Economic analysis of Tai Chi as a means of preventing falls and falls related injuries among older adults, CHERE Working Paper 2006/4

This study has examined the costs and consequences of a randomised controlled trial of a community based Tai Chi program for people over 60 years of age. The hypothesis for the trial was that compared to non-participants, participants in the Tai Chi program would have fewer falls and may experience additional health and other benefits. In terms of resource use it was anticipated that the Tai Chi program would use additional resources in terms of running costs but was expected to save resources as a result of falls prevented. Data for this economic evaluation were collected prospectively alongside the randomised controlled trial. The aim of this evaluation was to investigate the cost-effectiveness of Tai Chi as means of preventing falls in elderly people living in the community. Costs included were those of the Tai Chi trial and health service utilisation (including GP and specialist and other consultations, tests, hospitalisations and medications). Effectiveness was measured as the number of participants in the intervention and control groups, all participants and the number of falls avoided. SPSS was used to analyse the data; Fisher?s exact and the student?s t-test were used to test differences between the intervention and control groups. From the perspective of NSW Health, the cost of providing Tai Chi as part of this trial ($81232) outweighed any costs of health service provision ($24795). Only a small proportion used health services and this mostly involved the use of over-the-counter pain relieving medication and GP consultations. Only 3 people were admitted to hospital. There were no significant differences between the study and control groups in terms of utilisation and costs except in terms of overall costs where the control group costs were significantly more than the study group (p=0.43). However, this difference was driven by the cost of one admission to hospital. In the trial 3/216 falls resulted in hospitalisation. This means that for every 100 falls avoided, 1.4 serious falls were prevented. Assuming that Tai Chi would continue to prevent falls at the same rate as the trial, 740 individuals would need to participate in Tai Chi to avoid 100 falls and 1.4 serious falls. The value of avoiding a small number of serious falls must be weighed against the high cost of treating and managing the consequences of such falls.Tai chi, economic aspects, Australia

A nanoradian differential VLBI tracking demonstration

The shift due to Jovian gravitational deflection in the apparent angular position of the radio source P 0201+113 was measured with very long baseline interferometry (VLBI) to demonstrate a differential angular tracking technique with nanoradian accuracy. The raypath of the radio source P 0201+113 passed within 1 mrad of Jupiter (approximately 10 Jovian radii) on 21 Mar. 1988. Its angular position was measured 10 times over 4 hours on that date, with a similar measurement set on 2 Apr. 1988, to track the differential angular gravitational deflection of the raypath. According to general relativity, the expected gravitational bend of the raypath averaged over the duration of the March experiment was approximately 1.45 nrad projected onto the two California-Australia baselines over which it was measured. Measurement accuracies on the order of 0.78 nrad were obtained for each of the ten differential measurements. The chi(exp 2) per degree of freedom of the data for the hypothesis of general relativity was 0.6, which suggests that the modeled dominant errors due to system noise and tropospheric fluctuations fully accounted for the scatter in the measured angular deflections. The chi(exp 2) per degree of freedom for the hypothesis of no gravitational deflection by Jupiter was 4.1, which rejects the no-deflection hypothesis with greater than 99.999 percent confidence. The system noise contributed about 0.34 nrad per combined-baseline differential measurement and tropospheric fluctuations contributed about 0.70 nrad. Unmodeled errors were assessed, which could potentially increase the 0.78 nrad error by about 8 percent. The above chi(exp 2) values, which result from the full accounting of errors, suggest that the nanoradian gravitational deflection signature was successfully tracked

Secular trends and latitude gradients in sex ratios at birth in Australia and New Zealand (1950- 2010) demonstrate uncharacteristic homogeneity

Introduction: The male to female ratio of live births is expressed as the ratio of male live births divided by total live births (M/F). Although this would be more accurately abbreviated as M/T (male births divided by total births), it is widely (albeit technically incorrectly) abbreviated as M/F, and this will be used throughout. Globally, over the past four decades, this is expected to be 0.515, with a slight (1.5%) male excess. M/F exhibits an unexplained contrasting latitude gradient. More males are born towards the south of Europe, and the south of Asia, while more males are born toward the north in North American continent. M/F is also declining overall, in both of these continents. This study investigates secular trends and latitude gradients in M/F in Australia and New Zealand from a World Health Organization (WHO) dataset that includes the past sixty years. Methods: Permission was obtained to source WHO datasets going back to 1950, following which Microsoft Excel was used to calculate M/F ratios. Australian and New Zealand data were available for the years 1950-2006 and 1950-2009 respectively. Chi tests for trend were used for annual male and female births. These were performed using the Bio-Med-Stat Excel add-in for contingency tables. Results: There were 17035325 births for Australia and New Zealand during this period. M/F ratios ranged between 0.507-0.519. No latitude variations in M/F were found between Australia (9° to 44°) and New Zealand (29° to 53°). The overall M/F was 0.5134 - lower than the anticipated 0.515, with an estimated male birth deficit of 28009. Cycles of 30 years duration are apparent in the dataset but not at statistically significant levels. Discussion: The lack of latitude gradient in this region is not unexpected as there is a wide latitude overlap between Australia and New Zealand. It has been hypothesised that M/F exhibits a 30 year cycle due to an unknown mechanism that negatively correlates M/F with the adult sex ratio at the time of conception. Conclusion: The factor/s that are causing a decline in M/F ratios in Europe, North America and Asia are absent or not so strongly influential in Australasia.peer-reviewe

Monopole Dominance for Nonperturbative QCD

Monopole dominance for the nonperturbative features in QCD is studied both in the continuum and the lattice gauge theories. First, we study the dynamical chiral-symmetry breaking (D$\chi$SB) in the dual Higgs theory using the effective potential formalism. We find that the main driving force for D$\chi$SB is brought from the confinement part in the nonperturbative gluon propagator rather than the short-range part, which means monopole dominance for D$\chi$SB. Second, the correlation between instantons and QCD-monopoles is studied. In the Polyakov-like gauge, where $A_4(x)$ is diagonalized, the QCD-monopole trajectory penetrates the center of each instanton, and becomes complicated in the multi-instanton system. Finally, using the SU(2) lattice gauge theory with $16^4$ and $16^3 \times 4$, the instanton number is measured in the singular (monopole-dominating) and regular (photon-dominating) sectors, respectively. Instantons and anti-instantons only exist in the monopole sector both in the maximally abelian gauge and in the Polyakov gauge, which means monopole dominance for the topological charge.Comment: Talk presented by H. Suganuma at the Joint Japan-Australia Workshop on "Quarks, Hadrons and Nuclei'', 15 - 24 Nov. 1995, in Adelaide, Australia, 10 pages, Plain Latex, ( 6 figures - available on request from [email protected]

Comparing knowledge, accessibility, and use of evidence-based chronic disease prevention processes across four countries

<p>Background: Evidence-based chronic disease prevention (EBCDP) effectively reduces incidence rates of many chronic diseases, but contextual factors influence the implementation of EBCDP worldwide. This study aims to examine the following contextual factors across four countries: knowledge, access, and use of chronic disease prevention processes.</p><p>Methods: In this cross-sectional study, public health practitioners (N = 400) from Australia (n = 121), Brazil (n = 76), China (n = 102), and the United States (n = 101) completed a 26-question survey on EBCDP. One-way ANOVA and Pearson's Chi-Square tests were used to assess differences in contextual factors of interest by country.</p><p>Results: Practitioners in China reported less knowledge of EBCDP processes (p < 0.001) and less use of repositories of evidence-based interventions, than those from other countries (p < 0.001). Academic journals were the most frequently used method for accessing information about evidence-based interventions across countries. When selecting interventions, Brazilian and Chinese practitioners were more likely to consider implementation ease while the Australian and United States practitioners were more likely to consider effectiveness (p < 0.001).</p><p>Conclusions: These findings can help inform and improve within and across country strategies for implementing EBCDP interventions.</p

Comparison of general and cardiac care-specific indices of spatial access in Australia

&copy; 2019 Versace et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Objective To identity differences between a general access index (Accessibility/ Remoteness Index of Australia; ARIA+) and a specific acute and aftercare cardiac services access index (Cardiac ARIA). Research design and methods Exploratory descriptive design. ARIA+ (2011) and Cardiac ARIA (2010) were compared using cross-tabulations (chi-square test for independence) and map visualisations. All Australian locations with ARIA+ and Cardiac ARIA values were included in the analysis (n = 20,223). The unit of analysis was Australian locations. Results Of the 20,223 locations, 2757 (14% of total) had the highest level of acute cardiac access coupled with the highest level of general access. There were 1029 locations with the poorest access (5% of total). Approximately two thirds of locations in Australia were classed as having the highest level of cardiac aftercare. Locations in Major Cities, Inner Regional Australia, and Outer Regional Australia accounted for approximately 98% of this category. There were significant associations between ARIA+ and Cardiac ARIA acute (&chi;2 = 25250.73, df = 28, p&lt;0.001, Cramer&rsquo;s V = 0.559, p&lt;0.001) and Cardiac ARIA aftercare (&chi;2 = 17204.38, df = 16, Cramer&rsquo;s V = 0.461, p&lt;0.001). Conclusions Although there were significant associations between the indices, ARIA+ and Cardiac ARIA are not interchangeable. Systematic differences were apparent which can be attributed largely to the underlying specificity of the Cardiac ARIA (a time critical index that uses distance to the service of interest) compared to general accessibility quantified by the ARIA + model (an index that uses distance to population centre). It is where the differences are located geographically that have a tangible impact upon the communities in these locations&ndash;i.e. peri-urban areas of the major capital cities, and around the more remote regional centres. There is a strong case for specific access models to be developed and updated to assist with efficient deployment of resources and targeted service provision. The reasoning behind the differences highlighted will be generalisable to any comparison between general and service-specific access models

Self-reported substance use among high school students with and without learning difficulties

A total of 197 Year 9 and 10 students, 74 of whom had learning difficulties (LD), from two high schools in Brisbane, the capital city of Queensland, Australia, self-reported their substance use. Seventeen substances, including two fictitious ones to detect over-reporting, were presented to participants for them to indicate their current usage, ex-usage, or non-usage. The findings revealed that participants were most likely to use alcohol, tobacco, and marijuana. A series of Chi-square (chi(2)) analyses found that male students with LD and female students without LD were at greatest risk of substance use, overall. These findings are discussed in the light of the previous limited research pertaining to substance use amongst students with LD

Epidemiology of unintentional fatal drowning among migrants in Australia

Objective: This study aimed to describe the epidemiology and risk factors contributing to drowning among migrants in Australia. Methods: A total population retrospective epidemiological study of unintentional drowning deaths in Australia between 1 July 2009 and 30 June 2019 of people born outside Australia (migrants). Cases were extracted from the National Coronial Information System. Descriptive statistics, chi-square and relative risk were calculated. Crude drowning rates were based on country of birth and population in Australia. Results: There were 572 migrant deaths over the study period, 28.9% of total drowning deaths, 82.9% were male. Twenty-one per cent were aged 25–34 years and 40.8% had lived in Australia for 20+ years. Migrants at highest risk of drowning were from: South Korea (2.63/100,000 95%CI: 0.85–8.25), Taiwan (2.29/100,000 95%CI: 0.27–13.44), and Nepal (2.15/100,000 95%CI: 0.23–11.55). Migrants were more likely to drown when around rocks (p<0.001) compared with Australian-born people, who most frequently drowned in rivers (p<0.001). Conclusions: Migrants are not over-represented in drowning statistics. However, unique trends were found for drowning among migrants based on country of birth and length of time in Australia. Implications for public health: Holistic drowning prevention strategies and policies are required to effectively lower drowning risk among migrant communities