Perceptions of the influence of prescription medicine samples on prescribing by family physicians

Background: The provision of free prescription medicine samples is a common and traditional marketing strategy used by pharmaceutical companies, but concerns have been raised about their influence on physician prescribing behavior and patient safety. Objective: We sought to investigate the knowledge, attitudes, and behaviors of Australian family physicians regarding the use of sample prescription medications. Methods: Qualitative and quantitative techniques were used, including (1) mailed questionnaires to family physicians, (2) semistructured interviews with family physicians, and (3) sample cupboard inventories. Results: A number of issues about samples were identified by the questionnaires (208) and interviews (17 doctors), including insufficient labeling, poor record keeping, diversion of stock (personal use by doctors.. their families, practice staff and pharmaceutical representatives), and wasting of expired stock. Prescription medicine samples also influenced prescribing behavior. Australian doctors were less likely to provide samples to patients on financial grounds compared with a previous study in the United States on medical residents. Six sample cupboards were inventoried. Median wholesale value of sample cupboards was AUD $4959 (range $2395-$8709), with 6% of stock expired. Very little generic medicine was included in the sample cupboards. Conclusions: Better methods are needed to meet legislative requirements and to ensure quality use of medicines (and optimal public health) with respect to prescription medicine samples. Doctors and practice staff require training on the appropriate handling and storage of prescription medications. Alternative ways for distribution of sample medications need to be investigated.

The influence of perceptions of social identity on information technology-enabled change

Growth in the sophistication of information technology (IT) has led to the increasing importance of information accessibility in the workplace. The pervasiveness of the resultant knowledge-based economy has centered attention on issues of employee group identity. In this article we explore how employee perceptions of group membership guide the change outcomes of an organization implementing new information technology. Using a social identity framework, we investigate the salient intergroup relationships of two groups of employees (management and IT implementation teams) and how employees use their different group memberships to reframe positions of authority or knowledge around technology change. We discuss the extent to which perceptions of social identity legitimate institutional structures already in place despite the potential of new technology.

Hurt feelings in couple relationships: Exploring the role of attachment and perceptions of personal injury

This research program focused on perceptions of the appraisals and emotions involved in hurtful events in couple relationships. Study I tested the broad proposition that hurt feelings are elicited by relational transgressions that generally imply relational devaluation and that evoke a sense of personal injury by threatening positive mental models of self and/or others. Participants (N = 224) provided retrospective accounts of an experience of being hurt by a romantic partner. These accounts, together with expert judges' ratings, showed that most hurtful events involved relational transgressions that signal both relational devaluation and threat to positive mental models; however, relational devaluation was relatively unimportant in explaining the hurt associated with partners' distrust. A sense of injury emerged as the dominant theme in open-ended accounts of emotional reactions; however, other negative emotions also featured and were related to the type of event reported. The emotion terms generated in Study I were used as stimuli in a word-sorting task (Study 2). This study confirmed that many of the terms were perceived specifically as injury related, and shed further light on the link between appraisals and emotions. Theoretical and practical implications of the findings are discussed.

Perceptions of self and group in the context of a threatened national identity: A field study

Previous research indicates that people who are highly identified with their groups tend to remain committed to them under threat. This study examines the generalizability, of this effect to (a) a real-life context involving the perception that others view the ingroup (Australians) as intolerant of minorities and (b) various dimensions of social identification. The sample comprised 213 respondents to a random mail survey. Perceived threat was inversely related to self-stereotyping (i.e. perceptions of self-ingroup similarity), but only for individuals with weak subjective ties to other group members. Threat perceptions were also predictive of enhanced judgments of within-group variability on threat-relevant dimensions, particularly for individuals with weaker ingroup ties. Various strategies for coping with a threatened social identity are linked to different facets of social identification.

Perceptions of the intergroup structure and anti-Asian prejudice among white Australians

Subjective intergroup beliefs and authoritarianism were assessed in a field study (N=255) of White Australians' anti-Asian stereotyping and prejudice. A social identity analysis of intergroup prejudice was adopted, such that perceptions of the intergroup structure (instability, permeability, legitimacy and higher ingroup status) were proposed as predictors of higher prejudice (blatant and covert) and less favorable stereotyping. Consistent with the social identity approach, both independent and interacting roles for sociostructural predictors of Anti-Asian bias were observed, even after demographic and personality variables were controlled. For example, perceived legitimacy was associated with higher prejudice when White Australians' status position relative to Asian Australians was valued. Moreover, when participants evaluated Whites' position as unstable and high status or legitimate, perceptions of permeable intergroup boundaries were associated with anti-Asian bias. The present findings demonstrate status protection responses in advantaged group members in a field setting, lending weight to the contention that perceptions of sociostructural threat interact to predict outgroup derogation. Implications for theories of intergroup relations are discussed.

A Test of Performance of Breast MRI Interpretation in a Multicentre Screening Study

Objectives: The aim of this study was to assess the consistency and performance of radiologists interpreting breast magnetic resonance imaging (MRI) examinations. Materials and Methods: Two test sets of eight cases comprising cancers, benign disease, technical problems and parenchymal enhancement were prepared from two manufacturers' equipment (X and Y) and reported by 15 radiologists using the recording form and scoring system of the UK MRI breast screening study [(MAgnetic Resonance Imaging in Breast Screening (MARIBS)]. Variations in assessments of morphology, kinetic scores and diagnosis were measured by assessing intraobserver and interobserver variability and agreement. The sensitivity and specificity of reporting performances was determined using receiver operating characteristic (ROC) curve analysis. Results: Intraobserver variation was seen in 13 (27.7%) of 47 of the radiologists' conclusions (four technical and seven pathological differences). Substantial interobserver variation was observed in the scores recorded for morphology, pattern of enhancement, quantification of enhancement and washout pattern. The overall sensitivity of breast MRI was high [88.6%, 95% confidence interval (CI) 77.4-94.7%], combined with a specificity of 69.2% (95% CI 60.5-76.7%). The sensitivities were similar for the two test sets (P=.3), but the specificity was significantly higher for the Manufacturer X dataset (P

Aggressive behaviour in the high-secure forensic setting: the perceptions of patients

Twenty-seven patients undergoing treatment in a high-secure forensic facility participated in focus group interviews to elicit their perceptions of (1) the factors leading to aggressive behaviour; and (2) strategies to reduce the risk of such behaviour. The focus group interviews were audiotaped, transcribed and analysed using content analysis. The participants identified that a combination of patient, staff and environmental factors contributed to violence in the study wards. The cause of aggressive behaviour centred around five major themes: the environment; empty days; staff interactions; medication issues; and patient-centred factors. Potential strategies identified by patients to reduce aggressive behaviour included: early intervention; the provision of meaningful activities to reduce boredom; separation of acutely disturbed patients; improved staff attitudes; implementation of effective justice procedures; and a patient advocate to mediate during times of conflict. Findings suggested that social and organizational factors need to be addressed to change the punitive subculture inherent in forensic psychiatric facilities, and to ensure a balance between security and effective therapy.

Delivering culturally sensitive care: The perceptions of older Arabian Gulf Arabs concerning religion, health, and disease

Health professionals need to be cognizant of the varying perceptions of health shared by people from different religious, sociocultural, and linguistic backgrounds to deliver culturally sensitive health care. In this qualitative study, the authors used semistructured interviews to provide insight into how 10 older Arabian Gulf Muslim persons understand and perceive health and illness with emphasis on the role of Islam in formulating health behaviors. Participants' views were strongly influenced by their religious convictions. Good health was equated with the absence of visible disease, with participants demonstrating limited understanding of silent or insidious disease. They attended doctors for treatment of visible disease rather than seeking preventive health care for diseases such as hypertension, diabetes, and hyperlipidemia. Building oil the results from this study could help inform both health service planners and providers to improve the appropriateness, relevancy, and effectiveness of aged care services for these individuals.

Evaluation of performance reference compounds in polyethylene-based passive air samplers

Polyethylene-based passive air samplers (PSDs) were loaded with performance reference compounds (PRCs) and deployed in a wind tunnel to examine the effects of wind speed on sampler performance. PRCs could be loaded reproducibly into PSDs, with coefficients of variation only exceeding 20% for the more volatile compounds. When PSDs were exposed to low (0.5-1.5 m s(-1)) and high (3.5-4.5 m s(-1)) wind speeds, PRC loss rate constants generally increased with increasing wind speed and decreased with increasing sampler/air partition coefficients. PSD-based air concentrations calculated using PRC loss rate constants and sampler/air partition coefficients and air concentrations measured using active samplers compared closely. PRCs can be used to account for the effect of differences in wind speeds on sampler performance and measure air concentrations with reasonable accuracy. (c) 2006 Elsevier Ltd. All rights reserved.

From partying to parenthood: young women's perceptions of cigarette smoking across life transitions

This study explored influences on adoption, maintenance and cessation of smoking among young women as they experienced life transitions: leaving home, gaining employment or attending college/university, marriage and parenthood. Standardized, open-ended telephone interviews were conducted with 80 women (including never smokers, continuing smokers, recent adopters and quitters) aged 24-29 years, recruited from participants in the Australian Longitudinal Study on Women's Health. The social context of smoking (socializing with other smokers, drinking alcohol and going to pubs and clubs) was perceived to be a predominant influence on smoking from the time young women left home until they settled into a committed relationship or started their own family. Stress was identified as an important factor as they experienced lifestyle changes. An increased sensitivity to the negative aspects of smoking after turning 21 was reported, and around the mid-20s the women became concerned about the addictive nature of cigarettes. Motherhood was seen to carry increased responsibilities to protect children from passive smoking and there was a perceived importance of positive role modelling to protect children from becoming smokers themselves. This study highlights the need for public health campaigns to address the social role that smoking plays in young women's lives, and the perceived use of cigarettes for stress relief. Life changes such as settling down with a partner and the contemplation of motherhood provide opportunities for targeted interventions to promote quitting.

Promoting Learning for Sustainability: Principals' Perceptions of the Role of Outdoor and Environmental Education Centres

Outdoor and Environmental Education Centres provide programs that are designed to address a range of environmental education aims, and contribute broadly to student learning for sustainability. This paper examines the roles such Centres can play, and how they might contribute to the Australian Government’s initiative in relation to sustainable schools. Interviews with the principals of 23 such Centres in Queensland revealed three roles or models under which they operate: the destination model; the expert/advisor model; and the partnership model. Principals’ understandings of these roles are discussed and the factors that support or hinder their implementation are identified. It is concluded that while the provision of programs in the environment is still a vital role of outdoor and environmental education centres, these can also be seen as a point of entry to long-term partnerships with whole school communities.

Exploring Visitors' Perceptions of Art Gallery Festivals

The contemporary directions of art galleries worldwide are changing as social patterns and demands, and visitor expectations of their experiences at art galleries change. New programs and strategies are being developed in galleries to make these institutions more appealing to people who would not normally visit them. One such strategy is the staging of special events, which in galleries take a variety of forms. As special events are increasingly being employed by galleries to inspire new audiences, it is important that these institutions develop an awareness of how their visitors understand and respond to such events. Festivals are one type of special event that visitors identify as having a distinct role and nature. This paper explores visitors’ perceptions of festivals in art galleries and identifies several characteristics that distinguish festivals from other special events. These characteristics include the focus of the event, the audience attending, the degree of interactivity offered, the timing, and the place at which the event is staged. Understanding visitors’ perceptions and expectations of festivals will enable galleries to develop and further enhance their programs and special events to meet visitors’ needs.