanced allocation of scarce health care resources.