Opportunities to gamble, particularly on electronic gaming machines (EGMs) have been rapidly increasing in Australia during the 1990s. The increase in expenditure on gambling and the related problems have subsequently become a growing concern, particularly in relation to disadvantaged sectors of the population. Given this, the development of a geography of gambling is an important step in understanding the implications of this rapidly expanding industry. This paper addresses this issue at two distinct geographical scales in metropolitan Melbourne and considers the distribution of EGMs in relation to levels of economic well‐being. Findings suggest that patterns evident at the wider Melbourne scale of greater concentration of EGMs in less advantaged regions are also reflected at a local level. These findings are related to the wider issues of accessibility to gambling facilities and problem gambling.

Behavioral and autonomic signs of the morphine withdrawal syndrome were measured in dependent rats injected with the opiate antagonist naloxone. The purpose of this study was to determine whether spinal cholinergic pathways play a role in the expression of spinally mediated withdrawal symptoms. lntrathecal (i.t.) administration of 1 pg carbachol or 5 ccg neostigmine resulted in increases in mean anterial pressure (MAP) of 32 and 45 mm Hg, respectively, in conscious, freely moving rats. The pressor response to carbachol began almost immediately after injection, but that to neostigmine was delayed in onset. Both responses were completely abolished following i.v. injection of 2 mg/kg atropine. However, in spinal-transected (C-l ), ventilated rats, i.t. injection of carbachol or neostigmine resulted in only small, transient increases in MAP. Intraarterial (i.a.) injection of 0.5 mg/kg naloxone to morphine-dependent rats resulted in an immediate increase in MAP (to 33 mm Hg) that lasted at least 1 hr. This was accompanied by classical behavioral signs of withdrawal. Pretreatment of dependent rats with i.t. injection of atropine or hemicholinium3 (HC-3) significantly reduced the pressor and several behavioral responses elicited by naloxone. In contrast, when morphine-dependent, spinal-transected rats were pretreated with i.t. injection of cholinergic antagonists, i.a. injection of naloxone resulted in an enhanced MAP response. Finally, in intact dependent rats, i.t. injection of naloxone (6 pg) produced a 14 mm Hg increase in MAP that was significantly augmented (21 mm Hg) following i.t. pretreatment with HC-3. These results may be explained by the presence of a descending spinal cholinergic pathway that facilitates the autonomic component of morphine withdrawal and an intrinsic spinal cholinergic pathway that is inhibitory to the expression of withdrawal.In drug-dependent rats, there is a significant pressor response associated with morphine withdrawal following systemic injection of the narcotic antagonist naloxone. Behavioral and autonomic signs of withdrawal can be elicited following the intraarterial (i.a.) injection (Buccafusco, 1983) of naloxone, as well as by injection of naloxone into localized areas of the CNS. For example, injection of naloxone into the lateral or fourth cerebral

Background Neck of femur fractures (NOFF) pose significant socio-economic costs to society with a high degree of morbidity and mortality. Its incidence rate has been collated within the Global Burden of Disease (GBD) database; however, to date, no comparison across countries has been reported. Method NOFF age-standardised incidence rates (ASIR) per 100,000 population were extracted from the GBD database for European Union (EU) 15+ countries over the period 1990 to 2017. Joinpoint regression analysis of the data identified trends in ASIR and associated estimated annual percentage changes (EAPC). These were analysed by specified timeframe, country, and gender. Results Of the 19 EU15+ countries, 11 (58%) had overall increases in NOFF ASIRs in 2017 compared to 1990. The median ASIRs were 240/100,000 and 322/100,000 for males and females, respectively, in 1990. By 2017, this had increased to 259/100,000 and 325/100,000, respectively. Females consistently had relatively higher NOFF ASIRs with a median gender fracture gap of 62/100,000 in 2017. Males had a higher percentage change in increasing ASIRs, with a smaller percentage change in decreasing ASIRs for all included countries. The highest national ASIRs was observed in Australia, followed by Finland and Belgium. Conversely the Mediterranean countries demonstrated the lowest ASIRs, closely followed by the USA. Conclusions Despite significant advances in primary and secondary hip fracture prevention strategies over the 28-year study period, significant increases in NOFF ASIRs among most EU15+ countries were observed, especially with respect to gender.

IntroductionRespiratory disease consistently ranks among the most fatal disease processes globally. Previous reports from Global Burden of Disease have identified higher burden of respiratory disease in the UK compared to similar health systems.MethodsWe compared UK to EU15 +countries (i.e., Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, Netherlands, Portugal, Spain, and Sweden, Australia, Canada, United States, and Norway) because of similar or higher health expenditure in these countries. We obtained respiratory-related, sex-specific mortality data from countries of interest from the WHO World Mortality database between 1985 and 2013 and covariate data from the World Bank’s Development Indicators DataBank. Age-standardised death rates (ASDR) were computed using the WHO World standard population. We used Joinpoint regression analysis to test changes in trends for respiratory disease. We used Poisson regression to test the difference between UK and EU15 +countries after controlling for smoking and pollution factors.ResultsIn the UK, there was a significant decreasing trend in respiratory-related mortality between 1985 and 1991 with an estimated annual percentage change (EAPC) of −0.89 and −1.70, for men and women respectively. Between 1994 and 2013, there was a steady decline in ASDR with EAPC −2.06 and −0.85, for men and women, respectively. For EU15 +men, there was a decreasing trend in ASDR between until 1999 with EAPC −0.81 and from 1999 onwards the EAPC was −2.14. For EU15 +women, there was an increasing trend in ASDR until 2002 with EAPC of +1.48 which was followed by overall decreasing trend with EAPC −0.44 until 2013. After multivariable adjustment for pollution exposure and smoking prevalence in each country there was a persistent significant difference in ASDR with approximately 20% higher mortality in UK compared to EU15+ (p=0.009).ConclusionThere was significantly greater mortality from respiratory-related illnesses in UK compared to EU15 +over the period from 1985 to 2013 after controlling for smoking and pollution exposure. System-level and population-level factors may contribute to this difference and additional investigations are necessary to further explain these differences.ReferenceMurrayet al. Lancet 2013;997.Abstract S125 Figure 1

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