Motivations and perceived influences on rural and urban general practitioners when prescribing conventional non-steroidal anti-inflammatory drugs or COX-2 inhibitors

Background and objective: Prescribers in rural and remote locations perceive that there are different influences on their prescribing compared with those experienced by urban prescribers. The aim of this study was to compare the motivations and perceived influences on general practitioners (GPs) when prescribing COX-2 inhibitors rather than conventional non-steroidal anti-inflammatory drugs (NSAIDs) between rural and urban-based GPs in Queensland, Australia. Methods: A questionnaire was administered to two geographically distinct groups of GPs, one urban (n = 67) and one rural (n = 67), investigating the reasons that the GP would prescribe a COX-2 inhibitor rather than a conventional NSAID or vice versa and also focusing on patients requesting a prescription for a COX-2 inhibitor. Results and discussion: A 51% response rate (n = 68) was achieved. The difference between the rural and the urban GPs was that the urban GPs were more likely to perceive that they were influenced to prescribe COX-2 inhibitors by their patients' knowledge of these new (at the time) drugs. GPs in both the rural and urban areas perceived the COX-2 selective inhibitors to be safer than conventional NSAIDs, and that there was little difference in terms of efficacy between the two drug classes. However, GPs from both of the study areas stated that conventional NSAIDs were preferred over COX-2 selective inhibitors, primarily due to their expense, if their patients were not at risk for developing a GI bleed. Conclusion: The motivations and perceived influences to prescribe a COX-2 inhibitor in rural and in urban areas of Queensland, Australia were very similar. Almost all surveyed GPs in rural and urban areas had patients request a prescription, or enquire about the COX-2 inhibitors. Urban GPs were more likely to feel pressured to prescribe a COX-2 inhibitor than their rural counterparts, agreeing with other research which found that patient pressure to prescribe appears to be greater in urban general practice.

Relations between social support, appraisal and coping and both positive and negative outcomes for children of a parent with multiple sclerosis and comparisons with children of healthy parents

Objective: To examine adjustment in children of a parent with multiple sclerosis within a stress and coping framework and compare them with those who have 'healthy' parents. Subjects: A total of 193 participants between 10 and 25 years completed questionnaires; 48 youngsters who had a parent with multiple sclerosis and 145 youngsters who reported that they did not have a parent with an illness or disability. Method: A questionnaire survey methodology was used. Variable sets included caregiving context (e.g. additional parental illness, family responsibilities, parental functional impairment, choice in helping), social support (network size, satisfaction), stress appraisal, coping (problem solving, seeking support, acceptance, wishful thinking, denial), and positive (life satisfaction, positive affect, benefits) and negative (distress, health) adjustment outcomes. Results: Caregiving context variables significantly correlated with poorer adjustment in children of a parent with multiple sclerosis included additional parental illness, higher family responsibilities, parental functional impairment and unpredictability of the parent's multiple sclerosis, and less choice in helping. As predicted, better adjustment in children of a parent with multiple sclerosis was related to higher levels of social support, lower stress appraisals, greater reliance on approach coping strategies (problem solving, seeking support and acceptance) and less reliance on avoidant coping (wishful thinking and denial). Compared with children of 'healthy' parents, children of a parent with multiple sclerosis reported greater family responsibilities, less reliance on problem solving and seeking social support coping, higher somatization and lower life satisfaction and positive affect. Conclusions: Findings delineate the key impacts of young caregiving and support a stress and coping model of adjustment in children of a parent with multiple sclerosis.

Social capital society and peace: Reflections on conflict transformation in the Philippines

Civil society is recognised as comprising complex and multifaceted entities, resilient to and yet responsive to both the state apparatus and global market processes. Civil society in the Philippines, long regarded as one of the most vibrant, diverse and innovative in Asia, has emerged as a significant actor in the field of conflict resolution and peace-building. In thinking about the work of peace, this paper engages with the effectiveness of civil society in mobilising societal awareness for a ‘just and lasting peace’ in the southern Philippines. Shaped by development paradigms that privilege concepts such as social capital, the paper aims to interrogate how such concepts situated within the development–security nexus proposed by the Philippine government and funding agencies have influenced conflict-transformation initiatives in Mindanao, Philippines.

Autochthonous heritage languages and social media:writing and bilingual practices in Low German on Facebook

This article analyses how speakers of an autochthonous heritage language (AHL) make use of digital media, through the example of Low German, a regional language used by a decreasing number of speakers mainly in northern Germany. The focus of the analysis is on Web 2.0 and its interactive potential for individual speakers. The study therefore examines linguistic practices on the social network site Facebook, with special emphasis on language choice, bilingual practices and writing in the autochthonous heritage language. The findings suggest that social network sites such as Facebook have the potential to provide new mediatized spaces for speakers of an AHL that can instigate sociolinguistic change.

Social network theory and the sales manager role:engineering the right relationship flows

Sales leadership research has typically taken a leader-focused approach, investigating key questions from a top-down perspective. Yet considerable research outside sales has advocated a view of leadership that takes into account the fact that employees look beyond a single designated individual for leadership. In particular, the social networks of leaders have been a popular topic of investigation in the management literature, although coverage in the sales literature remains rare. The present paper conceptualizes the sales leadership role as one in which the leader must manage a network of simultaneous relationships; several types of sales manager relationships, such as the sales-manager-to-top-manager and the sales-manager-to-sales manager relationships, have received limited attention in the sales literature to date. Taking an approach based on social network theory, we develop a conceptualization of the sales manager as a "network engineer," who must manage multiple relationships, and the flows between them. Drawing from this model, we propose a detailed agenda for future sales research. © 2012 PSE National Educational Foundation. All rights reserved.