Estimating the burden of minor ailment consultations in general practices and emergency departments through retrospective review of routine data in North East Scotland

Minor ailment attendances in general practices and emergency departments (EDs) place significant burden on health care resources

Getting evidence into policy: The need for deliberative strategies?

Getting evidence into policy is notoriously difficult. In this empirical case study we used document analysis and key informant interviews to explore the Australian federal government’s policy to implement a national bowel cancer screening programme, and the role of evidence in this policy. Our analysis revealed a range of institutional limitations at three levels of national government: within the health department, between government departments, and across the whole of government. These limitations were amplified by the pressures of the 2004 Australian federal election campaign. Traditional knowledge utilisation approaches, which rely principally on voluntarist strategies and focus on the individual, rather than the institutional level, are often insufficient to ensure evidence-based implementation. We propose three alternative models, based on deliberative strategies which have been shown to work in other settings: review of the evidence by a select group of experts whose independence is enshrined in legislation and whose imprimatur is required before policy can proceed; use of an advisory group of experts who consult widely with stakeholders and publish their review findings; or public discussion of the evidence by the media and community groups who act as more direct conduits to the decision-makers than researchers. Such deliberative models could help overcome the limitations on the use of evidence by embedding public review of evidence as the first step in the institutional decision-making processes. Highlights  Achieving evidence-based policy implementation is much harder than the rhetoric suggests.  Our case study showed traditional voluntarist approaches are not enough to overcome institutional filtering of the evidence.  Deliberative strategies open up the decision-making processes to greater expert and public scrutiny.  Our framework illustrates the potential for deliberative strategies to increase the relative weight of evidence in policy.  This article challenges researchers and policy-makers to acknowledge and address the institutional context of decision-making. Keywords: Australia; Health policy; Decision-making; Evidence; Knowledge utilisation; Bowel cancer; Screening; DeliberativeNHMR

Challenging the Moral Status of Blood Donation

The World Health Organisation encourages that blood donation becomes voluntary and unremunerated, a system already operated in the UK. Drawing on public documents and videos, this paper argues that blood donation is regarded and presented as altruistic and supererogatory. In advertisements, donation is presented as something undertaken for the benefit of others, a matter attracting considerable gratitude from recipients and the collecting organisation. It is argued that regarding blood donation as an act of supererogation is wrongheaded, and an alternative account of blood donation as moral obligation is presented. Two arguments are offered in support of this position. First, the principle of beneficence, understood in a broad consequentialist framework obliges donation where the benefit to the recipient is large and the cost to the donor relatively small. This argument can be applied, with differing levels of normativity, to various acts of donation. Second, the wrongness of free riding requires individuals to contribute to collective systems from which they benefit. Alone and in combination these arguments present moral reasons for donation, recognised in communication strategies elsewhere. Research is required to evaluate the potential effects on donation of a campaign which presents blood donation as moral obligation, but of wider importance is the recognition that other-regarding considerations in relation to our own as well as others’ health result in a range not only of choices but also of obligations

Evaluation of the effectiveness of an Internet-based continuing education program on pharmacy-based minor ailment management: a randomized controlled clinical trial

ABSTRACT The aim of this work was to evaluate the effectiveness of an internet-based continuing education (CE) program on pharmacy-based minor ailment schemes (PMASs). A controlled randomized clinical trial was conducted in community pharmacies in Brazil. Community pharmacists (CPs) were enrolled in two groups: intervention (n = 61) and control (n = 60). CPs who were enrolled to the intervention group participated in an Internet-based CE program. CPs in the control group received no educational intervention. We evaluated participant perception, learning outcomes, and practice performance. Learner satisfaction with the CE program was high for every point evaluated (mean ± standard deviation = 4.2 ± 0.4). Posttest learner outcome scores and practice performance in the intervention group after the conclusion of the CE program significantly improved compared with pretest scores (p < 0.001) and were significantly better compared with the control group (p < 0.001). The present Internet-based CE program is a viable educational strategy for improving participant perception, learning outcomes, and practice performance in PMASs

Approach to neutrophil antigen and antibody investigations

Background: Blood collection agencies worldwide face the difficult task of securing a steady supply of blood. With limited resources to spend on marketing, an understanding of the factors that motivate and discourage donations is essential. Although several reviews of the donor literature have been produced, most have failed to outline their strategy for collecting primary research, their selection criteria for including each study in their synthesis, and their approach to combining individual study results to draw general conclusions. Aims: This paper compares and contrasts the results of two meta-analyses of studies of blood donor motivation: the first investigating self-reported motivators and deterrents to donating, the second investigating factors that have been linked to donation intentions and future donation behavior. The aims of the two meta-analyses were: (i) to produce an organised and consistent taxonomy of blood donation motivators and deterrents, (ii) to estimate the prevalence of donation motivators and deterrents across populations, (iii) to identify the strongest predictors of future donation behavior, (iv) to inform an agenda for future research. Methods: The same general procedure was followed for both meta-analyses: (i) we searched the literature, and attempted to obtain a near-exhaustive coverage of literature on factors influencing blood donation; (ii) we applied rigorous selection criteria to each study based on its relevance, research design, and sampling, (iii) we made a verbatim list of factors from each study, and two coders independently grouped these into categories, (iv) we synthesised the results across studies to produce estimates of the prevalence of each motivator and deterrent, and the correlation between each factor and future donation behavior. Results: From the first meta-analysis, the most commonly reported motivators included convenience of the collection location, desire to help people, obligation to donate, reputation of the collection agency, and perceived need for donation. The most prevalent deterrents were lifestyle barriers (e.g., lack of time), lack of interest in donating, inconvenience of centre locations, lack of exposure to marketing communications, and incentives being unwanted or insufficient. From the second metaanalysis, the factors most strongly associated with donation behavior were perceived control over donation barriers, confidence (self-efficacy) about donating, anticipated regret about not donating, and self-identity as a donor. Donors were less likely to redonate after being temporarily deferred, but only if the collection agency failed to contact them after the deferral period had elapsed. Vasovagal events also had a negative impact on return behavior. Measures of altruistic motivation failed to correlate with return behavior. Summary/Conclusions: The combined results of the two meta-analyses suggest that the reasons typically given for donating are at odds with the factors that actually facilitate repeat donations. In particular, while donors list convenience and altruism as principal reasons for donating, predictive correlational studies reveal these factors have only a modest effect at best on donation behavior. Collection organisations should direct their resources to initiatives designed to maximise donors' confidence and overcome lifestyle barriers to donating, promotions featuring obligation- themed messages, and re-activating temporarily deferred donors through direct contact

The Effects of Expert and Referent Power on Knowledge Sharing and Knowledge Hiding

Purpose – The purpose of this research study is to determine the ways in which employees’ personal power-expert and referent power influences their knowledge sharing and hiding behaviour. There are hardly any studies that have investigated the effects of employee power and expectations regarding the consequences of divulging knowledge. In this study, the authors investigate whether expected gains and losses in employee personal power influence employees’ willingness to participate in knowledge transfer. Design/methodology/approach – The authors adopted a two-wave survey design and collected critical data from 288 employees of knowledge-intensive industries identified through online technogroups, such as Stack Exchange. In the first wave, out of the total, 192 knowledge workers attended the follow-up survey. The authors apply polynomial regression followed by surface response analysis to establish the effects of any discrepancy between the current levels of employees’ personal power and their expected levels if they divulge their unique critical knowledge. Findings – The authors find out that employees having relatively strong personal power are more likely to share knowledge, and the expected losses in power are categorically associated with a reduced intention to share knowledge. The authors also observed an increased knowledge hiding with expected losses in power. Surprisingly, the authors find that these established negative outcomes are also specifically associated with the expected gains in personal power. Research limitations/implications – The most significant contribution of this study is to establish that power plays an important but complex role in determining the employees’ participation in knowledge transfer activities. The authors specifically conclude that the optimal scenario for knowledge sharing is one in which the employees’ contributions are fairly valued and their reputation is not expected to change because of knowledge sharing. Originality/value – To the best of the authors’ knowledge, this study is one of the first comprehensive studies that link power to both sharing and hiding of knowledge. This study is also unique in terms of its investigation of the effects of any discrepancy between current levels of employees’ personal power and their expected levels if they share or hide their unique critical knowledge. Thus, this research study is a unique contribution in terms of what and why of an untouched area in the entire knowledge management literature with a special focus on knowledge sharing and hiding