Attention Deficit Hyperactivity Disorder (ADHD)

Total Page:16

File Type:pdf, Size:1020Kb

Attention Deficit Hyperactivity Disorder (ADHD) John Curtin Institute of Public Policy – Curtin Business School Attention Deficit Hyperactivity Disorder Policy, Practice and Regulatory Capture in Australia 1992–2012 Martin Paul Whitely This thesis is presented for the Degree of Doctor of Philosophy of Curtin University March 2014 Declaration To the best of my knowledge and belief this thesis contains no material previously published by any other person except where due acknowledgment has been made. This thesis contains no material which has been accepted for the award of any other degree or diploma in any university. Signature: …………………………………………. Date: ………………………... Abstract Like many first world nations, Australia has demonstrated an increasingly pharmaceuticalized response to Attention Deficit Hyperactivity Disorder (ADHD). Per capita rates of prescriptions of ADHD medications grew 277 percent between 1995 and 2010. However, there have been large and inconsistent intertemporal variations between state jurisdictions (shifting over time in relative terms). Most notably, in Western Australia (WA) in 2002 the child Pharmaceutical Benefits Scheme (PBS) per capita prescribing rate was 142 percent above the national average. However, after 2003, while in other states prescribing rates grew, they fell by 50 percent in WA, and by 2011 they were 11 percent below the national average. There has been significant academic, public and media interest not only about the growing and inconsistent prescribing rates, but also about concerns that conflicts of interests and ‘regulatory capture’ may have affected significant policy development and regulatory processes in relation to ADHD. Regulatory capture occurs if an entity that is supposed to advance the public interest instead acts to benefit commercial or industry interests in ways that are contrary to the public interest. The thesis draws heavily on the work of British sociologist John Abraham, who contends that regulatory capture is the most significant explanation of the process of pharmaceuticalization for many health conditions, including ADHD. Here key ADHD policy development processes are analysed to evaluate the extent of regulatory capture in Australian national and state jurisdictions. These include the development of national treatment guidelines and state-specific reviews of WA and New South Wales (NSW) prescribing practices. For the purposes of this thesis, the term ‘regulatory capture’ is taken to have a broad scope, encompassing capture of any or all of the actors, both government and non-government, which have the declared intention of protecting and enhancing the public good. Examples of non-government actors include professional organisations, researchers, and patient advocacy groups. The history of ADHD policy and regulation nationally from 1992 to 2012, in WA from 1993 to 2011 and in NSW from 2007 to 2011 is that regulatory capture occurred in the majority of policy development and regulatory processes. These ‘captured’ processes have been associated with subsequent ADHD child pharmaceuticalization. Conversely the only ADHD- critic dominated process identified occurred in WA in 2002 and was associated with subsequent ADHD child de-pharmaceuticalization. The findings of this thesis are consistent with Abraham’s assertion that regulatory capture is a significant driver of pharmaceuticalization. Acknowledgements First and foremost I wish to thank my supervisor, Professor John Phillimore, for his support and guidance. His prompt and comprehensive feedback has made completing this thesis possible. I also thank Professor Alan Fenna, Dr Alan Tapper, Dr Melissa Raven and Dr Ann Jones for their expert assistance. I am also grateful to my former constituents, the residents of the Western Australian state electorates of Bassendean and Roleystone, for providing me with the opportunity to influence some of the policy processes described in this thesis. Finally I wish to thank my family, Melinda, Shane and Patrick for their love, patience and support during the writing this thesis, and throughout my, at times, obsessive involvement in the policy processes described within it. Contents Preface 1 Chapter 1. Introduction: Regulatory Capture and Australian ADHD Child Prescribing 1.1 The significance of and need for the Study 4 1.2 The Research Questions 7 1.3 Working Hypothesis 7 1.4 Methodology 8 1.5 Structure of the Thesis Chapter 2. Literature Review - Competing perspectives on ADHD Pharmaceuticalization; Biomedicalism versus Medicalization and Regulatory Capture 2.1 The Controversies about ADHD 16 2.1.1 The validity of the diagnosis 16 2.1.2 The safety and efficacy of the pharmaceutical used to treat ADHD 21 2.1.2.1 ADHD Stimulants 21 2.1.2.2 Atomoxetine (Brand name Strattera) 22 2.1.3 ADHD and Drug Abuse 24 2.2 Pharmaceuticalization 26 2.2.1 Competing Explanations for ADHD Pharmaceuticalization 27 2.2.1.1 The Biomedicalisation viewpoint of ADHD Proponents 27 2.2.1.2 The Medicalisation perspective of ADHD critics 33 2.3 Injury versus Access Orientated Consumerism 42 2.4 Summary of ADHD proponent’s and ADHD critic’s positions 43 2.5 The Theory of Regulatory Capture 46 2.6 Abraham on Regulatory Capture and Pharmaceuticalization 52 2.7 What policies have been proposed for regulatory capture and the pharmaceutical industry? 54 2.8 Summary 57 Chapter 3. ADHD and Imported Regulatory Capture 3.1 Defining ADHD 60 3.2 The American Psychiatric Association and Regulatory Capture 64 3.3 History of ADHD: the broadening of the diagnostic criteria 70 61 3.4 Further broadening of ADHD criteria in DSM-5 73 3.5 Regulatory Capture and International Drug Research 78 3.6 Oregon Health and Science University ADHD Drug Effectiveness Review Project 80 3.7 Imported Regulatory Capture Summary 81 Chapter 4. Statistics on Australian National and Western Australian and New South Wales ADHD prescribing rates 4.1 Sources of Data 83 4.2 National prescribing rates for ADHD medications 1992-2011 84 4.3 Western Australian inter-temporal statistics on ADHD child prescribing 88 4.3.1 Patient numbers growth from 1992 to 2002 92 4.3.2 Analysis of intertemporal trends in WA prescribing 93 4.4 A comparison of New South Wales and Western Australian inter-temporal statistics on ADHD prescribing 94 4.4.1 WA versus NSW Child Prescribing Rates 94 4.4.2 WA versus NSW Adult Prescribing Rates 96 4.5 - Summary of ADHD prescribing statistics 1992-2011 97 Chapter 5. National ADHD policy and regulation 5.1 Commonwealth Government Responsibilities in Regard to ADHD 99 5.2 Department of Health commissioned research into the prevalence of ADHD 101 5.3 The National Health and Medical Research Council 106 5.3.1 - The 1997 National Health and Medical Research Council National ADHD Treatment Guidelines 108 5.3.2 The 2009 NHMRC Draft National ADHD Treatment Guidelines 115 5.3.2.1 Timeline of controversy around the 2009 NHMRC Draft National ADHD Treatment Guidelines and Clinical Practice Points 116 5.3.3 - The 2012 Australian Clinical Practice Points for the Diagnosis and Treatment of ADHD in Children 129 5.3.4- Summary of the NHMRC’s involvement in ADHD policy processes 134 5.4 The Therapeutic Goods Authority 135 5.4.1 Licencing of Ritalin and Ritalin LA via the TGA 136 5.4.2 Licencing of Strattera by the Therapeutic Goods Administration 138 5.4.3 Post licencing monitoring of Strattera by the Therapeutic Goods Administration 140 5.4.4 Off Label Prescribing and the TGA 145 5.5 The Pharmaceutical Benefits Scheme 147 5.5.1 Case Study: The marketing of Strattera and subsidisation via the Pharmaceutical Benefits Scheme 148 5.5.2 Other evidence of Pharmaceutical Benefits Scheme Regulatory Capture 153 5.6 The effects of other Commonwealth Government policies on the economics of diagnosing and treating ADHD 153 5.7 Summary of the Australian Government experience of Pharmaceuticalization and Regulatory Capture 154 Chapter 6. Western Australian and New South Wales ADHD policy and Regulatory Capture 6.1 Western Australian State Government Responsibilities in Regard to ADHD 156 6.2 Timeline of significant events regarding the Western Australian Government’s response to ADHD 158 6.3 WA ADHD policy and politics 1994 -2001 159 6.3.1 Block Authorisation 160 6.3.2 Western Australian Stimulants Committee 161 6.3.3 The 1998 Western Australian Health Department convened International Panel on the Diagnosis and Treatment of ADHD 165 6.3.4 The 1999 Parliamentary Inquiry into a petition concerning Attention Deficit Hyperactivity Disorder 167 6.3.5 Training of Western Australian Paediatricians 171 6.4 WA ADHD policy and politics 2002-2012 174 6.4.1 Child Prescribing 176 6.4.2 Why did Western Australian adult prescribing rates continue to grow when child prescribing rates fell? 177 6.4.3 Limitations on Stimulant Dispensing 182 6.4.4 The 2004 WA Legislative Assembly Education and Health Standing Committee into ADHD 182 6.5 Amphetamine Abuse and ADHD Prescribing In Western Australia 186 6.6 Learning and Attentional Disorders Society a Western Australian ADHD Patient Support Group 189 6.7 The Raine Study: a unique Western Australian long-term data review of the safety and efficacy of ADHD psychostimulant use by children 193 6.8 Summary of Western Australia’s ADHD history 197 6.9 - New South Wales ADHD policy and regulatory history 198 6.9.1 ADHD in Children and Adolescents in New South Wales – 2007 Clinical Excellence Commission Prescribing Review 198 6.10 WA and NSW comparative history of regulation and prescribing rates 204 Chapter 7. Discussion, Conclusions and Recommendations 7.1 The Hypothesis 205 7.2 Pharmaceuticalization
Recommended publications
  • The Effect of Birthday on the Fluctuation of Suicides in Hungary
    REVIEW OF SOCIOLOGY 20(2): 96–105. The Effect of Birthday on the Fluctuation of Suicides STUDIES in Hungary (1970–2002) Tamás ZONDA – Károly BOZSONYI – Előd VERES – Zoltán KMEttY email: [email protected], [email protected], [email protected], [email protected] ABSTRACT: The authors have not found any studies that show an unambiguous and close relation between the date of suicide and the birthday of the victims. They made an analysis on the Hungarian suicides between 1970 and 2002 with a method known from the literature and also with a modern, more sophisticated one. It was found that Hungarian men show explicit sensitivity to their birthday’s date: significantly more men commit suicide on their birthday in all age groups than on any other day of the year. Among women, a relation of weak significance appeared only in the older age group. The authors suggest the special sensitivity of Hungarian men which they interpret in the framework of Gabennesch’s ”broken promise effect”, but they think it necessary to do further research on this theme in Hungary. Introduction Researches in the past decades have revealed several circumstances in the back- ground of a particular suicide that are generally typical and almost identical in every fatal action, but many circumstances and relationships that are inter- pretable or understandable with difficulty are discovered during the precise reconstruction of a tragic action. The decision of self-destruction is composed of a complicated mesh of numerous life events, injuries and constellations of personality development. It is known that certain biographical dates affect the personality to a greater or lesser extent.
    [Show full text]
  • The Perth Voice
    Discover how you The Perth can Quit Smoking in just 1 Hour Call Now 1300 953 881 Voiceo N 713 Saturday February 11, 2012 • Phone 9430 7727 • [email protected] • www.perthvoice.com www.QuitSmokingPerth.com.au Collins in run for Libs in north metro Party’s Legislative Council ticket ticket are said to include Peter family and focus on his family-run and thoroughly devoted myself by STEPHEN POLLOCK for North Metropolitan region. Katsambanis, who’d served in property consultancy. to the task but the next four years FORMER Stirling city If successful, the 40-year-old Victoria’s upper house from 1996 “Dad is 64 and the next few require that I must focus on the family business with spare time councillor Paul Collins is will bump little-known Liberal to 2002. years will see a transition as I take MLC Liz Behjat into fourth place. Mr Collins retired from an increasing role in the running of devoted to my family as my three having a tilt at state politics. Topping the ticket are energy Stirling’s Lawley ward last year the business,” he’d said. girls have reached school age.” The former solicitor is minister Peter Collier and Michael after serving just one term. “I was honoured and Mr Collins says that under understood to be seeking the Mischin. He’d told the Voice he wanted privileged to have represented party rules he cannot discuss his winnable third spot on the Liberal Other contenders for the to spend more time with his the Lawley ward for four years candidacy.
    [Show full text]
  • A Police Whistleblower in a Corrupt Political System
    A police whistleblower in a corrupt political system Frank Scott Both major political parties in West Australia espouse open and accountable government when they are in opposition, however once their side of politics is able to form Government, the only thing that changes is that they move to the opposite side of the Chamber and their roles are merely reversed. The opposition loves the whistleblower while the government of the day loathes them. It was therefore refreshing to see that in 2001 when the newly appointed Attorney General in the Labor government, Mr Jim McGinty, promised that his Government would introduce whistleblower protection legislation by the end of that year. He stated that his legislation would protect those whistleblowers who suffered victimization and would offer some provisions to allow them to seek compensation. How shallow those words were; here we are some sixteen years later and yet no such legislation has been introduced. Below I have written about the effects I suffered from trying to expose corrupt senior police officers and the trauma and victimization I suffered which led to the loss of my livelihood. Whilst my efforts to expose corrupt police officers made me totally unemployable, those senior officers who were subject of my allegations were promoted and in two cases were awarded with an Australian Police Medal. I describe my experiences in the following pages in the form of a letter to West Australian parliamentarian Rob Johnson. See also my article “The rise of an organised bikie crime gang,” September 2017, http://www.bmartin.cc/dissent/documents/Scott17b.pdf 1 Hon.
    [Show full text]
  • Looking Back Featured Stories from the Past
    ISSN-1079-7832 A Publication of the Immortalist Society Longevity Through Technology Volume 49 - Number 01 Looking Back Featured stories from the past www.immortalistsociety.org www.cryonics.org www.americancryonics.org Who will be there for YOU? Don’t wait to make your plans. Your life may depend on it. Suspended Animation fields teams of specially trained cardio-thoracic surgeons, cardiac perfusionists and other medical professionals with state-of-the-art equipment to provide stabilization care for Cryonics Institute members in the continental U.S. Cryonics Institute members can contract with Suspended Animation for comprehensive standby, stabilization and transport services using life insurance or other payment options. Speak to a nurse today about how to sign up. Call 1-949-482-2150 or email [email protected] MKMCAD160206 216 605.83A SuspendAnim_Ad_1115.indd 1 11/12/15 4:42 PM Why should You join the Cryonics Institute? The Cryonics Institute is the world’s leading non-profit cryonics organization bringing state of the art cryonic suspensions to the public at the most affordable price. CI was founded by the “father of cryonics,” Robert C.W. Ettinger in 1976 as a means to preserve life at liquid nitrogen temperatures. It is hoped that as the future unveils newer and more sophisticated medical nanotechnology, people preserved by CI may be restored to youth and health. 1) Cryonic Preservation 7) Funding Programs Membership qualifies you to arrange and fund a vitrification Cryopreservation with CI can be funded through approved (anti-crystallization) perfusion and cooling upon legal death, life insurance policies issued in the USA or other countries.
    [Show full text]
  • 5 Ways to Deal with Anniversary Reactions What Do You Do When Anniversary Memories Are Anything but Silver Or Gold? Posted Sep 22, 2016
    Psychology Today Ellen Hendriksen, Ph.D. Reprinted from Psychology Today September 22, 2016 5 Ways to Deal with Anniversary Reactions What do you do when anniversary memories are anything but silver or gold? Posted Sep 22, 2016 Anniversaries aren’t just for couples, and some aren’t so happy. The anniversary reaction: it’s the annual echo of a trauma or loss such as the death of a beloved, a nightmarish experience like sexual assault, a near-fatal accident, or military combat. Regardless of what happened, the anniversary reaction is specifically timed (hence the name), emotionally invested, and truly distressing. Moreover, it’s common; some researchers think the anniversary reaction should even be an official symptom of post-traumatic stress disorder. But despite the patterns being predictable, the reactions themselves are as varied as the individuals experiencing them. Sometimes, the mind remembers, even unconsciously, and a psychological reaction—like a spike in depression or PTSD—can be triggered by the weather, the light, or other seasonal reminders like back to school or the first signs of spring. For example, a study conducted by the Yale University School of Medicine looked at anniversary reactions in veterans of the early 1990s Gulf War. Several years after the war ended, each veteran, along with his or her spouse, was asked how well the veteran functioned over each of the previous 12 months. Each person identified the veteran’s worst month, best month, the month with the most PTSD symptoms, and the month with the fewest. Then, the researchers compared the veterans’ functioning to documented dates of their traumatic war experiences.
    [Show full text]
  • PINTS for PRESS Business Park in Scottsdale, Arizona, Offers Two Types of “Cryonic Suspension” Services: Full-Body for $200,000, and APRIL 24 Head-Only for $80,000
    COVER STORY THEFROZEN FIGHT FOR THE ONE SON’S MISSION TO MAKE HIS DAD WHOLE AGAIN BY TYLER HAYDEN Dr. Laurence Pilgeram didn’t believe in heaven, but HEAD he did believe in life after death. In 1990, at the age of 66, Pilgeram signed a contract with the Alcor Life Extension Foun- dation to freeze his body upon his death with the hope that, decades or centuries from now, medical science would resurrect him. Alcor, headquartered in a sand-colored PINTS FOR PRESS business park in Scottsdale, Arizona, offers two types of “cryonic suspension” services: full-body for $200,000, and APRIL 24 head-only for $80,000. It’s a bargain for Dr. Laurence Pilgeram a shot at immortality. Clients typically pay by signing over their life insurance policies. The head-only option, the company This article’s author, Tyler Hayden, will explains, is the most cost-effective way When Kurt demanded to to preserve a patient’s identity; using know why his father’s whole body COURTESY discuss the reporting and writing of this story future nanotechnology, a new hadn’t been preserved, he received conflicting with editor Matt Kettmann on Wednesday, body might be grown around accounts from Alcor, according to court records. First, the the brain. But Pilgeram never company said Laurence’s body had decayed beyond saving. Then, it April 24, 5:30 p.m., at Night Lizard liked the idea of “Neurocryo- claimed he hadn’t kept up with his yearly $525 membership dues. Finally, preservation,” his family has it suggested the technicians didn’t want to wait for the permit necessary Brewing Company in the Santa Barbara said, so he chose “Whole-Body to transport a full body across state lines.
    [Show full text]
  • Clash of Norms Final 29June21
    Clash of norms Judicial leniency on defendant birthdays1 Daniel L. Chen Arnaud Philippe Abstract We document judicial leniency on defendant birthdays across 5 million decisions. Our results are consistent with reference-dependent social preferences. First, French sentences are 1% fewer and around 5% shorter. Second, U.S. federal judges also round down sentences except when rounding up makes available sentencing reductions for good behavior. No leniency appears on the days before or after a defendant’s birthday. Judges’ experience and economic reasoning seem to mitigate the effect, consistent with isolating a judicial channel. 1. Introduction Individuals frequently have to evaluate others’ productions, acts or personhood. In professional settings, those evaluations usually have to be done in an impartial way. Professors marking exams, loan officers evaluating demands, judges deciding cases are supposed to follow precise rules and to only evaluate some defined material. While they are supposed to be independent, surrounding norms could affect those evaluations. National or religious holidays, birthday of the evaluated person, birth or death of one of the person’s relatives could change the evaluators’ judgment. 1 Daniel L. Chen, [email protected], Toulouse School of Economics, Institute for Advanced Study in Toulouse, University of Toulouse Capitole, Toulouse, France; [email protected], LWP, Harvard Law School. Arnaud Philippe, [email protected], Institute for Advanced Study in Toulouse, Toulouse School of Economics, University of Toulouse Capitole, Toulouse, France. First draft: June 2017. Current draft: June 2018. Latest version at: http://users.nber.org/~dlchen/papers/Clash_of_Norms.pdf. Work on this project was conducted while Chen received financial support from the European Research Council (Grant No.
    [Show full text]
  • June 2021 Issue 2 Using Data in the Presence of Uncertainty Can Numbers Go Wrong?
    IR CORNER June 2021 Issue 2 Using Data in the Presence of Uncertainty Can numbers go wrong? Lost in the Pandemic Which groups of students returned at lower rates in 2020? Online, Choose Your Time Did outcomes differ between asynchronous and synchronous TARRANT COUNTY COLLEGE online sections? OFFICE OF INSTITUTIONAL RESEARCH DIVISION OF INFORMATION TECHNOLOGY EDITORIAL IR OFFICE: In the Presence of Robert Lorick Uncertainty Interim Executive Director of IR Holly Stovall Kira Barrington Asst. Executive Director of IR From varying 2020 election polls to widely differing projections for the number of COVID- Arjun Banjade 19 cases, some may question how the numbers Director of State Reporting that defined 2020 could have been so ‘wrong’. Unfortunately, information consumed through Sarah Davis sound bites and character-limited tweets is inspIRe Research Analyst often reduced and presented as news-worthy absolutes with no mention of limitations or Bonnie Hurford implications of uncertainty. Lead Programmer Analyst In 2021, you are watching the beginning miles of the Olympic marathon when an app on your Sarah Mizher phone alerts you that the 2-hour mark is being “Knowledge is Administrative Assistant broken. Should you be surprised when the winner’s final time is not faster than this an unending Elizabeth Northern famous threshold? Perhaps statements that adventure at Research Analyst the race will likely be finished very near the 2- hour mark or if the early pace holds the 2-hour the edge of Teresa Ray mark will be shattered more aptly convey some uncertainty.”* Coordinator of State Reporting uncertainty in the prediction with the embedded assumption that the current average pace continues.
    [Show full text]
  • Reproductions Supplied by EDRS Are the Best That Can Be Made from the Original Document
    DOCUMENT RESUME ED 443 037 CG 030 087 AUTHOR Hann, Della M., Ed.; Huffman, Lynne C., Ed.; Lederhendler, Israel I., Ed.; Meinecke, Douglas, Ed. TITLE Advancing Research on Developmental Plasticity: Integrating the Behavioral Science and Neuroscience of Mental Health. Proceedings (Chantilly, Virginia, May 12-15, 1996). INSTITUTION National Inst. of Mental Health (DHEW), Rockville, MD. REPORT NO NIMH-98-4338 PUB DATE 1998-00-00 NOTE 299p. PUB TYPE Books (010) Collected Works Proceedings (021) EDRS PRICE MF01/PC12 Plus Postage. DESCRIPTORS Adjustment (to Environment); *Behavior Development; *Behavioral Sciences; Cognitive Development; *Developmental Stages; *Individual Development; Intervention; *Mental Health; Neuropsychology; Prevention; Psychiatry; *Research Needs; Social Behavior IDENTIFIERS *Neurosciences ABSTRACT This book represents the proceedings of the Conference on Advancing Research on Developmental Plasticity: Integrating Behavioral Science and the Neuroscience of Mental Health. The conference featured scientific presentations from many leading scientists in behavioral sciences, neuroscience and psychiatry, as well as a poster session for newer investigators and roundtable seminars for more in-depth discussion. The conference focused on three primary areas of development: stress and early development, cognition, and social behavior. The primary goal of the conference was to bring together scientists from neuroscience, the behavioral sciences, and psychiatry in order to begin identifying substantive topics that may benefit from more integrated cross-disciplinary research on developmental plasticity. The proceedings emphasize the importance of developmental plasticity in brain and behavior to mental health. Identifying the mechanisms and the timing by which these mechanisms operate could produce a greater understanding of the multiple and interconnected levels of functioning that lead to adjustment, as well as a much better understanding of when and how functioning becomes impaired.
    [Show full text]
  • The Power of Voodoo
    HIST/ANTH 442 The Power of Voodoo Voodoo’s Effect on the Haitian African Diaspora (Name Removed) 2013 CSUCI L ast Name | 1 The Power of Voodoo: Voodoo’s Effect on the Haitian African Diaspora Voodoo has been a powerful force in the lives of innumerable people of African descent, both positively and negatively. One of its largest groups of adherents resides in Haiti, where Voodoo is practiced by close to 5 million people, which accounts for nearly half of the population. Voodoo is a true syncretism; a mix of the worship of the gods their West African ancestors observed from ancient times and the worship of the Catholic saints that the slaves were taught in the New World. Its strongest influence came from the West African kingdom of Dahomey, and the word “voodoo” itself means a “god, spirit, or sacred object” in the Dahomean language (Wilmeth, 28). Voodoo brings a community together, remembering and honoring those that came before, but it also tends to create fear in outsiders who don’t understand it. Its demise has been predicted many times due to the “anti-superstitious persecution it aroused,” but it holds together against all the pressure against it and is practiced around the world to this day (Dominique, 104). L ast Name | 2 The positive effects of Voodoo on the diaspora are more obvious than the negative. When the anthropologist Katherine Dunham visited Haiti to observe the Haitian peoples’ lives and practices, Voodoo provided her with “a sense of ethnic ‘belonging’ that she never possessed before (Gelder, 92).” Levi-Strauss thinks of Voodoo as a social force, and believes it has the ability to hold a society together.
    [Show full text]
  • In This Issue
    DOWNSIZING? SINGLE? We can help you FREE We have your partner sell and nd the MONTHLY Providing perfect new home. a personal introductions For expert advice, service for active seniors call Adrian Abel since 1995 0410 564 304 NO COMPUTER NEEDED! 9371 0380 See Friend to Friend on page 49 for Solutions Contacts Column www.solutionsmatchmaking.com.au Established 1991 PRINT POST APPROVED: 64383/00006 SUPPORTING SENIORS’ RECREATION COUNCIL OF WA (INC) WA’S PREMIER MONTHLY PAPER FOR THE OVER 45s45s VOLUME 24 NO. 12 ISSUE NO. 280 JULY 2015 • FoodIn & Wine this Issue Australia’s rock and roll - Wine for winter • Let’s Go Travelling - WIN a trip to Bali plus much more... • Downsizing • Grand Activities royalty return to Perth - School Holiday Fun by Brad Elborough THE PERTH ARENA opened late in 2012, but it Competitions/Giveaways will nally come of age in November when it plays host to Australian music royalty, Cold Chisel. You just can’t be taken seriously as a music venue in this country until the unique vocal tones of Jimmy Barnes and the beautiful guitar play- ing of Ian Moss have echoed through your halls. The Arena crowds were Peace Train - A Cat Stevens Tribute warmed up earlier this year Tommy Emmanuel when it welcomed the prin- Chris Hadfield cess of Aussie music, Kylie The Great Britain Retro Film Festival Minogue - but a Chisel con- The Audience - Helen Mirren cert is something different. Mr Holmes These guys have been Madame Bovary rocking venues, festivals Scandinavian Film Festival and major events throughout Australia (on and off) since 1973, since Kylie was ve.
    [Show full text]
  • Too Young to Die: Regression Discontinuity of a Two-Part Minimum Legal Drinking Age Policy and the Causal Effect of Alcohol on Health
    Working Paper 2018:4 Department of Economics School of Economics and Management Too Young to Die: Regression Discontinuity of a Two-Part Minimum Legal Drinking Age Policy and the Causal Effect of Alcohol on Health Gawain Heckley Ulf-G. Gerdtham Johan Jarl March 2018 Too young to die: Regression discontinuity of a two-part minimum legal drinking age policy and the causal effect of alcohol on health∗ March 5, 2018 Gawain Heckley Ulf-G Gerdtham Johan Jarl Health Economics Unit, Health Economics Unit, Health Economics Unit, Dep of Clinical Science; Dep of Clinical Science; Dep of Clinical Science, Centre for Economic Centre for Economic Lund University Demography, Demography; Lund University and Dep of Economics, Lund University Abstract This study examines the impact of Sweden’s unique two-part Minimum Legal Drinking Age (MLDA) policy on alcohol consumption and health using regression discontinuity design. In Sweden on-licence purchasing of alcohol is legalised at 18 and off-licence purchasing is legalised later at 20 years of age. We find an immediate and significant 6% jump in participation and a larger increase in number of days drinking at age 18 of about 16% but no large jumps at age 20. No discernible increases in mortality at age 18 or 20 are found but hospital visits due to external causes do see an increase at both 18 and 20 years. Compared to previous findings for single MLDAs the alcohol impacts we find are smaller and the health impacts less severe. The findings suggest that a two-part MLDA can help young adults in their transition to unrestricted alcohol and help contain the negative health impacts that have been observed elsewhere.
    [Show full text]