Variations in chemoprophylaxis for meningococcal disease: a retrospective case note review, analysis of routine prescribing data and questionnaire of general practitioners

BACKGROUND: Invasive meningococcal disease is a significant cause of mortality and morbidity in the UK. Administration of chemoprophylaxis to close contacts reduces the risk of a secondary case. However, unnecessary chemoprophylaxis may be associated with adverse reactions, increased antibiotic resistance and removal of organisms, such as Neisseria lactamica, which help to protect against meningococcal disease. Limited evidence exists to suggest that overuse of chemoprophylaxis may occur. This study aimed to evaluate prescribing of chemoprophylaxis for contacts of meningococcal disease by general practitioners and hospital staff. METHODS: Retrospective case note review of cases of meningococcal disease was conducted in one health district from 1st September 1997 to 31st August 1999. Routine hospital and general practitioner prescribing data was searched for chemoprophylactic prescriptions of rifampicin and ciprofloxacin. A questionnaire of general practitioners was undertaken to obtain more detailed information. RESULTS: Prescribing by hospital doctors was in line with recommendations by the Consultant for Communicable Disease Control. General practitioners prescribed 118% more chemoprophylaxis than was recommended. Size of practice and training status did not affect the level of additional prescribing, but there were significant differences by geographical area. The highest levels of prescribing occurred in areas with high disease rates and associated publicity. However, some true close contacts did not appear to receive prophylaxis. CONCLUSIONS: Receipt of chemoprophylaxis is affected by a series of patient, doctor and community interactions. High publicity appears to increase demand for prophylaxis. Some true contacts do not receive appropriate chemoprophylaxis and are left at an unnecessarily increased risk

How does employer support and educational background effect an Ergonomics Practitioner’s awareness of the relationship between ergonomics and psychosocial hazard control?

There is a growning need to address psychological health and safety in the workplace. Ergonomics tends to be widely recognized for its physical applications, such as ¨office¨ and ¨manual materials handling¨ however the other domains of specialization of ergonomics (cognitive and organizational) appear to be less well known. This study evaluates the level of understanding that professionals who practice ergonomics have of the relation between ergonomics and the control of psychosocial hazards in the workplace. A survey was distributed to ergonomics practitioners and asked them about their awareness of the relation between ergonomics and workplace psychosocial hazard control. Ergonomists and human factors specialists demonstrated a greater awareness of this relationship than other allied occupational groups that also practice ergonomics, however they indicated that there may be difficulties in the “real world” applying these areas of knowledge into practice. Participants who demonstrated a high level of awareness of the relation between ergonomics and psychosocial hazard control demonstrated stronger organizational commitment than participants with a low awareness. Ergonomics practitioners who reported having employer support for professional development also demonstrated a higher degree of awareness of the relation between ergonomics and psychosocial hazard control, as did the professionals who had been practicing in the field the longest. This research provides some insight for professional associations for Ergonomists, employers of Ergonomists, and human resource professionals about how ergonomics practitioners perceive the ergonomics field and the profession as well as their employing organization.

Mistranslations of Film Titles: Between Fidelity and Advertising

In the paper, the authors present and analyse examples of mistranslated film titles into the Polish language, selected from a database of over 1,100 titles and presented on the sample of the film genre comedy with all its subgenres. The authors discuss various film title translation strategies and procedures with reference to the literature on the subject. In the conclusions, the authors attempt to explain the reasons for the selection of certain translation procedures, with special focus on the free formulation of titles as the least transparent.

Place, policy and practitioners: on rehabilitation, independence and the therapeutic landscape in the changing geography of care provision to older people in the United Kingdom

A growing body of literature in geography and other social sciences considers the role of place in the provision of healthcare. Authors have focused on various aspects of place and care, with particular interests emerging around the role of the psychological, social and cultural aspects of place in care provision. As healthcare stretches increasingly beyond the traditional four walls of the hospital, so questions of the role of place in practices of care become ever more pertinent. In this paper, we examine the relationship between place and practice in the care and rehabilitation of older people across a range of settings, using qualitative material obtained from interviews and focus groups with nursing, care and rehabilitation staff working in hospitals, clients’ homes and other sites. By analysing their testimony on the characteristics of different settings, the aspects of place which facilitate or inhibit rehabilitation and the ways in which place mediates and is mediated by social interaction, we consider how various dimensions of place relate to the power-inscribed relationships between service users, informal carers and professionals as they negotiate the goals of the rehabilitation process. We seek to demonstrate how the physical, psychological and social meanings of place and the social processes engendered by the rehabilitation encounter interact to produce landscapes that are more or less therapeutic, considering in particular the structuring role of state policy and formal healthcare provision in this dynamic.

A Letter of Consequence: Referral Letters from General Practitioners to Secondary Mental Health Services

The referral letter is a key instrument in moving patients from primary to secondary care services. Consequently, the circumstances in which a referral should be made and its contents have been the subject of clinical guidelines. This article is based on a project that demonstrated that physicians do not adhere to clinical guidelines when referring patients to secondary mental health services. This research supports earlier findings into noncompliance with guidelines by general practitioners (GPs). The authors briefly note possible reasons, which have been the subject of some debate. They also present a content analysis of referral letters to demonstrate the important ways in which they differ from guideline criteria. However, their central argument is that the role of the referral letter in relation to the GP’s repertoire of treatments has not been understood fully. Such understanding implies the need for a reexamination of the support available for GPs.

Job satisfaction among Australian general practitioners and specialists

OBJECTIVE:
To identify patterns of job satisfaction among Australian doctors using latent class analysis, and to determine the relationships of these patterns to personal and professional characteristics so as to improve satisfaction and minimize medical wastage.
METHODS:
MABEL (Medicine in Australia: Balancing Employment and Life) data in 2011 were used. The study collected information on 5764 doctors about their job satisfaction, demographic characteristics, their health, country of medical training, opportunities for professional development and social interaction, taking time off work, views of patients' expectations, unpredictable working hours, hours worked per week, preference to reduce hours and intention to leave the medical workforce.
RESULTS:
Four latent classes of job satisfaction were identified: 5.8% had high job satisfaction; 19.4% had low satisfaction with working hours; 16.1% had high satisfaction with working hours but felt undervalued; and 6.5% had low job satisfaction. Low job satisfaction was associated with reporting poor health, having trained outside Australia, having poor opportunities for professional development and working longer hours. Low satisfaction was associated with a preference to reduce work hours and an intention to leave the medical workforce.
CONCLUSION:
To improve job satisfaction and minimize medical wastage, policies need to address needs of overseas trained doctors, provide continuing professional development and provide good health care for doctors.

The non-advertising effects of screen-based sedentary activities on acute eating behaviours in children, adolescents, and young adults. A systematic review.

Sedentary screen time may be an important determinant of childhood obesity. A number of potential mechanisms to explain the link between screen time and increased bodyweight have been proposed; however, the relationship appears to be best explained by the effects on dietary intake, which is attributed to either food advertising or effects independent of food advertising. Technological advances have allowed for greater accessibility and exposure to advertisement-free screen-based media. This review was conducted to systematically synthesise the evidence from laboratory based studies which have investigated the non-advertising effects of screen time (TV viewing, sedentary video games, and computer use) on dietary intake in children, adolescents, and young adults. MEDLINE, PubMed, PsychInfo, CINAHL, and Embase were searched from inception through 5 July 2013. Ten trials met the inclusion criteria and were included in the review. Risk of study bias was judged to range from low to high. Screen time in the absence of food advertising was consistently found to be associated with increased dietary intake compared with non-screen behaviours. Suggested explanations for this relationship included: distraction, interruption of physiologic food regulation, screen time as a conditioned cue to eat, disruption of memory formation, and the effects of the stress-induced reward system. Due to the limited number of high-quality studies available for this review, our findings are preliminary. More work is required to better establish the link between dietary intake and advertisement-free screen time and assess whether differences exist between the different screen-based activities.

Alcohol advertising in sport and non-sport TV in Australia, during children's viewing times

Estimate the amount of alcohol advertising in sport vs. non-sport programming in Australian free-to-air TV and identify children's viewing audience composition at different times of the day. Alcohol advertising and TV viewing audience data were purchased for free-to-air sport and non-sport TV in Australia for 2012. We counted alcohol advertisements in sport and non-sport TV in daytime (6 am-8.29 pm) and evening periods (8.30 pm-11.59 pm) and estimated viewing audiences for children and young adults (0-4 years, 5-13 years, 14-17 years, 18-29 years). During the daytime, most of the alcohol advertising (87%) was on sport TV. In the evening, most alcohol advertising (86%) was in non-sport TV. There was little difference in the mean number of children (0-17 years) viewing TV in the evening (N = 273,989), compared with the daytime (N = 235,233). In programs containing alcohol advertising, sport TV had a greater mean number of alcohol adverts per hour (mean 1.74, SD = 1.1) than non-sport TV (mean 1.35, SD = .94). Alcohol advertising during the daytime, when large numbers of children are watching TV, is predominantly in free-to-air sport TV. By permitting day-time advertising in sport programs and in any programs from 8.30 pm when many children are still watching TV, current regulations are not protecting children from exposure to alcohol advertising.

A prescription for resistance: management of Staphylococcal skin abscesses by general practitioners in Australia

Objectives: We investigated the management of staphylococcal abscesses (boils) by general practitioners (GPs) in the context of rising antibiotic resistance in community strains of Staphylococcus aureus.
Design, Setting, Participants: We analyzed patient-reported management of 66 cases of uncomplicated skin abscesses from the frequency matched methicillinresistant S. aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) Community- Onset Staphylococcus aureus Household Cohort (COSAHC) study (Melbourne, Australia, 2008–2012). Susceptibilities in all cases were known: 50/66 abscesses were caused by MRSA. In order to investigate GP-reported management of staphylococcal abscesses, we surveyed a random subset of GPs, from the COSAHC study (41), and of GPs (39) who used the same community-based pathology service (December 2011– May 2012). Main outcome measures: Patient outcomes, antibiotics prescribed, antibiotic resistance profiles of infecting strains, rates of incision and drainage (I&D), and attitudes to ordering microbiological cultures.
Results: MRSA was three times more likely to be cultured from an abscess than MSSA. Patient-reported management revealed 100% were prescribed antibiotics and only 60.6% had I&D. Of those 85% who remembered their prescription(s), 81% of MRSA cases and 23% of MSSA cases initially received inactive antibiotics. Repeat GP visits where antibiotics were changed occurred in 45 MRSA and 7 MSSA cases, although at least 33% of subsequent prescriptions were inactive for the MRSA infections. Patients treated with I&D and antibiotics did no better than those treated with only I&D, regardless of the antibiotic activity. In the GP surveys, 89% reported I&D, with or without antibiotics, to be their preferred management. Only 29.9% of GPs would routinely swab abscesses.

How has alcohol advertising in traditional and online media in Australia changed? Trends in advertising expenditure 1997-2011

Introduction and Aims The aim of this study was to determine changes in advertising expenditures across eight media channels for the four main alcohol beverage types and alcohol retailers in Australia. Design and Methods Yearly advertising expenditures between January 1997 and December 2011 obtained from a leading media-monitoring company. Media channels assessed were: free-to-air television, newspapers, magazines, radio, outdoors (billboards), cinema, direct mail (from 2005) and online (from 2008). Data were categorised into alcohol retailers (e.g. supermarkets, off-licences) or four alcoholic beverage types (beer, wine, spirits, premixed spirits/cider). Regression analyses examined associations between year and expenditure. Results Total alcohol advertising expenditure peaked in 2007, then declined to 2011 (P = 0.02). Television advertising expenditure declined between 2000 and 2011 (P < 0.001), while outdoor advertising expenditure increased between 1997 and 2007. Alcohol retailers' advertising expenditure increased over time (P < 0.001), and from the mid-2000s exceeded expenditure for any single beverage category. For both beer and spirits, television advertising expenditure declined over time (beer: P < 0.001; spirits: P < 0.001) while outdoor advertising expenditure increased (beer: P < 0.001; spirits: P = 0.02). However, the number of advertised beer (P < 0.001), spirits (P < 0.001) and wine (P = 0.01) products increased over time. Discussion and Conclusions Retailers are playing an increasing role in advertising alcohol. As our study excluded non-traditional advertising media (e.g. sponsorships, in-store) we cannot determine whether declines in television advertising have been offset by increases in advertising in newer media channels. However, our findings that media channels used for alcohol advertising have changed over time highlights the need for adequate controls on alcohol advertising in all media channels.

Creating symbolic cultures of consumption: an analysis of the content of sports wagering advertisements in Australia

BACKGROUND: Since 2008, Australia has seen the rapid emergence of marketing for online and mobile sports wagering. Previous research from other areas of public health, such as tobacco and alcohol, has identified the range of appeal strategies these industries used to align their products with culturally valued symbols. However, there is very limited research that has investigated the tactics the sports wagering industry uses within marketing to influence the consumption of its products and services.

METHOD: This study consisted of a mixed method interpretive content analysis of 85 sports wagering advertisements from 11 Australian and multinational wagering companies. Advertisements were identified via internet searches and industry websites. A coding framework was applied to investigate the extent and nature of symbolic appeal strategies within advertisements.

RESULTS: Ten major appeal strategies emerged from this analysis. These included sports fan rituals and behaviours; mateship; gender stereotypes; winning; social status; adventure, thrill and risk; happiness; sexualised imagery; power and control; and patriotism. Symbols relating to sports fan rituals and behaviours, and mateship, were the most common strategies used within the advertisements.

DISCUSSION/CONCLUSIONS: This research suggests that the appeal strategies used by the sports wagering industry are similar to those strategies adopted by other unhealthy commodity industries. With respect to gambling, analysis revealed that strategies are clearly targeted to young male sports fans. Researchers and public health practitioners should seek to better understand the impact of marketing on the normalisation of sports wagering for this audience segment, and implement strategies to prevent gambling harm.

Progettazione e Implementazione di una piattaforma di Geofencing per il Context-Aware Advertising

La diffusione di smartphone e dispostivi mobili a cui si è assistito nell’ultima decade ha portato con sé lo sviluppo di nuovi sistemi e tecnologie basate sulla localizzazione. Questi sistemi vengono chiamati Location Based Systems (LBS) ed il loro successo è stato reso possibile dai sensori come GPS, antenna WiFi e accelerometro che hanno permesso agli sviluppatori di creare contenuti e servizi basati sulla posizione dell’utente. Una delle tecnologie su cui si basano i LBS è chiamata Geofencing e consiste nella creazione di aree virtuali (dette geofence) per delimitare luoghi di interesse (Point of Interests) e notificare l’utente quando entra, esce o si trova nelle vicinanze di una delle aree delimitate. Questa caratteristica viene utilizzata soprattutto per realizzare applicazioni che ricordano all’utente di svolgere delle azioni, per esempio un’app di promemoria che ricorda all’utente di comprare il latte quando si trova vicino ad un supermercato. Dal punto di vista economico, uno degli utilizzi piu` promettenti `e il co- siddetto Context Aware Advertising: i possessori di dispositivi mobili che si trovano a camminare nelle vicinanze di un negozio o un centro commer- ciale possono essere considerati possibili clienti e ricevere delle notifiche con pubblicit`a o questionari. Nel seguente lavoro verrà analizzato nel dettaglio cos’è il Geofencing, le sue applicazioni e le tecnologie sulla quale si basa. Verranno presi in considerazione alcuni problemi relativi all’utilizzo delle tecnologie di posizionamento, con particolare attenzione ai consumi di batteria. Verrà inoltre descritta la progettazione e l’implementazione di una piattaforma che permette ai possessori di attività commerciali di creare e gestire dei POI nonché di monitorare gli spostamenti dei possibili clienti. Dopo aver installato l’applicazione mobile sul proprio smartphone, i clienti potranno ricevere notifiche una volta oltrepassati i confini di un geofence.

Akzeptanz und Wahrnehmung von In-Game-Advertising

Das Ziel der vorliegenden Bachelorarbeit ist es zu überprüfen in wie weit Werbung und Videospiele miteinander vereinbar sind und ob Wahrnehmung und Akzeptanz im Zusammenhang stehen (in Bezug auf In-Game-Advertising). Zunächst erfolgt eine Recherche der theoretischen Grundlagen über In-Game-Advertising. Hierbei werden als erstes Begriffe und Rahmenbedingungen definiert und erklärt. Weiter wird die Geschichte der Videospielindustrie erläutert. Anschließend wird das aktuelle Nutzungsverhalten von Videospielen behandelt und die Zielgruppe analysiert. Danach erfolgt eine Analyse des Marktes. Dabei werden Daten verwendet, welche sich auf die Vergangenheit und Gegenwart beziehen. Eine kurze Prognose ist auch enthalten. Das Potenzial in der Videospielbranche wird kurz geklärt. Die Begrifflichkeiten Wahrnehmung und Akzeptanz werden im Anschluss erläutert. Bevor am Ende die Kernhypothese überprüft werden kann, wird In-Game-Advertising anhand von zwei Videospielen beschrieben. Diese bilden die Grundlage für die empirische Analyse. Der letzte Teil beschäftigt sich mit dieser empirischen Analyse. Anhand der Antworten eines Onlinefragebogens werden die Hypothesen, welche sich unter anderen aus der Recherche ergeben haben, erörtert. Dabei stellte sich heraus, dass Wahrnehmung und Akzeptanz im Zusammenhang stehen, aber nicht so stark wie angenommen. In-Game-Advertising hat eine Zukunft, wenn bestimmte Rahmenbedingungen im Vorfeld der Implementierung beachtet und eingehalten werden. Am Ende der Arbeit erfolgt ein Fazit, in dem die Arbeit kurz zusammengefasst wird, mit einer kurzen Prognose in Sachen In-Game-Advertising.