Disparities in cataract surgery between Aboriginal and non-Aboriginal people in New South Wales, Australia

<b>Background:</b> To investigate variation in rates of cataract surgery in New South Wales (NSW), Australia by area of residence for Aboriginal and non-Aboriginal adults.<p></p> <b>Design:</b> Observational data linkage study of hospital admissions.<p></p> <b>Participants:</b> 289 646 NSW residents aged 30 years and over admitted to NSW hospitals for 444 551 cataract surgery procedures between 2001 and 2008.<p></p> <b>Methods:</b> Analysis of linked routinely collected hospital data using direct standardisation and multilevel negative binomial regression models accounting for clustering of individuals within Statistical Local Areas (SLAs).<p></p> <b>Main outcome measures:</b> Age-standardised cataract surgery rates and adjusted rate ratios (ARRs).<p></p> <b>Results:</b> Aboriginal people had lower rates of cataract procedures than non-Aboriginal people of the same age and sex, living in the same SLA (ARR 0.71, 95% CI 0.68-0.75). There was significant variation in cataract surgery rates across SLAs for both Aboriginal and non-Aboriginal people, with the disparity higher in major cities and less disadvantaged areas. Rates of surgery were lower for Aboriginal than non-Aboriginal people in most SLAs, but in a few, the rates were similar or higher for Aboriginal people.<p></p> <b>Conclusions:</b> Aboriginal people in NSW received less cataract surgery than non-Aboriginal people, despite evidence of higher cataract rates. This disparity was greatest in urban and wealthier areas. Higher rates of surgery for Aboriginal people observed in some specific locations are likely to reflect the availability of public ophthalmology services, targeted services for Aboriginal people and higher demand for surgery in these populations.<p></p&gt

Changes in mental health literacy about depression: South Australia, 1998 to 2004

The document attached has been archived with permission from the editor of the Medical Journal of Australia (26 April 2007). An external link to the publisher’s copy is included.OBJECTIVE: To identify changes in mental health literacy in regard to depression between 1998 and 2004. DESIGN AND SETTING: Face-to-face interviews with a random and representative sample of the South Australian population in 2004, compared with a similarly conducted survey in 1998 that used the same vignette, questions and methodology. PARTICIPANTS: 3015 randomly selected participants, aged 15 years and over. MAIN OUTCOME MEASURES: Responses to both open-ended and direct questions about symptoms and treatment options for depression. RESULTS: The 3015 interviews conducted represented a response rate of 65.9%. Compared with 1998, in 2004 there was a significant increase in the proportion of people recognising depression in the vignette, acknowledging personal experience of depression, and perceiving professional assistance to be more helpful and less harmful. However, although more people nominated psychiatrists or psychologists as therapists of choice, the difference between 1998 and 2004 was not significant. CONCLUSIONS: There has been a significant increase in mental health literacy, at least as regards depression, in the South Australian community between 1998 and 2004. The lack of significant change in psychiatrists and/or psychologists being perceived as therapists of choice is of concern and suggests that community education about their expertise may be appropriate.Robert D Goldney, Laura J Fisher, Eleonora Dal Grande and Anne W Taylo

Modeling of the Temporal Patterns of Fluoxetine Prescriptions and Suicide Rates in the United States

BACKGROUND: To study the potential association of antidepressant use and suicide at a population level, we analyzed the associations between suicide rates and dispensing of the prototypic SSRI antidepressant fluoxetine in the United States during the period 1960–2002. METHODS AND FINDINGS: Sources of data included Centers of Disease Control and US Census Bureau age-adjusted suicide rates since 1960 and numbers of fluoxetine sales in the US, since its introduction in 1988. We conducted statistical analysis of age-adjusted population data and prescription numbers. Suicide rates fluctuated between 12.2 and 13.7 per 100,000 for the entire population from the early 1960s until 1988. Since then, suicide rates have gradually declined, with the lowest value of 10.4 per 100,000 in 2000. This steady decline is significantly associated with increased numbers of fluoxetine prescriptions dispensed from 2,469,000 in 1988 to 33,320,000 in 2002 (r(s) = −0.92; p < 0.001). Mathematical modeling of what suicide rates would have been during the 1988–2002 period based on pre-1988 data indicates that since the introduction of fluoxetine in 1988 through 2002 there has been a cumulative decrease in expected suicide mortality of 33,600 individuals (posterior median, 95% Bayesian credible interval 22,400–45,000). CONCLUSIONS: The introduction of SSRIs in 1988 has been temporally associated with a substantial reduction in the number of suicides. This effect may have been more apparent in the female population, whom we postulate might have particularly benefited from SSRI treatment. While these types of data cannot lead to conclusions on causality, we suggest here that in the context of untreated depression being the major cause of suicide, antidepressant treatment could have had a contributory role in the reduction of suicide rates in the period 1988–2002

The MASSIVE survey – XIX. Molecular gas measurements of the supermassive black hole masses in the elliptical galaxies NGC 1684 and NGC 0997

Supermassive black hole (SMBH) masses can be measured by observing their dynamical effects on tracers, such as molecular gas. We present high angular resolution Atacama Large Millimeter/submillimeter Array observations of the 12CO(2–1) line emission of the early-type galaxies (ETGs) NGC 1684 and NGC 0997, obtained as part of the MASSIVE survey, a volume-limited integral-field spectroscopic study of the most massive local ETGs. NGC 1684 has a regularly rotating central molecular gas disc, with a spatial extent of ≈6 arcsec (≈1.8 kpc) in radius and a central hole slightly larger than the expected SMBH sphere of influence. We forward model the data cube in a Bayesian framework with the KINEMATIC MOLECULAR SIMULATION (KINMS) code and infer a SMBH mass of 1.40+0.44-0.39 x 109 M⊙ (3σ confidence interval) and an F110W-filter stellar mass-to-light ratio of (2.50 ± 0.05) M⊙/L⊙, F110W. NGC 0997 has a regularly rotating central molecular gas disc, with a spatial extent of ≈5 arcsec (≈2.2 kpc) in radius and a partially filled central hole much larger than the expected SMBH sphere of influence, thus preventing a robust SMBH mass determination. With the same modelling method, we nevertheless constrain the SMBH mass to be in the range 4.0 × 107–1.8 × 109 M⊙ and the F160W-filter stellar mass-to-light ratio to be (1.52 ± 0.11) M⊙/L⊙, F160W. Both SMBH masses are consistent with the SMBH mass–stellar velocity dispersion (MBH–σe) relation, suggesting that the overmassive SMBHs present in other very massive ETGs are fairly uncommon

The societal benefits of reducing six behavioural risk factors: an economic modelling study from Australia

BackgroundA large proportion of disease burden is attributed to behavioural risk factors. However, funding for public health programs in Australia remains limited. Government and non-government organisations are interested in the productivity effects on society from reducing chronic diseases. We aimed to estimate the potential health status and economic benefits to society following a feasible reduction in the prevalence of six behavioural risk factors: tobacco smoking; inadequate fruit and vegetable consumption; high risk alcohol consumption; high body mass index; physical inactivity; and intimate partner violence.MethodsSimulation models were developed for the 2008 Australian population. A realistic reduction in current risk factor prevalence using best available evidence with expert consensus was determined. Avoidable disease, deaths, Disability Adjusted Life Years (DALYs) and health sector costs were estimated. Productivity gains included workforce (friction cost method), household production and leisure time. Multivariable uncertainty analyses and correction for the joint effects of risk factors on health status were undertaken. Consistent methods and data sources were used.ResultsOver the lifetime of the 2008 Australian adult population, total opportunity cost savings of AUD2,334 million (95% Uncertainty Interval AUD1,395 to AUD3,347; 64% in the health sector) were found if feasible reductions in the risk factors were achieved. There would be 95,000 fewer DALYs (a reduction of about 3.6% in total DALYs for Australia); 161,000 less new cases of disease; 6,000 fewer deaths; a reduction of 5 million days in workforce absenteeism; and 529,000 increased days of leisure time.ConclusionsReductions in common behavioural risk factors may provide substantial benefits to society. For example, the total potential annual cost savings in the health sector represent approximately 2% of total annual health expenditure in Australia. Our findings contribute important new knowledge about productivity effects, including the potential for increased household and leisure activities, associated with chronic disease prevention. The selection of targets for risk factor prevalence reduction is an important policy decision and a useful approach for future analyses. Similar approaches could be applied in other countries if the data are available.<br /

Stellar Disks in Aquarius Dark Matter Haloes

We investigate the gravitational interactions between live stellar disks and their dark matter halos, using LCDM haloes similar in mass to that of the Milky Way taken from the Aquarius Project. We introduce the stellar disks by first allowing the haloes to respond to the influence of a growing rigid disk potential from z = 1.3 to z = 1.0. The rigid potential is then replaced with star particles which evolve self-consistently with the dark matter particles until z = 0.0. Regardless of the initial orientation of the disk, the inner parts of the haloes contract and change from prolate to oblate as the disk grows to its full size. When the disk normal is initially aligned with the major axis of the halo at z=1.3, the length of the major axis contracts and becomes the minor axis by z=1.0. Six out of the eight disks in our main set of simulations form bars, and five of the six bars experience a buckling instability that results in a sudden jump in the vertical stellar velocity dispersion and an accompanying drop in the m=2 Fourier amplitude of the disk surface density. The bars are not destroyed by the buckling but continue to grow until the present day. Bars are largely absent when the disk mass is reduced by a factor of two or more; the relative disk-to-halo mass is therefore a primary factor in bar formation and evolution. A subset of the disks is warped at the outskirts and contains prominent non-coplanar material with a ring-like structure. Many disks reorient by large angles between z=1 and z=0, following a coherent reorientation of their inner haloes. Larger reorientations produce more strongly warped disks, suggesting a tight link between the two phenomena. The origins of bars and warps appear independent: some disks with strong bars show no disturbances at the outskirts, while the disks with the weakest bars show severe warps.Comment: 19 pages, 13 figures, accepted MNRAS; fixed compatibility problem in figures 8,

Environment-economy tradeoff for Beijing–Tianjin–Hebei’s exports

The trade of goods among regions or nations associated with large environmental consequences. Yet balancing economic gains and environmental consequences induced by trade is still hindered by a lack of quantification of these two factors, especially for the environmental problems those are more locally oriented, such as the atmospheric pollution. Based on an environmental input-output analysis for 2010, we contrast economic gains (value added) against atmospheric pollutant emissions (sulfur dioxide (SO2), nitric oxide (NOx), primary fine particulate matter (PM2.5) and non-methane volatile organic compounds (NMVOC)) and the widely concerned CO2 emissions associated with international and interprovincial exports from Beijing-Tianjin-Hebei (BTH), the most polluted area in China. Our results show that exports contributed 55-62% of BTH's production emissions and 54% of its total value added. BTH's large exports of metals and metal products, nonmetal mineral products, chemical and transportation and warehousing, generated a larger share of pollutant emissions (36-46% of BTH's total) than that of value added (17%) along the supply chain. Most of BTH's embodied emissions in exports go to neighboring provinces and the developed east coastal regions in China, although the economic returns are comparatively low. Among BTH, industrial production in Beijing and Tianjin lead to more pollutant emission than value added in Hebei, due to reliance on pollution-intensive product imports from Hebei. Our results call for refocusing and restructuring of BTH's industry and trade structures to balance the economic gains and environmental losses for each region

NBS monograph

From Abstract: "Numerical results, in table form, on the required phases, the directive gain, the current excitations, the location of all the sidelobes and nulls, and the beamwidths for uniformly spaced optimum endfire arrays with equal sidelobes are given.