Attitudes and practices of general practitioners in the diagnosis and management of attention-deficit/hyperactivity disorder

Objective: To assess understanding of, and actual and potential roles in management of attention-deficit/hyperactivity disorder (ADHD) among GPs. Methods: A cross-sectional questionnaire survey of Queensland GPs selected randomly from the Royal Australian College of General Practitioners directory of members was carried out. Main outcome measures were knowledge levels of ADHD, current management practices, referral patterns and self-perceived information and training needs. Results: Three hundred and ninety-nine GPs returned a completed questionnaire (response rate 76%). Roles identified by GPs were: the provisional diagnosis of ADHD and referral to specialist services for confirmation of the diagnosis and initiation of management; assistance with monitoring progress once a management plan was in place; education of the child and their family regarding the disorder; and liaison with the school where necessary. Perceived barriers to increased involvement of GPs were: time and resource constraints of general practice; concerns regarding abuse and addiction liability of prescription stimulants; complex diagnostic issues associated with childhood behavioural problems; and lack of training and education regarding ADHD. Conclusions: General practitioners identify a role for themselves in ADHD care that is largely supportive in nature and involves close liaison with specialist services.

The ambivalent practices of reflexivity

Reflexivity involves turning one's reflexive gaze oil discourse-turning language back on itself to see the Work it does in constituting the world. The subject/researcher sees simultaneously the object of her or his gaze and the means by which the object (which may include oneself as subject) is being constituted. The consciousness of self that reflexive writing sometimes entails may be seen to slip inadvertently into constituting the very (real) self that seems to contradict a focus on the constitutive power of discourse. This article explores this site of slippage and of ambivalence. In a collective biography oil the topic of reflexivity, the authors tell and write stories about reflexivity and in a doubled reflexive arc, examine themselves at work during the workshop. Examining their own memories and reflexive practices, they explore this place of slippage and provide theoretical and practical insight into what is going on in reflexive research and writing.

Beliefs and practices of patients with advanced cancer: implications for communication

The aim of this study was to investigate the beliefs that patients with advanced cancer held about the curability of their cancer, their use of alternatives to conventional medical treatment, and their need to have control over decisions about treatment. Of 149 patients who fulfilled the criteria for participation and completed a self-administered questionnaire, 45 patients (31%) believed their cancer was incurable, 61 (42%) were uncertain and 39 (27%) believed their cancer was curable. The index of need for control over treatment decisions was low in 53 patients (35.6%) and high in only 17 patients (11.4%). Committed users of alternatives to conventional medical treatments were more likely to believe that their cancer was curable (P

IS/IT outsourcing practices of small- and medium-sized manufacturers

Firms began outsourcing information system functions soon after the inception of electronic computing. Extant research has concentrated on large organizations and large-valued outsourcing contracts from a variety of different industries. Smaller-sized firms are inherently different from their large counterparts. These differences between small and large firms could lead to different information technology/information system (IT/IS) items being outsourced and different outsourcing agreements governing these arrangements. This research explores and examines the outsourcing practices of very small through to medium-sized manufacturing organizations. The in-depth case studies not only explored the extent to which different firms engaged in outsourcing but also the nuances of their outsourcing arrangements. The results reveal that all six firms tended to outsource the same sorts of functions. Some definite differences existed, however, in the strategies adopted in relation to the functions they outsourced. These differences arose for a variety of reasons, including size, locality, and holding company influences. The very small and small manufacturing firms tended to make outsourcing purchases on an ad hoc basis with little reliance on legal advice. In contrast, the medium-sized firms often used a more planned initiative and sought legal advice more often. Interestingly, not one of the six firms outsourced any of their transaction processing. These findings now give very small, small-, and medium-sized manufacturing firms the opportunity to compare their practices against other firms of similar size.

Publication practices of English language occupational therapy journals

The aim of this study was to determine the characteristics and publication practices of English language occupational therapy journals. An adapted version of the Survey of Editors Regarding Publishing Practices was posted to the editors of English language occupational therapy journals (n = 14) in September 2001. The response rate was 92.9% (n = 13). Journals were published on average 4.77 times per year and comprised 89% text and 10% advertising. The preferred average length of manuscripts was 20 pages using American Psychological Association format. The average acceptance rate of unsolicited manuscripts was 46.6%. All the journals were peer-reviewed publications and 80% were research oriented. The most frequently cited reasons for rejection of manuscripts were methodology problems, poorly developed idea, poorly written and data interpretation problems. The professional focus of published manuscripts was on research and the clinical foci were on paediatrics, gerontology and physical medicine. The study concludes that there are a variety of publishing opportunities available to occupational therapists. It is essential that prospective authors consult the journal guidelines for authors, including the types of manuscript accepted.

Farming under constrained budgets: Practices of agricultural credit users in central Lombok, Indonesia

There has been a long dependency on credit by Indonesian farmers as a result of the lack of capital to apply proper farming practices. This paper describes the farming activities applied by agricultural credit users in Central Lombok, Indonesia. A survey was conducted during July 2001- March 2002 of 65 farmers making use of government or private credit in three villages within the Regency. Data from the farmers were collected using face-to-face, semi-structured interviews. Survey results indicated that on average, farmers had some 20 years experience of farming, were aged 40 years, but lacked of formal education. Their main asset was cropping land with average landholding of 0.69 ha. As a consequence of their capital constraints, farmers were commonly making use of credit to finance their farming activities, including both production of rice as the main crop and secondary crops. Farmers generally applied less than recommended amount of inputs in their farming practices, since the amount of credit they obtained was limited. As a result, their farms become less productive and their repayment capability of loans diminished. Of 65 farmers interviewed, 54 could earn extra income by engaging in a variety of non-farm activities, which contributed on average some 36% to family incomes of over Rp 5 million (A$ 1 thousand). The average credit repayment rate made by agricultural producers was 60%. The repayment made did not always reflect farm production capacity, being sometimes supported by other borrowings. The greater role of credit is not in increasing agricultural production or improving farmers’ income, but in helping them to sustain farm production and their living. Farmers need a bigger amount of credit to make an impact on their livelihood. This should be accompanied by extension services for farmers to enable better use of credit and to change their attitude towards it. As well, farmers require to be equipped with technical and market skills to run a business. Interdisciplinarity, holistic analysis, and an expansion of traditional ‘agricultural’ interests to embrace the span of interests included in rural livelihood, are each critical features of revision of the existing system.