A clinical audit of the prescribing of celecoxib and rofecoxib in Australian rural general practice

Aims The new cyclooxygenase-2 (COX-2) selective inhibitors, celecoxib (Celebrex®) and rofecoxib (Vioxx®), have been widely prescribed since their launch. No reviews currently appear in the literature of prescribing patterns in Australia. This paper describes a self-audit of the clinical use of selective COX-2 inhibitor therapy undertaken with rural general practitioners (GPs) in Australia. Methods A structured audit form was developed and distributed to interested GPs. The form was self-administered and focused on issues about COX-2 inhibitors and the types of patients who were receiving them, e.g. indications, patient demographics, risk factors and drug interactions. Results A total of 627 patients were recruited (569 celecoxib and 58 rofecoxib). A range of doses was prescribed. Osteoarthritis was the most common indication (68.1%). Risk factors known for the nonselective nonsteroidal anti-inflammatory drugs were identified in 65.1% of patients, with the most common being advanced age, hypertension and previous peptic ulcer disease. Potential drug interactions were common. A variety of reasons for initiation of therapy was identified; these included perceived increased efficacy, safety and failure of other treatment. Conclusions These results show that COX-2 inhibitors are being prescribed for patients with multiple risk factors that may place the patient at increased risk of adverse drug reactions to a COX-2 inhibitor. The perception of improved safety and efficacy was common and is of concern. Limitations of the study include the reliance on self-reporting.

Remitting behaviour of Nepalese rural-to-urban migrants: Implications for theory and policy

This article uses data for Nepal to test contemporary hypotheses about the remitting behaviour and associated motives of rural-to-urban migrants and to consider the likely impact of such remittances on rural development. Possibilities for inheritance, degree of family attachment, likelihood of eventual return to place of origin and family investment in the education of the migrants are found to be significant influences on levels of remittances by Nepalese migrants. However, in Nepal, remittances do not seem to result in long-term capital investment in rural areas and so may not promote long-term development of these areas.

Rural lines of flight: Telecommunications and post-metro dreaming

Information and communications technologies hold a prominent place in the cultural imagination of many people living outside the Australian metropolis, especially recent émigrés. A vision of a wired pastoral conjures up the possibilities of city work, connections and pleasures accompanying the flight to the country. Such aspirations have given a twist to one of the great topos of Australian post-invasion communications history, communications ameliorating the perceived isolation in the bush. This article examines important changes to rural telecommunications in the 1990s coinciding with post-metro dreaming and digital convergence, namely the rise of local telecommunications. Neo-Foucauldian accounts of citizenship hold some promise for explaining the criss-cross of tangled lines of flight in regional communications in the twenty-first century: emergent subjectivities, utopian digital modes of becoming, new politics of infrastructure, reconfigured relationships among state, market and citizen.

Food safety and development of the beef industry in China

Food safety concerns have escalated in China as they have elsewhere, especially in relation to meats. Beef production and consumption has increased proportionately faster than all other meats over the last two decades. Yet the slaughtering, processing and marketing of beef remains, for the most part, extremely primitive when compared with Western beef supply chains. By comparing the economics of household slaughtering with that of various types of abattoirs, this paper explains why household slaughtering and wet markets still dominate beef processing and distribution in China. The negative economic, social and industry development implications of enforcing more stringent food safety regulations are highlighted. The willingness/capacity of consumers to pay the added cost of better inspection and other services to guarantee food safety is investigated. In this context, the paper also evaluates the market opportunities for both domestic and imported Green Beef. The paper questions the merit of policy initiatives aimed at modernising Chinese beef supply chains for the mass market along Western lines. (C) 2002 Elsevier Science Ltd. All rights reserved.

Mathematical modelling of schistosomiasis japonica: comparison of control strategies in the People's Republic of China

We present the first mathematical model on the transmission dynamics of Schistosoma japonicum. The work extends Barbour's classic model of schistosome transmission. It allows for the mammalian host heterogeneity characteristic of the S. japonicum life cycle, and solves the problem of under-specification of Barbour's model by the use of Chinese data we are collecting on human-bovine transmission in the Poyang Lake area of Jiangxi Province in China. The model predicts that in the lake/marshland areas of the Yangtze River basin: (1) once-early mass chemotherapy of humans is little better than twice-yearly mass chemotherapy in reducing human prevalence. Depending on the heterogeneity of prevalence within the population, targeted treatment of high prevalence groups, with lower overall coverage, can be more effective than mass treatment with higher overall coverage. Treatment confers a short term benefit only, with prevalence rising to endemic levels once chemotherapy programs are stopped (2) depending on the relative contributions of bovines and humans, bovine treatment can benefit humans almost as much as human treatment. Like human treatment, bovine treatment confers a short-term benefit. A combination of human and bovine treatment will dramatically reduce human prevalence and maintains the reduction for a longer period of time than treatment of a single host, although human prevalence rises once treatment ceases; (3) assuming 75% coverage of bovines, a bovine vaccine which acts on worm fecundity must have about 75% efficacy to reduce the reproduction rate below one and ensure mid-term reduction and long-term elimination of the parasite. Such a vaccination program should be accompanied by an initial period of human treatment to instigate a short-term reduction in prevalence, following which the reduction is enhanced by vaccine effects; (4) if the bovine vaccine is only 45% efficacious (the level of current prototype vaccines) it will lower the endemic prevalence, but will not result in elimination. If it is accompanied by an initial period of human treatment and by a 45% improvement in human sanitation or a 30% reduction in contaminated water contact by humans, elimination is then possible. (C) 2002 Elsevier Science B.V. All rights reserved.

Role of China in the quest to define and control severe acute respiratory syndrome

China holds the key to solving many questions crucial to global control of severe acute respiratory syndrome (SARS). The disease appears to have originated in Guangdong Province, and the causative agent, SARS coronavirus, is likely to have originated from an animal host, perhaps sold in public markets. Epidemiologic findings, integral to defining an animal-human linkage, may be confirmed by laboratory studies; once animal host(s) are confirmed, interventions may be needed to prevent further animal-to-human transmission. Community seroprevalence studies may help determine the basis for the decline in disease incidence in Guangdong Province after February 2002. China will also be able to contribute key data about how the causative agent is transmitted and how it is evolving, as well as identifying pivotal factors influencing disease outcome.

Programa de documenta????o da trabalhadora rural

No Brasil, h?? uma escassez de informa????es estat??sticas sobre a aus??ncia de documenta????o civil e trabalhista, al??m de outros problemas relacionados a esse tema, como dispers??o de ??rg??os emissores, aus??ncia de recursos da popula????o pobre para custear a emiss??o dos documentos,desinforma????o sobre os pr??-requisitos para a sua obten????o, falta de reconhecimento da cidadania plena das mulheres. Por reivindica????o dos movimentos sociais, o governo federal, por meio do Minist??rio do Desenvolvimento Agr??rio (MDA) e do Instituto Nacional de Coloniza????o e Reforma Agr??ria (Incra), implantou, em 2004, o Programa Nacional de Documenta????o da Trabalhadora Rural (PNDTR). O programa j?? atendeu mais de 275 mil mulheres com a emiss??o de 561 mil documentos e incrementou a participa????o delas nas pol??ticas de desenvolvimento rural. A iniciativa envolve diversos ??rg??os governamentais e a representa????o da sociedade civil, por meio de comit??s gestores

Prosa Rural: o programa de r??dio da Embrapa

Para tornar p??blicos seus conhecimentos, tecnologias, metodologias desenvolvidas e/ou adaptados para toda a sociedade, em especial aos jovens e pequenos produtores rurais, a Empresa est?? utilizando, al??m da m??dia convencional, mais uma m??dia ??? o r??dio. Isso porque, al??m da sua facilidade de uso e de entendimento, esse ve??culo ?? capaz de levar informa????es aos lugares de mais dif??cil acesso do Pa??s, onde, muitas vezes, outros meios de comunica????o n??o t??m acesso. Hoje, conta-se com cerca de 504 emissoras cadastradas, que transmitem o programa semanalmente com capacidade de atingir 14 milh??es de ouvintes e, certamente, est??o contribuindo para fortalecer os pequenos produtores e a juventude do campo, para que tenham reais possibilidades de constru????o de um futuro melhor, no contexto da agricultura familiar, e de um novo projeto de desenvolvimento regional

Condom??nio de empregadores rurais: um novo modelo de contrata????o no meio rural

O Minist??rio do Trabalho e Emprego, por interm??dio de sua Secretaria de Inspe????o do Trabalho, vem desenvolvendo arrojado programa de metas, visando diminuir os altos ??ndices de informalidade na contrata????o de m??o-de-obra. Al??m de ilegal, tal situa????o provoca graves preju??zos aos trabalhadores. Visando superar este contexto no meio rural, a Secretaria de Inspe????o do Trabalho lan??ou o projeto denominado "Condom??nio de Empregadores". O Condom??nio de Empregadores ?? a uni??o de produtores rurais pessoas f??sicas, com a ??nica finalidade de contratar diretamente empregados rurais, sendo outorgados a um dos produtores poderes para contratar e gerir a m??o-de-obra em suas propriedades. Iniciado em julho de 1999, o projeto consiste na capacita????o dos auditores fiscais, no estabelecimento de parcerias com institui????es governamentais e n??o governamentais e na implanta????o desse novo modelo de contrata????o em ??mbito nacional. Com o apoio do Minist??rio P??blico do Trabalho, do Instituto Nacional de Seguridade Social e de entidades representativas dos trabalhadores e segmento patronal, j?? foram implantados condom??nios no Paran??, Minas Gerais e S??o Paulo. Espera-se at?? o final do ano a cria????o de condom??nios em quase todo o territ??rio nacional, com a regulariza????o de dezenas de milhares de v??nculos laborais

Casa familiar rural

A Casa Familiar Rural ?? destinada ?? forma????o de agricultores e administrada por uma associa????o de produtores, ?? voltada especialmente ao jovem do meio rural que tenha se decidido permanecer na atividade rural e deseja produzir com profissionalismo. Trabalha com um m??todo de educa????o adaptado, tendo como pontos principais a fam??lia e a sua realidade