scholarly journals US haemophilia centre nurses and advanced practice providers: Demographics, roles/responsibilities, training, educational barriers and employment benefits

2017 ◽  
Vol 4 (1) ◽  
pp. 14-21 ◽  
Author(s):  
Michelle L. Witkop ◽  
Christine Guelcher ◽  
Margaret Hall ◽  
Jennifer Maahs
Keyword(s):  
United States ◽  
Online Survey ◽  
Medical Center ◽  
Age Distribution ◽  
Healthcare Providers ◽  
Physician Assistants ◽  
The United States ◽  
Educational Opportunities ◽  
Advanced Practice ◽  
Employment Benefits

Abstract Introduction: As the focus on personalised treatment is refined, more products are brought to market and the life expectancy of persons with haemophilia increases, there will be an expanded need of experienced and expert healthcare providers to ensure optimal patient outcomes. Aim: This survey describes the demographics, roles/ responsibilities, practice patterns, educational opportunities/barriers and employment benefits of nurses and advanced practices providers (APPs), including advanced practice registered nurses (APRNs) and physician assistants (PAs) employed by haemophilia treatment centres (HTCs) across the United States. Methods: This one-time convenience online survey was approved by the Munson Medical Center Institutional Review Board. A survey of this type had never been attempted in the HTC nursing community; therefore. there was no opportunity to utilise a previous tool. Data was analysed using statistical tools through SurveyMonkey. Results: Gaps were identified in provider age distribution, research opportunities, and standardised educational opportunities for APPs. An aging but highly educated HTC nursing population is revealed: over 50% of respondents were over the age of 50; the majority held at least a baccalaureate degree and almost half had national board certification; most were experienced in healthcare but newer to the field of bleeding disorders. Conclusion: Development of an APP fellowship program would standardise the care and treatment of those with bleeding and clotting disorders across the United States. This fellowship should include a didactic portion, advocacy within the community, mentorship with experienced APPs and regular webinar-based case studies to review current trends in care. This survey is a call to action to begin standardised education programs for the advanced practice role.

Survey of opioid tapering practices of pediatric healthcare providers: A national perspective

2017 ◽  
Vol 13 (1) ◽  
pp. 59 ◽  
Author(s):  
Deborah Fisher, PhD, RN, PPCNP-BC ◽  
Suzanne W. Ameringer, PhD, RN
Keyword(s):  
Nurse Practitioners ◽  
Online Survey ◽  
Medical Center ◽  
Pediatric Population ◽  
Healthcare Providers ◽  
Physician Assistants ◽  
Pediatric Pain ◽  
Wide Range ◽  
Opioid Tapering ◽  
Pediatric Healthcare

Objective: The purpose of this study was to describe the current opioid tapering practice.Design: Cross-sectional, online, survey research.Participants: Pediatric healthcare providers from a national sample of practicing nurse practitioners, physician assistants, and physicians who participate in five different pediatric pain and/or palliative care list serves.Results: One hundred four participants responded to the survey. The respondents were predominantly physicians (n = 58, 62 percent). The majority of respondents worked in an academic children's medical center (n = 50, 52 percent). The average number of years in pediatric practice was 16 (mean = 16.33, range of 0-45 years). Of the 104 respondents, only 22 (27 percent) had a written protocol for opioid tapering. Use of expert consultants such as pharmacists or pediatric pain management teams varied. The majority of respondents (n = 46, 44 percent) seldom or never consult a pharmacist. Only 22 percent (n = 17) almost always or always consult a pediatric pain team. There was a wide range of personal tapering rate preferences. Conclusions: This study provided a baseline assessment of pediatric opioid tapering practices by pediatric healthcare providers. Results revealed a marked variation in practice patterns that may indicate deficits in the assessment and management of opioid withdrawal in children. The need for the development of assessment-based opioid tapering guidelines for the pediatric population is long overdue.

scholarly journals Applying mindfulness to influence the patient and care team experience

2017 ◽  
Vol 8 (5) ◽  
pp. 7
Author(s):  
Keerat S. Singh ◽  
Patricia Davis ◽  
Mona Cockerham
Keyword(s):  
United States ◽  
Patient Satisfaction ◽  
Educational Program ◽  
Online Survey ◽  
Healthcare Providers ◽  
The United States ◽  
Care Team ◽  
Post Discharge ◽  
Carry Over ◽  
Hcahps Survey

Objective: In today’s work environment, specifically in health care, mindfulness is a personal and professional strategy to improve performance and productivity. To influence the patient and care team hospital experience through the concepts of mindfulness and perception.Methods: This was a prospective observational project completed by medical/surgical nurses using an online survey pre- and post an educational program and an aggregate score of the 5 nurse-sensitive questions on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, a survey based in the United States that is mailed to patients post discharge to home to measure patient satisfaction with their hospitalization. The HCAHPS survey is a patient satisfaction survey required by the Centers for Medicare and Medicaid Services (CMS) for all hospitals in the United States. The purpose of the HCAHPS survey is to provide a standardized survey instrument and data collection methodology for measuring patients’ perspectives on their hospital care and hospital experience.Results: The aggregate nurse-sensitive HCAHPS scores increased from 85.5 to 89.8 over one month. For mindfulness, after the educational program, among the ten nurse survey questions the percentage went up as much as 0.57%.Conclusions: An educational program related to the benefits of mindfulness can positively effect nurses’ engagement in the workplace and positively increase HCAHPS scores. Continuing education on mindfulness should carry over month to month. In this research project, participants provided feedback to the researcher of feeling empowered to bring in new ideas, present different ways to grow, and tackle challenges.

An Assessment of the Cues College Students Interpret From a Sexual Partner to Determine They Are Refusing

2021 ◽  
pp. 088626052199793
Author(s):  
Tiffany L. Marcantonio ◽  
Danny Valdez ◽  
Kristen N. Jozkowski
Keyword(s):  
United States ◽  
College Students ◽  
Sexual Partner ◽  
Online Survey ◽  
The United States ◽  
Sexual Partners ◽  
Sexual Scripts ◽  
Nonverbal Cues ◽  
Sexual Experiences ◽  
Verbal Cues

The purpose of this study was to assess the cues college students use to determine a sexual partner is refusing vaginal-penile sex (i.e., refusal interpretations). As a secondary aim, we explored the influence of item wording ( not willing/non-consent vs refusal) on college students’ self-reported refusal interpretations. A sample of 175 college students from Canada and the United States completed an open-ended online survey where they were randomly assigned to one of two wording conditions ( not willing/non-consent vs refusal); students were then prompted to write about the cues they used to interpret their partner was refusing. An inductive coding procedure was used to analyze open-ended data. Themes included explicit and implicit verbal and nonverbal cues. The refusal condition elicited more explicit and implicit nonverbal cues than the not willing/non-consent condition. Frequency results suggested men reported interpreting more explicit and implicit verbal cues. Women reported interpreting more implicit nonverbal cues from their partner. Our findings reflect prior research and appear in line with traditional gender and sexual scripts. We recommend researchers consider using the word refusal when assessing the cues students interpret from their sexual partners as this wording choice may reflect college students’ sexual experiences more accurately.

scholarly journals Pre-Exposure Prophylaxis Training among Medical Schools in the United States

2021 ◽  
Vol 12 ◽  
pp. 215013272110287
Author(s):  
Robert L. Cooper ◽  
Mohammad Tabatabai ◽  
Paul D. Juarez ◽  
Aramandla Ramesh ◽  
Matthew C. Morris ◽  
...  
Keyword(s):  
United States ◽  
Hiv Prevention ◽  
Injection Drug Users ◽  
Drug Users ◽  
Healthcare Providers ◽  
Medical Schools ◽  
The United States ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Exposure Prophylaxis

Pre-Exposure Prophylaxis (PrEP) has been shown to be an effective method of HIV prevention for men who have sex with-men (MSM) and -transgender women (MSTGWs), serodiscordant couples, and injection drug users; however fewer than 50 000 individuals currently take this regimen. Knowledge of PrEP is low among healthcare providers and much of this lack of knowledge stems from the lack or exposure to PrEP in medical school. We conducted a cross sectional survey of medical schools in the United States to assess the degree to which PrEP for HIV prevention is taught. The survey consisted Likert scale questions assessing how well the students were prepared to perform each skill associated with PrEP delivery, as well as how PrEP education was delivered to students. We contacted 141 medical schools and 71 responded to the survey (50.4%). PrEP education was only reported to be offered at 38% of schools, and only 15.4% reported specific training for Lesbian, Gay, Bisexual, and Transgender (LGBT) patients. The most common delivery methods of PrEP content were didactic sessions with 11 schools reporting this method followed by problem-based learning, direct patient contact, workshops, and small group discussions. Students were more prepared to provide PrEP to MSM compared to other high-risk patients. Few medical schools are preparing their students to prescribe PrEP upon graduation. Further, there is a need to increase the number of direct patient contacts or simulations for students to be better prepared.

scholarly journals Household COVID-19 risk and in-person schooling

Science ◽  
2021 ◽  
pp. eabh2939
Author(s):  
Justin Lessler ◽  
M. Kate Grabowski ◽  
Kyra H. Grantz ◽  
Elena Badillo-Goicoechea ◽  
C. Jessica E. Metcalf ◽  
...  
Keyword(s):  
United States ◽  
Online Survey ◽  
Positive Association ◽  
The United States ◽  
Mitigation Measures ◽  
Office Work ◽  
School Based ◽  
Increased Risk ◽  
Extra Curricular Activities ◽  
Low Levels

In-person schooling has proved contentious and difficult to study throughout the SARS-CoV-2 pandemic. Data from a massive online survey in the United States indicates an increased risk of COVID-19-related outcomes among respondents living with a child attending school in-person. School-based mitigation measures are associated with significant reductions in risk, particularly daily symptoms screens, teacher masking, and closure of extra-curricular activities. A positive association between in-person schooling and COVID-19 outcomes persists at low levels of mitigation, but when seven or more mitigation measures are reported, a significant relationship is no longer observed. Among teachers, working outside the home was associated with an increase in COVID-19-related outcomes, but this association is similar to other occupations (e.g., healthcare, office work). While in-person schooling is associated with household COVID-19 risk, this risk can likely be controlled with properly implemented school-based mitigation measures.

scholarly journals Evaluation of pharmacists’ awareness of illegal online pharmacies and perceived impact on safe access to medicines

2021 ◽  
Vol 5 ◽  
pp. 239920262110056
Author(s):  
John B Hertig ◽  
Shannon M James ◽  
Connor J Hummel ◽  
Matthew J Rubin
Keyword(s):  
United States ◽  
Healthcare Providers ◽  
Access To Medicines ◽  
The United States ◽  
Pharmacy Education ◽  
Electronic Survey ◽  
Medication Therapy ◽  
Online Pharmacies ◽  
Effective Medication ◽  
Selection Of

Background: An estimated 95% of all online pharmacies operate unlawfully. Illegal online pharmacies distribute substandard and falsified medical products that may result in patient harm and suboptimal treatment, leading to an overall mistrust of medications, healthcare providers, and health systems. As medication experts, pharmacists are trusted to guide patients in selection of safe and effective medication therapy. Objective: The objective of this study was to determine gaps in knowledge and recognition of the negative clinical and safety impacts associated with illegal Internet pharmacies by licensed pharmacists. Methods: A 37-question electronic survey was developed and distributed to pharmacists across the United States by email via a database from the American Pharmacists Association. Descriptive statistics was utilized to analyze data. Results: A total of 347 pharmacists from across the United States responded to at least one question in the survey. In all, 58% of pharmacists reported a lack of confidence in their ability to counsel patients on the identification of illegal pharmacy websites. Fewer than 60% of pharmacists were able to accurately identify the legitimacy of a webpage based on visual characteristics. In addition, 75% of pharmacists reported being unfamiliar with resources available to help consumers identify safe and legitimate online pharmacies. Conclusion: Integration of the topic into pharmacy education curricula, training on available resources, and additional research into the prevalence and impact of illegal pharmacy websites are necessary to ensure that pharmacists and other healthcare professionals are adequately prepared to protect their communities from the threat of illegal online pharmacies.

scholarly journals Abortion attempts without clinical supervision among transgender, nonbinary and gender-expansive people in the United States

2021 ◽  
pp. bmjsrh-2020-200966
Author(s):  
Heidi Moseson ◽  
Laura Fix ◽  
Caitlin Gerdts ◽  
Sachiko Ragosta ◽  
Jen Hastings ◽  
...  
Keyword(s):  
United States ◽  
Clinical Supervision ◽  
Online Survey ◽  
Clinical Care ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Physical Trauma ◽  
Abortion Care ◽  
And Gender

BackgroundTransgender, nonbinary and gender-expansive (TGE) people face barriers to abortion care and may consider abortion without clinical supervision.MethodsIn 2019, we recruited participants for an online survey about sexual and reproductive health. Eligible participants were TGE people assigned female or intersex at birth, 18 years and older, from across the United States, and recruited through The PRIDE Study or via online and in-person postings.ResultsOf 1694 TGE participants, 76 people (36% of those ever pregnant) reported considering trying to end a pregnancy on their own without clinical supervision, and a subset of these (n=40; 19% of those ever pregnant) reported attempting to do so. Methods fell into four broad categories: herbs (n=15, 38%), physical trauma (n=10, 25%), vitamin C (n=8, 20%) and substance use (n=7, 18%). Reasons given for abortion without clinical supervision ranged from perceived efficiency and desire for privacy, to structural issues including a lack of health insurance coverage, legal restrictions, denials of or mistreatment within clinical care, and cost.ConclusionsThese data highlight a high proportion of sampled TGE people who have attempted abortion without clinical supervision. This could reflect formidable barriers to facility-based abortion care as well as a strong desire for privacy and autonomy in the abortion process. Efforts are needed to connect TGE people with information on safe and effective methods of self-managed abortion and to dismantle barriers to clinical abortion care so that TGE people may freely choose a safe, effective abortion in either setting.

Measurement of Perceived Interpersonal and Societal Anti-Muslim Discrimination in the United States

Assessment ◽  
2020 ◽  
pp. 107319112097338
Author(s):  
Naheed Ahmed
Keyword(s):  
United States ◽  
Online Survey ◽  
Qualitative Data ◽  
High Reliability ◽  
The United States ◽  
Discrimination Index ◽  
Muslim Americans ◽  
Study Results ◽  
Development And Validation ◽  
Component Models

Background: Hate crimes against Muslim Americans have increased exponentially in the past 20 years, but there is currently no scale for measuring perceived anti-Muslim discrimination in the United States. To fill this gap, this study used a mixed-method approach to develop scales for measuring perceived anti-Muslim discrimination. Method: Qualitative data informed the development and validation of the 19-item Societal Anti-Muslim Discrimination Index and the 9-item Interpersonal Anti-Muslim Discrimination Index. Quantitative data ( N = 347) were collected from Muslim Americans using an online survey and used to assess the anti-Muslim indexes. Results: Qualitative data contributed to the refinement scale items. Quantitative results indicated one-component models and modest to high reliability of the Interpersonal Anti-Muslim Discrimination Index (.77) and Societal Anti-Muslim Discrimination Index (.88) scales. Discussion: Study results established the validity of these novel scales for measuring the distinct facets of anti-Muslim discrimination not captured by the Everyday Discrimination Index. These scales will facilitate research on anti-Muslim discrimination and the health implications of this form of religious-based discrimination.

scholarly journals 55 Malignant primary brain and other central nervous system tumours diagnosed in the Canadian population from 2009 to 2013

2018 ◽  
Vol 45 (S3) ◽  
pp. S16-S17
Author(s):  
EV Walker ◽  
F Davis ◽  
Keyword(s):  
United States ◽  
Central Nervous System ◽  
Nervous System ◽  
Brain Tumour ◽  
Age Distribution ◽  
Paediatric Population ◽  
The United States ◽  
Incidence Rates ◽  
Canadian Population ◽  
Cns Tumours

The Canadian Brain Tumour Registry (CBTR) project was established in 2016 with the aim of enhancing infrastructure for surveillance and clinical research to improve health outcomes for brain tumour patients in Canada. We present a national surveillance report on malignant primary brain and central nervous system (CNS) tumours diagnosed in the Canadian population from 2009-2013. Patients were identified through the Canadian Cancer Registry (CCR); an administrative dataset that includes cancer incidence data from all provinces/territories in Canada. Cancer diagnoses are coded using the ICD-O3 system. Tumour types were classified by site and histology using The Central Brain Tumour Registry of the United States definitions. Incidence rates (IR) and 95% confidence intervals (CI) were calculated per 100,000 person-years and standardized to the 2011 census population age-distribution. Overall, 12,115 malignant brain and CNS tumours were diagnosed in the Canadian population from 2009-2013 (IR:8.43;95%CI:8.28,8.58). Of these, 6,845 were diagnosed in males (IR:9.72;95%CI:9.49,9.95) and 5,270 in females (IR:7.20;95%CI:7.00,7.39). The most common histology overall was glioblastoma (IR:4.06;95%CI:3.95,4.16). Among those aged 0-19 years, 1,130 malignant brain and CNS tumours were diagnosed from 2009-2013 (IR:3.36;95%CI:3.16,3.56). Of these, 625 were diagnosed in males (IR:3.32;95%CI:3.34,3.92) and 505 in females (IR:3.08;95%CI:2.81,3.36). The most common histology among the paediatric population was pilocytic astrocytoma (IR:0.73;95%CI:0.64,0.83). The presentation will include: IRs for other histologies, the geographic distribution of cases and a comparison between Canada and the United States.

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