Soil moisture changes and water-use efficiency in zero and conventional tillage systems for spring wheat

Non-Peer Reviewe

Governments need better guidance to maximise value for money: the case of Australia’s Pharmaceutical Benefits Advisory Committee

Published online: 27 January 2016In Australia, the Pharmaceutical Benefits Advisory Committee (PBAC) makes recommendations to the Minister for Health on which pharmaceuticals should be subsidised. Given the implications of PBAC recommendations for government finances and population health, PBAC is required to provide advice primarily on the basis of value for money. The aim of this article is twofold: to describe some major limitations of the current PBAC decision-making process in relation to its implicit aim of maximising value for money; and to suggest what might be done toward overcoming these limitations. This should also offer lessons for the many decision-making bodies around the world which are similar to PBAC. The current PBAC decision-making process is limited in two important respects. First, it features the use of an implicit incremental cost-effectiveness ratio (ICER) threshold that may not reflect the opportunity cost of funding a new technology, with unknown and possibly negative consequences for population health. Second, the process does not feature a means of systematically assessing how a technology may be of greater or lesser value in light of factors that are not captured by standard measures of cost effectiveness, but which are nonetheless important, particularly to the Australian community. Overcoming these limitations would mean that PBAC could be more confident of maximising value for money when making funding decisions.Drew Carter, Arlene Vogan, Hossein Haji Ali Afzal

An ethical analysis of coverage with evidence development

Sometimes a government or other payer is called on to fund a new health technology even when the evidence leaves a lot of uncertainty. One way to manage this problem is for the payer to provisionally fund the technology and reduce uncertainty by developing evidence. This is referred to as coverage with evidence development (CED). When the payer funds the technology only for patients who participate in the evidence development, the coverage is known as only-in-research. This type of CED raises the sharpest questions of coercion and inducement. Is the patient coerced or induced into participating in the evidence development? If so, under what circumstances, if any, is this ethically justified? Building on work by Miller and Pearson, we argue that patients have a right to funding for a technology only when the payer can be confident that the technology provides reasonable value for money. This means that patients have no right to technologies under a CED arrangement, since technologies are candidates for CED precisely because serious questions remain about value for money. It is for this reason that CED induces rather than coerces. The separate question of whether the inducement is ethically justified remains. We argue that CED does pose risks to patients, and the worse these risks are, the more difficult it is to justify the inducement. Finally, we propose conditions under which the inducement could be ethically justified, as well as means of avoiding inducement altogether. All of this has major bearings on the types of CED that are ethically justified and the governance structures that need to be in place. To develop our argument, we draw on the Australian context, so our conclusions apply most directly to comparable contexts, where the payer is a government that provides universal coverage with a regard for cost effectiveness that is prominent and fairly clearly defined.Drew Carter, Tracy Merlin, David Hunte

A public health framework for reducing stigma: the example of weight stigma

We examine stigma and how it operates, then develop a novel framework to classify the range of positions that are conceptually possible regarding how stigma ought to be handled from a public health perspective. In the case of weight stigma, the possible positions range from encouraging the intentional use of weight stigma as an obesity prevention and reduction strategy to arguing not only that this is harmful but that weight stigma, independent of obesity, needs to be actively challenged and reduced. Using weight stigma as an illustrative example, we draw on prior theoretical work on stigma mechanisms and intervention strategies to develop a framework for improving the understanding, evaluation, and planning of anti-stigma interventions. This framework has the potential to help public health actors to map out how protest, contact, education, and regulation strategies can be used to reduce direct discrimination, structural discrimination, and internalized stigma (self-stigma).Alison Harwood, Drew Carter, Jaklin Eliot

Oscillation damping of chiral string loops

Chiral cosmic string loop tends to the stationary (vorton) configuration due to the energy loss into the gravitational and electromagnetic radiation. We describe the asymptotic behaviour of near stationary chiral loops and their fading to vortons. General limits on the gravitational and electromagnetic energy losses by near stationary chiral loops are found. For these loops we estimate the oscillation damping time. We present solvable examples of gravitational radiation energy loss by some chiral loop configurations. The analytical dependence of string energy with time is found in the case of the chiral ring with small amplitude radial oscillations.Comment: 10 pages, 2 figures. Accepted for publication in Physical Review

Explaining and inducing savant skills: privileged access to lower level, less-processed information

I argue that savant skills are latent in us all. My hypothesis is that savants have privileged access to lower level, less-processed information, before it is packaged into holistic concepts and meaningful labels. Owing to a failure in top-down inhibition, they can tap into information that exists in all of our brains, but is normally beyond conscious awareness. This suggests why savant skills might arise spontaneously in otherwise normal people, and why such skills might be artificially induced by low-frequency repetitive transcranial magnetic stimulation. It also suggests why autistic savants are atypically literal with a tendency to concentrate more on the parts than on the whole and why this offers advantages for particular classes of problem solving, such as those that necessitate breaking cognitive mindsets. A strategy of building from the parts to the whole could form the basis for the so-called autistic genius. Unlike the healthy mind, which has inbuilt expectations of the world (internal order), the autistic mind must simplify the world by adopting strict routines (external order)

Correlated variability of Mkn 421 at X-ray and TeV wavelengths on timescales of hours

Mkn 421 was observed for about two days with BeppoSAX, prior to and partly overlapping the start of a 1 week continuous exposure with ASCA in April 1998, as part of a world-wide multiwavelength campaign. A pronounced, well defined, flare observed in X-rays was also observed simultaneously at TeV energies by the Whipple Observatory's 10 m gamma-ray telescope. These data provide the first evidence that the X-ray and TeV intensities are well correlated on time-scales of hours.Comment: 4 pages, 1 figure, presented at the VERITAS Workshop on the TeV Astrophysics of Extragalactic Object

Magnetic Anisotropy in the Molecular Complex V15

We apply degenerate perturbation theory to investigate the effects of magnetic anisotropy in the magnetic molecule V15. Magnetic anisotropy is introduced via Dzyaloshinskii-Moriya (DM) interaction in the full Hilbert space of the system. Our model provides an explanation for the rounding of transitions in the magnetization as a function of applied field at low temperature, from which an estimate for the DM interaction is found. We find that the calculated energy differences of the lowest energy states are consistent with the available data. Our model also offers a novel explanation for the hysteretic nature of the time-dependent magnetization data.Comment: Final versio