Motivations and perceived influences on rural and urban general practitioners when prescribing conventional non-steroidal anti-inflammatory drugs or COX-2 inhibitors

Background and objective: Prescribers in rural and remote locations perceive that there are different influences on their prescribing compared with those experienced by urban prescribers. The aim of this study was to compare the motivations and perceived influences on general practitioners (GPs) when prescribing COX-2 inhibitors rather than conventional non-steroidal anti-inflammatory drugs (NSAIDs) between rural and urban-based GPs in Queensland, Australia. Methods: A questionnaire was administered to two geographically distinct groups of GPs, one urban (n = 67) and one rural (n = 67), investigating the reasons that the GP would prescribe a COX-2 inhibitor rather than a conventional NSAID or vice versa and also focusing on patients requesting a prescription for a COX-2 inhibitor. Results and discussion: A 51% response rate (n = 68) was achieved. The difference between the rural and the urban GPs was that the urban GPs were more likely to perceive that they were influenced to prescribe COX-2 inhibitors by their patients' knowledge of these new (at the time) drugs. GPs in both the rural and urban areas perceived the COX-2 selective inhibitors to be safer than conventional NSAIDs, and that there was little difference in terms of efficacy between the two drug classes. However, GPs from both of the study areas stated that conventional NSAIDs were preferred over COX-2 selective inhibitors, primarily due to their expense, if their patients were not at risk for developing a GI bleed. Conclusion: The motivations and perceived influences to prescribe a COX-2 inhibitor in rural and in urban areas of Queensland, Australia were very similar. Almost all surveyed GPs in rural and urban areas had patients request a prescription, or enquire about the COX-2 inhibitors. Urban GPs were more likely to feel pressured to prescribe a COX-2 inhibitor than their rural counterparts, agreeing with other research which found that patient pressure to prescribe appears to be greater in urban general practice.

Pace of Civil Litigation in the Queensland Supreme Court

The overriding philosophy of the Uniform Civil Procedure Rules 1999 in Queensland is to facilitate the just and expeditious resolution of the issues in a civil proceeding at minimum expense. The court is enjoined to apply the rules to avoid undue delay, expense and technicality. Parties impliedly undertake to the court and each other to proceed expeditiously. These rules adopt management theories developed to contain delay and cost in the civil justice system. A survey was designed to determine whether the overriding objective is being achieved in practice. The results indicate a reduction in the time from initiation of a proceeding to termination as compared to a sample of similar cases determined under the repealed Rules of the Supreme Court.

Specification and validation of process constraints for flexible workflows

Workflow systems have traditionally focused on the so-called production processes which are characterized by pre-definition, high volume, and repetitiveness. Recently, the deployment of workflow systems in non-traditional domains such as collaborative applications, e-learning and cross-organizational process integration, have put forth new requirements for flexible and dynamic specification. However, this flexibility cannot be offered at the expense of control, a critical requirement of business processes. In this paper, we will present a foundation set of constraints for flexible workflow specification. These constraints are intended to provide an appropriate balance between flexibility and control. The constraint specification framework is based on the concept of pockets of flexibility which allows ad hoc changes and/or building of workflows for highly flexible processes. Basically, our approach is to provide the ability to execute on the basis of a partially specified model, where the full specification of the model is made at runtime, and may be unique to each instance. The verification of dynamically built models is essential. Where as ensuring that the model conforms to specified constraints does not pose great difficulty, ensuring that the constraint set itself does not carry conflicts and redundancy is an interesting and challenging problem. In this paper, we will provide a discussion on both the static and dynamic verification aspects. We will also briefly present Chameleon, a prototype workflow engine that implements these concepts. (c) 2004 Elsevier Ltd. All rights reserved.

Financial aspects of heart failure programs of care

As suggested by studies that have examined the economic burden imposed by heart failure and, more specifically where the greatest expenditure occurs, the key to cost-effectively minimising the impact of a sustained heart failure epidemic is to minimise recurrent hospital use-even at the expense of increasing levels of community-based care and prescribed pharmacotherapy [Mark DB. Economics of treating heart failure. Am J Cardiol 1997;80:33H-38H; Weintraub WS, Cole J, Tooley JF. Cost and cost-effectiveness studies in heart failure research. Am Heart J 2002;143:565-76]. This paper examines the potential cost-benefits of applying specialist heart failure programs of care and the range of financial issues that need to be considered when establishing a formal heart failure service. (C) 2005 European Society of Cardiology. Published by Elsevier B.V.

Co-opting conservation: Migrant resource control and access to national park management in the Philippine uplands

The history of political and economic inequality in forest villages can shape how and why resource use conflicts arise during the evolution of national parks management. In the Philippine uplands, indigenous peoples and migrant settlers co-exist, compete over land and forest resources, and shape how managers preserve forests through national parks. This article examines how migrants have claimed lands and changed production and exchange relations among the indigenous Tagbanua to build on and benefit from otherwise coercive park management on Palawan Island, the Philippines. Migrant control over productive resources has influenced who, within each group, could sustain agriculture in the face of the state's dominant conservation narrative - valorizing migrant paddy rice and criminalizing Tagbanua swiddens. Upon settling, migrant farmers used new political and economic strengths to tap into provincial political networks in order to be hired at a national park. As a result, they were able to steer management to support paddy rice at the expense of swidden cultivation. While state conservation policy shapes how national parks impact upon local resource access and use, older political economic inequalities in forest villages build on such policies to influence how management affects the livelihoods of poor households.

Confirmation of the existence of alloparasitoids in nature - host relationships of an Australian Coccophagus species that parasitizes mealy bugs

Heteronomous hyperparasitoids are parasitic wasps with sex-related host relationships that are unique to a group of genera in the chalcidoid family Aphelinidae. Females are primary parasitoids of various sedentary bugs (mainly, scale insects, mealy bugs, and whiteflies). Males, in contrast, are hyperparasitic, and they frequently develop at the expense of female conspecifics. Alloparasitoids constitute a special category of heteronomous hyperparasitoids, for their males never develop through female conspecifics. The existence of alloparasitic host relationships and the utility of the category 'alloparasitoid' have both been questioned. Here, we present results that confirm the existence of the alloparasitic way of life among heteronomous aphelinids. We investigated an undescribed species of Coccophagus (Hymenoptera: Aphelinidae), an Australian parasitoid that attacks the introduced lantana mealy bug, Phenacoccus parvus Morrison (Homoptera: Pseudococcidae), in Queensland. A year-long field survey regularly returned large numbers of female Coccophagus spec. near gurneyi individuals from P. parvus (total n = 4212), but only few males (n = 11). Males emerged from samples only when the encyrtid parasitoid Anagyrus diversicornis (Howard) (Hymenoptera: Encyrtidae) was present in samples in relatively high numbers. Laboratory oviposition tests confirmed that A. diversicornis is a male host and showed that males do not develop at the expense of conspecific females. Other studies show that males are attracted in numbers to virgin females held in cages above mealy bug-infested Lantana montevidensis (Spreng.) Briq. (Verbenaceae) in the field, demonstrating that they are common in the population as a whole. This confirms that the males need hosts other than conspecific females and that their usual hosts are present outside of the lantana/P. parvus system. The implications of these results for developing a realistic classification of heteronomous host relationships are discussed.

Optimal periodic preventive maintenance policy for leased equipment

For leased equipment the lessor incurs penalty costs for failures occurring over the lease period and for not rectifying such failures within a specified time limit. Through preventive maintenance actions the penalty costs can be reduced but this is achieved at the expense of increased maintenance costs. The paper looks at a periodic preventive maintenance policy which achieves a tradeoff between the penalty and maintenance costs. (c) 2005 Elsevier Ltd. All rights reserved.

Should future health-care costs be discounted? The case of diabetes in Australia [Editorial]

No Abstract

The status and relevance of Vietnamese journalism education: An empirical analysis

Based primarily on data from indepth interviews with senior journalists and journalism educators as well as a content analysis of journalism curricula, this paper sets out to provide an overview of the demand, overall provision structure, teaching materials and methods of Vietnamese journalism education. It first shows that with a fast expansion in both size and substance, the Vietnamese media system is beginning to feel the urgent need for formal journalism education. However, the country's major journalism programs have been criticised for producing hundreds of unqualified journalism graduates a year. In general, the most deplorable aspects of Vietnamese journalism education include its body of outdated and awkward teaching material, its undue focus on theories and politics at the expense of practical training, its lack of qualified teaching staff and its inadequate teaching resources.

Public choice of species for the 'Ark': Phylogenetic similarity and preferred wildlife species for survival

Humans play a role in deciding the fate of species in the current extinction wave. Because of the previous Similarity Principle, physical attractiveness and likeability, it has been argued that public choice favours the survival of species that satisfy these criteria at the expense of other species. This paper empirically tests this argument by considering a hypothetical ‘Ark’ situation. Surveys of 204 members of the Australian public inquired whether they are in favour of the survival of each of 24 native mammal, bird and reptile species (prior to and after information provision about each species). The species were ranked by percentage of ‘yes’ votes received. Species composition by taxon in various fractions of the ranking was determined. If the previous Similarity Principle holds, mammals should rank highly and dominate the top fractions of animals saved in the hierarchical list. We find that although mammals would be over-represented in the ‘Ark’, birds and reptiles are unlikely to be excluded when social choice is based on numbers ‘voting’ for the survival of each species. Support for the previous Similarity Principle is apparent particularly after information provision. Public policy implications of this are noted and recommendations are given.

O DIREITO É TORCIDO À PORTA PORQUE A JUSTIÇA SE ENCONTRA DEITADA POR TERRA: Um estudo sobre o direito e a justiça na profecia de Amós, a partir de Am 5,10-13

O trabalho que tem por título: O Direito é torcido à Porta porque a Justiça se encontra deitada por terra é um exercício exegético que tem por objeto a perícope Am 5,10-13. Na análise semântica dos seus principais vocábulos evidenciou-se uma realidade social, política e econômica paradoxal em Israel, sob o comando de Jeroboão II (787-747 a.C.), como resultado de uma expansão territorial e comercial, de vitórias militares e da organização de um Estado tributarista. Esse modelo de sociedade gerou um antagonismo social entre uma elite abastada que esbanjava luxo e ostentação, à custa do suor e da fome de uma população empobrecida, especialmente a classe camponesa, que trabalhava para sustentar as benesses do mundo urbano. É de dentro dessa realidade que ecoa o grito de Amós como denúncia a esse estado de coisas, como palavra de desgraça e condenação a toda sorte de desmandos praticados em Israel. Entre esses a falência do sistema judiciário, pela prática da exploração e corrupção por parte dos magistrados, de ricos comerciantes e latifundiários, desviando o pobre do seu direito de recorrer em sua defesa perante o tribunal. Em razão disso, Amós anuncia a ruína de Israel, com o Dia de Javé, que será um anti-Êxodo, e aponta uma exigência ético-religiosa como forma de reverter esse não futuro para Israel, que se traduz no compromisso de estabelecer à Porta o Direito e a Justiça.

SER PROFESSOR: UM ESTUDO SOBRE A CONSTITUIÇÃO IDENTITÁRIA PROFISSIONAL DO ENFERMEIRO DOCENTE

O presente estudo foi desenvolvido com o objetivo de compreender a construção da identidade profissional de enfermeiros docentes do curso de graduação em Enfermagem de uma instituição privada localizada na cidade de São Paulo. Para tanto, discute os processos de constituição identitária pautado nos estudos de Vera Placco de Souza, no âmbito nacional, e de Maurice Tardif e Claude Dubar, no âmbito internacional. Em uma etapa exploratória, foi aplicado um questionário semi-estruturado a cinco professoras da pós-graduação em Enfermagem e realizada uma entrevista semi-diretiva com dois desses participantes com o objetivo de refinar os instrumentos de coleta. A pesquisa principal fez uso de entrevista realizada com sete professores do curso de graduação em Enfermagem da mesma instituição. Os dados, tanto do estudo exploratório como da pesquisa principal, foram analisados tendo como referência os pressupostos da análise de conteúdo sistematizados por Laurence Bardin e Maria Laura P. B. Franco. Os resultados indicaram que os enfermeiros se tornam professores impelidos pelo desejo de ensinar e de compartilhar conhecimentos, oportunidade de trabalho, flexibilidade de horário e complementação da renda profissional, e são influenciados por professores de sua trajetória formativa e por familiares. As características valorizadas por eles em um professor foram: o domínio do conteúdo ensinado, sobretudo o saber técnico; a busca contínua do conhecimento; ética; profissionalismo; humanização. Nota-se um predomínio das características que envolvem o conhecimento dos conteúdos em detrimento das questões pedagógicas. A reflexão e preocupação com a Docência estão presentes em suas falas, assim como a busca constante para a superação das dificuldades existentes na profissão. Eles consideram a Docência uma profissão com um papel social de destaque do mesmo modo que a Enfermagem. Outro fator destacado nas respostas foi a forte representação do enfermeiro na carreira profissional dos pesquisados. Em seus relatos, foi possível perceber que sua construção como docentes ocorre de forma contínua ao longo da carreira, o que fica evidenciado em suas falas quando afirmam serem melhores professores agora do que no início de sua trajetória profissional e que, apesar de ser uma caminhada espinhosa inicialmente, tornou-se prazerosa e significativa com o passar do tempo. Ressalta-se aqui a importância de se valorizar os saberes do professor, partindo deles e trabalhando-os teórica e conceitualmente para que o docente amplie a compreensão do processo de ensino em saúde que, no mundo contemporâneo, tornou-se de alta complexidade.

A (R)EXISTÊNCIA DAS VOCACIONADAS AO MINISTÉRIO PASTORAL BATISTA: DESCORTINANDO A RELAÇÃO ENTRE AS PASTORAS BATISTAS DE SÃO PAULO E A NÃO FILIAÇÃO NA ORDEM DOS PASTORES BATISTAS DO BRASIL EM SÃO PAULO (OPBB-SP)

O contexto batista é predominantemente marcado por lideranças masculinas, destinando às mulheres apenas lugares e comportamentos socialmente estabelecidos, como a casa, o cuidado, a maternidade, a submissão, entre outras características que enfatizam a hierarquia de gênero. Mesmo diante do desenvolvimento econômico e da ocupação que as mulheres estão conquistando no campo público, a igreja e principalmente as igrejas batistas, permanecem fundadas em alicerces que exaltam o poder masculino em detrimento do lugar que deve ser ocupado pelas mulheres, ou seja, onde elas decidirem atuar. Caso elas decidam atuar num campo predominantemente masculino, terão que lidar com a desconstrução de um pensamento socialmente permeado de dominação masculina e com a árdua construção de um pensamento que vise a igualdade de gênero. O objeto desta pesquisa é o ministério pastoral feminino no contexto batista brasileiro. O texto analisa o discurso das Pastoras Batistas do Estado de São Paulo e o discurso dos líderes da Ordem dos Pastores Batistas de São Paulo (OPBB-SP) a respeito do ministério pastoral feminino e a não filiação de mulheres na OPBB-SP. A importância deste trabalho é a de demostrar as relações de micro poder existentes entre pastores e pastoras e concomitantemente as desigualdades dentro do contexto batista com relação ao ministério pastoral feminino. Essa afirmação se consolida por meio das análises das entrevistas semiestruturadas que realizei na pesquisa de campo, com sete pastoras batistas do Estado de São Paulo, bem como com três líderes da OPPB-SP. Esta é uma pesquisa qualitativa, em que foram analisados documentos oficiais da igreja, como pautas de convenções, atas, sites institucionais, periódicos e documentos não oficiais encontrados em redes sociais, blogs, jornais online, entre outros. Posso afirmar que as pastoras batistas estão se mobilizando para cumprir sua vocação, usando argumentos transcendentes que impedem qualquer pessoa de desafiar ou duvidar de seu chamado pastoral, pois: “O vento sopra onde quer; ouve-se o ruído, mas não sabes de onde vem, nem para onde vai. Assim acontece com aquele(a) que nasceu do Espírito.” (João 3.8).

Market orientation in a multiple stakeholder orientation context:implications for marketing capabilities and assets

Does a market orientation approach focus too heavily on customers at the expense of other stakeholders? Managers also need to address the interests of other stakeholders when making marketing decisions. This gives an orientation to each stakeholder group, which exist simultaneously, giving a multiple stakeholder orientation profile (MSOP). In the reported empirical study of senior marketing executives, this weakness is addressed, by taking a simultaneous multiple stakeholder orientation approach. The study identified where marketing capabilities and assets are both different and similar among executives with a market focus in their MSOPs, and those with other MSOPs. © 2004 Elsevier Inc. All rights reserved.

The tribology of linear tape recording systems

This thesis is devoted to the tribology at the head~to~tape interface of linear tape recording systems, OnStream ADRTM system being used as an experimental platform, Combining experimental characterisation with computer modelling, a comprehensive picture of the mechanisms involved in a tape recording system is drawn. The work is designed to isolate the mechanisms responsible for the physical spacing between head and tape with the aim of minimising spacing losses and errors and optimising signal output. Standard heads-used in ADR current products-and prototype heads- DLC and SPL coated and dummy heads built from a AI203-TiC and alternative single-phase ceramics intended to constitute the head tape-bearing surface-are tested in controlled environment for up to 500 hours (exceptionally 1000 hours), Evidences of wear on the standard head are mainly observable as a preferential wear of the TiC phase of the AI203-TiC ceramic, The TiC grains are believed to delaminate due to a fatigue wear mechanism, a hypothesis further confirmed via modelling, locating the maximum von Mises equivalent stress at a depth equivalent to the TiC recession (20 to 30 nm). Debris of TiC delaminated residues is moreover found trapped within the pole-tip recession, assumed therefore to provide three~body abrasive particles, thus increasing the pole-tip recession. Iron rich stain is found over the cycled standard head surface (preferentially over the pole-tip and to a lesser extent over the TiC grains) at any environment condition except high temperature/humidity, where mainly organic stain was apparent, Temperature (locally or globally) affects staining rate and aspect; stain transfer is generally promoted at high temperature. Humidity affects transfer rate and quantity; low humidity produces, thinner stains at higher rate. Stain generally targets preferentially head materials with high electrical conductivity, i.e. Permalloy and TiC. Stains are found to decrease the friction at the head-to-tape interface, delay the TiC recession hollow-out and act as a protective soft coating reducing the pole-tip recession. This is obviously at the expense of an additional spacing at the head-to-tape interface of the order of 20 nm. Two kinds of wear resistant coating are tested: diamond like carbon (DLC) and superprotective layer (SPL), 10 nm and 20 to 40 nm thick, respectively. DLC coating disappears within 100 hours due possibly to abrasive and fatigue wear. SPL coatings are generally more resistant, particularly at high temperature and low humidity, possibly in relation with stain transfer. 20 nm coatings are found to rely on the substrate wear behaviour whereas 40 nm coatings are found to rely on the adhesive strength at the coating/substrate interface. These observations seem to locate the wear-driving forces 40 nm below the surface, hence indicate that for coatings in the 10 nm thickness range-· i,e. compatible with high-density recording-the substrate resistance must be taken into account. Single-phase ceramic as candidate for wear-resistant tape-bearing surface are tested in form of full-contour dummy-heads. The absence of a second phase eliminates the preferential wear observed at the AI203-TiC surface; very low wear rates and no evidence of brittle fracture are observed.