A national case-control study of Ewing's sarcoma family of tumours in Australia

Limited population-based epidemiologic information is available on Ewing's sarcoma family of tumours (ESFT), a rare group of neoplasms. Several associations have been noted on a few studies but results were not consistent, except for exposure to farming among cases and their parents. Here we present the non-farm findings of a nationwide case-control study of ESFT in children and young adults in Australia. The analysis included 106 persons with confirmed ESFT and 344 population-based controls selected randomly via telephone. Information was collected by interview (84% face to face). We found a strong and significant association of ESFT with hernias, in particular hernia repaired in hospital (OR = 5.6, 95% Cl 1.3-6.4). Among other factors, there was a near doubling of risk for males, and male cases had their pubertal signs earlier (started shaving earlier) than male controls. There was also an increased risk of ESFT at higher levels of self-assessed exercise, but no other factor really stood out. For pregnancy-related factors, there was a tripling of risk for glandular fever, a doubling of risk for urinary tract infection and a near doubling of risk for X-rays during or just before pregnancy, but these estimates were not significant. In addition, there was a large number of inverse associations with medical conditions (specifically bone disorders), case exposure to medications, vaccinations and X-rays, with ultrasound during the pregnancy having the most certain effects. We conclude that, although the aetiology of ESFT remains obscure, overall there is strong evidence of an association with inguinal hernia; this can now be added to the farm-associated risk reported by others and us. The other associations reported here await replication and refinement in future studies. (C) 2003 Wiley-Liss, Inc.

Farming under constrained budgets: Practices of agricultural credit users in central Lombok, Indonesia

There has been a long dependency on credit by Indonesian farmers as a result of the lack of capital to apply proper farming practices. This paper describes the farming activities applied by agricultural credit users in Central Lombok, Indonesia. A survey was conducted during July 2001- March 2002 of 65 farmers making use of government or private credit in three villages within the Regency. Data from the farmers were collected using face-to-face, semi-structured interviews. Survey results indicated that on average, farmers had some 20 years experience of farming, were aged 40 years, but lacked of formal education. Their main asset was cropping land with average landholding of 0.69 ha. As a consequence of their capital constraints, farmers were commonly making use of credit to finance their farming activities, including both production of rice as the main crop and secondary crops. Farmers generally applied less than recommended amount of inputs in their farming practices, since the amount of credit they obtained was limited. As a result, their farms become less productive and their repayment capability of loans diminished. Of 65 farmers interviewed, 54 could earn extra income by engaging in a variety of non-farm activities, which contributed on average some 36% to family incomes of over Rp 5 million (A$ 1 thousand). The average credit repayment rate made by agricultural producers was 60%. The repayment made did not always reflect farm production capacity, being sometimes supported by other borrowings. The greater role of credit is not in increasing agricultural production or improving farmers’ income, but in helping them to sustain farm production and their living. Farmers need a bigger amount of credit to make an impact on their livelihood. This should be accompanied by extension services for farmers to enable better use of credit and to change their attitude towards it. As well, farmers require to be equipped with technical and market skills to run a business. Interdisciplinarity, holistic analysis, and an expansion of traditional ‘agricultural’ interests to embrace the span of interests included in rural livelihood, are each critical features of revision of the existing system.