Pharmaceutical company influences on medication prescribing and their potential impact on quality use of medicines

Background Pharmaceuticals are big business, reporting strong market growth year after year. The ‘gatekeepers’ of this market are prescribers of medicines, who are the major target of pharmaceutical companies, utilizing direct and indirect influences. Methods This paper draws on previous research investigating pharmaceutical company prescribing influences to develop a qualitative model demonstrating the synergism between commercial influences on prescribing. The generic model was used to explore a realistic but hypothetical scenario to ascertain the applicability of the model. Results and Discussion A generic influence model was developed. The model was readily able to be adapted to reflect a realistic practice scenario. Conclusion Prescriber awareness of the linkages between various seemingly separate marketing techniques could potentially improve medicines usage in an evidence-based practice paradigm.

Self-efficacy moderation and mediation roles on BPSD and social support influences on subjective caregiver burden in Chinese spouse caregivers of dementia patients

Background: This study aims to explore moderation and mediation roles of caregiver self-efficacy between subjective caregiver burden and (a) behavioral and psychological symptoms (BPSD) of dementia; and (b) social support. Methods: A cross-sectional study with 137 spouse caregivers of dementia patients was conducted in Shanghai. We collected demographic information for the caregiver–patient dyads, as well as information associated with dementia-related impairments, caregiver social support, caregiver self-efficacy, and SF-36. Results: Multiple regression analysis showed that caregiver self-efficacy was a moderator both between BPSD and subjective caregiver burden, and social support and subjective caregiver burden. Results also showed a partial mediation effect of caregiver self-efficacy on the impact of BPSD on subjective caregiver burden, and a mediation effect of social support on subjective caregiver burden. Caregiver self-efficacy and subjective burden significantly influenced BPSD and social support. Conclusion: Caregiver self-efficacy played an important role in the paths by which the two factors influenced subjective burden. Enhancing caregiver self-efficacy for symptom management (particularly BPSD) can be an essential strategy for determining interventions to support dementia caregivers in China, and possibly in other countries.

Chinese TEFL teachers’ perceptions about research and influences on their research endeavours

English has always occupied a key position in China’s education. The quality of English education depends largely on the quality of the English teaching force. Improving the overall quality of Teaching English as a Foreign Language (TEFL) teachers entails advancing both their teaching and research competence. This study, with its focus on Chinese TEFL teachers working in a higher education institution, was set up in a context where Chinese higher education colleges are being transformed into universities and research is becoming a crucial aspect of all teachers’ work. This small-scale case study investigated a group of Chinese TEFL teachers’ perceptions about research and their individual and workplace characteristics that influenced their research endeavours. The findings revealed that Chinese TEFL teachers recognised the significance of research for teaching, professional growth and career advancement. However, lack of individual characteristics such as research and disciplinary knowledge, confidence in research and intrinsic motivation impeded their research efforts. Their institution and departments seemed to encourage research; yet, more specific financial and academic support to start and sustain their research endeavours is required. This study’s findings provide implications for both individual teachers and their institutions to engage TEFL teachers more actively in research.

Influences of luminance and accommodation stimuli on pupil size and pupil center location

PURPOSE. To investigate effects of luminance and accommodation stimuli on pupil size and pupil center location and their implications for progressive addition lens wear. METHODS. Participants were young and older adult groups (n=20, 22±2 years, age range 18-25 years; n=19, 49±4 years, 45-58 years). A wave aberrometer included a relay system to allow a 12.5°x11° background for the internal fixation target. Participants viewed the target under a matrix of conditions with luminance levels 0.01, 3.7, 120 and 6100 cd/m² and with accommodation stimuli up to 6 diopters in 2 diopter steps. Pupil sizes and their centers, relative to limbus centers, were determined from anterior eye images. RESULTS. With luminance increase, reduction in pupil size was accentuated by increase in accommodation stimulus in the young, but not in the older, group. As luminance increased, pupil center location altered. This was nasally in both groups with an average shift of approximately 0.12mm. Relative to the lowest stimulus condition, the mean of the maximum absolute pupil center shifts was 0.26±0.08mm for both groups with individual shifts up to 0.5mm, findings consistent with previous studies. There was no significant effect of accommodation on pupil center locations for either age group, or evidence that location was influenced by the combination of luminance and accommodation stimulus that resulted in any particular pupil size. CONCLUSIONS. Variations in luminance and accommodation influence pupil size, but only the former affects pupil center location significantly. Pupil center shifts are too small to be of concern in fitting progressive addition lenses.

Influences of molecular structure on co-crystallization of polypyridyl metal complexes.

Heteroleptic complexes of the type \[RuL2L′](PF6)2 (L, L′ = combinations of 1,10-phenanthroline (phen) and 2,2′-bipyridine (bipy)) were found to cocrystallize with \[Ni(phen)3](PF6)2 to produce cocrystals of \[Ni(phen)3]x\[RuL2L′]1–x(PF6)2. In this report we show that the ability of the complexes to cocrystallize is influenced by the number of common ligands between complexes in solution. Supramolecular selection is a phenomenon caused by molecular recognition through which cocrystals can grow from the same solution but contain different ratios of the molecular components. It was found that systems where L = phen displayed less supramolecular selection than systems where L = bipy. With increasing supramolecular selection, the composition of cocrystals was found to vary significantly from the initial relative concentration in the cocrystallizing solution, and therefore it was increasingly difficult to control the final composition of the resultant cocrystals. Consequently, modulation of concentration-dependent properties such as phase was also found to be less predictable with increasing supramolecular selection. Notwithstanding the complication afforded by the presence of supramolecular selection, our results reaffirm the robustness of the \[M(phen)3](PF6)2 structure because it was maintained even when ca. 90% of the complexes in the cocrystals were \[Ru(phen)(bipy)2](PF6)2, which in its pure form is not isomorphous with \[M(phen)3](PF6)2. Experiments between complexes without common ligands, i.e., \[Ru(bipy)3](PF6)2 cocrystallized with \[Ni(phen)3](PF6)2, were found to approach the limit to which molecular recognition processes can be confused into cocrystallizing different molecules to form single cocrystals. For these systems the result was the formation of block-shaped crystals skewered by a needle-shaped crystals.

Key influences on cycling for transport

Over recent years, the health, transport and environment sectors have been increasingly focused on the promotion of transport cycling. From a health perspective, transport cycling is recognised as a beneficial form of physical activity as it can be easily integrated into daily living, is done at an intensity that confers health benefits, and is associated with reductions in mortality and morbidity [1]. From a safety perspective, the risk of a serious cycling injury decreases as cycling increases [2] as having more cyclists on roads increases motor vehicle drivers’ awareness of cyclists and in turn makes cycling safer. Whereas cycling for recreation is the fourth most commonly reported physical activity among Australian adults [3], transport cycling is an underutilised travel mode. Approximately 1.3% of journeys to work in Australia are made by bicycle [4]. This low prevalence is mirrored in the UK and the US, but not in some European countries like the Netherlands and Denmark, where over 18% and 26%, respectively, of all journeys are made by bicycle [5]. In the past decade, concerted efforts have been made by Australian state and local governments to increase cycling rates [6]. Notably, Melbourne, Sydney and Brisbane have implemented policies, increased bicycle commuting infrastructure, and offered information and promotion programs to encourage commuter cycling [6,7]. Governments have also developed comprehensive longterm plans for guiding future cycling strategies, using lessons learned from around the world in developing successful cycling policy and promotion [6,7]. Changes in transport cycling rates in inner cities since these efforts have been implemented are encouraging. In Sydney, census data indicate an 83% increase in the number of people using a bicycle for commuting between 2001 and 2011 [8]. Counts of bicycles being ridden along major cycling commuter routes indicate increases in weekday morning cycling trips in Brisbane (63% increase from 2004 to 2010) [7] and in Melbourne (a 43% increase from 2006 to 2008) [9]. However, bicycle mode share to work has changed little: for example, between 2001 and 2011, it decreased slightly from 1.6% to 1.3% in Brisbane [10,11]. Researchers have been investigating factors that may be contributing to low rates of cycling for transport, to inform future policy and programming to encourage transport cycling. The aim of this paper is to overview our work to date in this area of research in Queensland.

Method of symptom assessment influences cognitive, affective and somatic post-concussion-like symptom base rates

Primary objective: To investigate whether assessment method influences the type of post-concussion-like symptoms. Methods and procedures: Participants were 73 Australian undergraduate students (Mage = 24.14, SD = 8.84; 75.3% female) with no history of mild traumatic brain injury (mTBI). Participants reported symptoms experienced over the previous 2 weeks in response to an open-ended question (free report), mock interview and standardized checklist (British Columbia Post-concussion Symptom Inventory; BC-PSI). Main outcomes and results: In the free report and checklist conditions, cognitive symptoms were reported significantly less frequently than affective (free report: p < 0.001; checklist: p < 0.001) or somatic symptoms (free report: p < 0.001; checklist: p = 0.004). However, in the mock structured interview condition, cognitive and somatic symptoms were reported significantly less frequently than affective symptoms (both p < 0.001). No participants reported at least one symptom from all three domains when assessed by free report, whereas most participants did so when symptoms were assessed by a mock structured interview (75%) or checklist (90%). Conclusions: Previous studies have shown that the method used to assess symptoms affects the number reported. This study shows that the assessment method also affects the type of reported symptoms.

Changing influences on the concept of ‘media influence’

The concept of media influence has a long history in media and communication studies, and has also had significant influence on public policy. This article revisits questions of media influence through three short case studies. First, it critically analyses the strongly partisan position of News Corporation’s newspapers against the Labor government during the 2013 Australian Federal election to consider whether the potential for media influence equated to the effective use of media power. Second, it discusses the assumption in broadcasting legislation, in both the United Kingdom and Australia, that terrestrial broadcasting should be subject to more content regulation than subscription services, and notes the new challenges arising from digital television and over-the-top video streaming services. Finally, it discusses the rise of multi-platform global content aggregators such as Google, Apple, Microsoft and others, and how their rise necessitates changes in ways of thinking about concentration of media ownership, and regulations that may ensue from it.

Influences of biodiesel chemical compositions and physical properties on engine exhaust particle emissions

This thesis presents a comprehensive study on the influences of biodiesel chemical composition and physical properties on diesel engine exhaust particle emissions. It examines biodiesels from several feedstocks having wide variations in their chemical composition (carbon chain length, unsaturation and oxygen content) and physical properties (density, viscosity, surface tension, boiling point etc.), and evaluates their influence on exhaust particle emissions. The outcome of this thesis is significant since it reveals the importance of regulating biodiesels chemical composition in order to ensure lowest possible emissions with better overall performance.

Focus group discussions exploring major social influences on young driver safety in Oman. Report to the Research Council of Oman, Muscat.

This report documents the findings of in-depth focus groups conducted with 17 young drivers. The main aim of these focus groups was to explore key themes related to the risky behaviour of young drivers (17-25 years) in Oman. Specifically the interviews explored the influence of parents and peers, who may serve as a source of imitation, reward and punishment. Additionally, the interviews explored the influence of policing and licensing on young driver behaviour.

Take me seriously. Now laugh at me! How gender influences the creation of contemporary physical comedy

This paper unpacks some of the complexities of the female comic project, focussing on the creation of physical comedy, via multiple readings of the term “serious”. Does female desire to be taken seriously in the public realm compromise female-driven comedy? Historically, female seriousness has been a weapon in the hands of such female-funniness sceptics as the late Christopher Hitchens (2007), who (in)famously declared that women are too concerned with the grave importance of their reproductive responsibility to make good comedy. The dilemma is clear: for the woman attempting to elicit laughs, she’s not serious enough outside the home, and far too serious inside it.

Women's perceptions of communication in pregnancy and childbirth: Influences on participation and satisfaction with care

In this study, 3531 Queensland women, who had recently given birth, completed a questionnaire that included questions about their participation in decision making during pregnancy, their ratings of client centred care and perceived quality of care. These data tested a version of Street’s (2001) linguistic model of patient participation in care (LMOPPC), adapted to the maternity context. We investigated how age and education influenced women’s perceptions of their participation and quality of care. Hierarchical multiple regressions revealed that women’s perceived ability to make decisions, and the extent of client-centred communication with maternity care providers were the most influential predictors of participation and perceived quality of care. Participation in care predicted perceived quality of care, but the influence of client-centred communication by a care provider and a woman’s confidence in decision making were stronger predictors of perceived quality of care. Age and education level were not important predictors. These findings extend and support the use of LMOPPC in the maternity context.

The challenge of normative influences for program design for youth in detention

Young people in detention are at greater risk of death and disability from injury sustained while not in custody. Injury prevention and mental health programs have been designed for this group but their theoretical basis is rarely discussed. The present study investigates whether the conceptual basis of the Theory of Planned Behavior (TPB) is relevant to youth in a detention center. Focus group and observational data were collected. A thematic analysis supported central theoretical constructs and emphasized “Subjective Norms.” The challenge of normative influences must be actively addressed in the design of health interventions for youth in detention.