Pharmaceutical ecomonics and politics vs. patient safety : Lumiracoxib in Australia

Lumiracoxib (Prexige©) 200 mg was listed in Australia’s Pharmaceutical Benefits Scheme (PBS) schedules on 01 August 2006. The listing was intended as a cost-minimisation strategy, as lumiracoxib 200 mg was deemed equivalent in therapeutic effect to celecoxib (Celebrex©) 200 mg, and was available at a lower cost. By the time of listing on the PBS, a safety re-evaluation of the recommended daily dose of lumiracoxib was being considered in other national regulatory jurisdictions. Within 3 months of listing, the manufacturer revised the recommended dosage to half that of the PBS-listed dosage. However, the PBS listing was neither revoked nor modified. At the time of listing on the PBS, lumiracoxib was known to be 17 times as biochemically selective in inhibiting the COX-2 isoform as celecoxib, and twice as selective as rofecoxib, already withdrawn for safety reasons. Safety concerns had already been raised about adverse hepatic outcomes on daily doses of lumiracoxib 200 mg. Communication of information about the risk potential of lumiracoxib was inadequate. Economic and political considerations were prioritised over patient safety, and lumiracoxib 200 mg remained available via the PBS until 10 August 2007, when it was withdrawn for safety reasons following cases of hepatic morbidity and mortality.

Political Islam and human security

Summary: "In the wake of the September 11 and subsequent terrorist attacks, the academic and media commentaries on Islam the religion and Islam the basis for political ideology haves received an unprecedented high level of exposure and attention. The acts of political violence by extremist groups and the omnipresent war on terror have added fresh uncertainties to an already complex global order. Just as terrorism and counter-terrorism are locked in a mutually re-enforcing symbiosis, the sense of insecurity felt by Muslims and non-Muslims alike is mutually dependent and has the potential to escalate. This general assessment holds true for Muslims living in the Muslim world and beyond. The pervasive sense of being under attack physically and culturally by the United States and its allies has contributed to a growing unease among Muslims and re-enforced deep-seated mistrust of the ʻWestʼ. Public articulation of such misgivings has in turn, lent credence to Western observers who posit an inherent antipathy between the West and the Muslim world. The subsequent policies that have emerged in this context of fear and mutual distrust have contributed to the vicious cycle of insecurity. The present volume is anchored in the current debates on the uneasy and potentially mutually destructive relationship between the Muslim world and certain West countries. It brings together leading international scholars in this interdisciplinary field to deal with such inter-related questions as the nature of Islamism, the impact of the ʻwar on terrorʼ on the spread of militancy, the growing sense of being under siege by Muslim Diasporas and the many unintended ramifications of a security-minded world order. This volume deliberately focuses on these issues both at a broad theoretical level but more importantly in the form of a number of prominent case studies including Indonesia, Algeria and Turkey."--Publisher description.

Event that never happened : the history and politics of decentralisation in Victoria and New South Wales 1885-1985

The thesis is an account of movements and policies for decentralisation of population and economic activity away from metropolitan to non-metropolitan areas in Victoria and N.S.W. in the period 1885-1985. It examines the pull from the country and the push from the capitals for decentralisation. Ballarat (Victoria) and Bathurst (N.S.W.) are used as case studies. Introductory chapters describe the historic pattern of population distribution in the two Colonies/States and discuss theories about the spatial distribution of population and industry. Chapters recounting and discussing the history and politics of decentralisation in Victoria and N.S.W. are organised in three periods: 1885-1940; 1940-1965; 1965-1985. A more decentralised distribution of population in Victoria and N.S.W. was almost always widely accepted as being in the public interest. Decentralisation rose and fell recurrently on the issue attention cycle. The pull from the country was fragmented and locally self-interested. The push from the capitals occurred only when life or its quality was perceived as threatened because of factors related to city size. Governments in both States introduced micro policies ostensibly to counter formidable centralising forces. In the 1970s there was an abortive attempt to implement a selective decentralisation policy in N.S.W. The thesis argues that decentralisation did not happen because: (1) there was not a consistent set of values and goals underlying the pull and push; (2) there was never a sustained, unified constituency for decentralisation, even in the country; (3) the power to influence, subvert or obstruct decentralisation policies was too widely diffused; (4) insufficient account was taken in decentralisation policymaking of the underlying economic, social and political dynamics.

Power and politics in a system implementation

The central concern of this study is to identify the role of power and politics in systems implementation. The current literature on systems implementation is typically divided into two areas, process modelling and factor based studies. Process modelling classifies the implementation into a linear process, whereas factor based studies have argued that in order to ‘successfully’ implement a system, particular critical factors are required. This literature misses the complexities involved in systems implementation through the human factors and political nature of systems implementation and is simplistic in its nature and essentially de-contextualises the implementation process. Literature has investigated some aspects of human factors in systems implementation. However, it is believed that these studies have taken a simplistic view of power and politics. It is argued in this thesis that human factors in systems implementation are constantly changing and essentially operating in a dynamic relationship affecting the implementation process. The concept of power relations, as proposed by Foucault (1976, 1977, 1978, 1980, 1982), have been utilised in order to identify the dynamic nature of power and politics. Foucault (1978) argued that power is a dynamic set of relationships constantly changing from one point in time to the next. It is this recognition that is lacking from information systems. Furthermore, these power relations are created through the use of discourse. Discourse represents meaning and social relationships, forming both subjectivity and power relations. Discourses are also the practices of talk, text and argument that continuously form that which actors speak. A post-structuralist view of power as both an obvious and hidden concept has provided the researcher a lens through which the selection and implementation of an enterprise-wide learning management system can be observed. The framework aimed to identify the obvious process of system selection implementation, and then deconstruct that process to expose the hegemonic nature of policy, the reproduction of organisational culture, the emancipation within discourse, and the nature of resistance and power relations. A critical case study of the selection and implementation of an enterprise-wide learning management system at the University of Australia was presented providing an in-depth investigation of the implementation of an enterprise-wide learning management system, spanning five years. This critical case study was analysed using social dramas to distinguish between the front stage issues of power and the hidden discourses underpinning the front stage dramas. The enterprise-wide learning management system implemented in the University of Australia in 2003 is a system which enables academic staff to manage learners, the students, by keeping track of their progress and performance across all types of training activities. Through telling the story of the selection and implementation of an enterprise-wide learning management system at the University of Australia discourses emerged. The key findings from this study have indicated that the system selection and implementation works at two levels. The low level is the selection and implementation process, which operates for the period of the project. The high level is the arena of power and politics, which runs simultaneously to the selection and implementation process. Challenges for power are acted out in the front stage, or public forums between various actors. The social dramas, as they have been described here, are superfluous to the discourse underpinning the front stage. It is the discourse that remains the same throughout the system selection and implementation process, but it is through various social dramas that reflect those discourses. Furthermore, the enactment of policy legitimises power and establishes the discourse, limiting resistance. Additionally, this research has identified the role of the ‘State’ and its influence at the organisational level, which had been previously suggested in education literature (Ball, 1990).

Tariff protection and politics : Castlemaine 1870-1901

This study, set within the contextual background of Victorian politics, ‘seeks to identify the economic, political and social implications of tariff protection for the Castlemaine region from 1870-1901. The introduction of the Victorian tariff in 1865 precipitated a reversal of earlier attitudes towards protection by politicians and their constituents. Reasons are sought for changes in the perceptions of the Castlemaine electorate and its political representatives towards the tariff between 1870 and Federation. An examination has been made of the role of the tariff in the creation of employment in the region’s primary and secondary industries together with its influence on politicians, primary and secondary industry leaders and workers. Also explored is the relative impact of the tariff on the economic performance of Castlemaine industries, whether producing for export or domestic markets.

Inclusive schooling : contexts, texts and politics

The title ‘Inclusive schooling: contexts, texts and politics’, names a thesis which critically analyses the development of inclusive schooling in the small Australian Island state of Tasmania between 1996 and 1998. The ‘Inclusion of Students with Disabilities’ policy, introduced in 1995 by the Tasmanian Department of Education, Community and Cultural Development, provides an opportunity to understand the cultural context and politics of change in schooling over this period. The qualitative methodology deployed here is informed by poststructuralism and captures the everyday experiences of university teaching as a research site. The teacher/researcher as the visible maker of the research use metaphors of fibre and textile practice, techniques of textual juxtaposition and her positioned subjectivity as a female academic to tell a 'big story'. The researcher develops a 'double method' as a possible model for Inclusive research practice and educational policy analysis. Using a critical ethnographic method, derived from the work of Carspecken (1996), 'data stories' (Lather & Smithies 1997, p.34) are produced from the narratives of five key informants – a parent, two teachers, a policy-maker and the researcher. Assembled as the data of the thesis the multi-voiced texts provide an account of the sociocultural, professional and systemic context of Inclusive schooling over a three-year period. In the analysis these data are interpreted from a feminist poststructural standpoint. A deconstructuive reading of the data stories interprets the discourse of inclusive schooling emphasising the dominant foundation of the special education knowledge tradition. The idea of author function (after Foucault 1975, 1984b and Grundy and Hatton 1995) is used to interpret the 'texts' of the key Informants as discursive constructions. The researcher theorises inclusive schooling as an entangled, multiple and contradictory discourse, embedded in the social, cultural and material contexts, rather than a singular unitary Idea of the progress within the special education knowledge tradition. The study contributes a fine-grained analysis of the constructed knowledge of inclusive schooling in one locality. The thesis advocates continuing engagement with questions of epistemology and social transformation in inclusive schooling, rather than persisting with technical rationality and the status quo. The researcher takes the position that the opportunities to theorise inclusive schooling lie within the multiple and disparate constructed texts of the micro world of everyday practice and the macro understanding of understandings of contemporary social justice. The poststructuralist writing/reading questions traditionalist theorising in the special education field. Central to the negotiations of power and truth inclusive schooling research and practice is a communicative theory that transforms populist conceptions of inclusion.

Islam and political violence : Muslim diaspora and radicalism in the West

How do we engage with the pressing challenges of xenophobia, radicalism and security in the age of the "war on terror"? The widely felt sense of insecurity in the West is shared by Muslims both within and outside Western societies. Growing Islamic militancy and resulting increased security measures by Western powers have contributed to a pervasive sense among Muslims of being under attack (both physically and culturally). Islam and Political Violence brings together the current debate on the uneasy and potentially mutually destructive relationship between the Muslim world and the West and argues we are on a dangerous trajectory, strengthening dichotomous notions of the divide between the West and the Muslim world.