Do rural consumers expect a prescription from their GP visit? Investigation of patients' expectations for a prescription and doctors' prescribing decisions in rural Australia

Objective: To assess patients’ expectation for receiving a prescription and GPs’ perceptions of patient expectation for a prescription. Design: Matched questionnaire study completed by patients and GPs. Setting: Seven general practices in rural Queensland, Australia. Subjects: The subjects were 481 patients consulting 17 GPs. Main outcome measures: Patients’ expectation for receiving a prescription and GPs’ perceptions of patients’ expectation. Results: Ideal expectation (hope) for a prescription was expressed by 57% (274/481) of patients. Sixty-six per cent (313/481) thought it was likely that the doctor would actually give them a prescription. Doctors accurately predicted hope or lack of hope for a prescription in 65% (314/481) of consultations, but were inaccurate in 19% (93/481). A prescription was written in 55% of consultations. No increase in patients’ expectation, doctors’ perceptions of expectation, or decision to prescribe were detected for patients living a greater distance from the doctors. Conclusions: Rural patients demonstrated similar rates of hope for a prescription to those found in previous urban studies. Rural doctors seem to be similarly ‘accurate’ and ‘inaccurate’ in determining patients’ expectations. Rates of prescribing were comparable to urban rates. Distance was not found to increase the level of patient expectation, affect the doctors’ perception or to influence the decision to prescribe.

Student expectations of TESOL programs: Student and teacher perspectives

Most practitioners teaching English to speakers of other languages (TESOL) will agree that students come with some expectations about course content and teaching methodology and that these expectations play a vital role in student motivation and learning. However, the study of student expectations has been a surprising omission from Second Language Acquisition research. In the studies reported here, the authors develop a model of student expectations by adapting the Expectation Disconfirmation paradigm, widely used in consumer psychology. Student and teacher perspectives on student expectations were gathered by interviews. Responses shed light on the nature of expectations, factors causing expectations and effects of expectation fulfilment (or lack of it). The findings provide new avenues for research on affective factors as well as clarify some ambiguities in motivational research in second language acquisition. The model presented here can be used by teachers or institutions to conduct classroom-based research, thus optimising students' learning and performance, and enhancing student morale.

Using quantity/intensity relationships to assess the potential for ammonium leaching in a Vertosol

High concentrations of ammonium (up to 0.1 cmol/kg) have been observed below 1 m depth in a Vertosol soil near Warra in south-eastern Queensland. This study examined whether ammonium leaching could be responsible for the ammonium accumulation observed in the Warra soil. This was done by using quantity/intensity (Q/I) relationships to compare the ammonium retention capacity of the Warra soil with other similar soils throughout the region that did not contain elevated subsoil ammonium concentrations. Analysis of Q/I curves revealed that in the concentration range studied, the amount of ammonium retained on high affinity adsorption sites in all 3 soils was low, and the Warra soil was not significantly different from the other 2 soils. The ability of the soils to retain ammonium in the soil solution against leaching [i.e. their potential buffer capacity (PBC)] did differ between soils and was greatest at Warra. This indicates that at any one time the Warra soil holds more ammonium on the exchange complex and less in solution than the other soils examined. It was concluded that ammonium is no more likely to leach through the surface horizons of the Warra soil than the other soils examined. Indeed, the data indicated that the Warra soil probably has greater capacity to retain ammonium against leaching due to its greater PBC. Consequently, it is considered unlikely that leaching of ammonium has been a major contributor to the subsoil ammonium concentrations at Warra.