BackgroundGovernments and health care providers are keen to find innovative ways to deliver care more efficiently. Interest in electronic consultation (e-consultation) has grown, but the evidence of benefit is uncertain.ObjectiveThis study aimed to assess the evidence of delivering e-consultation using secure email and messaging or video links in primary care.MethodsA systematic review was conducted on the use and application of e-consultations in primary care. We searched 7 international databases (MEDLINE, EMBASE, CINAHL, Cochrane Library, PsycINFO, EconLit, and Web of Science; 1999-2017), identifying 52 relevant studies. Papers were screened against a detailed inclusion and exclusion criteria. Independent dual data extraction was conducted and assessed for quality. The resulting evidence was synthesized using thematic analysis.ResultsThis review included 57 studies from a range of countries, mainly the United States (n=30) and the United Kingdom (n=13). There were disparities in uptake and utilization toward more use by younger, employed adults. Patient responses to e-consultation were mixed. Patients reported satisfaction with services and improved self-care, communication, and engagement with clinicians. Evidence for the acceptability and ease of use was strong, especially for those with long-term conditions and patients located in remote regions. However, patients were concerned about the privacy and security of their data. For primary health care staff, e-consultation delivers challenges around time management, having the correct technological infrastructure, whether it offers a comparable standard of clinical quality, and whether it improves health outcomes.ConclusionsE-consultations may improve aspects of care delivery, but the small scale of many of the studies and low adoption rates leave unanswered questions about usage, quality, cost, and sustainability. We need to improve e-consultation implementation, demonstrate how e-consultations will not increase disparities in access, provide better reassurance to patients about privacy, and incorporate e-consultation as part of a manageable clinical workflow.

Anthrax lethal toxin (LT) is a major virulence factor of Bacillus anthracis. LT challenge suppresses platelet counts and platelet function in mice, however, the mechanism responsible for thrombocytopenia remains unclear. LT inhibits cellular mitogen-activated protein kinases (MAPKs), which are vital pathways responsible for cell survival, differentiation, and maturation. One of the MAPKs, the MEK1/2-extracellular signal-regulated kinase pathway, is particularly important in megakaryopoiesis. This study evaluates the hypothesis that LT may suppress the progenitor cells of platelets, thereby inducing thrombocytopenic responses. Using cord blood-derived CD34+ cells and mouse bone marrow mononuclear cells to perform in vitro differentiation, this work shows that LT suppresses megakaryopoiesis by reducing the survival of megakaryocytes. Thrombopoietin treatments can reduce thrombocytopenia, megakaryocytic suppression, and the quick onset of lethality in LT-challenged mice. These results suggest that megakaryocytic suppression is one of the mechanisms by which LT induces thrombocytopenia. These findings may provide new insights for developing feasible approaches against anthrax.

PurposeThe authors examine psychologically informed coaching approaches for evidence-based work-applied management through a meta-analysis. This analysis synthesized previous empirical coaching research evidence on cognitive behavioral and positive psychology frameworks regarding a range of workplace outcomes, including learning, performance and psychological well-being.Design/methodology/approachThe authors undertook a systematic literature search to identify primary studies (k = 20, n = 957), then conducted a meta-analysis with robust variance estimates (RVEs) to test the overall effect size and the effects of each moderator.FindingsThe results confirm that psychologically informed coaching approaches facilitated effective work-related outcomes, particularly on goal attainment (g = 1.29) and self-efficacy (g = 0.59). Besides, these identified coaching frameworks generated a greater impact on objective work performance rated by others (e.g. 360 feedback) than on coachees' self-reported performance. Moreover, a cognitive behavioral-oriented coaching process stimulated individuals' internal self-regulation and awareness to promote work satisfaction and facilitated sustainable changes. Yet, there was no statistically significant difference between popular and commonly used coaching approaches. Instead, an integrative coaching approach that combines different frameworks facilitated better outcomes (g = 0.71), including coachees' psychological well-being.Practical implicationsEffective coaching activities should integrate cognitive coping (e.g. combining cognitive behavioral and solution-focused technique), positive individual traits (i.e. strength-based approach) and contextual factors for an integrative approach to address the full range of coachees' values, motivators and organizational resources for yielding positive outcomes.Originality/valueBuilding on previous meta-analyses and reviews of coaching, this synthesis offers a new insight into effective mechanisms to facilitate desired coaching results. Frameworks grounded in psychotherapy and positive appear most prominent in the literature, yet an integrative approach appears most effective.

This paper aims to provide an analytic review of contemporary coaching evidence and future research directions through reviewing the development of coaching (e.g. executive, health and life coaching) and coaching psychology definitions. We offer alternative perspectives from psychologist and non-psychologist coaching practice in the development of both traditions over the past two decades. As part of this paper we will summarise systematic reviews and meta-analyses in workplace coaching and outline the key messages for evidence-based practice. Three key messages are identified from this review. First, coaching itself is a professional helping relationship since the process mainly relies on reciprocal actions between the coach and coachee. Second, coachees should be placed in the centre of the coaching relationship, recognising their motivation to change is the essential antecedent for coaching success. Third, social psychological perspectives are an important element in dyadic coaching interactions. Our aim in this paper is to encourage coaching scholars and practitioners towards future research collaborations in the interest of developing evidenced based practice in coaching.

This case study offers a new insight into application of multiple-criteria decision-making methods (MCDM) to social identity issues in the context of talent management. This study used MCDM to help a high-tech company to identify potential talents in its sale and marketing team (n=54). MCDM adjusted subjective information consisted of intangible organisational political issues into a transparent, objective benchmark. The transparency and consistency of this evaluation process reduced potential social identity disruption between individuals or groups. Furthermore, the involvement of multiple decision-makers (both managers and employees) in the talent identification procedure enhanced employees' motivation for further development.