scholarly journals Learning HIP: Speaking the Language of Healthcare

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Matthew Wilcox, MPH ◽  
Sarah E. Wiehe, MD, MPH ◽  
Brenda L. Hudson, MA ◽  
Fiona Schicho ◽  
Ivan D. Hicks, PhD ◽  
...  
Keyword(s):  
Personal Responsibility ◽  
Church Of The Nazarene ◽  
Poverty Line ◽  
Office Visits ◽  
Framework Analysis ◽  
Community Members ◽  
Baptist Church ◽  
Phone Calls ◽  
Healthcare Decision Making ◽  
Line Elements

Background The Healthy Indiana Plan serves as an insurance program, expansion of Medicaid, and unique initiative of Indiana, serving citizens near the poverty line. Elements of the program like the distinction between HIP Plus and HIP Basic, as well as the Gateway to Work program and their effects on the community have yet to be fully understood in their impact on healthcare decision making, stimulating personal responsibility, and ER utilization rates. Churches and faithbased organizations have consistently provided model forms of health support supplementation for reaching community, especially as demonstrated in the work of First Baptist Church North Indianapolis and Shepherd Community Church of the Nazarene. Project Methods 18 previously conducted and transcribed interviews with community leaders and community members were deductively analyzed with qualitative assessments, specifically descriptive content analysis and later framework analysis. Key themes and a framework were developed to understand and clarify responses and to produce direct recommendations. Results Participants in HIP Plus enjoy their insurance and experience minimal difficulty in receiving prescriptions and tests. However, remaining on HIP Plus is difficult for many participants, with the fallback of HIP Basic requiring copays that many are unable or unwilling to pay in light of greater financial priorities. Important factors arose, including: threshold knowledge to gain and maintain access, community necessitated assistance (advisory and financial), easy loss of HIP Plus status, gateway to work’s incompatibility with seasonal/temporal work, and no central administrative hub to check HIP status. Successful participants are adamant about their insurance, using phone calls, office visits, or consistent communication with navigators to ensure HIP Plus status. Conclusion & Future Directions This study, as well as Worlds Apart: Gaps in Life Expectancy in the Indianapolis Metro Area, have contributed to a continuing study on health inequity, community perspective, and organizational activities in Indianapolis communities.

scholarly journals Treatment of Recurrent Clostridium difficile Infection in an Immunocompromised Patient with Severe Neutropenia Not Responding to Standard Therapy

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Hajar AlQahtani ◽  
Saeed Baloch ◽  
Deanne Tabb
Keyword(s):  
Clostridium Difficile ◽  
Adverse Events ◽  
Fecal Microbiota Transplantation ◽  
Immunocompromised Patient ◽  
Fecal Microbiota ◽  
Watery Diarrhea ◽  
Severe Neutropenia ◽  
High Dose ◽  
Office Visits ◽  
Phone Calls

One of the most effective strategies in reducing the risk of Clostridium difficile infection (CDI) recurrence is fecal microbiota transplantation (FMT). However, several adverse events have been reported post FMT, and data on the efficacy and safety of FMT in immunocompromised patients with hematological malignancies are rare. This report presents FMT treatment for refractory CDI in a severely immunocompromised patient. A 69-year-old female presented to the emergency department complaining of foul smelling, intractable, watery diarrhea and generalized abdominal pain. She was recently diagnosed with high-risk myelodysplastic Syndrome (MDS) requiring daily blood transfusions and reported multiple CDI episodes in the past treated successfully with metronidazole and vancomycin as mono- or combotherapy. During this admission, treatment with oral vancomycin (high dose) and intravenous metronidazole was unsuccessful, so FMT was administered. The patient recovered well despite an absolute neutrophil count (ANC) < 0.25 × 109/L, and chemotherapy was initiated soon after. FMT was successful and safe in this patient, with no relapse and adverse events seen in 8 weeks of follow-up via phone calls and office visits.

Abstract 17319: Management of Advanced Heart Failure Patients With the Combined Use of CardioMEMS™ and Telehealth: A Single Center Experience in a Veteran’s Affairs Population

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Nishi Patel ◽  
Amit Alam ◽  
Subash Banerjee ◽  
Nicole Minniefield ◽  
Shelley Hall ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Admissions ◽  
Text Message ◽  
Admission Rate ◽  
Encounter Rate ◽  
Office Visits ◽  
Hospital Admission Rate ◽  
Phone Calls ◽  
Virtual Visits ◽  
Veteran's Affairs

Background: Due to the Coronavirus Disease of 2019 pandemic many clinics began to utilize virtual visits in lieu of traditional office visits. It is unclear what effect this will have on outcomes and admission rates for heart failure (HF). We describe our approach and outcomes in managing HF in a Veteran’s Affairs population with previously implanted CardioMEMS™ during this time. Methods: Starting February 15 th 2020, virtual visits were utilized in patients with CardioMEMS™ during which their symptoms were discussed and medications adjusted. Patients also received weekly phone calls to ensure that they had medications and to adjust diuretics based on pulmonary artery (PA) pressure readings. They received text message reminders if a reading was missed. A nurse was also tasked to follow up on lab results. Data was collected by reviewing the charts of CardioMEMS™ patients followed in our clinic by cardiology fellows and divided into pre pandemic period of July 1 st 2018 to February 14 th 2020 and a post pandemic period of February 15 th 2020 to May 15 th 2020. Data collected included baseline demographics, number of in-office and virtual visits, hospital admissions for HF, PA pressures, and compliance with CardioMEMS™ readings. Phone calls to adjust diuretics or review labs were not counted as virtual visits. Results: In the pre-pandemic period we identified 49 patients with prior CardioMEMS™; baseline demographics are shown in Table 1A. Table 1B shows our results comparing the pre pandemic and post pandemic periods when our telemedicine program was started. Although in the post pandemic period our encounter rate was lower, our virtual program was able to maintain stable PA pressures and a lower overall hospital admission rate. Compliance with CardioMEMS™ also increased though this was not statistically significant. Conclusion: Both CardioMEMS™ and virtual visits may be used effectively to maintain low PA pressures and reduce hospital admissions for in patients with chronic HF.

Streamlined data-gathering techniques to estimate the price and affordability of healthy and unhealthy diets under different pricing scenarios

2020 ◽  
Vol 24 (1) ◽  
pp. 1-11 ◽  
Author(s):  
Christina Zorbas ◽  
Amanda Lee ◽  
Anna Peeters ◽  
Meron Lewis ◽  
Timothy Landrigan ◽  
...  
Keyword(s):  
Fast Food ◽  
Data Gathering ◽  
Poverty Line ◽  
Online Data ◽  
Cross Sectional ◽  
Phone Calls ◽  
Healthy Diets ◽  
Food And Beverage ◽  
Human Participants ◽  
Household Incomes

AbstractObjective:To determine the reliability of streamlined data-gathering techniques for examining the price and affordability of a healthy (recommended) and unhealthy (current) diet. We additionally estimated the price and affordability of diets across socio-economic areas and quantified the influence of different pricing scenarios.Design:Following the Healthy Diets Australian Standardised Affordability and Pricing (ASAP) protocol, we compared a cross-sectional sample of food and beverage pricing data collected using online data and phone calls (lower-resource streamlined techniques) with data collected in-store from the same retailers.Setting:Food and beverage prices were collected from major supermarkets, fast food and alcohol retailers in eight conveniently sampled areas in Victoria, Australia (n 72 stores), stratified by area-level deprivation and remoteness.Participants:This study did not involve human participants.Results:The biweekly price of a healthy diet was on average 21 % cheaper ($596) than an unhealthy diet ($721) for a four-person family using the streamlined techniques, which was comparable with estimates using in-store data (healthy: $594, unhealthy: $731). The diet price differential did not vary considerably across geographical areas (range: 18–23 %). Both diets were estimated to be unaffordable for families living on indicative low disposable household incomes and below the poverty line. The inclusion of generic brands notably reduced the prices of healthy and unhealthy diets (≥20 %), rendering both affordable against indicative low disposable household incomes. Inclusion of discounted prices marginally reduced diet prices (3 %).Conclusions:Streamlined data-gathering techniques are a reliable method for regular, flexible and widespread monitoring of the price and affordability of population diets in areas where supermarkets have an online presence.

WhatsApp and Mobile Money: Ameliorating Crowdfunding for Social Change in Kenya

2019 ◽  
Vol 29 (2) ◽  
pp. 237-248
Author(s):  
Frankline Matanji
Keyword(s):  
University Staff ◽  
Media Technology ◽  
Community Members ◽  
Mobile Money ◽  
Phone Calls ◽  
Interview Session ◽  
Inductive Research ◽  
Social And Economic Development ◽  
The Government ◽  
Social Amenities

Use of WhatsApp as a social media technology and M-pesa, a mobile money service for crowdfunding in Kenya are proliferating at an incredible pace. Crowdfunding helps communities organize for effective participation in social and economic development and empowerment by making sure that members of the community get to benefit from services, such as access to social amenities and better infrastructure, which would not have been available if the community members were to wait for the government to provide the services. This method is being used at Kisii University for students’ retention and providing social welfare to students, their parents and university staff. The approach adopted by this study was qualitative inductive research, where the researcher had a one-on-one interview session with creators of crowdfunding campaigns and the funders using Skype and phone calls as interview tools.

scholarly journals The contribution of stigma to the transmission and treatment of tuberculosis in a hyperendemic indigenous population in Brazil

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243988
Author(s):  
Ida Viktoria Kolte ◽  
Lucia Pereira ◽  
Aparecida Benites ◽  
Islândia Maria Carvalho de Sousa ◽  
Paulo Cesar Basta
Keyword(s):  
Healthcare Service ◽  
Indigenous Communities ◽  
Treatment Delay ◽  
The Body ◽  
Indigenous Populations ◽  
Snowball Sampling ◽  
Framework Analysis ◽  
Community Members ◽  
Significant Treatment ◽  
Mato Grosso

Background The Guarani-Kaiowá are Brazil's second-largest indigenous group. Average annual tuberculosis (TB) incidence rates among the Guarani-Kaiowá are nearly 400/100,000 in Mato Grosso do Sul state, ten times the national average. Although stigma is considered crucial for TB control in indigenous communities, few studies have investigated TB stigma among indigenous populations. This study sought to understand the role of TB-related stigma and perceptions of TB in maintaining hyperendemic TB transmission in the Guarani-Kaiowá communities. Methods Various forms of stigma were explored through semi-structured interviews with 19 patients, 11 relatives, and 23 community members. Patients were identified from the registry of the healthcare service. Community members, selected by snowball sampling, were matched by gender and village of residence. Interviews were conducted in Guarani and Portuguese and later translated into English. Framework analysis was performed using NVivo. Results Traditional beliefs of a weakening of the body allowing the disease to enter were common, but the exact mechanism of transmission was unknown. Strong community/public stigma associated TB with uncleanliness, abuse, and irresponsibility. Anticipated stigma led to significant treatment delays for fear of exclusion and losing employment. While most patients felt supported by their families, nearly all patients related experienced/enacted stigma in the community such as gossip, avoidance, and social exclusion, leading to long-lasting internalized/self-stigma. Secondary stigmatization of relatives was widespread, and blanket latent TB infection (LTBI) treatment of patients’ households was a contributing factor in treatment delay. The healthcare service unnecessarily added to stigmatization by enforcing separate utensils and sleeping arrangements for patients. Conclusions Our findings suggest that stigma is a driver for treatment delay and continued transmission of TB in the community. The stigmatization of TB was rooted in a poor understanding of TB transmission, partly because of incorrect orientation by the healthcare service. Interventions to reduce TB-associated stigma are urgently needed.

scholarly journals Stigma and Discrimination towards People Living with HIV in the Context of Families, Communities, and Healthcare Settings: A Qualitative Study in Indonesia

2021 ◽  
Vol 18 (10) ◽  
pp. 5424
Author(s):  
Nelsensius Klau Fauk ◽  
Karen Hawke ◽  
Lillian Mwanri ◽  
Paul Russell Ward
Keyword(s):  
Qualitative Study ◽  
Hiv Stigma ◽  
People Living With Hiv ◽  
Hiv Education ◽  
Snowball Sampling ◽  
Framework Analysis ◽  
Community Members ◽  
Stigma And Discrimination ◽  
Healthcare Settings ◽  
Living With Hiv

HIV stigma and discrimination are a major challenge facing people living with HIV (PLHIV) globally. As part of a larger qualitative study with PLHIV in Yogyakarta and Belu, Indonesia, this paper describes the participants’ perceptions about drivers of HIV stigma and discrimination towards them within families, communities and healthcare settings, and highlights issues of HIV stigma as a social process. Participants were recruited using a snowball sampling technique. Data analysis was guided by the framework analysis for qualitative data, and conceptualization and discussion of the study findings were guided by the HIV stigma framework. The findings showed that participants experienced stigma and discrimination across settings, including in families and communities by family and community members, and in healthcare settings by healthcare professionals. The lack of knowledge about HIV, fear of contracting HIV, social and moral perceptions about HIV and PLHIV were perceived facilitators or drivers of stigma and discrimination towards PLHIV. HIV stigma and discrimination were also identified as a process linked to the whole groups of people within families or communities, which occurred within social context in Yogyakarta and Belu. The findings indicate the need for HIV education for family and community members, and healthcare providers to enhance their knowledge of HIV and improve acceptance of PLHIV within families, communities and healthcare settings.

scholarly journals Costing recommended (healthy) and current (unhealthy) diets in urban and inner regional areas of Australia using remote price collection methods

2021 ◽  
pp. 1-10
Author(s):  
Christina Zorbas ◽  
Ruby Brooks ◽  
Rebecca Bennett ◽  
Amanda Lee ◽  
Josephine Marshall ◽  
...  
Keyword(s):  
Low Income ◽  
Poverty Line ◽  
Disposable Income ◽  
National Guidelines ◽  
Phone Calls ◽  
Current Consumption ◽  
Low Incomes ◽  
Healthy Diets ◽  
The Cost ◽  
Household Incomes

Abstract Objective: To compare the cost and affordability of two fortnightly diets (representing the national guidelines and current consumption) across areas containing Australia’s major supermarkets. Design: The Healthy Diets Australian Standardised Affordability and Pricing protocol was used. Setting: Price data were collected online and via phone calls in fifty-one urban and inner regional locations across Australia. Participants: Not applicable. Results: Healthy diets were consistently less expensive than current (unhealthy) diets. Nonetheless, healthy diets would cost 25–26 % of the disposable income for low-income households and 30–31 % of the poverty line. Differences in gross incomes (the most available income metric which overrepresents disposable income) drove national variations in diet affordability (from 14 % of the median gross household incomes in the Australian Capital Territory and Northern Territory to 25 % of the median gross household income in Tasmania). Conclusions: In Australian cities and regional areas with major supermarkets, access to affordable diets remains problematic for families receiving low incomes. These findings are likely to be exacerbated in outer regional and remote areas (not included in this study). To make healthy diets economically appealing, policies that reduce the (absolute and relative) costs of healthy diets and increase the incomes of Australians living in poverty are required.

Hybrid Telecoaching for Corporate Speech Training and Potential Applications to Clinical Practice

2019 ◽  
Vol 4 (2) ◽  
pp. 322-324
Author(s):  
Thomas F. Burke
Keyword(s):  
Clinical Practice ◽  
Engineering Teams ◽  
Corporate Strategies ◽  
Corporate Speech ◽  
Phone Calls ◽  
Future Clinical Practice ◽  
Fortune 100 ◽  
Potential Applications ◽  
Language Pathology ◽  
Development Engineering

Purpose The purpose of this article was to describe a model for “hybrid speech telecoaching” developed for a Fortune 100 organization and offer a “thought starter” on how clinicians might think of applying these corporate strategies within future clinical practice. Conclusion The author contends in this article that corporate telecommunications and best practices gleaned from software development engineering teams can lend credibility to e-mail, messaging apps, phone calls, or other emerging technology as viable means of hybrid telepractice delivery models and offer ideas about the future of more scalable speech-language pathology services.

Teens' Hardships Overlooked in Office Visits

2010 ◽  
Vol 44 (9) ◽  
pp. 50
Author(s):  
PATRICE WENDLING
Keyword(s):  
Office Visits
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