Using behavioral economics concepts to increase organizational learning in an NHS hospital

Purpose The purpose of this paper is to assess whether the dissemination systems that hospitals use to spread information about particular safety incidents can be enhanced using behavioural economics concepts. Design/methodology/approach The current service evaluation took place within eight wards in a single acute care hospital. It was conducted as a randomized controlled trial with two groups. In the control group nothing was altered. In the intervention group ward managers received additional support to disseminate information to their nurses. Nurses were randomly selected to be surveyed during their scheduled shifts. The surveys revealed how the nurses learned about particular safety incidents and how many they remembered. Findings Nurses in the intervention group were more likely to learn about particular safety incidents than nurses in the control group. Practical implications Enhancing common dissemination systems in hospitals can increase organizational learning about safety incidents. The current study presents some means by which dissemination systems can be enhanced. Originality/value The current service evaluation is a unique application of behavioural economics concepts to enhance organizational learning of particular adverse safety incidents in an NHS hospital

The use of commitment techniques to support weight loss maintenance in obese adolescents

Objectives: Obesity is a rising problem in adolescents related to unhealthy behaviours. Commitment devises are one type of behavioural intervention that may help people change their behaviours. The current pilot trial tests whether commitment devices delivered via text message help adolescents maintain their recent weight loss. Methods: During a 12-week pilot trial adolescents who attended a weight loss camp were randomly assigned to either received text messages that contained only information, i.e., advice, about weight loss management (n=13) or asked for them to commit to following the same advise (n=14). Results: The BMI of the adolescents in the commitment group did not change. In contrast, the BMI of adolescents in the information group increased. A linear regression revealed that group was a significant predictor of BMI change. A logistic regression revealed that adolescents in the information group were nearly eight times more likely to regain weight than those in the commitment group. Conclusions: This is the first study with adolescents to show weight maintenance using a commitment device. The results suggest that commitment devices can help adolescents maintain their recent weight loss

Immigration and recommended care after a suicide attempt in Europe: equity or bias?

This report describes the investigation of care recommendations in the medical system across European countries to immigrants who attempted suicide. Data from seven European countries with 8865 local and 2921 immigrant person-cases were derived from the WHO/EURO Multicentre Study on Suicidal Behaviour and ensuing MONSUE (Monitoring Suicidal Behaviour in Europe) project. The relationship between immigrant status and type of aftercare recommended was analysed with binary logistic regression, adjusting for gender, age, method of attempt and the Centre collecting the data. Clear disparities were identified in the care recommendation practices toward immigrants, compared with hosts, over and above differing policies by the European Centres

Pathway Analysis of Differentially Expressed Genes in Patients with Acute Aortic Dissection

Background: Acute aortic dissection (AAD) is a life-threatening condition with high mortality and a relatively unclarified pathophysiological mechanism. Although differentially expressed genes in AAD have been recognized, interactions between these genes remain poorly defined. This study was conducted to gain a better understanding of the molecular mechanisms underlying AAD and to support the future development of a clinical test for monitoring patients at high risk. Materials and Methods: Aortic tissue was collected from 19 patients with AAD (mean age 61.7 ± 13.1 years), and from eight other patients (mean age 32.9 ± 12.2 years) who carried the mutated gene for Marfan syndrome (MS). Six patients (mean age 56.7 ± 12.3 years) served as the control group. The PIQOR TM Immunology microarray with 1076 probes in quadruplicates was utilized; the differentially expressed genes were analysed in a MedScan search using PathwayAssist software. Quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and protein analysis were performed. Results: Interactions of MS fibrillin-1 (FBN1) in the MedScan pathway analysis showed four genes, fi bulin-1 (FBLN1), fi bulin-2 (FBLN2), decorin (DCN) and microfi brillar associated protein 5 (MFAP5), which were differentially expressed in all tissue from AAD. The validation of these genes by qRT-PCR revealed a minimum of three-fold downregulation of FBLN1 (0.5 ± 0.4 vs. 6.1 ± 2.3 fold, p = 0.003) and of DCN (2.5 ± 1.0 vs. 8.5 ± 4.7 fold, p = 0.04) in AAD compared to MS and control samples. Conclusions: Downregulation of fibrillin-1 (FBN1) may weaken extracellular components in the aorta and/or interfer with the transmission of cellular signals and eventually cause AAD. Additional research on these four identified genes can be a starting point to develop a diagnostic tool

Recommended care for young people (15-19 years) after suicide attempts in certain European countries

Abstract Data on recommended care for young people aged 15±19 years after attempted suicide from nine European research centres dur- ing the period 1989±1992 were ana- lysed in terms of gender, history of previous suicide attempt and meth- ods used. Altogether 438 suicide attempts made by 353 boys and 1,102 suicide attempts made by 941 girls were included. Analyses of the total data from all centres showed that young people with a history of previous suicide attempt and those using violent methods had signi®- cantly higher chance of being rec- ommended aftercare than ®rst-time attempters or those choosing self- poisoning. There were no signi®cant di erences of being recommended care between genders. Logistic re- gression analyses of the material were performed and the results were similar. Both having previous at- tempted suicide (odds ratio 2.0, 95% CI 1.53±2.61) and using ``hard'' methods (odds ratio 1.71, 95% CI 1.49±1.96) were signi®cantly associ- ated with increased possibility of being recommended aftercare. When individual centres were analysed, large disparities of recommended care after suicide attempts were found and there were no uniform criteria of recommending care for young suicide attempters in Europe. Key words Young people ± attempted suicide ± method ± recommended car

Behavioural insights into benefits claimants’ training.

Purpose The purpose of this paper is to explore the behavioural determinants of work-related benefits claimants’ training behaviours and to suggest ways to improve claimants’ compliance with training referrals. Design/methodology/approach Qualitative interviews were conducted with 20 Jobcentre Plus staff and training providers, and 60 claimants. Claimants were sampled based on whether or not they had been mandated to training and whether or not they subsequently participated. Along with general findings, differences between these groups are highlighted. Findings Claimants’ behaviours are affected by their capabilities, opportunities, and motivations in interrelated ways. Training programmes should appreciate this to better ensure claimants’ completion of training programmes. Originality/value Whilst past papers have largely examined a limited number of factors that affect claimants’ training behaviours, this report offers a synchronised evaluation of all the behavioural factors that affect claimants’ training behaviours