Factors influencing the choice of drug therapy in primary and secondary health care

A prescribing decision model incorporating drug characteristics, professional opinions and past experience was used to predict the choices made by prescribers when selecting a non‐steroidal anti‐inflammatory drug (NSAID) for inclusion in a formulary. Thirty general practitioners (GPs) and 14 hospital doctors (HDs), most practising within the South East Thames regional health authority, were asked to select either ibuprofen, diclofenac or indomethacin, based on the needs of a described population, and then to answer a questionnaire. Looking at the relative importance of factors influencing the choice of treatment, there was generally a high degree of agreement between HDs and GPs. However, the majority of HDs ranked efficacy as the most important drug characteristic whereas GPs were generally more concerned with side effects. Fundholding GPs ranked cost more highly than did their non‐fundholding counterparts, and GPs working in single handed practices were more influenced by specialists and company representatives than were GPs working in groups. The decision model correctly predicted the drug choice of all the HDs and of 76 per cent of the GPs. These values were considerably better than the 33 per cent that would be predicted based on chance alone. Although various limitations of this type of study are noted, it is hoped that the model could be developed as a valuable tool to assist in understanding complex prescribing issues. 1995 Royal Pharmaceutical Society of Great Britai

Destination Positioning Analysis Through a Comparison of Cognitive, Affective, and Conative Perceptions

There has been exponential growth in the number of studies of destination image appearing in the tourism literature. However, few have addressed the issues of destination positioning analysis and the role of affective perceptions. This paper analyses the market positions held by a competitive set of destinations, through a comparison of cognitive, affective and conative perceptions. Cognition was identified by trialing a factor analytic adaptation of importance-performance analysis. Affect was measured using an affective response grid, while conation was gauged by stated intent to visit. The alignment of the results from these techniques identified leadership positions held by two quite different destinations on two quite different dimensions of destination attractiveness. It is suggested this method of positioning analysis offers a practical means for destination marketers faced with the challenge of identifying the one or few features from their diverse and multi-attributed product range that could be developed by to differentiate their destination in a meaningful way to consumers

Territoriality during trophobiosis between wasps and homopterans

Wasps of Belonogaster juncea juncea (Fabricius), Ropalidia guttatipennis (saussure) and Polybioides tabida (Fabricius) harvest the honeydew dropped onto leaves by various species of homopterans, or can tend homopterans directly. All three species of wasps exploit Aleyrodidae; R. guttatipennis and P. tabida can milk Coccidae and Tettigometridae whilst p. tabida has also been observed tending Aphididae. Ropalidia guttatipennis workers defend specific territories of concentrations of Coccidae And Tettigometridae on infested trees from competitors such as arboreal ants and flies. in this context, we observed a division of tasks between the wasps: some individuals act as guards, others as honeydew harvesters and yet others, the «intermediates», mainly as harvesters but are ready to intervene against intruding flies