Communicating information about medication side effects: effects on satisfaction, perceived risk to health, and intention to comply

Previous research has shown that people's evaluations of explanations about medication and their intention to comply with the prescription are detrimentally affected by the inclusion of information about adverse side effects of the medication. The present study (Experiment 1) examined which particular aspects of information about side effects (their number, likelihood of occurrence, or severity) are likely to have the greatest effect on people's satisfaction, perception of risk, and intention to comply, as well as how the information about side effects interacts with information about the severity of the illness for which the medication was prescribed. Across all measures, it was found that manipulations of side effect severity had the greatest impact on people's judgements, followed by manipulations of side effect likelihood and then number. Experiments 2 and 3 examined how the severity of the diagnosed illness and information about negative side effects interact with two other factors suggested by Social Cognition models of health behaviour to affect people's intention to comply: namely, perceived benefit of taking the prescribed drug, and the perceived level of control over preventing or alleviating the side effects. It was found that providing people with a statement about the positive benefit of taking the medication had relatively little effect on judgements, whereas informing them about how to reduce the chances of experiencing the side effects had an overall beneficial effect on ratings.

What is the new medicines use review ‘patient survey’ attempting to capture in the context of existing patient satisfaction with pharmacy questionnaires and a new conceptual framework?

The community pharmacy service medicines use review (MUR) was introduced in 2005 ‘to improve patient knowledge, concordance and use of medicines’ through a private patient–pharmacist consultation. The MUR presents a fundamental change in community pharmacy service provision. While traditionally pharmacists are dispensers of medicines and providers of medicines advice, and patients as recipients, the MUR considers pharmacists providing consultation-type activities and patients as active participants. The MUR facilitates a two-way discussion about medicines use. Traditional patient–pharmacist behaviours transform into a new set of behaviours involving the booking of appointments, consultation processes and form completion, and the physical environment of the patient–pharmacist interaction moves from the traditional setting of the dispensary and medicines counter to a private consultation room. Thus, the new service challenges traditional identities and behaviours of the patient and the pharmacist as well as the environment in which the interaction takes place. In 2008, the UK government concluded there is at present too much emphasis on the quantity of MURs rather than on their quality.[1] A number of plans to remedy the perceived imbalance included a suggestion to reward ‘health outcomes’ achieved, with calls for a more focussed and scientific approach to the evaluation of pharmacy services using outcomes research. Specifically, the UK government set out the main principal research areas for the evaluation of pharmacy services to include ‘patient and public perceptions and satisfaction’as well as ‘impact on care and outcomes’. A limited number of ‘patient satisfaction with pharmacy services’ type questionnaires are available, of varying quality, measuring dimensions relating to pharmacists’ technical competence, behavioural impressions and general satisfaction. For example, an often cited paper by Larson[2] uses two factors to measure satisfaction, namely ‘friendly explanation’ and ‘managing therapy’; the factors are highly interrelated and the questions somewhat awkwardly phrased, but more importantly, we believe the questionnaire excludes some specific domains unique to the MUR. By conducting patient interviews with recent MUR recipients, we have been working to identify relevant concepts and develop a conceptual framework to inform item development for a Patient Reported Outcome Measure questionnaire bespoke to the MUR. We note with interest the recent launch of a multidisciplinary audit template by the Royal Pharmaceutical Society of Great Britain (RPSGB) in an attempt to review the effectiveness of MURs and improve their quality.[3] This template includes an MUR ‘patient survey’. We will discuss this ‘patient survey’ in light of our work and existing patient satisfaction with pharmacy questionnaires, outlining a new conceptual framework as a basis for measuring patient satisfaction with the MUR. Ethical approval for the study was obtained from the NHS Surrey Research Ethics Committee on 2 June 2008. References 1. Department of Health (2008). Pharmacy in England: Building on Strengths – Delivering the Future. London: HMSO. www. official-documents.gov.uk/document/cm73/7341/7341.pdf (accessed 29 September 2009). 2. Larson LN et al. Patient satisfaction with pharmaceutical care: update of a validated instrument. JAmPharmAssoc 2002; 42: 44–50. 3. Royal Pharmaceutical Society of Great Britain (2009). Pharmacy Medicines Use Review – Patient Audit. London: RPSGB. http:// qi4pd.org.uk/index.php/Medicines-Use-Review-Patient-Audit. html (accessed 29 September 2009).

The maintenance requirement of domestic drakes

1. Mature domestic drakes of 7 genotypes, ranging in live weight from 1.1to 5.1 kg, were each given a daily allowance of feed just below the level of recorded ad libitum intake. 2. House temperature was maintained at 26 degrees C for 16 weeks and then at 10 degrees C for a further 8 weeks. 3. Under these conditions, live weight quickly adjusted to the level of feed supplied and then remained stable. 4. Regression of metabolisable energy intake on live weight (W) yielded estimates of maintenance requirement of 583 kJ/kg W-0.75 center dot d at 10 degrees C and 523 kJ/kg W-0.75 center dot d at 26 degrees C.

Predicting the profile of nutrients available for absorption: from nutrient requirement to animal response and environmental impact

Current feed evaluation systems for dairy cattle aim to match nutrient requirements with nutrient intake at pre-defined production levels. These systems were not developed to address, and are not suitable to predict, the responses to dietary changes in terms of production level and product composition, excretion of nutrients to the environment, and nutrition related disorders. The change from a requirement to a response system to meet the needs of various stakeholders requires prediction of the profile of absorbed nutrients and its subsequent utilisation for various purposes. This contribution examines the challenges to predicting the profile of nutrients available for absorption in dairy cattle and provides guidelines for further improved prediction with regard to animal production responses and environmental pollution. The profile of nutrients available for absorption comprises volatile fatty acids, long-chain fatty acids, amino acids and glucose. Thus the importance of processes in the reticulo-rumen is obvious. Much research into rumen fermentation is aimed at determination of substrate degradation rates. Quantitative knowledge on rates of passage of nutrients out of the rumen is rather limited compared with that on degradation rates, and thus should be an important theme in future research. Current systems largely ignore microbial metabolic variation, and extant mechanistic models of rumen fermentation give only limited attention to explicit representation of microbial metabolic activity. Recent molecular techniques indicate that knowledge on the presence and activity of various microbial species is far from complete. Such techniques may give a wealth of information, but to include such findings in systems predicting the nutrient profile requires close collaboration between molecular scientists and mathematical modellers on interpreting and evaluating quantitative data. Protozoal metabolism is of particular interest here given the paucity of quantitative data. Empirical models lack the biological basis necessary to evaluate mitigation strategies to reduce excretion of waste, including nitrogen, phosphorus and methane. Such models may have little predictive value when comparing various feeding strategies. Examples include the Intergovernmental Panel on Climate Change (IPCC) Tier II models to quantify methane emissions and current protein evaluation systems to evaluate low protein diets to reduce nitrogen losses to the environment. Nutrient based mechanistic models can address such issues. Since environmental issues generally attract more funding from governmental offices, further development of nutrient based models may well take place within an environmental framework.

Chill unit models for blackcurrant (Ribes nigrum L.) cultivars 'Ben Gairn', 'Ben Hope' and 'Ben Tirran'

Temperate-zone crops require a period of winter chilling to terminate dormancy and ensure adequate bud break the following spring. The exact chilling requirement of blackcurrant (Ribes nigrum), a commercially important crop in northern Europe, is relatively unknown. Chill unit models have been successfully utilized to determine the optimum chilling temperature of a range of crops, with one chill unit equating to I h exposure to the optimum temperature for chill satisfaction. Two-year-old R. nigrum plants of the cultivars 'Ben Gairn', 'Ben Hope' and 'Ben Tirran' were exposed to temperatures of -10.1 degrees C. -3.4 degrees C. 0.1 degrees C, 1.5 degrees C, 2.1 degrees C, 3.4 degrees C or 8.9 degrees C (+/- 0.7 degrees C) for durations of 0, 2, 4, 6, 8 or 10 weeks and multiple regression analyses used to determine the optimum temperature for chill satisfaction. (C) 2009 Elsevier B.V. All rights reserved.

The relationships of age and length of service with job satisfaction: an examination of hotel employees in Thailand

Earlier studies suggest age is positively associated with job satisfaction, while others use length of service, or tenure, as a predictor of job satisfaction levels. This article examines whether age and tenure are individual determinants of satisfaction, or whether there is an interaction between the two. The results indicate that employee age is not significantly associated with overall job satisfaction level, but that tenure is. There is also significant relationship between tenure and facets of satisfaction (job, pay and fringe benefits), but the effect of tenure on satisfaction is significantly modified by age.

Customer satisfaction and organisational justice

Applies organisational justice theory to facilities management with the aim of increasing customer satisfaction with the service received. Provides an overview of organisational justice theory, and reviews the numerous different forms that this may take. Although there is strong theoretical support for participative decision making, in practice it often leads to conflict and delays. Two-way communication appears to represent the most effective form. The conclusions are based upon theoretical support as well as semi-structured interviews and observations in an organisational setting. The conclusions drawn do not have the benefits of more objective quantitative research methods. Contributes to practical understanding of how to maintain customer satisfaction in the facilities management industry and the theoretical reasons why the proposed methods will be effective. Argues that the impact of organisational justice on employee satisfaction can be applied to customer satisfaction with specific reference to facilities management.

Doctoral supervision of colleagues: peeling off the veneer of satisfaction and competence

The nexus of teaching, administration and research activities engaged in by academic staff in higher education means that each individual plays a multitude of roles in relation to colleagues, producing inevitable tensions. One role relationship that epitomizes this extraordinary juggling task is that of doctoral supervisor/supervisee, when both are academic staff in the same institution. The last 10 years has seen an upsurge of research interest in doctoral research students, and government and funding bodies have imposed ever more stringent requirements on supervisors. However, staff pairings have been ignored in this literature and research. This article reports on an exploration that seeks to redress this omission by giving voice to the participants (colleague supervisor or research student), allowing them to articulate constructs about what may be unique in the interaction, thus highlighting factors that support or impede success in the enterprise.

Doctoral supervision of colleagues: peeling off the veneer of satisfaction and competence

The nexus of teaching, administration and research activities engaged in by academic staff in higher education means that each individual plays a multitude of roles in relation to colleagues, producing inevitable tensions. One role relationship that epitomizes this extraordinary juggling task is that of doctoral supervisor/supervisee, when both are academic staff in the same institution. The last 10 years has seen an upsurge of research interest in doctoral research students, and government and funding bodies have imposed ever more stringent requirements on supervisors. However, staff pairings have been ignored in this literature and research. This article reports on an exploration that seeks to redress this omission by giving voice to the participants (colleague supervisor or research student), allowing them to articulate constructs about what may be unique in the interaction, thus highlighting factors that support or impede success in the enterprise.