Quantifying the use of the statin antilipemic drugs: Comparisons and contrasts between Nova Scotia, Canada, and Queensland, Australia

Background: jurisdictions are developing public drug insurance systems to improve access to pharmaceuticals, cost-effective prescribing, and patient health and well-being. We compared 2 Jurisdictions with different pharmaceutical policies to determine prescribing patterns for 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (le, statins). Objective: The aim of this work was to investigate the feasibility of using available prescription admimstrative databases to compare the use of statins in Queensland, Australia, and in Nova Scotia, Canada. Methods: Data from the Nova Scotia Pharmacare Program and the Health Insurance Commission in Australia were used to obtain dispensing data. Utilization was compared for the 5-year period from 1997 through 2001, using the World Health Organization anatomic therapeutic chemical/defined daily dose (DDD) system. Results: In the year 2001, there were 177,000 beneficiaries in the public drug plan in Nova Scotia (62% aged ≥ 65 years old) and 960,000 concession beneficiaries (pensioners and social security recipients, 61% aged ≥ 65 years) in Queensland. These 2 groups were comparable. The overall utilization of statin medications increased steadily in both areas over the study period, from 50 to 205 DDD/1000 beneficiaries per day. Comparison of the 2 growth lines showed no statistically significant differences in overall statin use despite differences in brand availabilities and policies about prescribing. In the year 2001, atorvastatin was the most commonly prescribed statin in both areas, comprising 46% of statin use in Nova Scotia and 51% in Queensland. Mean doses of each statin prescribed were slightly above the DDDs. Expenditure on statins per 1000 beneficiaries and per DDD were similar in each jurisdiction, being slightly higher in Nova Scotia. Conclusions: Despite differences in pharmaceutical reimbursement systems, use of the statins was similar in Nova Scotia and Queensland. The feasibility of the methodology was demonstrated. Future studies, including comparisons of drug utilization for other classes of drugs for which drug policies may be divergent (eg, different pricing structures or prior authorization requirements), or for which less evidence for appropriate use is available, may be useful. © 2005 Excerpta Medica, Inc.

Disgrace, Benang, and the search for benevolence

This Article does not have an abstract.

Diversity of polyketide synthase genes from bacteria associated with the marine sponge Pseudoceratina clavata: culture-dependent and culture-independent approaches

Diverse ketosynthase (KS) genes were retrieved from the microbial community associated with the Great Barrier Reef sponge Pseudoceratina clavata. Bacterial isolation and metagenomic approaches were employed. Phylogenetic analysis of 16S rRNA of culturable sponge-associated bacterial communities comprised eight groups over four phyla. Ten KS domains were amplified from four genera of isolates and phylogenetics demonstrated that these KS domains were located in three clusters (actinobacterial, cyanobacterial and trans-AT type). Metagenomic DNA of the sponge microbial community was extracted to explore community KS genes by two approaches: direct amplification of KS domains and construction of fosmid libraries for KS domain screening. Five KS domains were retrieved from polymerase chain reaction (PCR) amplification using sponge metagenome DNA as template and five fosmid clones containing KS domains found using multiplex PCR screening. Analysis of selected polyketide synthase (PKS) from one fosmid showed that the PKS consists of two modules. Open reading frames located up- and downstream of the PKS displayed similarity with membrane synthesis-related proteins such as cardiolipin synthase. Metagenome approaches did not detect KS domains found in sponge isolates. All KS domains from both metagenome approaches formed a single cluster with KS domains originating from metagenomes derived from other sponge species from other geographical regions.

The commentariat and discourse failure: language and atrocity in Cool Britannia

Recent terrorist events in the UK, such as the security alerts at British airports in August 2006 and the London bombings of July 2005 gained extensive media and academic analysis. This study contends, however, that much of the commentary demonstrated a wide degree of failure among government agencies, academic and analytic experts and the wider media, about the nature of the threat and continues to distort comprehension of the extant danger. The principal failure, this argument maintains, was, and continues to be, one of an asymmetry of comprehension that mistakes the still relatively limited means of violent jihadist radicals with limited political ends. The misapprehension often stems from the language that surrounds the idea of 'terrorism', which increasingly restricts debate to an intellectually redundant search for the 'root causes' that give rise to the politics of complacency. In recent times this outlook has consistently underestimated the level of the threat to the security of the UK. This article argues that a more realistic appreciation of the current security condition requires abandoning the prevailing view that the domestic threat is best prosecuted as a criminal conspiracy. It demands instead a total strategy to deal with a totalizing threat. The empirical evidence demonstrates the existence of a physical threat, not merely the political fear of threat. The implementation of a coherent set of social policies for confronting the threat at home recognizes that securing state borders and maintaining internal stability are the first tasks of government. Fundamentally, this requires a return to an understanding of the Hobbesian conditions for sovereignty, which, despite the delusions of post-Cold War cosmopolitan multiculturalism, never went away.

Oscar Asche's Modernisms: Flesh, Colour and Light

The article examines the early 20th century Australian actor, theater director, and writer Oscar Asche and how various aspects of his work are expressive of an aesthetic modernism. His theatrical productions with his wife Lily Brayton are discussed, as well as his solo projects like the highly acclaimed musical "Chu Chin Chow." Asche is described as a "vitalist."