An exploratory investigation of attitude toward the website and the advertising hierarchy of effects

The paper discusses the findings of a study designed to increase the generalisability, validity and reliability of earlier studies concerning the relationships between attitude toward the ad and aspects of the advertising hierarchy of effects model in the online marketing context. The findings suggest that the traditional advertising hierarchy of effects model is relevant in the online marketing environment, and that investment in online marketing communication can be evaluated using this stable and reliable method. It is, however, suggested that further research is needed to improve the generalisability of the findings.

Perceptions of ad hoc supervision encounters in general practice training: a qualitative interview-based study

BACKGROUND: Ad hoc supervision encounters occur between general practitioner (GP) supervisors and general practice registrars outside scheduled teaching sessions. Anecdotally reported as important learning opportunities, these encounters are rarely explored in the literature. OBJECTIVE: This study examined supervisors', registrars' and practice managers' perceptions of ad hoc supervisory encounters. METHODS: Semi-structured interviews were conducted with purposively sampled supervisors, registrars and practice managers from regional general practice settings. Data were analysed using template analysis. RESULTS: Fifteen respondents participated in the interviews. Their perceptions of ad hoc encounters were reported under the categories of immediacy, safety, education, professional identity and supervisor stress. DISCUSSION: Ad hoc encounters in general practice registrar training are highly valued for supporting patient safety and registrar education. The encounters serve a range of practical purposes for supervisors, registrars and practices, and warrant further exploration on how to optimise their benefits within general practice.

Investigation of the effects of microcomputers on the work of professional accountants

Information technology research over the past two decades suggests that the installation and use of computers fundamentally affects the structure and function of organisations and, m particular, the workers in these organizations. Following the release of the IBM Personal Computer in 1982, microcomputers have become an integral part of most work environments. The accounting services industry, in particular, has felt the impact of this ‘microcomputer revolution’. In Big Six accounting firms, there is almost one microcomputer for each professional accountant employed, Notwithstanding this, little research has been done on the effect of microcomputers on the work outcomes of professional accountants working in these firms. This study addresses this issue. It assesses, in an organisational setting, how accountant’ perceptions of ease of use and usefulness of microcomputers act on their computer anxieties, microcomputer attitudes and use to affect their job satisfaction and job performance. The research also examines how different types of human-computer interfaces affect the relationships between accountants' beliefs about microcomputer utility and ease of use, computer anxiety, microcomputer attitudes and microcomputer use. To attain this research objective, a conceptual model was first developed, The model indicates that work outcomes (job satisfaction and job performance) of professional accountants using microcomputers are influenced by users' perceptions of ease of use and usefulness of microcomputers via paths through (a) the level of computer anxiety experienced by users, (b) the general attitude of users toward using microcomputers, and (c) the extent to which microcomputers are used by individuals. Empirically testable propositions were derived from the model to test the postulated relationships between these constructs. The study also tested whether or not users of different human-computer interfaces reacted differently to the perceptions and anxieties they hold about microcomputers and their use in the workplace. It was argued that users of graphical interfaces, because of the characteristics of those interfaces, react differently to their perceptions and anxieties about microcomputers compared with users of command-line (or textual-based) interfaces. A passive-observational study in a field setting was used to test the model and the research propositions. Data was collected from 164 professional accountants working in a Big Six accounting firm in a metropolitan city in Australia. Structural equation modelling techniques were used to test the, hypothesised causal relationships between the components comprising the general research model. Path analysis and ordinary least squares regression was used to estimate the parameters of the model and analyse the data obtained. Multisample analysis (or stacked model analysis) using EQS was used to test the fit of the model to the data of the different human-computer interface groups and to estimate the parameters for the paths in those different groups. The results show that the research model is a good description of the data. The job satisfaction of professional accountants is directly affected by their attitude toward using microcomputers and by microcomputer use itself. However, job performance appears to be only directly affected by microcomputer attitudes. Microcomputer use does not directly affect job performance. Along with perceived ease of use and perceived usefulness, computer anxiety is shown to be an important determinant of attitudes toward using microcomputers - higher levels of computer anxiety negatively affect attitudes toward using microcomputers. Conversely, higher levels of perceived ease of use and perceived usefulness heighten individuals' positive attitudes toward using microcomputers. Perceived ease of use and perceived usefulness also indirectly affect microcomputer attitudes through their effect on computer anxiety. The results show that higher levels of perceived ease of use and perceived usefulness result in lower levels of computer anxiety. A surprising result from the study is that while perceived ease of use is shown to directly affect the level of microcomputer usage, perceived usefulness and attitude toward using microcomputers does not. The results of the multisample analysis confirm that the research model fits the stacked model and that the stacked model is a significantly better fit if specific parameters are allowed to vary between the two human-computer interface user groups. In general, these results confirm that an interaction exists between the type of human-computer interface (the variable providing the grouping) and the other variables in the model The results show a clear difference between the two groups in the way in which perceived ease of use and perceived usefulness affect microcomputer attitude. In the case of users of command-line interfaces, these variables appear to affect microcomputer attitude via an intervening variable, computer anxiety, whereas in the graphical interface user group the effect occurs directly. Related to this, the results show that perceived ease of use and perceived usefulness have a significant direct effect on computer anxiety in command-line interface users, but no effect at all for graphical interface users. Of the two exogenous variables only perceived ease of use, and that in the case of the command-line interface users, has a direct significant effect on extent of use of microcomputers. In summary, the research has contributed to the development of a theory of individual adjustment to information technology in the workplace. It identifies certain perceptions, anxieties and attitudes about microcomputers and shows how they may affect work outcomes such as job satisfaction and job performance. It also shows that microcomputer-interface types have a differential effect on some of the hypothesised relationships represented in the general model. Future replication studies could sample a broader cross-section of the microcomputer user community. Finally, the results should help Big Six accounting firms to maximise the benefits of microcomputer use by making them aware of how working with microcomputers affects job satisfaction and job performance.

Australia and East Timor : elitism, pragmatism and the national interest

For over two decades the issue of East Timor's right to self-determination has been a ‘prickly’ issue in Australian foreign policy. The invasion by Indonesian forces in 1975 was expected, as Australian policy-makers had been well informed of the events leading up to the punitive action being taken. Indeed, prior discussions involving the future of the territory were held between the Australian Prime Minister and the Indonesian President in 1974. In response to the events unfolding in the territory the Australian Labor Government at the time was presented with two policy options for dealing with the issue. The Department of Defence recommended the recognition of an independent East Timor; whereas the Department of Foreign Affairs proposed that Australia disengage itself as far as possible from the issue. The decision had ramifications for future policy considerations especially with changes in government. With the Department of Foreign Affairs option being the prevailing policy what were the essential ingredients that give explanation for the government's choice? It is important to note the existence of the continuity and cyclical nature of attitudes by Labor governments toward Indonesia before and after the invasion. To do so requires an analysis of the influence ‘Doc’ Evatt had in shaping any possible Labor tradition in foreign policy articulation. The support given by Evatt for the decolonisation of the Netherlands East Indies (Indonesia) gave rise to the development of a special relationship-so defined. Evidence of the effect Evatt had on future Labor governments may be found in the opinions of Gough Whitlam. In 1975 when he was Prime Minister, Whitlam felt the East Timor issue was merely the finalisation of Indonesia's decolonisation honouring Evatt's long held anti-colonialist tradition existing in the Australian Labor Party. The early predisposition toward Indonesia's cohesiveness surfaced again in the Hawke and Keating Labor governments of later years. It did not vary a great deal with changes in government The on-going commitment to preserving and strengthening the bilateral relationship meant Indonesia's territorial integrity became the focus of the Australian political elites’ regional foreign policy determinations. The actions taken by policy-makers served to promote the desire for a stable region ahead of independence claims of the East Timorese. From a realist perspective, the security dilemma for Australian policy-makers was how to best promote regional order and stability in the South East Asian region. The desire for regional cohesiveness and stability continues to drive Australian political elites to promote policies that gives a priority to the territorial integrity of regional states. Indonesia, in spite of its diversity, was only ever thought of as a cohesive unitary state and changes to its construct have rarely been countenanced. Australia's political elite justifications for this stance vacillate between strategic and economic considerations, ideological (anti-colonialism) to one of being a pragmatic response to international politics. The political elite argues the projection of power into the region is in Australia’s national interest. The policies from one government to the next necessarily see the national interest as being an apparent fixed feature of foreign policy. The persistent fear of invasion from the north traditionally motivated Australia's political elite to adopt a strategic realist policy that sought to ‘shore up’ the stability, strength and unity of Indonesia. The national interest was deemed to be at risk if support for East Timorese independence was given. The national interest though can involve more than just the security issue, and the political elite when dealing with East Timor assumed that they were acting in the common good. Questions that need to be addressed include determining what is the national interest in this context? What is the effect of a government invoking the national interest in debates over issues in foreign policy? And, who should participate in the debate? In an effort to answer these questions an analysis of how the ex-foreign affairs mandarin Richard Woolcott defines the national interest becomes crucial. Clearly, conflict in East Timor did have implications for the national interest. The invasion of East Timor by Indonesia had the potential to damage the relationship, but equally communist successes in 1975 in Indo-China raised Australia's regional security concerns. During the Cold War, the linking of communism to nationalism was driving the decision-making processes of the Australian policy-makers striving to come to grips with the strategic realities of a changing region. Because of this, did the constraints of world politics dominated by Cold War realities combined with domestic political disruption have anything to do with Australia's response? Certainly, Australia itself was experiencing a constitutional crisis in late 1975. The Senate had blocked supply and the Labor Government did not have the funds to govern. The Governor-General by dismissing the Labor Government finally resolved the impasse. What were the reactions of the two men charged with the responsibility of forming the caretaker government toward Indonesia's military action? And, could the crisis have prevented the Australian government from making a different response to the invasion? Importantly, and in terms of economic security, did the knowledge of oil and gas deposits thought to exist in the Timor Sea influence Australia's foreign policy? The search for oil and gas requires a stable political environment in which to operate. Therefore for exploration to continue in the Timor Sea Australia must have had a preferred political option and thoughts of with whom they preferred to negotiate. What was the extent of each government's cooperation and intervention in the oil and gas industry and could any involvement have influenced the Australian political elites’ attitude toward the prospect of an independent East Timor? Australia's subsequent de jure recognition that East Timor was part of Indonesia paved the way for the Timor Gap (Zone of Cooperation) Treaty signing in 1989. The signing underpinned Australia's acceptance of Indonesian sovereignty over East Timor. The outcome of the analysis of the issues that shaped Australia's foreign policy toward East Timor showed that the political elite became locked into an integration model, which was defended by successive governments. Moreover, they formed an almost reflexive defence of Indonesia both at the domestic and international level.

Do GPs use electronic mental health resources? A qualitative study

BACKGROUND
The Better Outcomes in Mental Health Care (BOMHC) initiative encourages general practitioners to use electronic mental health resources (EMHRs) during consultation with patients requiring psychological assistance. However, there is little data on GPs’ acceptance and use of EMHRs.

METHOD
Semistructured interviews were conducted with 27 GPs to determine their attitude toward EMHRs, and their use during consultation with patients.

RESULTS
Few GPs reported frequently using EMHRs in consultation. Identified barriers to use included lack of familiarity with information technology, and insufficient knowledge of available resources. Identified advantages of electronic resources included high patient acceptance, time efficiency, and improved quality of information.

DISCUSSION
General practitioners recognise several advantages of utilising electronic resources for managing patients with mental illness. However, GPs are not sufficiently familiar with electronic resources to use them effectively. This could be overcome by education.

Frequency of excisions and yields of malignant skin tumors in a population-based screening intervention of 360 288 whole-body examinations

Objective To explore the frequency of excisions and yields of histopathologically confirmed skin cancer.

Design A population-based skin cancer screening intervention (the SCREEN project) in the German state of Schleswig-Holstein (July 1, 2003, to June 30, 2004).

Setting Physician offices. Participants could choose between nondermatologist physicians and dermatologists for their initial whole-body skin examination. All screening physicians received a mandatory 8-hour training course.

Participants Inhabitants of Schleswig-Holstein 20 years or older with statutory health insurance (N = 360 288).

Main Outcome Measures Frequency of excisions and yields of malignant skin tumors (malignant melanomas [MMs], basal cell carcinomas [BCCs], and squamous cell carcinomas [SCCs]), stratified by sex and age.

Results Overall, 15 983 excisions were performed (1 of 23 screenees). A total of 3103 malignant skin tumors were diagnosed in 2911 persons: 585 MMs, 1961 BCCs, 392 SCCs, and 165 other malignant skin tumors. Overall, 116 persons (3103 of 360 288) had to be screened to find 1 malignant tumor, with 1 of 620 for MM, 1 of 184 for BCC, and 1 of 920 for SCC. Twenty excisions were performed to find 1 melanoma in men 65 years and older, but more than 50 excisions were required to find 1 melanoma in men aged between 20 and 49 years.

Conclusions The results of SCREEN suggest a high yield of malignant skin tumors in a large-scale population-based screening project. We found that a high number of excisions was performed in the youngest screenees with an associated low yield, suggesting a need in screener training to emphasize a more conservative attitude toward excisions in young screenees.

Serving in Bosnia made me appreciate living in Bristol: stressful experiences, attitudes, and psychological needs of members of the United Kingdom Armed Forces

Peacekeeping operations form an increasing part of the role of the U.K. Armed Forces. This study identified perceived needs for training before such operations, experiences of stress during deployments, beliefs and attitudes regarding psychological support and debriefing on return, general attitudes toward peacekeeping duties, and positive aspects of the peacekeeping role. Although nearly all peacekeepers were exposed to a variety of experiences, most perceived stress came from professional difficulties and frustrations with the occupational role of being a peacekeeper, rather than from dangerous situations. The exception was a significant fear of land mines. For many, peacekeeping had a positive impact on soldiers' lives, most commonly an appreciation of "things back home." Respondents' opinions about the peacekeeping experience vary greatly. Additional training addressing and exploring potential conflicts between the traditional role of the soldier and the role of the peacekeeper may be useful.

Study protocol: the registrar clinical encounters in training (ReCEnT) study

Background
Patient encounters are the core learning activity of Australian general practice (family practice) training. Exposure to patient demographics and presentations may vary from one general practice registrar (vocational trainee) to another. This can affect comprehensiveness of training. Currently, there is no mechanism to systematically capture the content of GP registrar consultations. The aim of the Registrar Clinical Encounters in Training (ReCEnT) study is to document longitudinally the nature and associations of consultation-based clinical and educational experiences of general practice registrars.
Methods/design
This is an ongoing prospective multi-site cohort study of general practice registrars’ consultations, entailing paper-based recording of consultation data. The study setting is general practices affiliated with three geographically-based Australian general practice regional training providers. Registrars record details of 60 consecutive consultations. Data collected includes registrar demographics, details of the consultation, patient demographics, reasons for encounter and problems managed. Problems managed are coded with the International Classification of Primary Care (second edition) classification system. Additionally, registrars record educational factors related to the encounter. The study will follow the clinical exposure of each registrar six-monthly over the 18 months to two years (full-time equivalent) of their general practice training program.
Conclusions
The study will provide data on a range of factors (patient, registrar and consultation factors). This data will be used to inform a range of educational decisions as well as being used to answer educational research questions. We plan to use ReCEnT as a formative assessment tool for registrars and help identify and address educational needs. The study will facilitate program evaluation by the participating training providers and thus improve articulation of educational programs with practice experience. From the research point of view it will address an evidence gap – the in-practice clinical and educational experience of general practice trainees, determinants of these experiences, and the determinants of registrars’ patterns of practice (for example, prescribing practice) over the course of their training.

Influencing girls' interest in information technology

The lack of skilled labour that can support digital economies is a worldwide problem, exacerbated by the lack of female participation in the Information Technology (IT) industry. Interventions that promote IT study and career opportunities for girls can be a powerful means to counter the ongoing decline in IT interest amongst females. However, the impact of such interventions is rarely being evaluated. This study is, therefore, aimed at gaining insights into the influence on IT career perceptions of one IT intervention event for secondary school girls conducted in Australia in 2014. The analysis of comprehensive survey data (n=781) using the Partial Least Squares and other statistical techniques revealed that a positive attitude toward the analysed event had significant direct and indirect positive impacts on girls' intentions to choose a career in IT. The indirect influence was supported by such mediating factors as girls' self-efficacy towards IT careers and their intentions to learn more about IT, which the event affected directly. In addition to reporting on the results of testing the research model, further insights into girls' opinions and attitudes towards the intervention and IT in general are provided in the paper.

On- and off-campus engineering student usage of a computer conferencing system

This article reports on the introduction of a computer-conferencing component into a first-year study unit in technology management at Deakin University, Australia. It was found that significant variations in computer usage were correlated to student study mode, including source of computer access, source of Internet access, hours-per-week computer usage, regular use of e-mail, regular use of the Internet, number of times the conference was accessed, use of computers for games, and use of computers for learning. Other moderate differences were also noted. Following exposure to the computer conference, on-campus students were more likely to agree that computers could assist their learning, and off-campus students were less likely to agree that learning from computers would be better than classes/lectures.

Euthanasia: why it doesn`t matter (much) what the doctor thinks and why there is no suggestion that doctors should have a duty to kill

A major reason that The Netherlands has taken a different approach to the rest of the world on such a fundamental moral issue is that the courts and legislature in that country have accorded the interests of doctors a cardinal role in the euthanasia debate. This article argues that the interests of doctors are of only incidental and peripheral relevance in relation to the moral status of euthanasia. The moral status of euthanasia has little to do with the
preparedness ofdoctors to administer the lethal injection or their general attitude towards the practice. Euthanasia is principally about the interests of the patient and the impact that the practice may have on the community in general, not preserving the conscience or improving the working life ofdoctors.

Role of peer support and emotional expression on posttraumatic stress disorder in student paramedics

This exploratory study contrasted and tested the predictive value of the reverse buffering hypothesis of social support and the information processing model of posttraumatic stress disorder (PTSD) in an investigation of trauma-related symptomatology (TRS) in a single sample of 42 student paramedics. Participants completed several anonymous self-report measures of PTSD symptomatology, peer social support, and attitude toward emotional expression. Regression-based path analyses did not support either theory of PTSD in this population. A path model of PTSD in student paramedics was subsequently developed, indicating that a direct relationship exists between duty-related trauma exposure, dysfunctional peer social support, and students' negative attitudes toward emotional expression. This new model accounted for 30% of the variance in student paramedics' TRS.

Freud, civilization, religion and stoicism

Freud's debt to stoicism has been seldom discussed. His attitude toward science had a distinct ethical slant taken from the ancient world, via Freud's humanistic education. Freud's method involved detachment but did not imply moral coldness and indifference any more than stoicism did. The stoics wanted to be therapists of the mind just as physicians cared for the body. For both Freud and the stoics, reason was in battle with the passions and required clear sight to have a chance of prevailing over them. In contrasting religious worldviews with the scientific approach, Freud failed to see his own approach as ethical. Freud made extensive forays at individual and collective levels but in the years since Freud's death, the psychoanalytic vision has narrowed. At 150 years after his birth, the authors can still admire Freud's exceptional ethical courage and recognize that if psychoanalysis is to survive, it needs to regain his cultural range and spirit of critical inquiry

The design studio: fabricating a sense of architecture in drawing

The purpose of this paper is to provide a platform for investigating the relationship between the student and the tutor via the design drawing and in particular the idea that what gives grounds for architecture to embody something is what is imagined is expressed in the design drawing. It is suggested that in architectural education the sense of architecture's fabricated properties find their apparent expression from the convergence of the tutor and student toward these drawings. In an act of perceptual contortion, there is an endeavour to reconcile what they see with what they think the drawing might suggest. Part of this mental reconstruction is based on the expectation that something is in the drawing to see. The drawing is produced based on the supposition that it will be read, generating a particular conditioning of the student's attitude toward the relevance of the drawing. It is engaged as the receptacle of ideas about what architecture is. The result is that sometimes the emphasis on the drawing as something to be consumed implies a permeation of the supposed sensory qualities of architecture imagined by the student designer, the portrayal of which is indubitably a product of the medium. While this might be commonly experienced in studios, it is proposed that this may be perpetuated in architectural education not merely by the act of drawing itself and what the drawing is, but how the student/tutor exchange contributes to the consciousness of what is portrayed.