scholarly journals Influence of Provider Interaction on Patient's Readiness Toward Audiological Services and Technology

2020 ◽  
Vol 31 (05) ◽  
pp. 342-353
Author(s):  
Amyn M. Amlani
Keyword(s):  
Treatment Options ◽  
Descriptive Analysis ◽  
Univariate Analysis ◽  
The United States ◽  
Consumer Electronics ◽  
Medical Rehabilitation ◽  
Sample Survey ◽  
Consumer Decision Making ◽  
Medical Settings ◽  
Mean Differences

Abstract Background Patients and providers recognize the importance of patient-centered care. Clinical interactions, however, suggest that audiologists maintain their traditional provider-centered approach. Purpose The primary purpose of this study was to assess the degree to which provider interaction influenced patient readiness toward audiological services using the neobehavioral concept of need recognition described in consumer decision-making. Research Design We used a randomized, within-group experimental approach using survey responses to quantify predisposed expectations on ten dimensions toward service and technology provision 2 weeks before and 2 weeks after an audiological assessment. Responses were also categorized as a function of the respondent-perceived professional setting of the provider (medical, rehabilitation, and consumer electronics). Study Sample Survey respondents included 618 adults {186 males (mean age = 63.1 years; standard deviation [SD] = 5.3) and 432 females [mean age = 58.4 years; SD = 6.2]} from across the United States. Data Collection and Analysis Data were analyzed using two approaches. First, we used a two-step cluster analysis procedure that revealed natural groupings (i.e., profiles) of respondent characteristics of the ten dimensions. Second, we compared within-group mean differences between pre- and postappointment responses using a univariate analysis of variance, with mean differences reported as a function of professional setting and preappointment responses serving as the control condition. Results Results revealed that the predisposed expectation profiles among the ten dimensions differed among the professional settings, with rehabilitation having the highest mean response values and consumer electronics having the least mean response values. A descriptive analysis indicated that respondents in the rehabilitation and medical settings presented the greatest interest in amplification before the patient-provider interaction, but the least interest afterward. In addition, postappointment analyses revealed that providers failed statistically to meet patients' predisposed expectations in all three settings. Conclusions Overall, most respondents' predisposed expectations were unmet during their interaction with an audiologist. These expectations differed across professional settings, with the greatest unmet expectations observed in the rehabilitative and medical settings. Patient readiness is influenced by the behavior of the provider which, at present, appears to be a barrier to patients' acceptance of treatment options.

scholarly journals Isolation and Characterisation of the Bundooravirus Genus and Phylogenetic Investigation of the Salasmaviridae Bacteriophages

Viruses ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1557
Author(s):  
Cassandra R. Stanton ◽  
Daniel T. F. Rice ◽  
Michael Beer ◽  
Steven Batinovic ◽  
Steve Petrovski
Keyword(s):  
Treatment Options ◽  
Teichoic Acid ◽  
The United States ◽  
Industrial Processes ◽  
Antimicrobial Compounds ◽  
Wall Teichoic Acid ◽  
Medical Settings ◽  
Phage Evolution ◽  
Genetic Mosaicism ◽  
Resistant Mutants

Bacillus is a highly diverse genus containing over 200 species that can be problematic in both industrial and medical settings. This is mainly attributed to Bacillus sp. being intrinsically resistant to an array of antimicrobial compounds, hence alternative treatment options are needed. In this study, two bacteriophages, PumA1 and PumA2 were isolated and characterized. Genome nucleotide analysis identified the two phages as novel at the DNA sequence level but contained proteins similar to phi29 and other related phages. Whole genome phylogenetic investigation of 34 phi29-like phages resulted in the formation of seven clusters that aligned with recent ICTV classifications. PumA1 and PumA2 share high genetic mosaicism and form a genus with another phage named WhyPhy, more recently isolated from the United States of America. The three phages within this cluster are the only candidates to infect B. pumilus. Sequence analysis of B. pumilus phage resistant mutants revealed that PumA1 and PumA2 require polymerized and peptidoglycan bound wall teichoic acid (WTA) for their infection. Bacteriophage classification is continuously evolving with the increasing phages’ sequences in public databases. Understanding phage evolution by utilizing a combination of phylogenetic approaches provides invaluable information as phages become legitimate alternatives in both human health and industrial processes.

scholarly journals Accessibility in Inclusive Tourism? Hotels Distributed Through Online Channels

Societies ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 34
Author(s):  
Eva Martin-Fuentes ◽  
Sara Mostafa-Shaalan ◽  
Juan Pedro Mellinas
Keyword(s):  
United Arab Emirates ◽  
Local Level ◽  
Descriptive Analysis ◽  
Distribution Channel ◽  
People With Disabilities ◽  
The United States ◽  
Travel Agency ◽  
International Studies ◽  
The Status ◽  
Accommodation Sector

There is a lack of comprehensive international studies on accommodations for people with disabilities; only small, local-level studies exist. This study aims to show the status of the tourist accommodation sector through the online distribution channel in terms of accessibility to offer more inclusive tourism. A descriptive analysis has been carried out with more than 31,000 hotels from the online travel agency Booking.com, in the 100 most touristic cities in the world. For the first time, an accurate picture of adaptation in the hotel sector for people with disabilities is presented. Results show that the adapted hotel infrastructures by countries are uneven. The main adaptations are those that help to avoid mobility barriers, and in contrast, hotels offer very few adaptations for sensory disabilities such as visual disabilities. Moreover, this study shows that, worldwide, countries with the highest income per capita, such as the United States of America, Canada, Ireland, Australia, New Zealand, Qatar or the United Arab Emirates, have the highest degree of hotel adaptation.

scholarly journals “It’s way more than just writing a prescription”: A qualitative study of preferences for integrated versus non-integrated treatment models among individuals with opioid use disorder

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Elizabeth C. Saunders ◽  
Sarah K. Moore ◽  
Olivia Walsh ◽  
Stephen A. Metcalf ◽  
Alan J. Budney ◽  
...  
Keyword(s):  
Qualitative Study ◽  
The United States ◽  
Opioid Use Disorder ◽  
Integrated Treatment ◽  
Medical Setting ◽  
Integrated Models ◽  
Opioid Use ◽  
Medical Settings ◽  
Psychosocial Services ◽  
Treatment Models

Abstract Background Increasingly, treatment for opioid use disorder (OUD) is offered in integrated treatment models addressing both substance use and other health conditions within the same system. This often includes offering medications for OUD in general medical settings. It remains uncertain whether integrated OUD treatment models are preferred to non-integrated models, where treatment is provided within a distinct treatment system. This study aimed to explore preferences for integrated versus non-integrated treatment models among people with OUD and examine what factors may influence preferences. Methods This qualitative study recruited participants (n = 40) through Craigslist advertisements and flyers posted in treatment programs across the United States. Participants were 18 years of age or older and scored a two or higher on the heroin or opioid pain reliever sections of the Tobacco, Alcohol, Prescription Medications, and Other Substances (TAPS) Tool. Each participant completed a demographic survey and a telephone interview. The interviews were coded and content analyzed. Results While some participants preferred receiving OUD treatment from an integrated model in a general medical setting, the majority preferred non-integrated models. Some participants preferred integrated models in theory but expressed concerns about stigma and a lack of psychosocial services. Tradeoffs between integrated and non-integrated models were centered around patient values (desire for anonymity and personalization, fear of consequences), the characteristics of the provider and setting (convenience, perceived treatment effectiveness, access to services), and the patient-provider relationship (disclosure, trust, comfort, stigma). Conclusions Among this sample of primarily White adults, preferences for non-integrated versus integrated OUD treatment were mixed. Perceived benefits of integrated models included convenience, potential for treatment personalization, and opportunity to extend established relationships with medical providers. Recommendations to make integrated treatment more patient-centered include facilitating access to psychosocial services, educating patients on privacy, individualizing treatment, and prioritizing the patient-provider relationship. This sample included very few minorities and thus findings may not be fully generalizable to the larger population of persons with OUD. Nonetheless, results suggest a need for expansion of both OUD treatment in specialty and general medical settings to ensure access to preferred treatment for all.

scholarly journals PSV-13 Genetic parameters and quantitative trait loci for heat stress related traits in sheep

2020 ◽  
Vol 98 (Supplement_3) ◽  
pp. 163-164
Author(s):  
Devin R Jacobs ◽  
Claudia E Silvera-Rojas ◽  
Jennifer M Bormann ◽  
Terry A Gipson ◽  
Arthur L Goetsch ◽  
...  
Keyword(s):  
Heat Stress ◽  
Quantitative Trait Loci ◽  
Rectal Temperature ◽  
Quantitative Trait ◽  
Fixed Effects ◽  
Univariate Analysis ◽  
Average Daily Gain ◽  
The United States ◽  
Nucleotide Polymorphisms ◽  
Trait Loci

Abstract Greater selection emphasis has been placed on efficiency than on fitness in livestock populations over the last several decades. Heat stress is a concern in production systems due to the negative effects on production, reproduction, and immunity. The objective of the study was to estimate variance components and identify quantitative trait loci (QTL) for heat stress related traits in sheep. A total of 125 Dorper, Katahdin, and St. Croix ewes originating from four regions of the United States were selected for the experiment. Animals were separated into four trials due to facility limitations. Data were collected for each trial over four consecutive two-week periods in an environmentally controlled facility with targeted heat load index (HLI) for daytime/nighttime of 70/70, 85/77, 90/77, and 95/81. Body weight was collected three times per week and rectal temperature was collected weekly. Black globe temperature and humidity were measured every 15 minutes. Animals were genotyped using the Illumina OvineSNP50 BeadChip. After quality control, 49,396 effective single nucleotide polymorphisms were included in the univariate analysis performed with the BLUPF90 suite of programs. Fixed effects in the models included region of origin, breed, trial, and age as a covariate. Traits analyzed included rectal temperature at 95 HLI (RT95), feed intake at 95 HLI (FI95), and average daily gain for the period for HLI between 90 and 95 (ADG). Heritabilities for RT95, FI95, and ADG were 0.35, 0.10, and 0.10, respectively. Largest effect QTL were identified on chromosomes 23, 9, and 6 for RT95, chromosomes 9, 2, and 20 for FI95, and chromosomes 6, 1, and 5 for ADG. Many of the regions identified have also been associated with weight and carcass traits in other studies, but few had obvious connections to the heat stress related response. In conclusion, results suggest selection could improve heat tolerance in sheep.

scholarly journals How Are Residents Trained in Neuropathology? A Survey of Neurology Program Directors in the United States

2020 ◽  
Vol 79 (11) ◽  
pp. 1218-1222
Author(s):  
Appaji Rayi ◽  
Kiran Rajneesh ◽  
Vineet Punia ◽  
Amanda R Start
Keyword(s):  
Descriptive Analysis ◽  
Program Directors ◽  
The United States ◽  
Categorical Variables ◽  
Training Methods ◽  
Child Neurology ◽  
Alternative Evaluation ◽  
Current State ◽  
Service Training ◽  
Program Characteristics

Abstract To understand the current state of neurology residents training in neuropathology, we electronically distributed a 16-item survey to 150 adult and 70 child neurology program directors (PDs). The survey inquired about their program characteristics, neuropathology curriculum and assessment methods, trainee performance, and attitudes. Descriptive analysis was used to summarize categorical variables as frequencies and percentages and continuous as means and standard deviations. We conducted a series of Mann-Whitney U and Fisher’s exact tests to evaluate differences between various program characteristics. Sixty-four (29%) PDs responded to the survey, including 45 (30%) adult and 19 (27%) child neurology PDs. Thirty-one programs required a dedicated neuropathology rotation. The majority (92%) used the Residency In-Service Training Examination (RITE) to assess trainee’s knowledge. Approximately 86% of the PDs agreed that neuropathology is essential and a defined curriculum is necessary during residency training. There was no difference in the RITE scores between programs. We conclude that a neuropathology rotation was felt to be essential even though the RITE scores did not differ between programs with and without a dedicated rotation. Alternative evaluation and training methods may need consideration. A future survey of all the stakeholders may be required to thoroughly understand and disseminate the neuropathology education well.

You’re Fired! Donald Trump and the 2020 Congressional Elections

The Forum ◽  
2020 ◽  
Vol 18 (4) ◽  
pp. 627-650
Author(s):  
Jamie L. Carson ◽  
Spencer Hardin ◽  
Aaron A. Hitefield
Keyword(s):  
United States ◽  
Presidential Election ◽  
Descriptive Analysis ◽  
Vice President ◽  
The United States ◽  
Congressional Elections ◽  
General Election ◽  
Donald Trump ◽  
Modern Era

Abstract The 2020 elections brought to an end one of the most divisive and historic campaigns in the modern era. Former Vice President Joe Biden was elected the 46th President of the United States with the largest number of votes ever cast in a presidential election, defeating incumbent President Donald Trump in the process. The record turnout was especially remarkable in light of the ongoing pandemic surrounding COVID-19 and the roughly 236,000 Americans who had died of the virus prior to the election. This article examines the electoral context of the 2020 elections focusing on elections in both the House and Senate. More specifically, this article examines the candidates, electoral conditions, trends, and outcomes in the primaries as well as the general election. In doing so, we provide a comprehensive descriptive analysis of the climate and outcome of the 2020 congressional elections. Finally, the article closes with a discussion of the broader implications of the election outcomes on both the incoming 117th Congress as well as the upcoming 2022 midterm election.

scholarly journals EPIDEMIOLOGY OF PEDIATRIC CARTILAGE RESTORATION PROCEDURES IN THE UNITED STATES: INSURANCE AND GEOGRAPHY PLAY A ROLE

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0024
Author(s):  
Tyler B. Hall ◽  
Max J. Hyman ◽  
Neeraj M. Patel
Keyword(s):  
United States ◽  
Children And Adolescents ◽  
Statistical Significance ◽  
Private Insurance ◽  
Univariate Analysis ◽  
The United States ◽  
National Database ◽  
The West ◽  
Cartilage Restoration ◽  
Common Diagnosis

Background: A number of surgical options are available for sizeable articular cartilage lesions of the knee. These include osteochondral autograft (OAU) or allograft (OAL) transfer, or autologous chondrocyte implantation (ACI). In the pediatric population, there is little data on the patients undergoing these procedures or evidence to support one technique over another, which may lead to variation in preferred practice. Hypothesis/Purpose: The purpose of this study is to analyze the epidemiology of children and adolescents undergoing OAU, OAL, and ACI in the United States, with attention to variation along the lines of demographic and geographic factors. Methods: The Pediatric Health Information System, a national database consisting of 49 children’s hospitals, was queried for all patients undergoing OAU, OAL, and ACI between 2012 and 2018. Demographic information was collected for each subject. United States Census guidelines were used to categorize hospitals geographically into regions. Univariate analysis was followed by purposeful entry multivariate regression to adjust for confounding factors. Results: A total of 809 subjects with a mean age of 15.4±2.4 years were included in the analysis. Of these, 393 (48.6%) underwent OAL, 339 (41.9%) underwent OAU, and 77 (9.5%) underwent ACI. The most common diagnosis at the time of surgery was osteochondritis dissecans in 360 patients (44.5%) followed by an associated cruciate ligament injury in 126 (15.6%) and patellar instability in 98 (12.1%). After adjusting for confounders in a multivariate model, ACI was more 3.4 times more likely to be performed in patients with private insurance than those that were publicly insured (95% CI 1.5-7.5, p=0.002). Furthermore, a patient in this Northeast was 29.3 times more likely to undergo ACI than in the West (95% CI 4.0-217.4, p=0.001). OAU was performed most frequently in the West and Midwest (52.4% and 51.8% of the time, respectively; p<0.001). Univariate analysis also revealed differences along the lines of race, but these findings did not maintain statistical significance in multivariate analysis. Conclusion: In the United States, there is substantial variation in the procedures performed for cartilage restoration in children and adolescents. Though ACI is the least commonly selected operation overall, it is significantly more likely to be performed on patients with private insurance and those in the Northeast. OAU is the most commonly performed procedure in the West and Midwest.

scholarly journals The Public’s Perception of Interventions for Migraine Headache Disorders: A Crowdsourcing Population-Based Study

2019 ◽  
Vol 1 (2) ◽  
Author(s):  
Orr Shauly ◽  
Daniel J Gould ◽  
Ketan M Patel
Keyword(s):  
Migraine Headache ◽  
Treatment Options ◽  
The United States ◽  
Cost Of Care ◽  
Adverse Outcomes ◽  
Amazon Mechanical Turk ◽  
Cross Sectional ◽  
Economic Productivity ◽  
Migraine Headaches ◽  
Patient Reported

Abstract Background Migraine disorders are a leading cause of morbidity and decreased economic productivity in the United States among both men and women. As such, it is important to consider patient opinions, and have an accurate representation of the burden and sentiment toward currently available interventions among those suffering from migraines. Objectives The aim of the study was to assess patient options regarding adverse outcomes of the various treatment options available for migraine headaches. Methods A prospective cross-sectional study of volunteers recruited through an internet crowdsourcing service, Amazon Mechanical Turk©, was conducted. Surveys were administered to collect patient-reported opinions regarding adverse outcomes of both surgical and nonsurgical treatment options for migraine headaches. Results The prevalence of migraine headache across all study participants was 15.6% and varied slightly across participant demographics. Individuals ages 35–44 (2.73 migraines per month) experienced the fewest migraine and with the lowest severity. Those individuals ages 45+ experienced the most severe headaches (Visual Analog Scale = 44.23 mm). Additionally, the greatest migraine frequency and severity existed among those households with yearly income of $75,000–$100,000. The lowest injection therapy utility scores were obtained for adverse outcomes of hematoma (47.60 mm) and vertigo (54.40 mm). Conclusions Migraine headaches remains a significant problem among the US population, with an overall prevalence of 15.6% (approximately 50 million Americans). Additionally, physicians interesting in offering minimally invasive or surgical treatment for migraine headaches should focus on mitigating patient fears regarding clinical outcomes and cost of care.

Religion and Spiritual Advice as Surrogate Care Provision for Mental Health Problems in the ESEMED Survey

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
V. Kovess ◽  
R. de Graaf ◽  
J.M. Haro ◽  
R. Bruffaerts ◽  
F. Gilbert ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Disorders ◽  
Mental Health Problems ◽  
Religious Affiliation ◽  
Religious Practice ◽  
The United States ◽  
Health Problems ◽  
Sample Survey ◽  
Seeking Help

Objective:To complete missing information on the influence of spiritual and religious advisors as informal providers for mental health problems in Europe.Methods:Recourse to religious practice or belief when coping with mental health problems was evaluated using data from the ESEMED survey. This was a stratified, multistage, clustered-area probability sample survey of mental health carried out in six European countries which included 8796 subjects. Between countries differences in sociodemographic characteristics, religious affiliation, and prevalence of mental disorders and management of mental disorders were evaluated.Results:Religion appears to play a limited role in coping with mental health problems in Europe. Only 7.9% of individuals seeking help for such problems turned to a religious advisor. This proportion differed between countries from 13% in Italy, 12.5% in Germany, 10.5% in the Netherlands, 5.8% in France, 4.7% in Belgium to 4% in Spain. In addition, seeking help exclusively from religion was reported by only 1.3% of subjects. Practicing religion at least once a week and considering religion as important in daily life were predictors of using religion versus conventional health care only. Use of religion was not influenced by gender and age. Non-Christian respondents and individuals with alcohol disorders were more likely to use religion. In Spain, the use of religion is much lower than average.Conclusions:Unlike the situation in the United States, organised religion does not provide alternative informal mental health care in Europe. At best, it could be considered as an adjunct to conventional care.

Sign in / Sign up

Export Citation Format

Share Document