32 research outputs found

    The Cost of Autism Spectrum Disorders

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    Objective: A diagnosis of an autism spectrum disorders is usually associated with substantial lifetime costs to an individual, their family and the community. However, there remains an elusive factor in any cost-benefit analysis of ASD diagnosis, namely the cost of not obtaining a diagnosis. Given the infeasibility of estimating the costs of a population that, by its nature, is inaccessible, the current study compares expenses between families whose children received a formal ASD diagnosis immediately upon suspecting developmental atypicality and seeking advice, with families that experienced a delay between first suspicion and formal diagnosis. Design: A register based questionnaire study covering all families with a child with ASD in Western Australia. Participants: Families with one or more children diagnosed with an ASD, totalling 521 children diagnosed with an ASD; 317 records were able to be included in the final analysis.Results: The median family cost of ASD was estimated to be AUD 34,900perannumwithalmost9034,900 per annum with almost 90% of the sum (29,200) due to loss of income from employment. For each additional symptom reported, approximately $1,400 cost for the family per annum was added. While there was little direct influence on costs associated with a delay in the diagnosis, the delay was associated with a modest increase in the number of ASD symptoms, indirectly impacting the cost of ASD. Conclusions: A delay in diagnosis was associated with an indirect increased financial burden to families. Early and appropriate access to early intervention is known to improve a child's long-term outcomes and reduce lifetime costs to the individual, family and society. Consequently, a per symptom dollar value may assist in allocation of individualised funding amounts for interventions rather than a nominal amount allocated to all children below a certain age, regardless of symptom presentation, as is the case in Western Australia

    Prevalence, motivations, and adverse effects of vaginal practices in Africa and Asia : findings from a multicountry household survey

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    Abstract Background: Women worldwide use various vaginal practices to clean or modify their vulva and vagina. Additional population-level information is needed on prevalence and motivations for these practices, characteristics of users, and their adverse effects. Methods: This was a household survey using multistage cluster sampling in Tete, Mozambique; KwaZulu-Natal, South Africa; Yogyakarta, Indonesia; and Chonburi, Thailand. In 2006-2007, vaginal practices and their motivations were examined using structured interviews with women 18-60 years of age (n=3610). Results: Prevalence, frequency, and motivations varied markedly. Two thirds of women in Yogyakarta and Chonburi reported one or more practices. In Yogyakarta, nearly half ingest substances with vaginal effects, and in Chonburi, external washing and application predominate. In Tete, half reported three or four current practices, and a quarter reported five or more practices. Labial elongation was near universal, and 92% of those surveyed cleanse internally. Two third's in KwaZulu-Natal practiced internal cleansing. Insertion of traditional solid products was rare in Chonburi and Yogyakarta, but one tenth of women in KwaZulu-Natal and nearly two thirds of women in Tete do so. Multivariate analysis of the most common practice in each site showed these were more common among less educated women in Africa and young urban women in Asia. Explicit sexual motivations were frequent in KwaZulu-Natal and Tete, intended for pleasure and maintaining partner commitment. Practices in Chonburi and Yogyakarta were largely motivated by femininity and health. Genital irritation was common at African sites. Conclusions: Vaginal practices are not as rare, exotic, or benign as sometimes assumed. Limited evidence of their biomedical consequences remains a concern; further investigation of their safety and sexual health implications is warrante

    An ant-plant by-product mutualism is robust to selective logging of rain forest and conversion to oil palm plantation

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    Anthropogenic disturbance and the spread of non-native species disrupt natural communities, but also create novel interactions between species. By-product mutualisms, in which benefits accrue as side effects of partner behaviour or morphology, are often non-specific and hence may persist in novel ecosystems. We tested this hypothesis for a two-way by-product mutualism between epiphytic ferns and their ant inhabitants in the Bornean rain forest, in which ants gain housing in root-masses while ferns gain protection from herbivores. Specifically, we assessed how the specificity (overlap between fern and ground-dwelling ants) and the benefits of this interaction are altered by selective logging and conversion to an oil palm plantation habitat. We found that despite the high turnover of ant species, ant protection against herbivores persisted in modified habitats. However, in ferns growing in the oil palm plantation, ant occupancy, abundance and species richness declined, potentially due to the harsher microclimate. The specificity of the fern-ant interactions was also lower in the oil palm plantation habitat than in the forest habitats. We found no correlations between colony size and fern size in modified habitats, and hence no evidence for partner fidelity feedbacks, in which ants are incentivised to protect fern hosts. Per species, non-native ant species in the oil palm plantation habitat (18 % of occurrences) were as important as native ones in terms of fern protection and contributed to an increase in ant abundance and species richness with fern size. We conclude that this by-product mutualism persists in logged forest and oil palm plantation habitats, with no detectable shift in partner benefits. Such persistence of generalist interactions in novel ecosystems may be important for driving ecosystem functioning
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