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Kinds of NSW Selected AbstractsOutcomes of pregnancies in women with pre-gestational diabetes mellitus and gestational diabetes mellitus; a population-based study in New South Wales, Australia, 1998,2002DIABETIC MEDICINE, Issue 6 2008A. W. Shand Abstract Aim To determine population-based rates and outcomes of pre-gestational diabetes mellitus (pre-GDM) and gestational diabetes mellitus (GDM) in pregnancy. Methods This was a cross-sectional study, using linked population databases, of all women, and their infants, discharged from hospital following birth in New South Wales (NSW) between 1 July 1998 and 31 December 2002. Women with, and infants exposed to pre-GDM or GDM were compared with those without diabetes mellitus for pregnancy characteristics and outcomes. Results Women with a singleton pregnancy (n = 370 703) and their infants were included: 1248 women (0.3%) had pre-GDM and 17 128 (4.5%) had GDM. Of those women with pre-GDM, 57% had Type 1 diabetes, 20% had Type 2 diabetes and for 23% the type of diabetes was unknown. Major maternal morbidity or mortality was more common in women with pre-GDM (7.9%) [odds ratio (OR) 3.2, 95% confidence interval (CI) 2.6, 3.9] and in women with GDM (3.1%) (OR 1.2, 95% CI 1.1, 1.4) when compared with women without diabetes (2.6%). Major infant morbidity or mortality occurred more frequently in infants exposed to pre-GDM compared with no diabetes (13.6% vs. 3.1%) (OR 5.0, 95% CI 4.2, 5.8) and in infants exposed to GDM compared with no diabetes (3.2% vs. 2.3%) (OR 1.4, 95% CI 1.3, 1.5). Conclusions Pre-GDM and GDM continue to be associated with an increased risk of adverse maternal and neonatal outcomes; however, women with GDM have adverse outcomes less frequently. Rates of GDM and pre-GDM appear to be increasing over time. Clinicians should consider the potential for adverse outcomes, and arrange referral to appropriate services. [source] Evaluation of a training program to improve clinicians' assessment of patient stabilityDRUG AND ALCOHOL REVIEW, Issue 4 2009ADAM R. WINSTOCK Abstract Introduction and Aims. Public clinics in New South Wales (NSW), Australia play a central role in inducting and stabilising opioid dependent clients onto treatment before transfer to a community pharmacy. Clinical assessment of stability is a vital skill in ensuring that clients are appropriately and effectively transferred. A two-hour clinical training program was delivered to staff at 31 public clinics, that aimed to improve staff confidence in assessing client stability, and skills in negotiating the transfer of clients to community pharmacies. Design and Methods. Pre- and post-training evaluation was conducted examining self-ratings of confidence and ability in the assessment of client stability, and the perceived utility of a clinical algorithm to improve assessments. Follow-up was conducted 3 to 6 months post-training assessing individual and clinic level changes in clinical practice. Results. 205 staff completed pre- and post-training questionnaires. Staff demonstrated a moderate level of self-reported baseline knowledge and skills in assessing client stability (mean = 6.5; 1 = poor; 10 = excellent) that improved when re-assessed following the training (mean = 8.0). 76 staff responded to the follow-up questionnaire. , 75% reported some level of improvement in their approach to clinical practice regarding stability assessment, and 59% reported being more effective in identifying clients appropriate for community pharmacy transfer. Of 19 public clinics, 14 reported an increased focus on stability assessment. Nine clinics reported barriers to achieving changes in clinical practice. Discussion and Conclusions. This evaluation demonstrates that it is possible to implement a targeted clinical training package to staff that translates into positive changes in clinical practice.[Winstock AR, Lea T. Evaluation of a training program to improve clinicians' assessment of patient stability. Drug Alcohol Rev 2009;28:353,359] [source] Patients' help-seeking behaviours for health problems associated with methadone and buprenorphine treatmentDRUG AND ALCOHOL REVIEW, Issue 4 2008ADAM R. WINSTOCK Abstract Introduction and Aims. Clients in opioid substitution therapy often have considerable unmet health-care needs. The current study aimed to explore health problems related to opioid substitution therapy among clients on methadone and buprenorphine treatment. Design and Methods. A self-complete, cross-sectional survey conducted among 508 patients receiving methadone and buprenorphine treatment at community pharmacies in New South Wales (NSW), Australia. Results. The most common problems for which participants had ever sought help were dental (29.9%), constipation (25.0%) and headache (24.0%). The most common problems for which participants would currently like help were dental (41.1%), sweating (26.4%) and reduced sexual enjoyment (24.2%). There were no significant differences between those currently on methadone and those currently on buprenorphine for any of the health problems explored, nor differences for gender or treatment duration. Participants on methadone doses 100 mg or above were significantly more likely to want help currently for sedation. Discussion and Conclusions. The considerable unmet health care needs among participants in this study suggest that treatment providers should consider improving the detection and response to common health problems related to opioid substitution therapy. [source] Documenting the heroin shortage in New South WalesDRUG AND ALCOHOL REVIEW, Issue 4 2006CAROLYN DAY Abstract Australian heroin markets have recently undergone dramatic change, sparking debate about the nature of such markets. This study aimed to determine the onset, peak and decline of the heroin shortage in New South Wales (NSW), using the most appropriate available methods to detect market level changes. The parameters of the heroin shortage were determined by reviewing: reports of heroin users about availability and price (derived from the existing literature and the Illicit Drug Reporting System); qualitative interviews with injecting drug users, and health and law enforcement professionals working in the illicit drug field; and examining data on heroin seizures over the past decade. There was a marked reduction in heroin supply in NSW in early 2001. An increase in the price of heroin occurred in 2001, whereas it had decreased steadily since 1996. A reduction in purity also occurred, as reported by drug users and heroin seizures. The peak period of the shortage appears to have been January to April 2001. The market appears to have stabilised since that time, although it has not returned to pre-2001 levels: heroin prices have decreased in NSW for street grams, but not to former levels, and the price of ,caps' (street deals) remain elevated. Heroin purity in NSW has remained low, with perhaps a 10% increase above the lowest recorded levels. These data support the notion that the heroin market in NSW underwent significant changes, which appear to have involved a lasting shift in the nature of the market. [source] Implementation of the ,Fresh Start' smoking cessation programme to 23 antenatal clinics: a randomized controlled trial investigating two methods of disseminationDRUG AND ALCOHOL REVIEW, Issue 1 2001MARGARET COOKE Abstract The aim of the research was to investigate the effect of two methods of dissemination on the implementation of a smoking cessation programme and use of smoking cessation interventions in antenatal clinics. A repeated-measures randomized design was used. Hospital antenatal clinics (n = 23) were randomized to simple or intensive dissemination groups. All clinics in NSW with > 500 births were asked to participate. A survey of all clinical staff (n = 323) in 23 antenatal clinics was carried out prior to programme dissemination and 18 months after dissemination (n = 283). The response rate was 63% at baseline and 64% at follow-up. Smoking cessation intervention significantly increased after dissemination. (F (18,1) = 49.26, p < 0.001). The average number of smoking cessation interventions provided by clinics after programme dissemination increased from 4.5 to 7. 48 (mean difference 2.98, t(19) 7.08, n < 0.001, 95% CI (2.1,3.86). Type of dissemination did not influence the number of programme components used or the number of smoking cessation interventions offered. Also, the estimated proportion of clients offered intervention by clinicians did not vary due to type of dissemination. A simple mail-out of a smoking cessation programme to antenatal clinics for use during pregnancy can increase clinician intervention for smoking. When more intensive methods of dissemination are used, the quality of the interventions implemented by clinicians improves. More research on dissemination methods are required as both methods of dissemination did not produce systematic or sustained use of the programme. [source] Organic litter: dominance over stones as a source of interrill flow roughness on low-gradient desert slopes at Fowlers Gap, arid western NSW, AustraliaEARTH SURFACE PROCESSES AND LANDFORMS, Issue 1 2003David Dunkerley Abstract Thirty-six runoff plot experiments provide data on flow depths, speeds, and Darcy,Weisbach friction coefficients (f) on bare soil surfaces, and surfaces to which were added sufficient extra plant litter or surface stones to provide projected cover of 5, 10 and 20 per cent. Precision flow depth data were derived with a computer-controlled gantry and needle gauge for two different discharges for each plot treatment. Taking a fixed flow intensity (Reynolds number, Re = 150) for purposes of comparison shows means of f = 17·7 for bare soil surfaces, f = 11·4 for added stone treatments, and f = 23·8 for added litter treatments. Many individual values of f for stone treatments are lower than for the bare soil surface, but all litter treatments show increases in fcompared to bare soil. The lowering of f in stone treatments relates to the submerged volume that the stones occupied, and the associated concentration of flow onto a smaller part of the plot surface. This leads to locally higher flow intensities and lower frictional drag along threads of flow that the obstacles create. Litter causes higher frictional drag because the particles are smaller, and, for the same cover fraction, are 100 times more numerous and provide 20 times the edge or perimeter length. Along these edges, which in total exceed 2·5 m g,1 (equivalent to 500 m m,2 for a loading of 2 t ha,1), surface tension draws up water from between the litter particles. This reduces flow depth there, and as a consequence of the lower flow intensity, frictional drag rises. Furthermore, no clear passage remains for the establishment of flow threads. These findings apply to shallow interrill flows in which litter is largely immobile. The key new result from these experiments is that under these conditions, a 20 per cent cover of organic litter can generate interrill frictional retardation that exceeds by nearly 41 per cent that of a bare soil surface, and twice that contributed by the same cover fraction of surface stones. Even greater dominance by litter can be anticipated at the many dryland sites where litter covers exceed those tested here. Copyright © 2002 John Wiley & Sons, Ltd. [source] Predicting the biodiversity benefits of the Saltshaker Project, Boorowa, NSWECOLOGICAL MANAGEMENT & RESTORATION, Issue 1 2004David Freudenberger Did the 2-year Saltshaker Project nudge the Boorowa Catchment along a new pathway towards improved biodiversity? [source] A practical protocol to assess impacts of unplanned disturbance: a case study in Tuggerah Lakes Estuary, NSWECOLOGICAL MANAGEMENT & RESTORATION, Issue 2003A. J. Underwood Summary Environmental managers are often confronted with unplanned or accidental disturbances that may lead to environmental impacts. Procedures for detecting or measuring the size of such impacts are complicated because of the lack of data available before the disturbance and because of the intrinsic variability of most natural measures. Here, a protocol for detecting impacts is illustrated for single-measure variables (numbers of individual species) and multivariate measures (relative abundances of invertebrates in assemblages). The present paper describes a case concerning drainage of acidified water into an estuary due to construction of a drainage channel in an area of wetland for which there had been no prior investigations (i.e. no ,before' data). The spatial extent of any impact was also unknowable. Sampling was, therefore, designed to allow for impacts of only a few tens of metres (using control sites 50 m from the mouth of the channel) and impacts covering much larger areas (500 m and 1 km from the mouth of the channel). Invertebrates in the mud around the channel and in control sites were sampled in replicated cores and the amount of seagrass in each core was weighed. Average abundances of invertebrate animals and weights of seagrass were compared, as was variation among samples in potentially impacted and control sites (using univariate analyses of variance). Sets of species were compared using multivariate methods to test the hypothesis that there was an impact at one of the scales examined. In fact, there was no evidence for any sort of impact on the fauna or seagrasses; the disturbance was a short-term pulse without any obvious or sustained ecological response. One consequence of the study was that the local council was able to demonstrate no impact requiring remediation and no penalties were imposed for the unapproved construction of the channel. The implications of this type of study after an environmental disturbance are discussed. The present study identifies the need for clear definition of relevant hypotheses, coupled with rigorous planning of sampling and analyses, so that reliable answers are available to regulators and managers. [source] The impact of a supervised injecting facility on ambulance call-outs in Sydney, AustraliaADDICTION, Issue 4 2010Allison M. Salmon ABSTRACT Aims Supervised injecting facilities (SIFs) are effective in reducing the harms associated with injecting drug use among their clientele, but do SIFs ease the burden on ambulance services of attending to overdoses in the community? This study addresses this question, which is yet to be answered, in the growing body of international evidence supporting SIFs efficacy. Design Ecological study of patterns in ambulance attendances at opioid-related overdoses, before and after the opening of a SIF in Sydney, Australia. Setting A SIF opened as a pilot in Sydney's ,red light' district with the aim of accommodating a high throughput of injecting drug users (IDUs) for supervised injecting episodes, recovery and the management of overdoses. Measurements A total of 20 409 ambulance attendances at opioid-related overdoses before and after the opening of the Sydney SIF. Average monthly ambulance attendances at suspected opioid-related overdoses, before (36 months) and after (60 months) the opening of the Sydney Medically Supervised Injecting Centre (MSIC), in the vicinity of the centre and in the rest of New South Wales (NSW). Results The burden on ambulance services of attending to opioid-related overdoses declined significantly in the vicinity of the Sydney SIF after it opened, compared to the rest of NSW. This effect was greatest during operating hours and in the immediate MSIC area, suggesting that SIFs may be most effective in reducing the impact of opioid-related overdose in their immediate vicinity. Conclusions By providing environments in which IDUs receive supervised injection and overdose management and education SIF can reduce the demand for ambulance services, thereby freeing them to attend other medical emergencies within the community. [source] Problems experienced by community pharmacists delivering opioid substitution treatment in New South Wales and Victoria, AustraliaADDICTION, Issue 2 2010Adam R. Winstock ABSTRACT Aims To explore service provision and the range of problems that New South Wales (NSW) and Victoria (VIC) community pharmacists providing opioid substitution treatment (OST) have experienced with clients and prescribers. Design Cross-sectional postal survey. Setting All community pharmacies providing OST in NSW (n = 593) and VIC (n = 393), Australia. Participants Completed questionnaires were received from 669 pharmacists (68% response rate). Measurements The questionnaire addressed pharmacy characteristics, recent problems experienced with clients including refusal to dose, provision of credit for dispensing fees, termination of treatment, responses of pharmacists to problems experienced with clients, as well as problems experienced with OST prescribers. Findings In the preceding month, 41% of pharmacists had refused to dose a client for any reason, due most commonly to expired prescriptions (29%), or ,3 missed doses (23%). Terminating a client's treatment in the past month was reported among 14% of respondents, due most commonly to inappropriate behaviour and missed doses. Treatment termination was reported by a significantly higher proportion of pharmacists in VIC (P < 0.001). Treatment termination in last month was predicted having more clients (P < 0.001), the provision of buprenorphine treatment (P = 0.008), having a separate dosing area (P = 0.021), and being a female pharmacist (P = 0.013). Past month refusal to dose was predicted by the pharmacy being in VIC (P < 0.001) and having more clients (P < 0.001). Problems experienced most commonly in the past month with prescribers were difficulty contacting prescriber (21%) and provision of takeaway doses to clients considered unstable by the pharmacist (19%) (higher in VIC: both P < 0.001). Conclusions This study highlights the range of problems experienced by community pharmacists in the delivery of OST and the consequences for people in treatment. Particular attention should be focused upon considering number of clients per pharmacy and improving professional communication between pharmacists and prescribers. [source] Do Private Patients have Shorter Waiting Times for Elective Surgery?ECONOMIC PAPERS: A JOURNAL OF APPLIED ECONOMICS AND POLICY, Issue 2 2010Evidence from New South Wales Public Hospitals I11; D63 The Productivity Commission (2008) identified waiting times for elective surgery as a measure of governments' success in providing accessible health care. At the 2007 COAG meeting, the Prime Minister identified reduction of elective surgery waiting times in public hospitals as a major policy priority. To date, the analysis of waiting time data has been limited to summary statistics by medical procedure, doctor specialty and state. In this paper, we look behind the summary statistics and analyse the extent to which private patients are prioritised over comparable public patients in public hospitals. Our empirical evidence is based on waiting list and admission data from public hospitals in NSW for 2004,2005. We find that private patients have substantially shorter waiting times, and tend to be admitted ahead of their listing rank, especially for procedures that have low urgency levels. We also explore the benefits and costs of this preferential treatment on waiting times. [source] THE VALUE OF PRIVATISATION: THE CASE OF THE STATE BANK OF NSWECONOMIC PAPERS: A JOURNAL OF APPLIED ECONOMICS AND POLICY, Issue 1 2001C.V. CURRIE First page of article [source] Opioid agonist pharmacotherapy in New South Wales from 1985 to 2006: patient characteristics and patterns and predictors of treatment retentionADDICTION, Issue 8 2009Lucy Burns ABSTRACT Aims The aims of this study were to: examine the number and characteristics of patients entering and re-entering opioid replacement treatment between 1985 and 2006, to examine select demographic and treatment correlates of leaving treatment between 1985 and 2000, and to compare retention rates in methadone and buprenorphine maintenance treatment from 2001 to 2006. Design A retrospective cohort study using register data from the Pharmaceutical Drugs of Addiction System. Setting Opioid substitution treatment in New South Wales (NSW), Australia. Participants A total of n = 42 690 individuals prescribed opioid replacement treatment between 1985 and 2006 in NSW. Measurements Client characteristics over time, retention in days in first treatment episode, number of episodes of treatment and proportion switching medication. Findings Overall, younger individuals were significantly more likely to leave their first treatment episode than older individuals. In 2001,06, after controlling for age, sex and first administration point, the hazard of leaving treatment was 1.9 times for those on buprenorphine relative to those on methadone. Retention in treatment varied somewhat across historical time, with those entering during 1995,2000 more likely to leave at an earlier stage than those who entered before that time. Conclusions Retention in treatment appears to fluctuate in inverse proportion to the availability of heroin. Individuals in contemporary treatment are older users with a lengthy treatment history. This study has provided population-level evidence to suggest that retention in methadone and buprenorphine differ in routine clinical practice. Future work might investigate ways in which patient adherence and retention may be improved. [source] Increasing hospital-wide delivery of smoking cessation care for nicotine-dependent in-patients: a multi-strategic intervention trialADDICTION, Issue 5 2009Megan Freund ABSTRACT Aims, design and intervention Smoking care provision to in-patients is important in assisting smoking cessation and for management of nicotine withdrawal. Limited studies have reported the effectiveness of interventions designed to increase the hospital-wide provision of such care. A quasi-experimental matched-pair trial, involving two intervention and two control hospitals in NSW, Australia, investigated whether a multi-strategic intervention increased hospital-wide smoking care provision. Participants and measurements Patient surveys (n = 274,347 per experimental condition), medical notes audits (n = 181,228) and health professional surveys (n = 229,302) were used to collect outcome data at baseline and follow-up. Findings Significantly greater increases in intervention hospitals compared to control hospitals were found for patient-reported offer of nicotine replacement therapy (NRT) (intervention 34% versus control 12%), provision of NRT (16% versus 4%) and provision of written resources (11% versus 2%), and for the recording in medical notes of smoking management discussion (13% versus 3%), offer of NRT (24% versus 3%) and provision of NRT (21% versus 5%). Intervention group health professionals reported significantly greater increases in the mean estimate of patients who: had their smoking management discussed (30% versus 17%); were offered or provided with NRT (30% versus 18%); were asked their intention to smoke post-discharge (22% versus 10%); and were provided with discharge NRT (21% versus 4%). Conclusions Implementation of a multi-strategic intervention is effective in increasing hospital smoking care delivery, particularly the provision of NRT. Research is required to identify methods to increase further the delivery of this and other forms of smoking care. [source] Methods for the analysis of trends in streamflow response due to changes in catchment conditionENVIRONMETRICS, Issue 7 2001R. A. Letcher Abstract Two algorithms for analysing changes in streamflow response due to changes in land use and farm dam development, based on the Estimated Generalized Least Squares (EGLS) and the Generalized Additive Model (GAM) methods, were compared on three catchments in the Macquarie River Basin in NSW, Australia. In order to account for the influence of climatic conditions on streamflow response, the IHACRES conceptual rainfall-runoff model was calibrated on a daily time step over two-year periods then simulated over the entire period of concurrent rainfall, streamflow and temperature data. Residuals or differences between observed and simulated flows were calculated. The EGLS method was applied to a smoothing of the residual (daily) time series. Such residuals represent the difference between the simulated streamflow response to a fixed catchment condition (in the calibration period) and that due to the actual varying conditions throughout the record period. The GAM method was applied to quarterly aggregated residuals. The methods provided similar qualitative results for trends in residual streamflow response in each catchment for models with a good fitting performance on the calibration period in terms of a number of statistics, i.e. the coefficient of efficiency R2, bias and average relative parameter error (ARPE). It was found that the fit of the IHACRES model to the calibration period is critically important in determining trend values and significance. Models with well identified parameters and less correlation between rainfall and model residuals are likely to give the best results for trend analysis. Copyright © 2001 John Wiley & Sons, Ltd. [source] Effects of a sustained heroin shortage in three Australian StatesADDICTION, Issue 7 2005Louisa Degenhardt ABSTRACT Background In early 2001 in Australia there was a sudden and dramatic decrease in heroin availability that occurred throughout the country that was evidenced by marked increases in heroin price and decreases in its purity. Aim This study examines the impact of this change in heroin supply on the following indicators of heroin use: fatal and non-fatal drug overdoses; treatment seeking for heroin dependence; injecting drug use; drug-specific offences; and general property offences. The study was conducted using data from three Australian States [New South Wales (NSW), Victoria (VIC) and South Australia (SA)]. Methods Data were obtained on fatal and non-fatal overdoses from hospital emergency departments (EDs), ambulance services and coronial systems; treatment entries for heroin dependence compiled by State health departments; numbers of needles and syringes distributed to drug users; and data on arrests for heroin-related incidents and property-related crime incidents compiled by State Police Services. Time-series analyses were conducted where possible to examine changes before and after the onset of the heroin shortage. These were supplemented with information drawn from studies involving interviews with injecting drug users. Results After the reduction in heroin supply, fatal and non-fatal heroin overdoses decreased by between 40% and 85%. Despite some evidence of increased cocaine, methamphetamine and benzodiazepine use and reports of increases in harms related to their use, there were no increases recorded in the number of either non-fatal overdoses or deaths related to these drugs. There was a sustained decline in injecting drug use in NSW and VIC, as indicated by a substantial drop in the number of needles and syringes distributed (to 1999 levels in Victoria). There was a short-lived increase in property crime in NSW followed by a sustained reduction in such offences. SA and VIC did not show any marked change in the categories of property crime examined in the study. Conclusions Substantial reductions in heroin availability have not occurred often, but in this Australian case a reduction had an aggregate positive impact in that it was associated with: reduced fatal and non-fatal heroin overdoses; reduced the apparent extent of injecting drug use in VIC and NSW; and may have contributed to reduced crime in NSW. All these changes provide substantial benefits to the community and some to heroin users. Documented shifts to other forms of drug use did not appear sufficient to produce increases in deaths, non-fatal overdoses or treatment seeking related to those drugs. [source] Drug use patterns and mental health of regular amphetamine users during a reported ,heroin drought'ADDICTION, Issue 7 2004Amanda Baker ABSTRACT Aims The present study extends the findings of a pilot study conducted among regular amphetamine users in Newcastle, NSW, in 1998. It compares key features between current participants in a state capital city (Brisbane) and a regional city (Newcastle) and between the 1998 and current Newcastle sample. Design Cross-sectional survey. Setting Brisbane and Newcastle, Australia. Participants The survey was conducted among 214 regular amphetamine users within the context of a randomized controlled trial of brief interventions for amphetamine use. Measurements Demographic characteristics, past and present alcohol and other drug use and mental health, treatment, amphetamine-related harms and severity of dependence. Findings The main findings were as follows: (i) the rate of mental health problems was high among regular amphetamine users and these problems commonly emerged after commencement of regular amphetamine use; (ii) there were regional differences in drug use with greater accessibility to a wider range of drugs in a state capital city and greater levels of injecting risk-taking behaviour outside the capital city environment; and (iii) there was a significant increase in level of amphetamine use and percentage of alcohol users, a trend for a higher level of amphetamine dependence and a significant reduction in the percentage of people using heroin and benzodiazepines among the 2002 Newcastle cohort compared to the 1998 cohort. Conclusions Further longitudinal research is needed to elucidate transitions from one drug type to another and from recreational to injecting and regular use and the relationship between drug use and mental health in prospective studies among users. Implications Intervention research should evaluate the effectiveness of interventions aimed at: preventing transition to injecting and regular use of amphetamines; toward reducing levels of depression among amphetamine users and interventions among people with severe psychopathology and personality disorders; and toward reducing the prevalence of tobacco dependence among amphetamine users. [source] Supply control and harm reduction: lessons from the Australian heroin ,drought'ADDICTION, Issue 1 2003Don Weatherburn ABSTRACT Aims, To examine the effects of supply-side drug law enforcement on the dynamics of the Australian heroin market and the harms associated with heroin. Setting, Around Christmas 2000, heroin users in Sydney and other large capital cities in Australia began reporting sudden and significant reductions in the availability of heroin. The changes, which appear to have been caused at least in part by drug law enforcement, provided a rare opportunity to examine the potential impact of such enforcement on the harm associated with heroin. Design, Data were drawn from a survey of 165 heroin users in South-Western Sydney, Australia; from the Drug Use Monitoring in Australia (DUMA) project; from NSW Health records of heroin overdoses; and from the Computerized Operational Policing System (COPS) database. Findings, Heroin price increased, while purity, consumption and expenditure on the drug decreased as a result of the shortage. The fall in overall heroin use was accompanied by a significant reduction in the rate of overdose in NSW. However, the health benefits associated with the fall in overdose may have been offset by an increase in the use of other drugs (mainly cocaine) since the onset of the heroin shortage. There does not appear to have been any enduring impact on crime rates as a result of the heroin ,drought'. Conclusion, Supply control has an important part to play in harm reduction; however, proponents of supply-side drug law enforcement need to be mindful of the unintended adverse consequences that might flow from successfully disrupting the market for a particular illegal drug. [source] Modelling volatility clustering in electricity price return series for forecasting value at riskEUROPEAN TRANSACTIONS ON ELECTRICAL POWER, Issue 1 2009R. G. Karandikar Abstract Modelling of non-stationary time series using regression methodology is challenging. The wavelet transforms can be used to model non-stationary time series having volatility clustering. The traditional risk measure is variance and now a days Value at Risk (VaR) is widely used in finance. In competitive environment, the prices are volatile and price risk forecasting is necessary for the market participants. The forecasting period may be 1 week or higher depending upon the requirement. In this paper, a model is developed for volatility clustering in electricity price return series and its application for forecasting VaR is demonstrated. The first model is using GARCH (1, 1). The VaR of variance rate series, that is worst-case volatility is calculated using variance method using wavelet transform. The model is used to forecast variance rate (volatility) for a sample case of 1-week half-hourly price return series. The second model developed is for forecasting VaR for price return series of 440 days. This model is developed using wavelets via multi-resolution analysis and uses regime-switching technique. The historical data of daily average prices is obtained from 100% pool type New South Wales (NSW), a zonal market of National Electricity Market (NEM), Australia. Copyright © 2007 John Wiley & Sons, Ltd. [source] Sensitivity analysis of creep crack growth prediction using the statistical distribution of uniaxial dataFATIGUE & FRACTURE OF ENGINEERING MATERIALS AND STRUCTURES, Issue 9 2010M. YATOMI ABSTRACT Due to the variables and unknowns in both material properties and predictive models in creep crack growth (CCG) rates, it is difficult to predict failure of a component precisely. A failure strain constraint based transient and steady state CCG model (called NSW) modified using probabilistic techniques, has been employed to predict CCG using uniaxial data as basic material property. In this paper the influence of scatter in the creep uniaxial properties, the parameter,C* and creep crack initiation and growth rate have been examined using probabilistic methods. Using uniaxial and CCG properties of C-Mn steel at 360 °C, a method is developed which takes into account the scatter of the data and its sensitivity to the correlating parameters employed. It is shown that for an improved prediction method in components containing cracks the NSW crack growth model employed would benefit from a probabilistic analysis. This should be performed by considering the experimental scatter in failure strain, the creep stress index and in estimating the,C* parameter. [source] STRINGS ATTACHED: NEW PUBLIC MANAGEMENT, COMPETITIVE GRANT FUNDING AND SOCIAL CAPITALFINANCIAL ACCOUNTABILITY & MANAGEMENT, Issue 2 2009Helen Irvine This paper first investigates the impact of New Public Management (NPM) practices, particularly competitive grant funding, on Bushcare New South Wales (NSW), an Australian environmental volunteering organisation. Secondly, identifying such local volunteering organisations as repositories of valuable social capital, it explores the link between volunteering and social capital. Using mixed methods and institutional theory, the study reveals that an increased level of professionalism and accountability is required of Bushcare groups, and that local coordinators face a challenge in balancing local, regional and national priorities without sacrificing Bushcare's mission. These dynamics, it is proposed, have potentially serious social capital implications. [source] Ichthyoplankton-based spawning dynamics of blue mackerel (Scomber australasicus) in south-eastern Australia: links to the East Australian CurrentFISHERIES OCEANOGRAPHY, Issue 4 2008FRANCISCO J. NEIRA Abstract We describe findings of three ichthyoplankton surveys undertaken along south-eastern Australia during spring (October 2002, 2003) and winter (July 2004) to examine spawning habitat and dynamics of blue mackerel (Scomber australasicus). Surveys covered ,860 nautical miles between southern Queensland (Qld; 24.6°S) and southern New South Wales (NSW; 41.7°S), and were mainly centred on the outer shelf including the shelf break. Egg identifications were verified applying mtDNA barcoding techniques. Eggs (n = 2971) and larvae (n = 727; 94% preflexion) occurred both in spring and winter, and were confined to 25.0,34.6°S. Greatest abundances (numbers per 10 m2) of eggs (1214,7390) and larvae (437,1172) occurred within 10 nm shoreward from the break in northern NSW. Quotient analyses on egg abundances revealed that spawning is closely linked to a combination of bathymetric and hydrographic factors, with the outer shelf as preferred spawning area, in waters 100,125 m deep with mean temperatures of 19,20°C. Eggs and larvae in spring occurred in waters of the East Australian Current (EAC; 20.6,22.3°C) and mixed (MIX; 18.5,19.8°C) waters, with none occurring further south in the Tasman Sea (TAS; 16.0,17.0°C). Results indicate that at least some of the south-eastern Australian blue mackerel stock spawns during winter-spring between southern Qld and northern NSW, and that no spawning takes place south of 34.6°S due to low temperatures (<17°C). Spawning is linked to the EAC intrusion, which also facilitates the southward transport of eggs and larvae. Since spring peak egg abundances came from where the EAC deflects offshore, eggs and larvae are possibly being advected eastwards along this deflection front. This proposition is discussed based on recent data on blue mackerel larvae found apparently entrained along the Tasman Front. [source] Stone artifact scatters in western NSW, Australia: Geomorphic controls on artifact size and distributionGEOARCHAEOLOGY: AN INTERNATIONAL JOURNAL, Issue 6 2001Patricia Fanning Surface scatters of Aboriginal stone artifacts have been exposed in many parts of inland Australia by accelerated erosion that followed the introduction of pastoralism by European settlers in the 19th century. This paper reports on a set of techniques developed to investigate and quantify the effects of these post-discard disturbance processes in Sturt National Park in northwest NSW, Australia. Backwards, stepwise, linear regression showed the influence of geomorphic parameters such as slope gradient, elevation, landform, and contemporary surface processes on artifact distribution, with artifact maximum dimension as the dependent variable. The results indicate that, even at low gradients, artifact size and slope angle are significantly related, but that the variance in maximum dimension explained by gradient is very low. Similar results were found for the other geomorphic variables. We conclude that artifact movement by surface wash across these surfaces is unlikely to significantly affect artifact distribution. While vertically conflated surface scatters do not preserve "living floors" in a short-term, functional sense, their apparent horizontal integrity allows investigation of the long-term use of place by hunter-gatherer people in the past. Insofar as assemblage integrity is important for assessing site significance in the heritage management industry, our methods provide a means for assessing the degree to which a site has been damaged by water flow. © 2001 John Wiley & Sons, Inc. [source] ,We're moving out': Youth Out-Migration Intentions in Coastal Non-Metropolitan New South WalesGEOGRAPHICAL RESEARCH, Issue 2 2008DANIELLE DROZDZEWSKI Abstract This article discusses youth out-migration on the non-metropolitan New South Wales Eastern Seaboard. High levels of in-migration and counter-urbanisation, typical of many coastal non-metropolitan towns in NSW, mask the out-migration of youth. There are relatively few 15,24 year olds in the coastal communities of non-metropolitan New South Wales, because many youths out-migrate to larger centres, for a range of reasons. Out-migration also demarcates a life transition away from school life, adolescence and the parental home. This paper draws from research with senior high school students in one coastal town , Coffs Harbour , where such trends have been particularly apparent. It examines the propensity for youth out-migration and discusses how young people articulate their migration intentions. Young people's perceptions of their current and future prospects feature prominently in their discourses about intended migration, although this research also demonstrates that the life courses of regional youth are unorthodox and diverse in nature. [source] The influence of diurnal temperatures on the hydrochemistry of a tufa-depositing streamHYDROLOGICAL PROCESSES, Issue 17 2003R. Drysdale Abstract At-a-station diurnal variations in carbonate hydrochemistry were measured during four observation periods at Davys Creek, a tufa-depositing stream in central NSW, Australia. Major ion concentrations and continuously logged measurements of specific conductivity, pH and temperature showed that changes in the amount of CaCO3 deposited upstream of the study reach were directly related to changes in diurnal water temperatures, which control the rate of CO2 efflux to the atmosphere. The greatest upstream losses occurred during the mid-afternoon water temperature peak, whereas the lowest upstream losses occurred at sunrise, when water temperatures were at their lowest. Cloudy days at all times of the year produced small diurnal water temperatures ranges (c. 2,5°C) and, consequently, relatively small changes in upstream CaCO3 loss (23,50 mg L,1) through the day. Clear sunny days, especially during summer months, produced large diurnal water temperature changes (up to c. 11°C), which in turn triggered diurnal changes in upstream CaCO3 loss of up to 100 mg L,1. By implication, the active reach of tufa deposition must advance downstream and increase in length during the evening and vice versa during the day. Given that the temperature of Davys Creek waters are a function of insolation, changes in the reach of tufa deposition under baseflow conditions are a direct function of the prevailing weather. This has implications for the palaeoclimatic interpretation of fossil tufa deposits. Copyright © 2003 John Wiley & Sons, Ltd. [source] BRIEF COMMUNICATIONS: A quantity survey of intravenous administration of metronidazole in its different forms in a tertiary teaching hospitalINTERNAL MEDICINE JOURNAL, Issue 8 2010L. L. Lee Abstract The aim of this paper is to examine the prescribing patterns and cost of various formulations of metronidazole in a hospital setting over a 3-month period. Oral metronidazole has high bioavailability (98.9%) with peak plasma concentrations averaged at 2.3 h after dosing. Despite the high bioavailability of oral metronidazole, many patients continue to receive metronidazole intravenously when they are suitable for oral preparation. An audit of 120 consecutive patients prescribed metronidazole was conducted at the Liverpool Hospital, NSW, from March to July 2005. There were 65 men and 55 women (age 18,93). Of the 120 patients, 16 were on oral, 1 on rectal and 103 were on intravenous metronidazole. Treatment was initiated based on clinical diagnoses. Potential pathogens were subsequently identified on only 21 occasions. The use of metronidazole as an oral preparation was contraindicated in 27 patients (22.5%) who were nil-by-mouth. Of these, rectally administered metronidazole was contraindicated in only eight patients. The average course of intravenous metronidazole was 8.0 ± 9.7 days (mean ± SD). The total number of intravenous metronidazole treatment days was 824. Oral metronidazole would have been possible in 618 out of the 824 days. The estimated cost to administer each dose of oral, suppository and intravenous forms of metronidazole is $A0.11, $A1.34 and $A6.09 respectively. Thus, substantial savings could be achieved if oral metronidazole were to be administered whenever possible. The early use of oral or rectal metronidazole should be encouraged when there are no clinical contraindications. [source] Do medical courses adequately prepare interns for safe and effective prescribing in New South Wales public hospitals?INTERNAL MEDICINE JOURNAL, Issue 7 2009S. N. Hilmer Abstract Aims: To assess ability of interns immediately before starting clinical practice in New South Wales (NSW) teaching hospitals to prescribe medications safely and appropriately and to describe their impressions of the adequacy of their clinical pharmacology training in medical school. Methods: A cross-sectional study was performed on all interns (n= 191) who attended intern orientation programmes at four NSW hospitals in January 2008. A clinical case scenario that tested prescribing ability and a survey investigating impressions of clinical pharmacology training in medical school were administered to the interns in exam format. Outcome measures were: (i) ability to prescribe medications safely and appropriately for the clinical case scenario and (ii) interns' impressions of their training in clinical pharmacology at medical school. Results: No intern completed all prescribing tasks correctly. No intern charted the patient's usual medications on admission completely correctly, only six wrote an accurate discharge medication list, and none wrote both an accurate discharge medication list and a legal Schedule 8 discharge script. None of the respondents strongly agreed that they felt adequately trained to prescribe medications in their intern year and 84% would have liked to have more training in pharmacology as medical students. Conclusions: Interns about to commence clinical practice in NSW teaching hospitals demonstrated significant deficits in prescribing of regular medications, initiation of new therapies, prescribing of discharge medications, and particularly prescribing of Schedule 8 medications. Most interns recognized these deficits and would have liked more clinical pharmacology training at medical school. [source] A mid-shelf, mean wave direction climatology for southeastern Australia, and its relationship to the El Niño,Southern Oscillation since 1878 A.D.INTERNATIONAL JOURNAL OF CLIMATOLOGY, Issue 13 2005Ian D. Goodwin Abstract Coastal systems behave on timescales from days to centuries. Shelf and coastal wave climatological data from the Tasman Sea are only available for the past few decades. Hence, the records are too short to investigate inter- and multidecadal variability and their impact on coastal systems. A method is presented to hindcast monthly mid-shelf mean wave direction (MWD) for southeastern Australia, based on the monthly, trans-Tasman mean sea-level pressure (MSLP) difference between northern NSW (Yamba) and the north island of New Zealand (Auckland). The MSLP index is calibrated to instrumental (Waverider buoy) MWD data for the Sydney shelf and coast. Positive/negative trans-Tasman MSLP difference is significantly correlated to southerly/easterly Sydney MWD, and to long/short mean wave periods. The 124-year Sydney annual (MWD) time series displays multidecadal variability, and identifies a significant period of more southerly annual MWD during 1884 to 1914 than in the period since 1915. The Sydney MWD is significantly correlated to the Southern Oscillation Index (SOI). The correlation with the SOI is enhanced during periods when the Interdecadal Pacific Oscillation (IPO) is in its negative state and warm SST anomalies occur in the southwest Pacific region. The Sydney MWD was found to be associated with Pacific basin-wide climate fluctuations associated with the El Niño-Southern Oscillation (ENSO). Southerly/easterly Sydney MWD is correlated with low/high MSLP anomalies over New Zealand and the central Pacific Ocean. Southerly/easterly Sydney MWD is also correlated with cool/warm SST anomalies in the southwest Pacific, particularly in the eastern Coral Sea and Tasman Sea. Copyright © 2005 Royal Meteorological Society. [source] Identifying measures for evaluating new models of nursing care: A survey of NSW nurse practitionersINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 6 2007Sandy Middleton RN BAppSc(Nursing) MN PhD Health-care reforms in Australia and worldwide have seen the creation of the position of nurse practitioner (NP). To date, no protocol has been developed in Australia to guide the evaluation of this new role. All NSW authorized NPs were invited to participate in a self-administered questionnaire. Generic process and outcome measures of NP services were taken from a review of the literature. NPs were asked to determine how ,essential' each of these measures would be to describe their clinical practice. Of the 36 eligible authorized NPs in NSW, 30 returned completed questionnaires (83% response rate). The following measures were rated ,essential' by all (100%) NPs: presenting issue as stated by patient; current medications; patient satisfaction with education, quality of care received, and provider knowledge and skill. Our results provide a unique set of indicators with which to evaluate process and outcome measures of NP services. Standard outcome measures will enable NPs to evaluate their service efficiently and to benchmark against other NPs. [source] A decision support tool for irrigation infrastructure investments,IRRIGATION AND DRAINAGE, Issue 4 2010Shahbaz Khan outil d'aide à la décision; gestion de l'eau; investissements saisonniers et à long terme; optimisation; simulation; analyse coûts-avantages; ensemble de l'exploitation; négociation de l'eau; économie d'eau Abstract Increasing water scarcity, climate change and pressure to provide water for environmental flows urge irrigators to be more efficient. In Australia, ongoing water reforms and most recently the National Water Security Plan offer incentives to irrigators to adjust their farming practices by adopting water-saving irrigation infrastructures to match soil, crop and climatic conditions. WaterWorks is a decision support tool to facilitate irrigators to make long- and short-term irrigation infrastructure investment decisions at the farm level. It helps irrigators to improve the economic efficiency, water use efficiency and environmental performance of their farm businesses. WaterWorks has been tested, validated and accepted by the irrigation community and researchers in NSW, Australia. The interface of WaterWorks is user-friendly and flexible. The simulation and optimisation module in WaterWorks provides an opportunity to evaluate infrastructure investment decisions to suit their seasonal or long-term water availability. The sensitivity analysis allows substantiation of the impact of major variables. Net present value, internal rate of return, benefit,cost ratio and payback period are used to analyse the costs and benefits of modern irrigation technology. Application of WaterWorks using a whole farm-level case study indicates its effectiveness in making long- and short-term investment decisions. WaterWorks can be easily integrated into commercial software such as spreadsheets, GIS, real-time data acquisition and control systems to further enhance its usability. WaterWorks can also be used in regional development planning. Copyright © 2009 John Wiley & Sons, Ltd. L'augmentation de la rareté de l'eau, le changement climatique et la pression pour fournir de l'eau pour l'environnement incitent les irrigants à être plus efficaces. En Australie les réformes en cours sur l'eau, et plus récemment le Plan National de Sécurité de l'Eau, incitent les irrigants à ajuster leurs pratiques agricoles par l'adoption d'infrastructures d'irrigation économisant l'eau pour s'adapter aux conditions de sols, de cultures et de climat. WaterWorks est un outil d'aide à la décision pour faciliter les décisions d'investissement à long terme et court terme au niveau de l'exploitation. Il aide les irrigants à améliorer l'efficacité économique, l'efficacité de l'utilisation de l'eau et la performance environnementale de leurs exploitations agricoles. Le WaterWorks a été testé, validé et accepté par la communauté de l'irrigation dans le New South Wales, Australie. L'interface de WaterWorks est convivial et flexible. Le module de simulation et d'optimisation dans WaterWorks permet d'évaluer les décisions d'investissement en fonction de la disponibilité en eau saisonnière ou à long terme. L'analyse de sensibilité permet d'étayer l'impact des principales variables. La valeur actuelle nette, le taux de rendement interne, le ratio coûts-avantages et la période de récupération sont utilisés pour analyser les coûts et les avantages des technologies modernes d'irrigation. L'application de WaterWorks à une étude de cas complète au niveau de l'exploitation montre son efficacité pour les décisions d'investissement à long terme et court terme. Le WaterWorks peut être facilement intégré dans des logiciels commerciaux tels que les tableurs, les SIG, des systèmes d'acquisition de données en temps réel et de contrôle afin d'améliorer sa convivialité. Le WaterWorks peut également être utilisé pour la planification du développement régional. Copyright © 2009 John Wiley & Sons, Ltd. [source] | ||||||||||||||||||||||||||||