The Effect of Positive and Negative Poster Messages on Organ Donor Registration.

BACKGROUND: There is a mismatch between the number of people who require transplants and the number of organ donors. Promotional materials have been shown to increase rates of organ donor registration. This study assessed the impact on the intention to join the organ donor registry of a gain-framed message about lives saved through organ donation compared to a loss-framed message about lives lost waiting for a transplant. METHODS: Two posters were designed that were identical other than the slogan. One slogan was gain-framed: "One organ donor can save 9 lives!" and the other loss-framed: "3 people die every day in the UK waiting for an organ transplant." Twenty copies of each were distributed between hospitals in Cambridge and Newcastle, UK, for 20 weeks. After 10 weeks, the gain-framed and loss-framed posters swapped locations. Each poster had a QR code that linked to the online organ donor register sign-up form, and the click-through rate was used to determine registration. Analysis was performed using a 2-tailed sign binomial test. RESULTS: Sixty-eight registrations occurred over a 20-week period. Overall, there was no significant difference in registrations between gain- and loss-framed posters (37 vs 31, P = .54). However, poster location influenced registration, as prior to the location swap there was a significant difference in gain-framed vs loss-framed posters (28 vs 10, P = .005). Additionally, registration was significantly higher in Cambridge vs Newcastle (47 vs 21, P = .01). CONCLUSIONS: Posters can increase organ donor register (ODR) registration independent of gain- or loss-framing. However, poster location, both intra- and inter-hospital, significantly influences effectiveness.

Investigating current practices in renal function measurement and carboplatin dosing in children with cancer - a UK perspective.

Renal function-based carboplatin dosing is a well-accepted practice in pediatric oncology. However, the accuracy of this approach is only as precise as the method of kidney function measurement, most commonly involving determination of glomerular filtration rate (GFR). Recent work by the Children's Oncology Group has raised concerns over nuclear medicine-based methodologies used to calculate GFR across US clinical centers. Current practices of GFR measurement, methods used to calculate carboplatin dosage and the utility of therapeutic drug monitoring were investigated in 21 UK primary pediatric oncology treatment centers through a questionnaire-based study. Information obtained was compared to results previously published in 2008 following a similar survey. In relation to GFR measurement, the main changes observed were a shift toward a greater number of samples being taken following tracer administration and an increase in number of centers using the Brochner-Mortensen correction factor. In relation to the use of renal function assessment data to inform dosing, EDTA elimination half-life in conjunction with body weight was used to calculate carboplatin dose in 18/21 (86%) centers, with uncorrected GFR and body weight utilized in 9/21 (43%) centers. A total of 14/21 (67%) centers utilize therapeutic drug monitoring approaches to carboplatin treatment in defined patient groups including neonates and infants. Results suggest that while GFR measurement across UK centers is relatively consistent, some uncertainties remain. In addition, for patient sub-populations where there are concerns over the potential for marked inter-patient variability in carboplatin exposures, adaptive dosing approaches are now well established.