Quality Of Advice Research Articles

Beyond entrepreneurship, raising broad academic professionals: Work-based learning in science from the employer’s perspective

The need for employees in the exact and natural sciences sector with both work experience and academic qualifications, especially combined with an entrepreneurial mindset, is rising. The University of Groningen offers an alternative Master’s program entitled Science, Business and Policy (SBP). SBP combines entrepreneurship education with the integration of a disciplinary science domain and thereby prepares students in science advising. This includes a work placement of 6 months, provided by companies, policy organisations and NGOs. To examine the impact of work placements from the perspective of the employer, this article analyses 20 semi-structured interviews with providers of placements. The results show that employers judge students who have undertaken a work placement as attractive future employees, and the quality of science advice given by students is seen as high. From a work floor perspective, work placements are a strong component in the optimal education of future employees. Integrating academic theory and experience in practice contributes to the employability of science students. The impact of work placements goes further than employability, since employers also indicate a direct effect on work dynamics and see the direct impact of advice reports in their organisation. The work-based learning approach chosen to achieve this specific entrepreneurship education fits the need of industry and other non-academic employers.

Measuring the gap between elicited and revealed risk for investors: An empirical study

AbstractFinancial advisors use questionnaires and discussions with clients to determine investment goals, elicit risk preference and tolerance and establish a suitable portfolio allocation for different risk categories. Financial institutions assign risk ratings to their financial products. Advisors use these ratings to categorize products into the same risk categories used for portfolio allocation. Subsequently, clients select a portfolio of assets whose risk profile we call revealed risk. This paper proposes a novel methodology for comparing an individual's elicited and revealed risk. We propose using Value‐at‐Risk to measure elicited and revealed risk and the discrepancy between them, showing whether clients are over‐risked or under‐risked. We demonstrate the methodology using a dataset from a Canadian private financial dealer. We find that elicited risk is consistently higher than revealed risk–advisors build a safety buffer into their recommendations–and elicited risk varies with respect to demographic features and trading behaviors in expected ways–investors are receiving sound advice. This risk discrepancy could be used, for example, to gauge the quality of financial advice an individual is receiving, or it could be used to help advisors communicate inconsistencies between client trading actions and client goals. Our methodology falls into the interest realms of advisors, regulators, and dealerships.

People's care seeking journey for a chronic illness in rural India: Implications for policy and practice

Drawing on interviews conducted in 2019–2020, across twenty villages in India, this paper unpacks how people with chronic illness navigate complex care-seeking terrain. We show how the act of seeking care involves navigating through personal, family, social, economic, cultural, and most importantly, difficult health systems spaces—and entails making difficult social, moral, and financial choices. We show how the absence of reliable and accessible points of first contact for primary care results in people running from pillar to post, taking wrong turns, and becoming disappointed, frustrated, and, sometimes, impoverished. We reveal the complex individual and social dynamics of hope and misplaced and misguided expectations, as well as social obligations and their performance that animate the act of navigating care in rural India. We shine light on how a health system with weak primary care and poor regulation amplifies the medical, social, and financial consequences of an otherwise manageable chronic illness, and how these consequences are the worst for those with the least social, network and economic capital. Crucially we highlight the problematic normalisation of the absence of reliable primary care services for chronic illness in India, in rural India specifically. We signpost implications for research, and for policy and practice in India and similar health system contexts, i.e. those with weak primary care and poor regulation of the private sector.We argue that in India, having in place accessible, good quality, and trustworthy sources of advice and care for chronic illness at the first point of call, for all, is critical. We contend that this first point of call should be quality, public primary care services. We conclude that if such arrangements are in place in public services, people will use them.

A feasibility study of a randomized controlled trial protocol to assess the impact of an eHealth intervention on the provision of dietary advice in primary care

BackgroundCanadian sodium intakes remain high despite population-wide sodium reduction initiatives, highlighting the need for personal action in reducing dietary sodium. eHealth interventions support patients in dietary change and assist clinicians in decision-making and delivering care, including provision of advice. To date, impact of diet-focused eHealth tools, like the Sodium Calculator (SC) dietary screening tool, on clinical outcomes has received minimal examination. This study assessed feasibility of a randomized controlled trial (RCT) protocol to examine the impact of the SC, a physician-focused intervention, on the quality of dietary sodium reduction advice provided by physicians to their patients with hypertension.MethodsPrimary care physicians from community-based primary care clinics were randomized to one of two groups: (1) ‘usual care’ for dietary sodium counselling or (2) dietary sodium counselling using the SC (‘experimental group’). The primary endpoint was protocol feasibility defined by the following outcomes: process (e.g. recruitment, retention, protocol adherence, acceptability of intervention), resources (e.g. needs, impact on workflow), and management (e.g. staff requirements). Outcomes were assessed using direct observation, interviews, and questionnaires with patients, physicians, and clinic staff.ResultsSeven physicians (n = 4 in experimental group, n = 3 in usual care group) and 65 patients with hypertension (48.5% men, 69.8 ± 10.1 years) successfully participated. The main challenges identified is related to recruitment rate (48% for patients, 20% for physicians) and physician protocol adherence (76%). These improved with minor protocol modifications. There were several areas of protocol success such as no disruption to physician workflow, hiring clinic nurses as research staff, having a physician site lead to support physician recruitment, and a ‘Protocol Prompt Form’ to increase physician protocol adherence. Importantly, there was a high degree of acceptability of the SC intervention among experimental group physicians [n = 3 (75%)].ConclusionsThe modified RCT protocol was considered feasible. The identified successes can be leveraged, and the risks can be mitigated, during implementation of a full-scale RCT. Assessment of this RCT protocol is an important step in understanding the effectiveness of diet-focused eHealth tools to supporting physician self-efficacy in assessing, monitoring, and implementing dietary advice in routine clinical practice and supporting patients in effective behaviour change.

A Bitter Pill to Swallow? The Consequences of Patient Evaluation in Online Health Question-and-Answer Platforms

Online health question-and-answer platforms (OHQPs), where patients post health-related questions, evaluate advice from multiple doctors and select their most preferred answer, are a prominent channel for patients to receive medical advice in China. They are gaining traction globally and have the potential to circumvent resource-based, geographic, or circumstantial barriers that limit access to care. At the same time, they are underregulated in contrast to brick-and-mortar points of care. Ours is the first study to evaluate the quality of healthcare advice promoted by these platforms and to provide insight into how patients respond to advice. We found that, though advice is generally good, patients cannot discern good advice from bad, choose poor advice (when offered) as often as good advice, and do so to a greater extent in vulnerable categories such as pediatrics, cancers/tumors, and internal medicine. Moreover, we found that OHQPs exacerbate care avoidance. Our findings suggest that platform owners and policymakers should ensure that signals of expert consensus are provided to patients to better assist their choices on OHQPs. We also unveiled bad actors on OHQPs, including drug promoters and spammers, indicating that stronger oversight and accountability mechanisms are needed. Physician peer reviewing and auditing can address both problems.

A meta-analysis of the weight of advice in decision-making

The degree to which people take advice, and the factors that influence advice-taking, are of broad interest to laypersons, professionals, and policy-makers. This meta-analysis on 346 effect sizes from 129 independent datasets (N = 17, 296) assessed the weight of advice in the judge-advisor system paradigm, as well as the influence of sample and task characteristics. Information about the advisor(s) that is suggestive of advice quality was the only unique predictor of the overall pooled weight of advice. Individuals adjusted estimates by 32%, 37%, and 48% in response to advisors described in ways that suggest low, neutral, or high quality advice, respectively. This indicates that the benefits of compromise and averaging may be lost if accurate advice is perceived to be low quality, or too much weight is given to inaccurate advice that is perceived to be high quality. When examining the three levels of perceived quality separately, advice-taking was greater for subjective and uncertain estimates, relative to objective estimates, when information about the advisor was neutral in terms of advice quality. Sample characteristics had no effect on advice-taking, thus providing no evidence that age, gender, or individualism influence the weight of advice. The findings contribute to current theoretical debates and provide direction for future research.

Adviser Compensation, Endogenous Entry, and the Advice Gap

To prevent biased advice, regulators increasingly ban commission payments to financial advisers. Such bans are associated with “advice gaps,” meaning that advice becomes less accessible. To understand the trade-off between the quality and accessibility of advice, this paper develops a model of price competition in advice markets with endogenous entry of advisers. While commission bans increase consumer surplus in the short run, they hurt the profitability of advisers. In the long run, advisers exit the market, advice becomes inaccessible, and consumer surplus decreases. These results imply that accounting for the endogeneity of market structure is important when regulating advice. (JEL D82, J33, L51, L84, L88, M52)

122 Head Injury discharge advice in an emergency department

BackgroundHead Injury (HI) is a common presentation to the Emergency Department (ED). Most injuries are mild and patients are often discharged directly from ED. However, persistent symptoms and failure to return-to-work are common. Comprehensive advice and a clear pathway if symptoms persist are critical to prevent unnecessary morbidity.ObjectivesTo audit the discharge advice and follow-up of patients discharged from an ED with a HI.MethodologyA Data Collection Tool was used to audit the advice and follow-up guidance given to patients attending St George’s Hospital ED in December 2018 with a HI. Data was audited against the NICE Guidelines for Head Injury: Assessment and Early Management (CG176).Results149 patients were identified. 41 (27.5%) were provided with written advice; 53 (35.6%) had no documentation of any HI advice being given; 55 (36.9%) had some documentation of HI advice but no documentation that written material was provided.ConclusionsA need for improvement in the quality of HI Discharge Advice from ED and access to spe- cialist HI outpatient assessment was identified. Improvements implemented included education of ED staff, new patient information sheet, and direct referral system to a specialist HI clinic. Re-audit is planned following these improvements.Samia.Elkommos@nhs.net

Goodwill in communication

An expert advises a decision maker over time. With both the quality of advice and the extent to which it is followed remaining private, the players have limited information with which to discipline each other. Even so, communication in and of itself facilitates cooperation, the relationship evolving based on the expert's advice. We show a formal equivalence between our setting and one of cheap talk with capped money burning, enabling an exact characterization (at fixed discounting) of the expert's attainable payoffs. While an ongoing relationship often helps, our characterization implies that, absent feedback, relational incentives can never restore commitment.

Youngstock Management as “The Key for Everything”? Perceived Value of Calves and the Role of Calf Performance Monitoring and Advice on Dairy Farms

Replacement heifers are key to the future milking herd and farm economic efficiency but are not always prioritised on dairy farms. Dairy enterprises are comprised of components which compete for limited resources; scarce information about calf performance and the associated losses and (potential) gains on farms can mean calves are prioritised less in management and investment decisions. The research reported in this paper explored the personal and contextual factors that influence calf management decisions on dairy farms. Forty in-depth, semi-structured interviews were conducted with dairy farmers (26 interviews) and farm advisors (14 interviews) who were recruited using purposive and “snowball” sampling. Interviews were recorded, transcribed, and thematically analysed. Six major themes were constructed from the interview data relating to: the perceived importance of youngstock management, the role and influence of calf rearers, calf performance monitoring, farmer engagement with information and advice, the quality of communication and advice, and veterinary involvement in calf rearing. Results indicated that although the wider dairy industry has promoted the importance of youngstock, calves often have not been fully integrated into the whole dairy farm system, nor culturally accepted as an integral part of the productive herd. Calves tended to be marginalised on farms, largely due to limited resources, lack of data monitoring, and their unrecognised potential, as well as social norms and scarcity of support structures impacting upon farm investment and management decisions. Many calf rearers were disappointed by the repetition and impractical nature of information in print media. Most farmers did not routinely consult their veterinarian about their calves, rather following a reactive treatment model even when a preventive herd health strategy was applied to the adult herd. Advisory structures often require a driven individual with calf-centric interest to prevent calves from being overlooked. Furthermore, advisory efforts often failed to motivate farmers to act on advice. These findings indicate the need for greater focus on how to achieve rearing targets by provision of technical and support structures to foster action toward improved calf wellbeing, and for the status of calves to be raised in line with their vital importance for the future dairy herd.

Financial advice, financial literacy and social interaction: what matters to retirement saving decisions?

ABSTRACT We analyze the effect of financial advice, financial literacy and social interaction on households’ retirement saving decisions. Financial advice is the only factor that positively influences individuals’ decisions to participate in a retirement plan, while only financial literacy increases risky asset allocation. These two important factors both influence the ultimate retirement account balance. Viewed collectively, we propose that financial advice and financial literacy benefit retirement saving decisions through different channels, they complement each other and they jointly lead to a better ultimate outcome. The evidence is consistent when we further consider quality of advice and self-rated financial literacy. However, social interaction is of little help in facilitating better retirement saving decisions.

Lay Advisers in Family law Settings: The Role and Quality of Advice Provided on Social media

The study explores the quality of advice offered by lay advisers on social media groups and online forums. The focus is on the online advice provision in relation to child-related cases, which are part of private or public family law proceedings in the context of England and Wales. Since many addressees of such advice are self-represented litigants, it is crucial to understand what kind of support is offered by law advisers, whose professional motivation or level of expertise are underexplored. By drawing on content analysis and discourse analysis, the study reflects on the substantive content and linguistic framing of the advice offered online. The article contextualises the role of lay advisers in light of (1) the challenges self-represented litigants experience when accessing the justice system and (2) the growing popularity of using online resources and social platforms for obtaining legal information and advice.

Are Global Environmental Uncertainties Inevitable? Measuring Desertification for the SDGs

Continuing uncertainty about the present magnitudes of global environmental change phenomena limits scientific understanding of human impacts on Planet Earth, and the quality of scientific advice to policy makers on how to tackle these phenomena. Yet why global environmental uncertainties are so great, why they persist, how their magnitudes differ from one phenomenon to another, and whether they can be reduced is poorly understood. To address these questions, a new tool, the Uncertainty Assessment Framework (UAF), is proposed that builds on previous research by dividing sources of environmental uncertainty into categories linked to features inherent in phenomena, and insufficient capacity to conceptualize and measure phenomena. Applying the UAF shows that, based on its scale, complexity, areal variability and turnover time, desertification is one of the most inherently uncertain global environmental change phenomena. Present uncertainty about desertification is also very high and persistent: the Uncertainty Score of a time series of five estimates of the global extent of desertification shows limited change and has a mean of 6.8, on a scale from 0 to 8, based on the presence of four conceptualization uncertainties (terminological difficulties, underspecification, understructuralization and using proxies) and four measurement uncertainties (random errors, systemic errors, scalar deficiencies and using subjective judgment). This suggests that realization of the Land Degradation Neutrality (LDN) Target 15.3 of the UN Sustainable Development Goal (SDG) 15 (“Life on Land”) will be difficult to monitor in dry areas. None of the estimates in the time series has an Uncertainty Score of 2 when, according to the UAF, evaluation by statistical methods alone would be appropriate. This supports claims that statistical methods have limitations for evaluating very uncertain phenomena. Global environmental uncertainties could be reduced by devising better rules for constructing global environmental information which integrate conceptualization and measurement. A set of seven rules derived from the UAF is applied here to show how to measure desertification, demonstrating that uncertainty about it is not inevitable. Recent review articles have advocated using ‘big data’ to fill national data gaps in monitoring LDN and other SDG 15 targets, but an evaluation of a sample of three exemplar studies using the UAF still gives a mean Uncertainty Score of 4.7, so this approach will not be straightforward.

The Influence of the Pharmacists’ Training on the Quality and Comprehensiveness of Professional Advice Given in the Field of Inhalation Techniques in Community Pharmacies in Poland

Background: Following the example of other countries, it is very important to educate patients on the correct use of inhalers by properly trained healthcare professionals, including pharmacists. Objectives: The aim of the study was to assess the quality and comprehensiveness of professional advice given by pharmacists on the use of inhalers, which was determined by the pharmacists’ level of training. Methods: The study was conducted from June 2019 to March 2020. 150 pharmacists from Poznan and Warsaw (Poland) were involved. Before the study began, the professional education of 240 pharmacists was conducted in Warsaw to implement standard operating procedures. The study used the model of a mystery shopper. Results: The conversation with a trained pharmacist lasted on average 5.5 min, with an untrained one—3.0 min (p < 0.0001). Placebo inhalers were used more often by trained pharmacists during patients’ education (p < 0.0001). Moreover, 10.3% of untrained pharmacists did not provide any education. Additionally, untrained employees’ quality of advice was assessed on an average of 3.5 points, while trained ones—7.6 points (p < 0.0001). Conclusions: This study has shown that there is a need for professional training among pharmacists in Poland, which translates into better patient education in the field of inhalation techniques.

‘I was putting her first’: Birth parents' experiences of ‘consent’ to adoption from care in England

AbstractAdoption is the preferred form of permanence for young children in care in England who are unable to live with their birth family or relatives. However, there have been growing concerns about the use of adoption, particularly in cases where birth parents have not given their consent. Despite concerns, there has been little research into birth parents' views of consent in adoption. This article reports on the experiences of 12 birth mothers and 2 birth fathers whose children were adopted from care in England. Birth parents' views on consent changed throughout the adoption process. They reported that care proceedings could be traumatic, and they did not always understand what was happening. There was a disparity in the quality of legal advice and social work support that birth parents received. The findings raise questions for practice around the level of support birth parents receive during and after care proceedings and highlight the importance of good quality support.

Quality of climate-smart agricultural advice offered by private and public sectors extensionists in Mbeere North Sub-County, Kenya

This research adds to the knowledge of extension education by revealing the quality of climate-smart agricultural (CSA) advice offered by private and public extension sectors. The study was aimed at addressing the paucity of empirical data that exists relating to the quality of CSA advice. Using a semi-structured questionnaire, the descriptive and correlational study gathered data from a systematic sample of 115 farmers. There was a moderate positive correlation between extension effectiveness and adoption of CSA. There were significant differences between public, private, and both sectors in relation to the quality of information disseminated. The quality of private sector’s advice was significantly lower than that of public sector and both sectors. There was no significant difference in quality of advice between public sector and both sectors. The quality of CSA advice was generally fair, however, heightened dissemination of CSA practices by both sectors of extension would yield better quality advice thus improve the adoption of the practices among farmers.

Women’s health claims in modern magazines: information accuracy and the role of experts

ABSTRACT This paper aimed to examine the quality of obstetric and gynecological advice provided to women in a sample of women’s magazines, and determine whether the inclusion of expert sources affected the quality of advice. A retrospective content analysis of popular Canadian magazines from January 2019 to 2020 was conducted. An adaptation of the Media Doctor Australia rating tool was used to assess the quality of reporting. Criteria included source, evidence base, benefits presented meaningfully, potential harms mentioned, no evidence of fear-based rhetoric, availability, and cost. Seventy-seven claims were rated, exhibiting a wide variation in quality, evidence base, and inclusion of expert sources. Approximately 55 of 77 health claims cited a medical professional source. A majority of health claims (71%, 54/77) were supported by robust evidence or generally in line with recommendations. The quality of the claims was low and varied widely across magazines. There was no significant association between expert sources and health claim quality. The prevalence of expert sources does not impact the quality of each article, though may increase the reader’s confidence in the claim. The overall prevalence of low quality or incomplete information found in this study suggests that women may not be receiving adequate health information from magazine content.

The Quality of Financial Advice: What Influences Client Recommendations?

The Quality of Financial Advice: What Influences Client Recommendations?

Do actions speak louder than words? Evidence from microblogs

This research identifies the determinants of investors’ future beliefs by analyzing more than 50 million tweets on thousands of stocks from the microblogging platform StockTwits. To do so, I divide tweets into two categories: beliefs, representing the average sentiment of all investors regarding a particular stock, and actions, representing the actual transactions disclosed by StockTwits’ users in their tweets. The results show that investors’ next-period beliefs are positively impacted both by beliefs and actions of the current day. The quality of the investment advice strengthens this effect. More communication between investors leads to greater diversity in beliefs and more uncertainty.

Time trends in access to smoking cessation support for people with depression or severe mental illness: a cohort study in English primary care

ObjectivesTo investigate delivery of smoking cessation interventions, recorded quit attempts and successful quitting rates within primary care in smokers with depression or severe mental illness (SMI) compared with those without.DesignLongitudinal...