Too much to handle? Pesticide dependence of smallholder vegetable farmers in Southeast Asia.

This study aimed to understand farmers' knowledge, attitudes, and practices regarding agricultural pest management and synthetic pesticide use in Southeast Asia. Data were used from 900 farm households producing leaf mustard (Brassica juncea (L.) Czern. et Coss.) and yard-long bean (Vigna unguiculata subsp. sesquipedalis (L.) Verdc.) in Cambodia, Laos and Vietnam. Farmers heavily depended on synthetic pesticides as their main method of pest control. Most farmers were aware of the adverse health effects associated with pesticide use and covered body parts while spraying, but also considered pesticides to be highly effective and indispensable farm inputs. Farmers were largely unable to distinguish between common beneficial and harmful arthropods. Greater knowledge about this was associated with less pesticide use while greater awareness of pesticide health risks was associated with fewer observed poisoning symptoms. For the average farm and while controlling for other factors, farmers who sought advice from friends and neighbors used 45% less pesticide, but those who sought advice from pesticide shopkeepers used 251% more pesticide. Pesticide use was 42% less when a woman was in charge of pest management and 31% less when farmers had adopted biopesticides. These findings suggest relevant entry points for interventions aimed at reducing pesticide dependence.

Measuring the performance of Critical Access Hospitals in Missouri using data envelopment analysis.

PURPOSE: Rural hospitals are critical for access to health care, and for their contributions to local economies. However, many rural hospitals, especially critical access hospitals (CAHs) need to strive for more efficiency for continued viability. Routinely evaluating their performance, and providing feedback to management and policy makers, is therefore important. METHOD: Three measures of relative efficiency are estimated for CAHs in Missouri using an Input-oriented Data Envelopment Analysis with a variable returns to scale assumption and compared with the efficiency of other rural hospitals in Missouri using Banker's F-test. Using 30-day readmission rate as a measure of quality, CAHs are evaluated against efficiency-quality dimensions. FINDINGS: CAHs in Missouri had a slight decline in average technical efficiency, but they had a slight gain in average cost efficiency in 2009 compared to 2006. More than half of the CAHs were neither economically nor technically efficient in both years. The relative efficiency of other rural hospitals was statistically higher than that of CAHs in Missouri. CONCLUSIONS: This study validates the finding of relative inefficiency of CAHs compared to other hospitals paid under the Prospective Payment System at a state level (Missouri). However, with considerable variation in socioeconomic as well as health care access indicators across states, a relative efficiency frontier may not be the only relevant indicator of value for the evaluation of the performance of CAHs. Access to health care and the impact on the local economy provided by these CAHs to the community are also critical indicators for more comprehensive performance evaluation.