Evaluating Australia's National Medicines Policy using geographical mapping

Background: There has been a proliferation of quality use of medicines activities in Australia since the 1990s. However, knowledge of the nature and extent of these activities was lacking. A mechanism was required to map the activities to enable their coordination. Aims: To develop a geographical mapping facility as an evaluative tool to assist the planning and implementation of Australia's policy on the quality use of medicines. Methods: A web-based database incorporating geographical mapping software was developed. Quality use of medicines projects implemented across the country was identified from project listings funded by the Quality Use of Medicines Evaluation Program, the National Health and Medical Research Council, Mental Health Strategy, Rural Health Support, Education and Training Program, the Healthy Seniors Initiative, the General Practice Evaluation Program and the Drug Utilisation Evaluation Network. In addition, projects were identified through direct mail to persons working in the field. Results: The Quality Use of Medicines Mapping Project (QUMMP) was developed, providing a Web-based database that can be continuously updated. This database showed the distribution of quality use of medicines activities by: (i) geographical region, (ii) project type, (iii) target group, (iv) stakeholder involvement, (v) funding body and (vi) evaluation method. At September 2001, the database included 901 projects. Sixty-two per cent of projects had been conducted in Australian capital cities, where approximately 63% of the population reside. Distribution of projects varied between States. In Western Australia and Queensland, 36 and 73 projects had been conducted, respectively, representing approximately two projects per 100 000 people. By comparison, in South Australia and Tasmania approximately seven projects per 100 000 people were recorded, with six per 100 000 people in Victoria and three per 100 000 people in New South Wales. Rural and remote areas of the country had more limited project activity. Conclusions: The mapping of projects by geographical location enabled easy identification of high and low activity areas. Analysis of the types of projects undertaken in each region enabled identification of target groups that had not been involved or services that had not yet been developed. This served as a powerful tool for policy planning and implementation and will be used to support the continued implementation of Australia's policy on the quality use of medicines.

Tracing the fate of N-15-enriched feed in an intensive shrimp system

The fate of N-15-nitrogen-enriched formulated feed fed to shrimp was traced through the food web in shallow, outdoor tank systems (1000 1) stocked with shrimp. Triplicate tanks containing shrimp water with and without sediment were used to identify the role of the natural biota in the water column and sediment in processing dietary nitrogen (N). A preliminary experiment demonstrated that N-15-nitrogen-enriched feed products could be detected in the food web. Based on this, a 15-day experiment was conducted. The ammonium (NH4+) pool in the water column became rapidly enriched (within one day) with N-15-nitrogen after shrimp were fed N-15-enriched feed. By day 15, 6% of the added N-15-nitrogen was in this fraction in the 'sediment' tanks compared with 0.4% in the 'no sediment' tanks. The particulate fraction in the water column, principally autotrophic nanoflagellates, accounted for 4-5% of the N-15-nitrogen fed to shrimp after one day. This increased to 16% in the 'no sediment' treatment, and decreased to 2% in the 'sediment' treatment by day 15. It appears that dietary N was more accessible to the phytoplankton community in the absence of sediment. The difference is possibly because a proportion of the dietary N was buried in the sediment in the 'sediment' treatment, making it unavailable to the phytoplankton. Alternatively, the dietary N was retained in the NH4+ pool in the water column since phytoplankton growth, and hence, N utilization was lower in the 'sediment' treatment. The lower growth of phytoplankton in the 'sediment' treatment appeared to be related to higher turbidity, and hence, lower light availability for growth. The percentage N-15-nitrogen detected in the sediment was only 6% despite the high capacity for sedimentation of the large biomass of plankton detritus and shrimp waste. This suggests rapid remineralization of organic waste by the microbial community in the sediment resulting in diffusion of inorganic N sources into the water column. It is likely that most of the dietary N will ultimately be removed from the tank system by water discharges. Our study showed that N-15-nitrogen derived from aquaculture feed can be processed by the microbial community in outdoor aquaculture systems and provides a method for determining the effect of dietary N on ecosystems. However, a significant amount of the dietary N was not retained by the natural biota and is likely to be present in the soluble organic fraction. (C) 2002 Elsevier Science B.V. All rights reserved.