Pilot Study of clinician attitudes to insulin pump therapy: international differences and the need for a greater understanding of the patient perspective

OBJECTIVES: To identify and survey health care professionals (HCPs) attitudes to insulin pump therapy (CSII).

METHODS: Eight specialists were interviewed to explore the attitudes and beliefs about CSII. Responses were analysed thematically and used to inform the design of a new 22-item questionnaire: the Attitudes to Pump Therapy (APT) Survey. The APT was pilottested among 95 HCPs (54% male; 75.5% diabetologists/DSNs, 13.8% general practitioners) at the International Diabetes Federation (IDF) conference, 2006. Results were analysed using non-parametric statistics with bonferroni correction.

RESULTS: Analyses of interview data identified 9 themes: biomedical, perceived control of care/diabetes, technology, quality of life, financial resources, training, education & support, suitability, and evidence-base. Items were designed to reflect these themes with responses scored on a 5-point Likert scale (strongly agree—strongly disagree). No statistically significant differences
were found by gender, HCP speciality, country (and continent) of origin or proportion of patients using CSII. Most notable differences were found in relation to gross domestic product (GDP) and the potential for pump therapy to achieve tight blood glucose control (lower GDP = more agreement: p = 0.001), and result in diabetic ketoacidosis (DKA) (lower GDP = less agreement: p < 0.005). Ranked mean scores showed a split between biomedical/clinical items (N = 11) and items concerned with patient experience (N = 11). Attitudes about biomedical/clinical issues were generally clear (i.e. for 7/11 items, the mean score was “agree”) but less decisive about patient experience (i.e. for 8/11 items, the mean score was “neither agree nor disagree”).

CONCLUSION: Few subgroup differences existed, but those that did may be explained by lack of access to treatment (directly corresponding to GDP). Clinicians’ were generally clear in their attitudes regarding biomedical aspects but less so regarding patient experience. Research focusing on patient-reported outcomes is likely to offer clinicians a greater understanding of the patients’ perspective of insulin pump therapy.

Modelling dimensionality of cultural experience attitudes for international tourists

This empirical research of tourists’ cultural experiences aims to advance theory by developing a measurement model of attitudes towards attending cultural experiences for a sample of international tourists visiting Melbourne, Australia. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to cross-validate the underlying dimensionality structure of cultural experience attitudes in the model. A five-factor model was extracted from the EFA and some further modifications were required to establish discriminant validity. A four-factor model was retained in the CFA, which included three factors based on a liking for different types of cultural experiences and one factor indicating that social interaction was the most liked socio-psychological attitude towards attending cultural experiences. Although the sample were all English-speaking international tourists, cross-cultural validation of the model was also examined for factor configural and metric invariance of the measurement model as there were three different groups of international tourists within the sample: North Americans; New Zealanders; and tourists from United Kingdom and Ireland. This measurement structure was found to be relatively invariant for the factor loadings across the three groups of international tourists.

Student attitudes toward professional practices in science

There has been anecdotal evidence that students from various cultures have different perspectives toward professional practices, including (1) how to use quotations, (2) occupational health and safety and (3) recording data, but there has been a lack of hard evidence to either confirm or contradict this belief. This paper presents a snapshot of student attitudes toward professional practices in Australia. The survey group consisted of students enrolled in an undergraduate 1st year, 2nd semester, chemistry subject. Students generally agreed that they should paraphrase and should cite sources of information. However, there was confusion about the use of extensive quotations and occupational health and safety. There was no significant difference in the responses by the country of secondary schooling or family background, but were some significant differences by the respondents’ age, number of years in university and by the discipline area of study.

Client and contractor attitudes to prequalification

The article discusses the prequalification criteria that are believed to be good indicators of future construction performance by both clients and contractors. A crucial task in contractor prequalification is to establish a set of decision criteria through which the capabilities of contractors are measured and judged. The use of universal prequalification criteria seems to be a widely researched utopian" ideal. Standard prequalification criteria provides more consistency across the industry.

A comparison of client and contractor attitudes to prequalification criteria

Contractor prequalification is concerned with assessing the likelihood of contractors meeting client and project requirements. The criteria used in this assessment have been developed in a largely idiosyncratic manner to date and with little or no consultation with the contractors affected. As a result, contractors are faced with a variety of calls for information by prequalifiers, the collection of which can be quite costly. This is leading to expensive duplication of effort by contractors in providing what is often similar information but in different formats. Furthermore, previous research has shown that the benefits of the information to prequalifiers are uncertain - many prequalifiers analyse the information in only a cursory manner. What is needed is some form of cost-benefit analysis to be carried out which will establish a common set of criteria for all to use.

As a precursor to this, the research described in this paper compares the different attitudes of both prequalifiers and contractors to prequalification criteria commonly in use in the Australian building industry. This was carried out via a postal questionnaire involving 49 contractors and 15 prequalifiers across Australia. The respondents were divided into three groups; (1) contractors doing work for mainly private sector clients and (2) contractors doing work for mainly private sector clients, and (3) construction prequalifiers (clients).

The results show that both clients and contractors have divergent opinions on the importance and value of the criteria in use. The possible reasons for these differences are discussed and the likely implications for future research in the topic.

Student attitudes and aspirations towards science

Research on student attitudes and aspirations towards science has been an increasing focus of concern in the past decade. Much of this is driven by a growing concern about students’ lack of interest in the further study of science in advanced societies. Because attitude to science is a multifaceted construct, the chapter first reviews research into attitudes in order to develop principles for its meaningful measurement. We then explore the main features of student responses to science and examine the common assertion that there is a negative downward trend as many have suggested. Recent research clearly shows a negative correlation between a country’s developmental index and student attitudes to science. The effects of gender, teacher quality and pre-adolescent experience on student attitudes and aspirations towards science are examined in some detail, as well as a number of other factors in attempting to understand the complex pathways and choices that students make throughout their schooling about the study of STEM subjects. The construct of identity is used to make sense of the variety of attitudes and aspirations of students towards science, with particular emphasis on gender and youth in post-industrial societies. Finally, the role of enrichment experiences in science is examined, as a real and potential influence on student engagement with science.

Institutional environment, managerial attitudes and environmental sustainability orientation of small firms

This study examines the direct impact of three dimensions of the institutional environment on managerial attitudes toward the natural environment and the direct influence of the latter on the environmental sustainability orientation (ESO) of small firms. We contend that when the institutional environment is perceived by owner–managers as supportive of sound natural environment management practices, they are more likely to develop a positive attitude toward natural environment issues and concerns. Such owner–manager attitudes are likely to lead to a positive and proactive orientation of their firms toward environmental sustainability. The study uses survey data from 166 small manufacturing firms located in three Philippine cities. First, the study develops and tests the measurement models to examine the validity of the constructs representing the firm’s institutional environment, managerial attitudes toward the natural environment and the ESO of firms. Second, the study develops and tests the structural models examining the institutional environment–managerial attitudes–ESO linkages. Multi-sample invariance structural model analysis shows the mediating role of managerial attitudes in the institutional environment–ESO nexus. The findings show that ESO is a construct comprising three dimensions: knowledge of environmental issues, sustainable practices and commitment toward environmental sustainability. The cognitive, regulatory and normative elements of the institutional environment are strongly linked to positive managerial attitudes toward environmental sustainability, which in turn, positively influences the firm’s overall ESO. Managerial attitudes play a mediating role in the institutional environment–ESO linkages. The managerial, practical, research and policy implications of the research findings are discussed.

Catholic intermarriages in Australia : attitudes to children, identity and sharing household responsibilities

A cursory glance of the human history shows a changing view about marriage on various aspects and levels. One of which is the level of people’s exploration leading to marriage with a spouse that may have different articles of faith.

This study’s focal concern is on Australia’s Catholics’ and Christians’ interfaith marriages, and its level of influence on attitudes to children, identity, and sharing household responsibilities. Expectations are predetermined from both parties but it can be discerned that with sound values, relationships can be rockbed strong.

Raising a family for two individuals with distinct spiritual formation can bring multidisciplinary results. It may be a source of inspiration not only for children seeing their parents respecting each other’s belief— for the love of fellow, own children, and especially the love that has flourished through the union of faith.