scholarly journals Influence of Provider Communication on Emerging Adults’ Medication Cognitions and Provider Satisfaction

2020 ◽  
Vol 45 (5) ◽  
pp. 573-582
Author(s):  
Samantha A Carreon ◽  
Lindsay Durkin ◽  
W Hobart Davies ◽  
Rachel Neff Greenley
Keyword(s):  
Medication Adherence ◽  
Emerging Adults ◽  
Antibiotic Use ◽  
Positive Outcome ◽  
Outcome Expectancy ◽  
Future Research ◽  
Oral Antibiotic ◽  
Provider Communication ◽  
Medical Provider ◽  
Provider Satisfaction

Abstract Objective This study examined how the content of medical provider communication related to medication prescriptions influenced emerging adults’ (EA) medication-related cognitions and satisfaction with care. Methods In total, 257 EA (ages 18–25) were randomized to one of three audio vignettes depicting a medical appointment in which the EA imagined him/herself as the recipient of an oral antibiotic prescription. Provider communication content varied by vignette as follows: the positive outcome expectancy (POE) vignette focused on enhancing patient POE related to antibiotic use; the negative outcome expectancy (NOE) vignette focused on reducing patient NOE; and the standard care vignette focused on providing factual medication information. Following the vignette, participants self-reported on demographics, select medication-related cognitions, and provider satisfaction from vignette. Results Those in the NOE vignette condition reported higher provider satisfaction, perceived the provider to have given more information, and evidenced lower NOE and higher POE about the antibiotic compared with those in the other conditions. Intent to adhere did not vary by vignette condition. Conclusions Brief, provider-initiated communication focused on reducing patient NOE may have unique value in altering EA’s medication-related cognitions. Given that medication-related beliefs are known correlates of adherence, future research should replicate and expand these findings in the context of real-world medical encounters and through the utilization of objective indices of medication adherence to more fully understand the potential significance of provider language emphasizing reduction of NOE on medication adherence.

Medication adherence among emerging adults: the influence of provider communication and patient personality

2021 ◽  
pp. 1-17
Author(s):  
Sara L. Lampert ◽  
Estée C. H Feldman ◽  
Lindsay K. Durkin ◽  
W. Hobart Davies ◽  
Rachel Neff Greenley
Keyword(s):  
Medication Adherence ◽  
Emerging Adults ◽  
Provider Communication

Habit and Routine Interventions with Emerging Adults with Diabetes: An Integrative Review

2021 ◽  
pp. 019394592110322
Author(s):  
Kathleen M. Hanna ◽  
Jed R. Hansen ◽  
Kim A. Harp ◽  
Kelly J. Betts ◽  
Diane Brage Hudson ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Health Outcomes ◽  
Emerging Adults ◽  
Text Messaging ◽  
Integrative Review ◽  
Self Management ◽  
Future Research ◽  
Medical Librarian

Although theoretical and empirical writings on habits and routines are a promising body of science to guide interventions, little is known about such interventions among emerging adults with type 1 diabetes. Thus, an integrative review was conducted to describe interventions in relation to habits and routines, their influence on outcomes, and users’ perspectives. A medical librarian conducted a search. Teams screened titles, abstracts, and articles based upon predefined criteria. Evidence from the final 11 articles was synthesized. A minority of investigators explicitly articulated habits and routines theoretical underpinnings as part of the interventions. However, text messaging or feedback via technology used in other interventions could be implicitly linked to habits and routines. For the most part, these interventions positively influenced diabetes self-management-related behaviors and health outcomes. In general, the interventions were perceived positively by users. Future research is advocated using habit and routine theoretical underpinnings to guide interventions.

Developing Leadership Talent in Adolescents and Emerging Adults: A Systematic Review

2021 ◽  
pp. 001698622110075
Author(s):  
Melanie S. Meyer ◽  
Anne N. Rinn
Keyword(s):  
Systematic Review ◽  
Emerging Adults ◽  
Gifted Education ◽  
Talent Development ◽  
State Standards ◽  
Database Search ◽  
Future Research ◽  
Review Of Literature ◽  
Leadership Programs ◽  
Service Models

Leadership talent development has been identified as a priority in national and state standards for gifted education. However, leadership programs in schools are not always supported by mandates or funding in individual states and implementation is not always feasible within the constraints of local gifted service models. Although some research has been devoted to leadership for gifted and high-ability adolescents and emerging adults, a limited number of studies on the identification, measurement, and development of leadership talent have been conducted. This systematic review of literature examined existing research on leadership talent development for adolescents and emerging adults. A database search identified 38 quantitative, qualitative, and mixed methods studies that were screened, summarized, and synthesized for discussion. The review highlighted research contexts, definitions of leadership, and themes that captured the recommendations researchers made across studies. Implications for developing leadership talent and suggestions for future research are discussed.

scholarly journals 144. Little evidence of same-day, oral antibiotic prescribing at ambulatory surgery centers

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S82-S83
Author(s):  
Laura M King ◽  
Lauri Hicks ◽  
Sarah Kabbani; Sharon Tsay ◽  
Katherine E Fleming-Dutra
Keyword(s):  
Surgical Procedures ◽  
Ambulatory Surgery ◽  
Antibiotic Use ◽  
Antibiotic Prescribing ◽  
Oral Antibiotic ◽  
Chi Square ◽  
Convenience Sample ◽  
Ambulatory Surgery Centers ◽  
National Public Health ◽  
Course Length

Abstract Background The objective of our study was to describe oral antibiotic prescriptions associated with procedures in ambulatory surgery centers (ASC) to evaluate if there are major national opportunities to improve antibiotic use in this setting. Methods We identified surgical procedures in ASCs and oral antibiotic prescriptions in the IBM® MarketScan® Commercial 2018 database, a large convenience sample of privately-insured individuals aged < 65 years. We excluded visits with same-day hospitalizations and those with infectious diagnoses that may warrant antibiotic treatment. We included only antibiotic prescriptions dispensed on the same day as an ASC visit. We calculated the number of visits and oral antibiotic prescriptions and the percent of visits with oral antibiotic prescriptions overall, and by patient age group (< 18 and 18–64 years), antibiotic class, and procedure type. We also calculated median antibiotic course length. Across-group comparisons were evaluated using chi-square tests. Results In 2018, 918,127 ASC visits with surgical procedure codes were captured, of which 37,032 (4.0%) were associated with same-day oral antibiotic prescriptions. The percent of visits with antibiotic prescriptions was significantly higher among children compared to adults (9.4% vs 3.8%; p< 0.01); however, adults accounted for 89% of prescriptions. Respiratory/nasal and urinary tract system procedures were most frequently associated with antibiotic prescriptions (Figure). Median course length was 5 (interquartile range 3–7) days. The most common antibiotic class was cephalosporins (49.6% of prescriptions), followed by penicillins (12.6%) and fluoroquinolones (10.9%). Figure. Percent of ambulatory surgery center visits with same-day antibiotic prescriptions by procedure category, IBM® MarketScan® Commercial Database, 2018 Conclusion Only 4% of ASC procedures were associated with same-day oral antibiotic prescriptions, suggesting antibiotics are not commonly prescribed in ASCs on the day of surgical procedures. Additionally, the observed 5-day median duration may suggest that some of these courses are intended for treatment rather than prophylaxis. Our estimates represent lower bounds for oral antibiotic prescriptions in this setting, as we only captured same-day prescriptions. However, our findings suggest that ASC facilities may not be high-impact targets for national, public health antibiotic stewardship efforts. Disclosures All Authors: No reported disclosures

scholarly journals Improving intravenous-to-oral antibiotic switch in children: a team-based audit and implementation approach

2021 ◽  
Vol 10 (1) ◽  
pp. e001120
Author(s):  
Brendan Joseph McMullan ◽  
Michelle Mahony ◽  
Lolita Java ◽  
Mona Mostaghim ◽  
Michael Plaister ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Antibiotic Use ◽  
Hospital Length ◽  
Audit And Feedback ◽  
Hospital Length Of Stay ◽  
Oral Antibiotic ◽  
Intravenous Therapy ◽  
Paediatric Hospital ◽  
Inpatient Settings ◽  
Surgical Teams

Children in hospital are frequently prescribed intravenous antibiotics for longer than needed. Programmes to optimise timely intravenous-to-oral antibiotic switch may limit excessive in-hospital antibiotic use, minimise complications of intravenous therapy and allow children to go home faster. Here, we describe a quality improvement approach to implement a guideline, with team-based education, audit and feedback, for timely, safe switch from intravenous-to-oral antibiotics in hospitalised children. Eligibility for switch was based on evidence-based guidelines and supported by education and feedback. The project was conducted over 12 months in a tertiary paediatric hospital. Primary outcomes assessed were the proportion of eligible children admitted under paediatric and surgical teams switched within 24 hours, and switch timing prior to and after guideline launch. Secondary outcomes were hospital length of stay, recommencement of intravenous therapy or readmission. The percentage of children switched within 24 hours of eligibility significantly increased from 32/50 (64%) at baseline to 203/249 (82%) post-implementation (p=0.006). The median time to switch fell from 15 hours 42 min to 4 hours 20 min (p=0.0006). In addition, there was a 14-hour median reduction in hospital length of stay (p=0.008). Readmission to hospital and recommencement of intravenous therapy did not significantly change postimplementation. This education, audit and feedback approach improved timely intravenous-to-oral switch in children and also allowed for more timely discharge from hospital. The study demonstrates proof of concept for this implementation with a methodology that can be readily adapted to other paediatric inpatient settings.

scholarly journals NURSING HOME TELEED INTERVENTION: ADVANCING NEW CARE MODELS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S337-S338
Author(s):  
Charlene C Quinn ◽  
Anthony Roggio ◽  
Barr Erik ◽  
Ann Gruber-Baldini
Keyword(s):  
Medical Center ◽  
Business Case ◽  
Admission Policy ◽  
Care Utilization ◽  
Future Research ◽  
Technical Equipment ◽  
Nursing Facilities ◽  
Medical Problems ◽  
Provider Satisfaction ◽  
Care Models

Abstract New reimbursement and managed care models demonstrate the need to reduce avoidable Emergency Department (ED) use and limit preventable inpatient admissions for older adults in Skilled Nursing Facilities (SNF). The objective was to develop an ED telemedicine consultation intervention for SNF residents with acute medical problems. Secondary objectives including evaluation of health care utilization, provider satisfaction. Demonstration evaluation in three urban SNFs, telemedicine linked to university medical center ED. Mobile telemedicine cart equipment assessed SNF residents for any change in condition. ED physicians used tablets with secure access to conduct the resident assessment. Provider satisfaction measures imbedded in EMRs were completed at consultation visit end. 460 patients had changes in condition, 327 resulted in 911 calls, 85 deemed eligible for telemedicine consult. Conducted 57 telehealth consults. Forty (70%) telemedicine consult residents remained in the SNF. Fourteen residents were transferred to the ED. Average satisfaction scores were 5.8/7 for SNF nurses (n=49) and 5.6 for ED physicians (n=45). Lower-rated items related to technical equipment problems. ED physicians reported residents transferred to ED after telehealth visit had better continuity of care. The intervention was effective in preventing or delaying transfer of acutely ill, medically complex SNF residents. Implementation of the intervention identified need for SNF admission policy and procedure changes; weekly telemedicine training; SNF clinical advocates; on-site tracking and linkage of EMRs across providers; HIPAA shared medical record concerns. Future research plans include analyses of detailed SNF resident characteristics and business case assessment for reduction of transfers, ED and hospital utilization.

Toward a Grounded Theory of Student-Athlete Suffering and Dealing with Academic Corruption

2008 ◽  
Vol 22 (3) ◽  
pp. 273-302 ◽  
Author(s):  
Lisa A. Kihl ◽  
Tim Richardson ◽  
Charles Campisi
Keyword(s):  
Grounded Theory ◽  
Student Athletes ◽  
Positive Outcome ◽  
Comparison Method ◽  
Future Research ◽  
Theory Approach ◽  
Multiple Sources ◽  
Theoretical Concepts ◽  
Academic Corruption ◽  
Dual Consciousness

The purpose of this grounded theory study was to explain how student-athletes are affected by an instance of academic corruption. Using a grounded theory approach (Glaser & Strauss, 1967; Strauss & Corbin, 1998), multiple sources of data were collected and analyzed using the constant comparison method leading to theory generation. Findings revealed that student-athletes suffer three main consequences (negative treatment, sanctions, and a sense of loss) that lead to various harmful outcomes (e.g., distrust, embarrassment, dysfunctional relationships, stakeholder separation, anger, stress, and conflict). However, the consequences also created a positive outcome displayed through a dual consciousness of corruption (resiliency and empowerment). The results are compared with existing theoretical concepts and previous research associated with the outcomes of corruption. This theory adds to our knowledge of the nature of suffering experienced by student-athletes as a result of corruption and provides direction for future research and practice.

scholarly journals Microvascular decompression for tinnitus: systematic review

2017 ◽  
Vol 126 (4) ◽  
pp. 1148-1157 ◽  
Author(s):  
Brenton Nash ◽  
Matthew L. Carlson ◽  
Jamie J. Van Gompel
Keyword(s):  
Systematic Review ◽  
Microvascular Decompression ◽  
English Language ◽  
Positive Outcome ◽  
Future Research ◽  
Symptom Duration ◽  
Review Of The Literature ◽  
Preoperative Symptom ◽  
Operative Outcomes ◽  
Review Reports

OBJECTIVE The objective of this study was to examine operative outcomes in cases of microvascular decompression (MVD) of cranial nerve (CN) VIII for tinnitus through a critical review of the literature. METHODS Forty-three English-language articles were gathered from PubMed and analyzed. In this review, two different case types were distinguished: 1) tinnitus-only symptomatology, which was defined as a patient with tinnitus with or without sensorineural hearing loss; and 2) mixed symptomatology, which was defined as tinnitus with symptoms of other CN dysfunction. This review reports outcomes of those with tinnitus-only symptoms. RESULTS Forty-three tinnitus-only cases were found in the literature with a 60% positive outcome rate following MVD. Analysis revealed a 5-year cutoff of preoperative symptom duration before which a good outcome can be predicted with 78.6% sensitivity, and after which a poor outcome can be predicted with 80% specificity. CONCLUSIONS As the 60% success rate is more promising than several other therapeutic options open to the chronic tinnitus sufferer, future research into this field is warranted.

Abstract 112: Use of WhatsApp to Improve Medical Provider Communication for Children with Wilms Tumor in Tanzania

2021 ◽  
Author(s):  
John Igenge ◽  
Jacob Stocks ◽  
Gloria Zhang ◽  
Mocha George ◽  
Frank Kiwara ◽  
...  
Keyword(s):  
Wilms Tumor ◽  
Provider Communication ◽  
Medical Provider
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