Factors influencing e-diplomacy implementation: Exploring causal relationships using interpretive structural modelling

YesElectronic diplomacy (E-diplomacy) is the use of technology by nations to define and establish diplomatic goals and objectives and to efficiently carry out the functions of diplomats. These functions include representation and promotion of the home nation, establishing both bilateral and multilateral relations, consular services and social engagement. It encapsulates the adoption of multiple ICT tools over the Internet to support a nation’s interests in other countries while ensuring that foreign relations are improved between the countries. Given its embryonic nature, little scholarly research has been undertaken to study its influence on diplomatic functions and the various factors that influence its implementation. This paper applies the Interpretative Structural Modelling (ISM) methodological approach to identify factors that impact the implementation of e-diplomacy and to determine their causal relationship and rankings. This study applies the ISM methodology to the subject of e-diplomacy. The ISM-based model provides a framework for practitioners to aid decision-making and manage the implementation of e-diplomacy

How the field of infectious diseases can leverage digital strategy and social media use during a pandemic

Rapid information dissemination is critical in a world changing rapidly due to global threats. Ubiquitous internet access has created new methods of information dissemination that are rapid, far-reaching, and universally accessible. However, inaccuracies may accompany rapid information dissemination, and rigorous evaluation of primary data through various forms of peer review is crucial. In an era in which high-quality information can save lives, it is critical that infectious diseases specialists are well versed in digital strategy to effectively disseminate information to colleagues and the community and diminish voices spreading misinformation. In this study, we review how social media can be used for rapid dissemination of quality information, benefits and pitfalls of social media use, and general recommendations for developing a digital strategy as an infectious diseases specialist. We will describe how the Infectious Diseases Society of America has leveraged digital strategy and social media and how individuals can amplify these resources to disseminate information, provide clinical knowledge, community guidance, and build their own person brand. We conclude in providing guidance to infectious diseases specialists in aiming to build and preserve public trust, consider their audience and specific goals, and use social media to highlight the value of the field of infectious diseases

Clinical effectiveness and cost-effectiveness of issuing longer versus shorter duration (3-month vs. 28-day) prescriptions in patients with chronic conditions: systematic review and economic modelling.

BACKGROUND: To reduce expenditure on, and wastage of, drugs, some commissioners have encouraged general practitioners to issue shorter prescriptions, typically 28 days in length; however, the evidence base for this recommendation is uncertain. OBJECTIVE: To evaluate the evidence of the clinical effectiveness and cost-effectiveness of shorter versus longer prescriptions for people with stable chronic conditions treated in primary care. DESIGN/DATA SOURCES: The design of the study comprised three elements. First, a systematic review comparing 28-day prescriptions with longer prescriptions in patients with chronic conditions treated in primary care, evaluating any relevant clinical outcomes, adherence to treatment, costs and cost-effectiveness. Databases searched included MEDLINE (PubMed), EMBASE, Cumulative Index to Nursing and Allied Health Literature, Web of Science and Cochrane Central Register of Controlled Trials. Searches were from database inception to October 2015 (updated search to June 2016 in PubMed). Second, a cost analysis of medication wastage associated with < 60-day and ≥ 60-day prescriptions for five patient cohorts over an 11-year period from the Clinical Practice Research Datalink. Third, a decision model adapting three existing models to predict costs and effects of differing adherence levels associated with 28-day versus 3-month prescriptions in three clinical scenarios. REVIEW METHODS: In the systematic review, from 15,257 unique citations, 54 full-text papers were reviewed and 16 studies were included, five of which were abstracts and one of which was an extended conference abstract. None was a randomised controlled trial: 11 were retrospective cohort studies, three were cross-sectional surveys and two were cost studies. No information on health outcomes was available. RESULTS: An exploratory meta-analysis based on six retrospective cohort studies suggested that lower adherence was associated with 28-day prescriptions (standardised mean difference -0.45, 95% confidence interval -0.65 to -0.26). The cost analysis showed that a statistically significant increase in medication waste was associated with longer prescription lengths. However, when accounting for dispensing fees and prescriber time, longer prescriptions were found to be cost saving compared with shorter prescriptions. Prescriber time was the largest component of the calculated cost savings to the NHS. The decision modelling suggested that, in all three clinical scenarios, longer prescription lengths were associated with lower costs and higher quality-adjusted life-years. LIMITATIONS: The available evidence was found to be at a moderate to serious risk of bias. All of the studies were conducted in the USA, which was a cause for concern in terms of generalisability to the UK. No evidence of the direct impact of prescription length on health outcomes was found. The cost study could investigate prescriptions issued only; it could not assess patient adherence to those prescriptions. Additionally, the cost study was based on products issued only and did not account for underlying patient diagnoses. A lack of good-quality evidence affected our decision modelling strategy. CONCLUSIONS: Although the quality of the evidence was poor, this study found that longer prescriptions may be less costly overall, and may be associated with better adherence than 28-day prescriptions in patients with chronic conditions being treated in primary care. FUTURE WORK: There is a need to more reliably evaluate the impact of differing prescription lengths on adherence, on patient health outcomes and on total costs to the NHS. The priority should be to identify patients with particular conditions or characteristics who should receive shorter or longer prescriptions. To determine the need for any further research, an expected value of perfect information analysis should be performed. STUDY REGISTRATION: This study is registered as PROSPERO CRD42015027042. FUNDING: The National Institute for Health Research Health Technology Assessment programme

Public Service Broadcasting

Public service media are no longer limited to radio and television as new media genres emerge. Among others, online media supplement radio, television and the press since the mid 1990s and became a medium in its own right. Moreover, online media become an essential element of media consumption patterns. Public service media compete not only with private radio and television broadcasters but also with the press. The question arises, whether such competition in the online field results in more diversity and higher output quality, serving the public interest better. In Europe, there are at least two different schools of thought. One line of argument accepts the public service expansion into online and regards online media as necessary and important field for public service activities. Another line of argument suggests limiting the public service remit strictly to radio and broadcasting and considers online media as emerging market subject to competition among private companies only. Based on the results of a comparative empirical analysis of online media provided by public service broadcasters and print publishers in Switzerland, Germany and Austria (from 2006) the article shows that the achieved results in media output are disappointing. Only few online media live up to the expectations. The article finally argues that the extension of the public service remit to online media might enhance quality and diversity