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iw. „“The leading provider of cost effective carbon components”“. ATZautotechnology 4, Nr. 5 (September 2004): 36–37. http://dx.doi.org/10.1007/bf03246845.
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Matthews, Megan E., Patricia Evangelista und Tatyana Gurvich. „Geriatric Pharmacotherapy Case Series: Poly-Provider Leading to Polypharmacy“. Senior Care Pharmacist 37, Nr. 10 (01.10.2022): 499–509. http://dx.doi.org/10.4140/tcp.n.2022.499.
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Background: This case study reviews the complicated treatment of an older person under the care of numerous specialists in the ambulatory care setting. As various providers made concurrent changes in pharmacotherapy without communication with other providers, the patient experienced acute changes and decompensation. Assessment: Polypharmacy played a significant role in the acute decompensation of the patient. Changes made in the context of specific specialties inadvertently had a negative impact on other disease states. Outcome: Intentional communication between all providers on the patient’s health care team resulted in a deeper understanding of the overall plan and therapeutic goals. Care synchronization ultimately improved patient outcomes. The clinical pharmacy team provided multiple pharmacotherapy recommendations to improve pain and anxiety without jeopardizing safety and therapeutics for other disease states. These interventions provided a key element that streamlined and improved patient-centered care. Conclusion: In this case, poly-provider was responsible for polypharmacy that significantly impacted the patient’s care and quality of life. Pharmacists and the pharmacists’ patient care process play a significant role in improving patient-centered care by identifying medication changes and potential side effects, especially in the wake of interventions by multiple providers.
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Nobel, Jeremy, und Veronique Boissonnas. „Patient/Provider Internet Connectivity: Leading the Revolution of Healthcare Delivery“. Healthcare Quarterly 4, Nr. 2 (15.12.2000): 76–83. http://dx.doi.org/10.12927/hcq..16698.
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Board, Editorial. „eduCBA is a Leading Global Provider of Skill based Education Addressing the Needs“. Global Journal of Enterprise Information System 9, Nr. 2 (28.06.2017): 138. http://dx.doi.org/10.18311/gjeis/2017/16182.
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An initiative by IIT IIM Graduates, eduCBA is a leading global provider of skill based education addressing the needs 500,000+ members across 40+ Countries. Our unique step-by-step, online learning model along with amazing 2000+ courses prepared by top notch professionals from the Industry help participants achieve their goals successfully. All our training programs are Job oriented skill based programs demanded by the Industry. At eduCBA, it is a matter of pride to us to make job oriented hands on courses available to anyone, anytime and anywhere.
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Thistlethwaite, Jill E., Michael R. Kidd und Judith N. Hudson. „General practice: a leading provider of medical student education in the 21st century?“ Medical Journal of Australia 187, Nr. 2 (Juli 2007): 124–28. http://dx.doi.org/10.5694/j.1326-5377.2007.tb01160.x.
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Houck, Jeff, Jillian Santer, Kostantinos Vasalos und Judith Baumhauer. „Can Understanding Provider Expectations Improve Provider Adoption of Patient Reported Outcomes?“ Foot & Ankle Orthopaedics 3, Nr. 3 (01.07.2018): 2473011418S0025. http://dx.doi.org/10.1177/2473011418s00252.
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Category: Other Introduction/Purpose: New instruments like the Patient Reported Outcome Information System (PROMIS) minimize the burden to patients and providers addressing significant barriers to adoption. Despite these advances provider adoption remains lackluster. Models of technology adoption suggest adoption is more likely to occur when PRO’s directly improve patient care (performance expectancy) and it’s easy to implement (effort expectancy). Problems with effort expectancy are dealt with by training and improving logistics (i.e. eHR presentation, alerts), where performance expectancy is addressed through research (i.e. validation of thresholds). The purposes of this study were to: 1) evaluate the proportion of orthopedic rehabilitation providers who use PRO’s and how they use them; And, 2) to determine if performance expectancy, effort expectancy or provider burnout are related to provider use. Methods: Fifty rehabilitation providers (physical therapist and athletic trainers) anonymously completed the electronic PRO Adoption Survey. Participants were 23.4±5.8 years old and 54% were female. The purpose of the PRO Adoption Survey is to track adoption across health systems. The first section of the PRO Adoption survey includes whether providers use PRO’s and asks them to detail how they use them (Table 1). A factor analysis supported the use of sets of questions to determine performance expectancy and effort expectancy (Table 1). Performance expectancy captures the health benefits the provider expects to experience. Effort expectancy captures the provider’s expectations of how easy it will be to implement PRO tools. The validated Maslach-2 burnout scale (BO) was included as another a factor that may influence adoption. Proportions and chi square tests were used to describe provider use of PRO’s and its relationship with performance expectancy, effort expectancy, and burnout. Results: The profile of PRO use by rehabilitation professionals is that a majority know about PRO’s (86%) however only 34% utilize PRO’s during clinic visits (Table 1). The most common PRO used is PROMIS (83%), followed by generic measures (41%) and disease specific (29%) measures. Type of use indicated the most common use was to make clinical decisions (71%) with relatively few using it for research (12%). Interestingly, 47% of PRO users review data with patients. The average responses for performance expectancy were 3.9 ± 0.1. The average responses for effort expectancy were 3.2 ± 0.2 or “neutral”. The average BO score was 4.6 ± 1.0. Chi square analysis suggested performance expectancy, effort expectancy, and burn out were not significantly associated with provider use. Conclusion: PROMIS scales are currently available in the electronic medical record(eMR) leading to high use (86%) by current PRO users (34%). High performance expectancy scores (~4/5) and low BO suggest providers can be motivated to use PRO’s. However, providers are neutral (~3/5) on how easy PRO’s would be to implement. Also, lower scores for performance expectancy associated with “aggregate” PRO data (only 54% marked “Agree” for this item) suggests training on specific uses of aggregate data are also indicated. These data detail the real issues providers need addressed to effectively capitalize on the benefits of PRO’s to improve clinical care.
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Choi, Laee, und Sherry Lotz. „Motivations leading to customer citizenship behavior in services: scale development and validation“. Journal of Consumer Marketing 33, Nr. 7 (14.11.2016): 539–51. http://dx.doi.org/10.1108/jcm-01-2016-1683.
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Purpose The purpose of this study is to better understand customer citizenship behavior (CCB) motivation through the development and validation of a new scale to measure the CCB motivation (CCBM) construct. Design/methodology/approach The mixed-methods study, combination of qualitative and quantitative research, is used to develop the scale item that measures CCBM. For nomological validity testing, data were collected from customers who had transacted with a specific service provider business in the past six months. Data were analyzed using structural equation modeling. Findings This study suggests that CCBM can be reliably measured by 12 items, composed of four sub-dimensions, self-enhancement, personal principles, desire to support the service provider and perception of the service provider’s past performance. In addition, nomological validity testing through three empirical models confirms that CCBM is a multi-dimensional construct with a second-order nature and an antecedent that positively influences CCB. Originality/value The research provides an original view regarding CCBM scale development in the services contexts and makes invaluable contributions to understanding a variety of motivations that lead customers to voluntary participation behaviors.
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De Almeida Moraes, Sylvia T., und Angela Da Rocha. „International Entrepreneurship at a Leading Brazilian Software Services Provider: The Case of CI&T“. Internext 15, Nr. 1 (01.01.2020): 118. http://dx.doi.org/10.18568/internext.v15i1.479.
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Hoyt, David B., Peggy Hollingsuorth-Fridlund, Richar K. Simons, Robert J. Winchell und Dale Fortlage. „AN ANALYSIS OF RECURRENT PROCESS ERRORS LEADING TO PROVIDER COMPLICATIONS ON AN ORGANIZED TRAUMA SERVICE“. Journal of Trauma: Injury, Infection, and Critical Care 33, Nr. 1 (Juli 1992): 154. http://dx.doi.org/10.1097/00005373-199207000-00053.
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Hoyt, David B., Peggy Hollingsworth-Fridlund, Robert J. Winchell, Richard K. Simons, Troy Holbrook und Dale Fortiage. „ANALYSIS OF RECURRENT PROCESS ERRORS LEADING TO PROVIDER-RELATED COMPLICATIONS ON AN ORGANIZED TRAUMA SERVICE“. Journal of Trauma: Injury, Infection, and Critical Care 36, Nr. 3 (März 1994): 377–84. http://dx.doi.org/10.1097/00005373-199403000-00017.
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Miller, R. A., und A. Ozdas. „Care Provider Order Entry (CPOE): A Perspective on Factors Leading to Success or to Failure“. Yearbook of Medical Informatics 16, Nr. 01 (August 2007): 128–37. http://dx.doi.org/10.1055/s-0038-1638536.
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SummaryAuthors provide a perspective on factors leading to successful care provider order entry (CPOE) implementations.Viewpoint of authors supported by background literature review.Authors review both benefits and challenges related to CPOE implementation using three guiding principles: (1) a clinical approach to clinical systems, which claims that CPOE implementation is analogous to a “good” clinician delivering care to a patient; (2) a commitment to quality, which advocates that no compromises should be made in implementing system functionality and clinical system content – the highest objective for CPOE implementation is to provide better quality of care and increased safety for patients; (3) a commitment to fairness, as evidenced by respect for individuals and support of local autonomy, which advocates for minimizing disruptions to clinician-users’ workflows, and adequate local control over CPOE system design and evolution, including clinical content management.Past experiences with CPOE implementation can inform future installation attempts. Sociocultural factors dominate in determining the success of implementation, and should govern technical factors.
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Semeriahina, Myroslava, und Mariia Hryhorak. „The role of the airline as a logistics provider in the passenger travel chains involving air transport“. Electronic Scientific Journal Intellectualization of Logistics and Supply Chain Management #1 2020, Nr. 5 (Februar 2021): 62–79. http://dx.doi.org/10.46783/smart-scm/2021-5-5.
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The article is devoted to the classification of air carrier as a logistics provider. Therefore, in the outsourcing pyramid of logistics providing, the place of the air carrier was determined taking into account its business model: legacy, low-cost, hybrid. Based on this, insourcing pyramid of airline logistics services involving air transport was developed and varieties of 3PL providers were identified: 3–PL, 3PL, 3+PL air carriers. 3–PL air carrier is a logistics provider that provides a range of services within the air supply / travel chain. 3PL air carrier is a logistics provider that provides a range of services in the full supply / travel chain, when booking individual components of such a chain is carried out through the websites of the air carrier and its partners. 3+PL air carrier is a logistics provider that provides a range of services in the full supply / travel chain, when booking such services is carried out integrated through the air carrier's website, and business processes are performed by the air carrier and its partners. It was studied the websites of airlines in order to find out the providing level of modern global passenger airlines operating on legacy, low-cost and hybrid business models and to identify the main trends among air carrier to ensure a complete passenger travel chain. The main feature of the world's air carriers is that most of them provide services at the level of 3PL-provider, and only the world's leading air carriers provide the organization of the passenger travel chain at the level of 3+PL-provider. The generalized scheme of providing for a passenger travel chain involving air transport for the purpose of definition of a role of each type of logistics provider and their collaboration in such chains was constructed. For example, 3–PL, 3PL, 3+PL air carriers can involve 2 PL-companies in the performance of business processes in the passenger chain. At the same time, the air carrier of 4PL-level will involve performers from 2 PL 3-PL, 3PL levels in the processes of the travel chain. On the virtual 5 PL platform, the passenger will independently choose performers from different levels of providing according to their own needs.
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Lapane, K., C. Dubé, K. Ferrucci, S. Khan, K. A. Kuhn, A. Ogdie, E. Yi, J. Kay und S. H. Liu. „AB0892-HPR PATIENT PERSPECTIVES ON PROVIDER PRACTICES LEADING TO AN AXIAL SPONDYLOARTHRITIS DIAGNOSIS: A QUALITATIVE STUDY“. Annals of the Rheumatic Diseases 80, Suppl 1 (19.05.2021): 1469.2–1470. http://dx.doi.org/10.1136/annrheumdis-2021-eular.2749.
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Background:People with Axial Spondyloarthritis (axSpA) experience a diagnostic delay between 7 to 10 years. (1-5) This delay contributes to increased depression and desperation in searching for an appropriate diagnosis. (6) Consequently, people with axSpA experience impaired physical function, structural damage, and overall worsened quality of life than those who experience a timely diagnosis. (7)Objectives:To gain knowledge and understand patients’ experiences with healthcare providers in diagnosis of axSpA.Methods:Using qualitative study design, we conducted six focus groups, with a total of 26 participants with a confirmed diagnosis of axSpA by rheumatologists from three different geographic locations: Worcester, MA, Aurora, CO and Philadelphia, PA. Focus groups were audio recorded and approximately 2 hours in duration. The focus groups were transcribed, deidentified, cleaned and stored in a secure location. NVivo software was used to code the data using a coding scheme which emerged from the focus group discussion topics. For intercoder reliability, two researchers coded the data and generated summary reports for data analysis.Results:Patients described their frustrating journeys to diagnosis and attributed the lengthy diagnosis delays to a multitude of factors. These elements include, lack of definitive diagnostic test, disease characteristics, lack of primary care providers’ awareness of axSpA, time, and trust. Patients felt that their physicians dismissed their complaints or would describe their symptoms as psychosomatic. The health care system also contributed to their diagnostic delays, including the lengthy referral process to a rheumatologist and the short clinical appointments. Patients believe that to reduce diagnostic delay, physicians must work with their patients; listening and believing their patients while allotting time for patients to discuss their experiences. In addition, patients believe earlier referral to a rheumatologist, and HLA-B27 genetic testing would decrease the diagnostic delay of axSpA.Conclusion:In this study, patients desire definitive testing in clinical practice for earlier diagnosis of axSpA. Additionally, more education regarding the guidelines to diagnose axSpA and earlier referral to rheumatologists might be needed. Until this is feasible, patients seek clinicians who will work with them until a diagnosis is made, listening, and believing their experiences and symptoms.References:[1]Deodhar A, Mease P, Reveille J, Curtis J, Karunaratne P, Malhotra K. Prevalence of axial spondyloarthritis among undiagnosed chronic back pain patients in the United States [abstract]. Ann Rheum Dis. 2014;73:198-199.[2]Deodhar A, Mease PJ, Reveille JD, et al. Frequency of Axial Spondyloarthritis Diagnosis Among Patients Seen by US Rheumatologists for Evaluation of Chronic Back Pain. Arthritis Rheumatol. 2016;68(2326-5205 (Electronic)):1669–1676.[3]Garrido-Cumbrera M, Poddubnyy D, Gossec L, et al. The European Map of Axial Spondyloarthritis: Capturing the Patient Perspective-an Analysis of 2846 Patients Across 13 Countries. Curr Rheumatol Rep. 2019;21(1534-6307 (Electronic)):19.[4]Redeker I, Callhoff J, Hoffmann F, et al. Determinants of diagnostic delay in axial spondyloarthritis: an analysis based on linked claims and patient-reported survey data. Rheumatology (Oxford) 2019;58(1462-0332 (Electronic)):1634–1638.[5]Strand V, Singh JA. Evaluation and Management of the Patient With Suspected Inflammatory Spine Disease. Mayo Clin Proc 2017;92(1942-5546 (Electronic)):555–564.[6]Martindale J. The impact of delay in diagnosing ankylosing spondylitis/axial SpA. . Rheumatology. 2014;53.[7]Yi EA-O, Ahuja A, Rajput T, George AT, Park Y. Clinical, Economic, and Humanistic Burden Associated With Delayed Diagnosis of Axial Spondyloarthritis: A Systematic Review. Rheumatol Ther 2020(2198-6576 (Print)):65-87.Disclosure of Interests:Kate Lapane: None declared, Catherine Dubé Grant/research support from: Novartis, as personnel on such studies, Katarina Ferrucci: None declared, Sara Khan: None declared, Kristine A. Kuhn Consultant of: UCB, Eli Lilly, Novartis, Grant/research support from: Pfizer, Alexis Ogdie Consultant of: Abbvie, Amgen, BMS, Celgene, Corrona, Gilead, Janssen, Lilly, Novartis, Pfizer, UCB, Grant/research support from: Pfizer to Penn, Novartis to Penn, Amgen to Forward/NDB, Esther Yi Employee of: Novartis Pharmaceuticals, Jonathan Kay Consultant of: AbbVie, Inc.; Boehringer Ingelheim GmbH; Celltrion Healthcare Co. Ltd.; Jubilant Radiopharma; Merck & Co.,Inc.; Pfizer Inc.; Samsung Bioepis; Sandoz Inc.; Scipher Medicine; UCB, Inc., Grant/research support from: (paid to UMass Medical School) Gilead Sciences Inc.; Novartis Pharmaceuticals Corp.; Pfizer Inc., Shao-Hsien Liu Grant/research support from: Novartis
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Jóźków, Paweł, Felicja Lwow, Małgorzata Słowińska-Lisowska und Marek Mędraś. „Trends in the prevalence of autoimmune thyroiditis in the leading private health-care provider in Poland“. Advances in Clinical and Experimental Medicine 26, Nr. 3 (30.06.2017): 497–503. http://dx.doi.org/10.17219/acem/60862.
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Yen, Lim Khai, Shahira Ismail, Shukri Saad, Mohd Hashairi Fauzi und Nik Hisamuddin Nik Ab Rahman. „Rescue-Thrombolysis in Cardiac Arrest: The ‘Provider’ of Last Resort“. Bangladesh Journal of Medical Science 19, Nr. 2 (16.01.2020): 319–21. http://dx.doi.org/10.3329/bjms.v19i2.45015.
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Cardiac arrest is the leading cause of death globally, and heart disease is known to be a major risk factor for cardiac arrest. In practice, an arrest is presumed to be of cardiac origin unless it is known or likely due to non-cardiac causes. The prognosis of the patient following cardiac arrest is generally poor. Although thrombolytic therapy is well known to be the treatment for myocardial thrombosis, it is not routinely recommended in cardiac arrest due to its potential bleeding adverse effect. We described a case report of successful thrombolytic therapy in cardiac arrest patient
Bangladesh Journal of Medical Science Vol.19(2) 2020 p.319-321
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Toker, Aysegul, Kaan Varnali und Cengiz Yilmaz. „Mobile marketing at Turkcell: Turkey's leading mobile operator“. Emerald Emerging Markets Case Studies 1, Nr. 1 (01.01.2011): 1–9. http://dx.doi.org/10.1108/20450621111122309.
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Subject area Mobile marketing. Study level/applicability Undergraduate and Graduate levels. Case overview Driven by the ongoing evolution in mobile technologies and the increasing penetration of smart phones, the use of the mobile medium for marketing purposes is becoming more and more popular across industries. This case study presents an overview of the mobile marketing ecosystem embedded in the story of the transition of Turkcell from a traditional carrier into a leading mobile services provider. The aim is to familiarize the reader with the benefits and challenges of using the mobile medium for marketing communications and provide lessons from Turkcell experience for success in mobile marketing. Expected learning outcomes Develop a comprehensive understanding of the concept of “mobile marketing” and the current state of mobile technologies; develop a general knowledge of various types of mobile marketing applications; have a general knowledge and understanding of the consumer-centric value propositions of mobile marketing; gain a perspective on the nature and dynamics of mobile business environment and have the chance to examine real-market campaigns that leverage unique properties of the mobile medium. Supplementary materials Teaching notes.
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Wilke, Joshua, Cahit Kaya, Wajiha Akhtar, William Bull, Sarah Krechel, Randall Brown, Ryan Westergaard und David Seal. „Provider Perceptions of Attitudes toward People who Inject Drugs and Treatment Services among Community Members, Service Providers, and Law Enforcement Officials“. Health Behavior and Policy Review 10, Nr. 4 (August 2023): 1333–41. http://dx.doi.org/10.14485/hbpr.10.4.2.
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Objective: People who inject drugs (PWIDs) often face stigma, leading to barriers in accessing healthcare and may contribute to negative health outcomes. The objective of this study was to understand and describe the manifestations of stigma toward PWIDs and their impact on the utilization of essential prevention services. Methods: We interviewed 44 persons knowledgeable about PWIDs’ healthcare needs. Interviews explored perceptions of the community, healthcare service providers, law enforcement attitudes toward PWIDs, and treatment services. Results: Respondents believed that the community generally has stigmatizing attitudes towards PWIDs; treatment program personnel and healthcare providers have less stigmatized attitudes but could benefit from more education and training on drug use and addiction. Conclusions: Education and training on stigma and its negative impact on the lives of PWIDs for K-12 students and for healthcare professionals (eg, treatment options, harm reduction strategies) might mitigate stigma toward PWIDs and improve access to services and outcomes.
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Triyafebrianda, Handi Aulia, und Nila Armelia Windasari. „Factors Influence Customer Churn on Internet Service Provider in Indonesia“. TIJAB (The International Journal of Applied Business) 6, Nr. 2 (25.11.2022): 134–44. http://dx.doi.org/10.20473/tijab.v6.i2.2022.34030.
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Rapid growth of internet users in Indonesia and the Covid-19 pandemic situation has prompted the emergence of new Internet Service Providers in line with the increasing demand for internet access. Several new internet service providers are emerged leading to a more competitive environment. Churn in subscription model business become important variable since the brand of internet service provider increasing. The purpose of this study is to examine factors influence customer churn in internet service provider so company can resolve and anticipate the churn problems. By using the method SEM-PLS to 102 respondents data collected, it was concluded that customer churn was significantly influenced by complaint management and multi-brand attitude. Another result is the tendency of multi-brands attitudes moderates the price which is significantly related to customer churn.
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Maman, Stephan, und Michael Andreae. „3025 Individual Anesthesia Provider Performance Assessment“. Journal of Clinical and Translational Science 3, s1 (März 2019): 147. http://dx.doi.org/10.1017/cts.2019.334.
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OBJECTIVES/SPECIFIC AIMS: We developed a multilevel hierarchical statistical model which describes the association of prophylactic interventions to patient PONV risk, and provides an intuitive summary for anesthesiologists to understand how well they are adhering to PONV guidelines. METHODS/STUDY POPULATION: Accepted PONV risk factors as well as preventative interventions to reduce the PONV risk, (e.g. total intravenous anesthesia or pharmacological prophylaxis) are retrieved from the electronic medical record (EMR). Risk is regressed against interventions. Fig 1, Panel A visualizes adherence for an individual provider by plotting anesthesia cases, with PONV risk in the x-axis and the number of interventions in the y-axis. Fig 1, Panel B shows a “Jitterplot”, jittering individual cases, which would otherwise plot onto the same coordinates (Panel A). The distribution of the number of interventions in each risk category is better summarized in Fig 1 Panel C by overlaying a violin plot onto the “Jitterplot”. Finally, a fitted regression line provides a summary measure for the individual provider’s risk-adjusted utilization of PONV prophylaxis in Fig 1, Panel D. The model can control for confounders and interactions, such as patient or procedure characteristics, such as supervision by attending physicians, institutional culture, and surgical procedure. RESULTS/ANTICIPATED RESULTS: Fig. 2, Panel A demonstrates good adherence. The provider responded to increased risk with additional interventions leading to a steep regression line. Less discriminate administration of prophylaxis is shown in Fig 2, Panel B. The graphical representation of our proposed measure of individual provider performance is intuitive, allowing us to compare adherence of two distinct groups of providers (light lines) and institutional averages (dark lines) as shown in Fig 2, Panel C. Controlling for known risk factors and potential confounders renders the assessment irrepudiable. The rigorous statistical approach allows for multi-level modeling and comparative effectiveness research, realistically evaluating process changes and interventions like CDS in the hierarchical structure of contemporary healthcare delivery. DISCUSSION/SIGNIFICANCE OF IMPACT: The strength of our novel measure of individual provider performance is its generalizability to other care settings, as well as the intuitive graphical representation of risk-adjusted individual performance. However, accuracy, precision and validity, sensitivity to system perturbations (like the implementation of CDS), and acceptance among providers remain to be evaluated. Fig 1. Risk-Adjusted Utilization of Antiemetic Prophylaxis Fig 2. Comparing Performance between Provider Groups
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Connelly, Mark, Jennifer Bickel, Tammie Wingert und Cynthia Galemore. „The Headache Action Plan Project for Youth (HAPPY): School Nurses as Facilitators of System Change in Pediatric Migraine Care“. NASN School Nurse 33, Nr. 1 (04.08.2017): 40–47. http://dx.doi.org/10.1177/1942602x17719300.
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Migraine is a common health problem in youth that is ranked highest for disability among neurological conditions and is one of the leading reasons for school absences. Children with migraines frequently are seen by the school nurse for care, sometimes before ever being seen by another healthcare provider for evaluation and treatment. As such, school nurses have the unique opportunity to provide education and resources to children with migraines and their family. This article provides information on the Headache Action Plan Program for Youth (HAPPY), a project involving the provision of live and online migraine education and management resources to school nurses, children, families, and primary care providers in an effort to improve migraine recognition and care in the community.
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Gedzior, Joanna, und Arlen Kwong. „Pearls and pitfalls for prescribing opioids in a climate of increased provider scrutiny“. International Journal of Psychiatry in Medicine 52, Nr. 2 (März 2017): 190–95. http://dx.doi.org/10.1177/0091217417720897.
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In August 2016, U.S. Surgeon General Vivek Murthy, MD, MBA, issued a letter to healthcare providers requesting aid in addressing “an urgent health crisis facing America: the opioid epidemic.” In this article, we address some of the more poignant challenges that surface in treating patients with opiate addiction. We provide an outline of recommendations from the leading medical organizations to educate primary care providers on how to navigate patients to decreased or discontinued medication loads.
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Thuo, Nicholas, Tanimola Martins, Eugene Manley,, Maisha Standifer, Dawood H. Sultan, Nicholas R. Faris, Angela Hill, Matthew Thompson, Rohan Jeremiah und Morhaf Al Achkar. „Factors leading to disparity in lung cancer diagnosis among black/African American communities in the USA: a qualitative study“. BMJ Open 13, Nr. 10 (Oktober 2023): e073886. http://dx.doi.org/10.1136/bmjopen-2023-073886.
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ObjectiveThis study has two objectives: first, to explore the diagnostic experiences of black/African American (BAA) patients with lung cancer to pinpoint pitfalls, suboptimal experiences and instances of discrimination leading to disparities in outcomes compared with patients of other ethnic backgrounds, especially white patients. The second objective is to identify the underlying causes contributing to health disparities in the diagnosis of lung cancer among BAA patients.MethodsWe employed a phenomenological research approach, guiding in-depth interviews with patients self-identifying as BAA diagnosed with lung cancer, as well as caregivers, healthcare professionals and community advocates knowledgeable about BAA experiences with lung cancer. We performed thematic analysis to identify experiences at patient, primary care and specialist levels. Contributing factors were identified using the National Institute of Minority Health and Health Disparities (NIMHD) health disparity model.ResultsFrom March to November 2021, we conducted individual interviews with 19 participants, including 9 patients/caregivers and 10 providers/advocates. Participants reported recurring and increased pain before seeking treatment, treatment for non-cancer illnesses, delays in diagnostic tests and referrals, poor communication and bias when dealing with specialists and primary care providers. Factors contributing to suboptimal experiences included reluctance by insurers to cover costs, provider unwillingness to conduct comprehensive testing, provider bias in recommending treatment, high healthcare costs, and lack of healthcare facilities and qualified staff to provide necessary support. However, some participants reported positive experiences due to their insurance, availability of services and having an empowered support structure.ConclusionsBAA patients and caregivers encountered suboptimal experiences during their care. The NIMHD model is a useful framework to organise factors contributing to these experiences that may be leading to health disparities. Additional research is needed to fully capture the extent of these experiences and identify ways to improve BAA patient experiences in the lung cancer diagnosis pathway.
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Saum, Christine A., Daniel J. O'Connell, Steven S. Martin, Matthew L. Hiller, Grant A. Bacon und D. Dwayne Simpson. „Tempest in a TC“. Criminal Justice and Behavior 34, Nr. 9 (September 2007): 1168–78. http://dx.doi.org/10.1177/0093854807304349.
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Corrections officials frequently use private contractors to operate in-prison, therapeutic community (TC) treatment programs. However, the recurrent competitive bidding process inherent in state agencies contracting for services sometimes results in a treatment-provider change. Few studies have focused on whether this change leads to better or worse treatment motivation and engagement for clients and how it might be evaluated. Using data collected during the larger Criminal Justice Drug Abuse Treatment Studies Performance Indicators for Corrections study, quantitative assessments of client functioning were made at two points in time. Changing to new treatment providers in three in-prison TC treatment facilities caused significant disruptions, leading to decreased client—counselor rapport and peer support as well as lower levels of treatment readiness, participation, and satisfaction of clients. Qualitative client and staff interviews provided further insight relevant for correctional administrators and treatment providers who may be considering similar changes. General recommendations for provider transition planning are offered.
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Pitkänen, Visa, und Ismo Linnosmaa. „Choice, quality and patients’ experience: evidence from a Finnish physiotherapy service“. International Journal of Health Economics and Management 21, Nr. 2 (19.01.2021): 229–45. http://dx.doi.org/10.1007/s10754-020-09293-z.
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AbstractWe study the relationship between patient choices and provider quality in a rehabilitation service for disabled patients who receive the service frequently but do not have access to quality information. Previous research has found a positive relationship between patient choices and provider quality in health services that patients typically do not have previous experience or use frequently. We contribute by examining choices of new patients and experienced patients who were either forced to switch or actively switched their provider. In the analysis, we combine register data on patients’ choices and switches with provider quality data from a competitive bidding, and estimate conditional logit choice models. The results show that all patients prefer high-quality providers within short distances. We find that the willingness to travel for quality is highest among new patients and active switchers. These results suggest that new patients and active switchers compare different alternatives more thoroughly, whereas forced switchers choose their new provider in limited time leading into poorer choices.
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Hastomo Putra, Dwiki, Fauzan Firdaus, Muhammad Dzikri Mustofa und Muhammad Uweis Al-Qorny Virdinant. „Influence of Quality of Health Services on Patient Satisfaction in Islamic Hospital "X" in 2021“. Muhammadiyah International Public Health and Medicine Proceeding 1, Nr. 1 (01.11.2021): 109–14. http://dx.doi.org/10.53947/miphmp.v1i1.36.
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Hospital is a health service institution that provides complete individual health services that provide inpatient, outpatient, and emergency services. Indeed, a health service provider can provide maximum service by the expectations and desires of patients. This research is in the form of qualitative and uses a Cross-Sectional study to see the relationship between the quality of services provided to patient satisfaction at Islamic Hospital X in 2021. The data collection procedure was carried out by observation, interviews, and literature studies that took place from May to July 2021. The results showed that based on the dimensions of Reliability, Responsiveness, Assurances, It can be seen from the alertness indicators of health workers, the availability of adequate and modern medical devices, communication skills of health workers, the appearance of health workers, in general, showing good results and leading to patient satisfaction with the services received at Islamic Hospital X in 2021.
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Cuttin, Karen, Elizabeth Dupont, Adama Mamby Keita, Samba Sow und Karen Kotloff. „767. Identification and Management of Diarrhea in Children Under Five in Bamako, Mali“. Open Forum Infectious Diseases 7, Supplement_1 (01.10.2020): S428. http://dx.doi.org/10.1093/ofid/ofaa439.957.
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Abstract Background Diarrhea is a leading cause of death for Children Under Five Years Old (CUFYO) worldwide, and Mali has the second highest diarrhea-related case fatality rate among African countries. The World Health Organization’s Integrated Management for Childhood Illness (IMCI) handbook provides recommendations for management of acute watery diarrhea (AWD), including: increased fluids, continued feeding, and zinc supplementation. It restricts antibiotics to dysentery. The 2018 Malian Demographic and Health Survey noted low rates of rehydration and zinc use. This study aimed to evaluate how provider knowledge, beliefs, and practices (KBPs) align with IMCI recommendations for diagnosis and management of diarrhea in Mali. Methods This qualitative cross-sectional study interviewed 136 providers who manage diarrhea in CUFYO in Bamako, Mali from July - August 2017. Providers included: doctors (D), pharmacists (P), market vendors of allopathic medications (MV), traditional healers (TH), and vendors of traditional medicines (TV). Participants were randomly selected and presented with scenarios depicting diarrheal syndromes. They provided a diagnosis, etiology of illness, and management recommendations. Providers were surveyed on KBPs regarding IMCI recommendations. Results Only 43% of providers provided the IMCI definition of AWD. Participant-IMCI concordant diagnosis varied by provider group for AWD (D-73%, P-67%, MV-31%, TH-18%, TV-40%), Dysentery (D-38%, P-75%, MV-38%, TH-61%, TV-40%), and Some Dehydration (D-31%, P-4%, MV-4%, TH-7%, TV-40%). Only 41% of all providers identified dehydration as a sequela of AWD; 18% noted mortality. Etiologies of AWD cited included: infection, teething, diet, hygiene, and many others. Participants volunteered treatment of AWD with fluids (D-52%, P-8%, MV-0%, TH-0%, TV-0%), but not zinc (0%). MK alone offered inappropriate use of antibiotics for AWD (23%). Conclusion Provider identification and management of diarrheal syndromes in CUFYO remain largely inconsistent with IMCI recommendations across all sectors of providers interviewed, specifically for rehydration therapy and zinc supplementation. Disclosures All Authors: No reported disclosures
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&NA;, &NA;. „Leading Provider of Pediatric home care Offers Expert Advice to Caregivers of Seriously III Children Via the Internet“. Home Healthcare Nurse: The Journal for the Home Care and Hospice Professional 16, Nr. 7 (Juli 1998): 489. http://dx.doi.org/10.1097/00004045-199807000-00025.
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Zahari, Abdul Rahman, Elinda Esa, Nor Hazlin Nor Asshidin, Khairul Nizam Surbaini und Azmer Ezwan Abdullah. „Mobile Touchpoint and Customer Effort: Leading energy firm in Malaysia“. Environment-Behaviour Proceedings Journal 8, SI15 (19.09.2023): 81–87. http://dx.doi.org/10.21834/e-bpj.v8isi15.5076.
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This study aims to investigate if the mobile touchpoint and customer effort were significantly different by customer types of the leading energy provider in Malaysia. The study is essential because past literature revealed a limited study on mobile touchpoint in the energy sector. 1156 respondents were captured in this study using a stratified sampling technique. The findings showed significant differences between three mobile app’s variables and no differences with customer effort is recorded. Managers of energy firms may use the findings to strategize the mobile app services because it leads to better customer experience and facilitates customer satisfaction and loyalty.
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Basu, Aveek, und Sanchita Ghosh. „Implementing Fuzzy TOPSIS in Cloud Type and Service Provider Selection“. Advances in Fuzzy Systems 2018 (15.11.2018): 1–12. http://dx.doi.org/10.1155/2018/2503895.
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Cloud computing can be considered as one of the leading-edge technological advances in the current IT industry. Cloud computing or simply cloud is attributed to the Service Oriented Architecture. Every organization is trying to utilize the benefit of cloud not only to reduce the cost overhead in infrastructure, network, hardware, software, etc., but also to provide seamless service to end users with the benefit of scalability. The concept of multitenancy assists cloud service providers to leverage the costs by providing services to multiple users/companies at the same time via shared resource. There are several cloud service providers currently in the market and they are rapidly changing and reorienting themselves as per market demand. In order to gain market share, the cloud service providers are trying to provide the latest technology to end users/customers with the reduction of costs. In such scenario, it becomes extremely difficult for cloud customers to select the best service provider as per their requirement. It is also becoming difficult to decide upon the deployment model to choose among the existing ones. The deployment models are suitable for different companies. There exist divergent criteria for different deployment models which are not tailor made for an organization. As a cloud customer, it is difficult to decide on the model and determine the appropriate service provider. The multicriteria decision making method is applied to find out the best suitable service provider among the top existing four companies and choose the deployment model as per requirement.
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Zhang, Rong, Mengjiao Li und Bin Liu. „Pricing Decisions and Provider Choice on Extended Warranty Service in Supply Chain“. International Journal of Information Systems and Supply Chain Management 12, Nr. 4 (Oktober 2019): 55–71. http://dx.doi.org/10.4018/ijisscm.2019100104.
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This article constructed a manufacturer-leading supply chain system considering the extended warranty service (EW) with a single manufacturer and a single retailer to study the influence of service cost on the choice of the EW provider. First, this article analyzed retail pricing, EW pricing, EW quality, the manufacturer's profit, the retail's profit and the total system profit in Model M and Model R. Then, the article analyzed the influence of service cost on the choice of the EW provider. Finally, it shows that if only part of consumers purchases the product with the EW, the manufacturer benefits from EW provided by the retailer. However, the retailer has to balance the ratio of the service cost coefficient. Furthermore, all consumers purchase the product with the EW, both the manufacturer and the retailer has to balance the ratio of service cost coefficient between manufacturer and retailer.
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Malouf, Lina Samir. „Towards Query Processing Over Homomorphic Encrypted Data in Cloud“. Association of Arab Universities Journal of Engineering Sciences 26, Nr. 4 (31.12.2019): 65–72. http://dx.doi.org/10.33261/jaaru.2019.26.4.008.
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With data growth very fast, the need for data storage and management in the cloud in a secure way is rapidly increasing, leading developers to find secure data management solutions through new technologies. One of the most advanced technologies at present is cloud computing technology that functions as an online service. Cloud computing technology relies on an external provider to provide online demand services. On the other hand, this technology is pay-for-use technology which means that the user must pay for each service provided by the provider. When we have a look back at the literature, we can find that regular database management systems with query processing specifications do not meet the requirements in cloud computing. This paper focuses on homogeneous coding, which is used primarily for knowledge security within the cloud. Homomorphic encryption has been clarified because of encryption technology in which specific operations can be managed on encrypted data information.
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Anakpa, Manawa, Yuyu Yuan und Ghazaros Barseghyan. „A Modified Bayesian Trustworthiness Evaluation Method to Mitigate the Effect of Unfair Ratings“. Mathematical Problems in Engineering 2018 (2018): 1–8. http://dx.doi.org/10.1155/2018/5636319.
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The choice of trustworthy interaction partners is one of the key factors for successful transactions in online communities. To choose the most trustworthy sellers to interact with, buyers rely on trust and reputation models. Therefore, online systems must be able to accurately assess peers’ trustworthiness. The Beta distribution function provides a sound mathematical basis for combining feedback and deriving users’ trustworthiness. But the Beta reputation system suffers from many forms of cheating behavior such as the proliferation of unfair positive ratings, leading a poor service provider to build a good reputation, and the proliferation of unfair negative feedback, leading a good service provider to end up with a bad reputation. In this paper, we propose a new and coherent method for computing users’ trustworthiness by combining the Beta trustworthiness expectation function with the credibility function. This novel combination mechanism mitigates the impact of unfair ratings. In comparison with Bayesian trust model, we quantitatively show that our approach provides significantly more accurate estimation of peers’ trustworthiness through feedback gathered from multiple sources. Furthermore, we propose an extension of Bayesian trustworthiness expectation function by introducing the initial trust propensity to allow assessing individuals’ initial trust.
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Kamimura, Akiko, Rebecca Higham, Naveen Rathi, Samin Panahi, Edward Lee und Jeanie Ashby. „Patient–Provider Relationships Among Vulnerable Patients: The Association With Health Literacy, Continuity of Care, and Self-Rated Health“. Journal of Patient Experience 7, Nr. 6 (12.01.2020): 1450–57. http://dx.doi.org/10.1177/2374373519895680.
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While the patient–provider relationship is one factor that can improve access to primary care for underserved populations, vulnerable patients often experience challenges to have a good relationship with providers. The purpose of this study is to examine factors that affect patient–provider relationship among vulnerable patients; in particular, among uninsured primary care patients. This study focused on health literacy, continuity of care, and self-rated health as predictors of patient–provider relationship. A self-administered survey was collected from uninsured primary care patients utilizing a free clinic in the metropolitan area in the Rocky Mountain Region in the United States from May to July in 2018. Higher levels of health literacy and continuity of care are associated with a better patient–provider relationship. Better self-rated health is associated with better patient–provider relationship. Health literacy may improve by the communication and connection with a specific provider because patients better understand the care and/or medications that are being prescribed. Seeing the same provider helps patients develop a better relationship and make clinical decisions in a way that they prefer. Improving the patient–provider relationship can potentially change health outcomes positively for vulnerable patients. Informing patients that they can request a specific medical provider may allow them to increase continuity of care, and improve communication, partnering, connection, and patient centeredness, leading to an increase in health literacy and better self-rated health.
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Schiller, Brigitte. „Leading a Dialysis Organization: Role and Responsibilities of the Chief Medical Officer (Nephrologist Leadership in a Dialysis Provider Organization)“. Advances in Chronic Kidney Disease 25, Nr. 6 (November 2018): 485–89. http://dx.doi.org/10.1053/j.ackd.2018.08.015.
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Keil, Shauna, Michelle Van Der Wege und Patricia Drees. „Leading the charge: Identifying stressors in nursing leadership“. Clinical Nursing Studies 7, Nr. 3 (02.06.2019): 12. http://dx.doi.org/10.5430/cns.v7n3p12.
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Objective: This study aimed to examine and identify specific stressors for charge nurses at a rural Midwestern hospital.Methods: The Charge Nurses Stress Questionnaire (CNSQ) was administered to charge nurses of all units at a small Midwestern hospital. A total of 30 charge nurses completed the survey. The charge nurses completed 25 questions on four stress subscales, in addition to 11 demographic questions.Results: Study results revealed the highest stressors were primarily related to being unable to meet patient needs. This situation includes when a nurse cannot reach the provider when an urgent patient need arises; when the unit is at capacity with high acuity patients and receives notification another patient has been assigned to the unit; and when the patient is in pain or otherwise suffering, and care is delayed because orders are needed.Conclusions: Stress was noted by all charge nurses. The levels of different stressors from subscales correlate with each other, and thus an increase in one subscale of stress directly affects the level of stress of another subscale. The level of stress among charge nurses was not statistically significant among the nurses of different age, different units, different shifts, and different years of experience.
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Mastera, Michael Thomas. „Shaping Off-Highway With Computer Vision and AI“. Industrial Vehicle Technology International 28, Nr. 3 (September 2020): 56. http://dx.doi.org/10.12968/s1471-115x(23)70379-6.
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Lasota, Sean T., Jessica W. Merrey, Patricia A. Ross, Martin A. Bishop und Scott A. Feeser. „Provider Responsiveness to Pharmacist Recommendations in a Population Health Setting“. Senior Care Pharmacist 34, Nr. 5 (01.05.2019): 308–16. http://dx.doi.org/10.4140/tcp.n.2019.308.
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OBJECTIVE: Geriatric patients are more sensitive to medications and are at risk for polypharmacy, requiring a medication review. It is hypothesized that a justin-time message to the primary care provider (PCP) recommending a change to potentially inappropriate medications may increase the rate of acceptance of pharmacist recommendations.<br/> DESIGN: Prospective, quality improvement study.<br/> SETTING: Health-system-based primary care facilities.<br/> INTERVENTIONS: Providers were contacted two business days prior to the patient's appointment with a recommendation based on a Beers criteria-derived algorithm. If a PCP was colocated with a pharmacist in the clinic, the preferred method of communication was queried.<br/> PATIENTS, PARTICIPANTS: Medical records of patients 65 years of age or older enrolled in the Johns Hopkins Medicine Alliance for Patients Accountable Care Organization were evaluated for tricyclic antidepressant use in neuropathy, insomnia, and depression; and benzodiazepine use in anxiety and insomnia if prescribed by the PCP.<br/> MAIN OUTCOME MEASURE: The primary outcome was to determine the number of recommendations accepted by the PCP.<br/> RESULTS: A total of 252 recommendations were made with a total of 26.2% recommendations being accepted (22.1% for benzodiazepines and 22.7% for tricyclic antidepressants). Of the 26.2% of recommendations accepted, 56% had a pharmacist in the clinic. A total of 96.7% of PCPs preferred a message to be sent through the patient's medication record.<br/> CONCLUSION: A just-in-time approach in making recommendations to PCPs was successful in leading to medication changes. There was no statistical difference between physician acceptance of pharmacist recommendations in relation to a pharmacist being embedded in the clinic.
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COLOMBO, GABRIELE, CLAUDIO DELL'ERA und FEDERICO FRATTINI. „NEW PRODUCT DEVELOPMENT (NPD) SERVICE SUPPLIERS IN OPEN INNOVATION PRACTICES: PROCESSES AND ORGANIZATION FOR KNOWLEDGE EXCHANGE AND INTEGRATION“. International Journal of Innovation Management 15, Nr. 01 (Februar 2011): 165–204. http://dx.doi.org/10.1142/s136391961100312x.
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New Product Development (NPD) service providers have assumed a prominent role in enabling a more widespread use of Open Innovation strategies, thanks to their ability to acquire, recombine and sell specialized knowledge and technologies. This paper adopts the point of view of the NPD service provider to investigate the approaches it can employ in order to favor knowledge exchange with its clients, throughout the service delivery process. The research relies on a multiple case study, which focuses on three collaborative projects undertaken by a worldwide leading provider of NPD services with some of its most important clients. The analysis reveals some important findings. First, the NPD service provider uses standard approaches, both as regards process and organizational variables, to address two critical barriers toward a successful completion of the inter-organizational relationship: the tacit nature of the knowledge to be exchanged and the difficulties in predicting the content of collaboration activities. Second, in implementing these approaches, the NPD service provider takes into account the distinctive characteristics of each client and the peculiarities of the specific collaborative project. Besides providing several managerial insights that will be useful for managers working in NPD service providers, the paper contributes to the academic debate, e.g., investigating the importance of trust in successful inter-organizational knowledge exchange processes.
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Ayu Sabrina, Nabila, Indradi Wijatmiko und Wisnumurti Wisnumurti. „Analysis Of Dominant Factors Affecting Construction Service Providers On Tender Electronically In Malang Raya 2021“. International Journal of Science, Technology & Management 4, Nr. 1 (10.01.2023): 182–90. http://dx.doi.org/10.46729/ijstm.v4i1.703.
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Provider process service construction participates in tenders electronics in Malang Raya; provider service construction will upload an offer or no for a project and make an offer that requires commitment source power. The influencing factors include the characteristics project, the ability company, the challenge operational project, the Economy, the environment, the market, and the government. The study aims to know the dominant factor influencing _ provider service construction bids on delicate electronics located in Malang Raya in 2021. Five hundred and fifty-nine respondents are provider service construction ever _ upload requirements nor only view tenders _ electronics at LPSE Malang Raya. Method research used _ is interviews and questionnaires — data analysis using Structure Equation Modeling (SEM) with SmartPLS (Partial Least Square) software.
Modeling results bid Y = 0.123 X1 + 0.325 X2 + 0.196 X3 + 0.406 X4 Effect dominant leading provider service construction bid on Tender directly electronics at LPSE Malang Raya is a category of Economy, Environment, Market, and Government (X4) with Variable Replacement Value loss (X4.4). Influence dominant second that is category Enterprise Capability (X2) with variable Profitability (X2.3). Influence chief third category Challenge Operational Project (X3) with variable Availability another project (X3.4). And Influence dominant final category Characteristics Project (X1) with variable Tender Method (One File) (X1.8) Keywords: Tender, Construction Service Provider, Structural Equation Modeling (SEM), SmartPLS (Partial Least Square).
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Debenham, Sierra, Matthew Fuller, Matthew Stewart und Raymond R. Price. „Where There is No EMS: Lay Providers in Emergency Medical Services Care - EMS as a Public Health Priority“. Prehospital and Disaster Medicine 32, Nr. 6 (11.08.2017): 593–95. http://dx.doi.org/10.1017/s1049023x17006811.
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AbstractBy 2030, road traffic accidents are projected to be the fifth leading cause of death worldwide, with 90% of these deaths occurring in low- and middle-income countries (LMICs). While high-quality, prehospital trauma care is crucial to reduce the number of trauma-related deaths, effective Emergency Medical Systems (EMS) are limited or absent in many LMICs. Although lay providers have long been recognized as the front lines of informal trauma care in countries without formal EMS, few efforts have been made to capitalize on these networks. We suggest that lay providers can become a strong foundation for nascent EMS through a four-fold approach: strengthening and expanding existing lay provider training programs; incentivizing lay providers; strengthening locally available first aid supply chains; and using technology to link lay provider networks.DebenhamS, FullerM, StewartM, PriceRR. Where there is no EMS: lay providers in Emergency Medical Services care - EMS as a public health priority. Prehosp Disaster Med. 2017;32(6):593–595.
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Doyle-Lindrud, Susan. „Testicular Cancer: Implications for Primary Care Providers“. Clinical Scholars Review 1, Nr. 2 (November 2008): 114–20. http://dx.doi.org/10.1891/1939-2095.1.2.114.
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Germ cell tumors are the most common solid tumor in men between 15 and 34 years of age. Survival from germ cell tumor is high, with a 5-year survival rate of 90% (Schmoll et al., 2004). Because this cancer affects young men, they have many years to manifest the long-term side effects of treatment. Second primary cancers are a leading cause of death among testicular cancer survivors (Zagars, Ballo, Lee, & Strom,2004). This case study reviews the clinical course of a 27-year-old male with a newly diagnosed nonseminoma germ cell tumor. Diagnostic and treatment-related issues for both patient and health care provider are addressed. Guidelines for the surveillance of nonseminoma patients after treatment and the implications of long-term follow-up are reviewed.
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Lam, Jasmine Siu Lee, und Jing Dai. „Environmental sustainability of logistics service provider: an ANP-QFD approach“. International Journal of Logistics Management 26, Nr. 2 (10.08.2015): 313–33. http://dx.doi.org/10.1108/ijlm-08-2013-0088.
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Purpose – The purpose of this paper is to propose a methodology with systematic metrics for logistics service providers (LSPs) to develop their environmental sustainability performance in the context of green supply chain management. Design/methodology/approach – An integrated analytical approach which combines analytical network process (ANP) with quality function deployment (QFD) is proposed to develop LSPs’ environmental sustainability performance. In the approach, QFD is used to translate customer requirements (CRs) for “green” concerns into multiple criteria for LSP’s design requirements (DRs). ANP is used to analyze the inter-relationships among the various CRs and DRs. Findings – The effectiveness of the proposed approach is demonstrated by applying it to a global LSP. A case study shows how the proposed “ANP-QFD” technique can be deployed to understand customers’ expectation for environment management and develop tactics and measures with the aim to achieve the desirable outcome for LSPs’ environmental sustainability performance. Practical implications – Firms that emphasize sustainability as a competitive priority will benefit by communicating sustainability efforts to customers. Therefore, “ANP-QFD” is an integrative method which helps develop LSPs’ environmental sustainability performance by enabling logistics managers incorporate the “voice” of customers for environmental concerns into their decision-making process. The study demonstrates how to develop LSPs to be greener in order to realize the requirements of green supply chains. The proposed integrated approach can also be applied in other decision-making scenarios for effective green supply chain management. Originality/value – Various approaches that can deal with multiple and conflicting criteria have been adopted for LSP assessment in the literature. However, they fail to include the impact of business objectives and the requirements of company stakeholders (customer in this study) in the identification of performance criteria for LSP. They also did not incorporate the environmental sustainability perspective. This paper contributes to the emerging research topic of environmental sustainability in logistics and supply chains by tackling these inadequacies in the literature. The study facilitates LSPs and the supply chains they serve in achieving better economic and environmental performance, thus leading to truly sustainable outcomes.
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Marshall, Vanessa, Jeri Jewett-Tennant, Jeneen Shell-Boyd, Lauren Stevenson, Rene Hearns, Julie Gee, Kimberley Schaub et al. „Healthcare providers experiences with shared medical appointments for heart failure“. PLOS ONE 17, Nr. 2 (07.02.2022): e0263498. http://dx.doi.org/10.1371/journal.pone.0263498.
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Shared medical appointments (SMAs) offer a means for providing knowledge and skills needed for chronic disease management to patients. However, SMAs require a time and attention investment from health care providers, who must understand the goals and potential benefits of SMAs from the perspective of patients and providers. To better understand how to gain provider engagement and inform future SMA implementation, qualitative inquiry of provider experience based on a knowledge-attitude-practice model was explored. Semi-structured interviews were conducted with 24 health care providers leading SMAs for heart failure at three Veterans Administration Medical Centers. Rapid matrix analysis process techniques including team-based qualitative inquiry followed by stakeholder validation was employed. The interview guide followed a knowledge-attitude-practice model with a priori domains of knowledge of SMA structure and content (understanding of how SMAs were structured), SMA attitude/beliefs (general expectations about SMA use), attitudes regarding how leading SMAs affected patients, and providers. Data regarding the patient referral process (organizational processes for referring patients to SMAs) and suggested improvements were collected to further inform the development of SMA implementation best practices. Providers from all three sites reported similar knowledge, attitude and beliefs of SMAs. In general, providers reported that the multi-disciplinary structure of SMAs was an effective strategy towards improving clinical outcomes for patients. Emergent themes regarding experiences with SMAs included improved self-efficacy gained from real-time collaboration with providers from multiple disciplines, perceived decrease in patient re-hospitalizations, and promotion of self-management skills for patients with HF. Most providers reported that the SMA-setting facilitated patient learning by providing opportunities for the sharing of experiences and knowledge. This was associated with the perception of increased comradery and support among patients. Future research is needed to test suggested improvements and to develop best practices for training additional sites to implement HF SMA.
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Bradley, J. A., und L. Thrasher-Stallard. „Leading Laboratory Testing through a Viral Pandemic“. American Journal of Clinical Pathology 154, Supplement_1 (Oktober 2020): S131. http://dx.doi.org/10.1093/ajcp/aqaa161.287.
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Abstract Introduction/Objective In March, thrown into the 2019 Novel Coronavirus pandemic the first test result was returned on the first suspected of this virus. Since, we implemented numerous plans of action, control measures, test procedures and managed the flow of accurate information to the entire facility. Methods Control and leadership engagement were key to our success. Control of collection process, creating collection “kits”, methods of shipment, results reporting and regulated distribution. Key players maintained order and track all samples on a spreadsheet. The spreadsheet utilized was the most vital tool in weeks to come. Daily updates for both supplies and samples. Simultaneously, researching test capabilities with current analyzers. Daily huddles and group meetings to coordinate all efforts which included manning. Results Supply counts three times a day at the start and collection “kits” weekly. This measured the capabilities initially. Counting errors lead to numerous redundancies. This was a burden and abandoned. Reference laboratory instructions were verified for all transport media allowed and was as a starting point. Daily usage was subtracted. Patient management was populated with sample specificities, patient demographics and testing locations. Every result called to provider, public health, infectious disease, and a sanitized report to hospital management. This data became “the” source and used as a check against other methods. Later only positives were notified. In April, microbiology implemented Cepheid GeneXpert (Sunnyvale, Ca.). Protocols established changed rapidly. Confusion drove subpar test utilization this created processing errors. Multiple shifts were trained previously and no lag was noted. A back-up, BioFire Torch (Salt Lake City, Utah), was validated. Conclusion After eight weeks, over 900 tests, 800 patients and two systems brought online. Overall, a dedicated white board specific to COVID news was established. The “normalcy” phase has hit. Some early protocols have been established as working methods and new members were brought into the fold.
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Phillips, Shannon, Yumei Chen, Rita Masese, Laurence Noisette, Kasey Jordan, Sara Jacobs, Lewis L. Hsu et al. „Perspectives of individuals with sickle cell disease on barriers to care“. PLOS ONE 17, Nr. 3 (23.03.2022): e0265342. http://dx.doi.org/10.1371/journal.pone.0265342.
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Introduction Sickle cell disease (SCD) is an inherited hemoglobinopathy that predominantly affects African Americans in the United States. The disease is associated with complications leading to high healthcare utilization rates, including emergency department (ED) visits and hospitalizations. Optimal SCD care requires a multidisciplinary approach involving SCD specialists to ensure preventive care, minimize complications and prevent unnecessary ED visits and hospitalizations. However, most individuals with SCD receive sub-optimal care or are unaffiliated with care (have not seen an SCD specialist). We aimed to identify barriers to care from the perspective of individuals with SCD in a multi-state sample. Methods We performed a multiple methods study consisting of surveys and interviews in three comprehensive SCD centers from March to June 2018. Interviews were transcribed and coded, exploring themes around barriers to care. Survey questions on the specific themes identified in the interviews were analyzed using summary statistics. Results We administered surveys to 208 individuals and conducted 44 in-depth interviews. Barriers to care were identified and classified according to ecological level (i.e., individual, family/interpersonal, provider, and socio-environmental/organizational level). Individual-level barriers included lack of knowledge in self-management and disease severity. Family/interpersonal level barriers were inadequate caregiver support and competing life demands. Provider level barriers were limited provider knowledge, provider inexperience, poor provider-patient relationship, being treated differently, and the provider’s lack of appreciation of the patient’s SCD knowledge. Socio-environmental/organizational level barriers included limited transportation, lack of insurance, administrative barriers, poor care coordination, and reduced access to care due to limited clinic availability, services provided or clinic refusal to provide SCD care. Conclusion Participants reported several multilevel barriers to SCD care. Strategies tailored towards reducing these barriers are warranted. Our findings may also inform interventions aiming to locate and link unaffiliated individuals to care.
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Vogus, Timothy J., Andrew Gallan, Cheryl Rathert, Dahlia El-Manstrly und Alexis Strong. „Whose experience is it anyway? Toward a constructive engagement of tensions in patient-centered health care“. Journal of Service Management 31, Nr. 5 (27.08.2020): 979–1013. http://dx.doi.org/10.1108/josm-04-2020-0095.
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PurposeHealthcare delivery faces increasing pressure to move from a provider-centered approach to become more consumer-driven and patient-centered. However, many of the actions taken by clinicians, patients and organizations fail to achieve that aim. This paper aims to take a paradox-based perspective to explore five specific tensions that emerge from this shift and provides implications for patient experience research and practice.Design/methodology/approachThis paper uses a conceptual approach that synthesizes literature in health services and administration, organizational behavior, services marketing and management and service operations to illuminate five patient experience tensions and explore mitigation strategies.FindingsThe paper makes three key contributions. First, it identifies five tensions that result from the shift to more patient-centered care: patient focus vs employee focus, provider incentives vs provider motivations, care customization vs standardization, patient workload vs organizational workload and service recovery vs organizational risk. Second, it highlights multiple theories that provide insight into the existence of the tensions and how they may be navigated. Third, specific organizational practices that engage the tensions and associated examples of leading organizations are identified. Relevant measures for research and practice are also suggested.Originality/valueThe authors develop a novel analysis of five persistent tensions facing healthcare organizations as a result of a shift to a more consumer-driven, patient-centered approach to care. The authors detail each tension, discuss an existing theory from organizational behavior or services marketing that helps make sense of the tension, suggest potential solutions for managing or resolving the tension and provide representative case illustrations and useful measures.
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Mehta, Kayur, Amarpreet Kaur, Preetika Banerjee, Piyush Gupta, Naveen Thacker, Vineet Saxena und Anita Shet. „Healthcare provider perspectives on COVID-19 vaccination for children in India“. BMJ Paediatrics Open 7, Nr. 1 (November 2023): e002165. http://dx.doi.org/10.1136/bmjpo-2023-002165.
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BackgroundThe rapid development and deployment of effective COVID-19 vaccines have been critical to halt the spread of the pandemic. India started vaccinating children in early 2022, however, vaccine uptake has been suboptimal.MethodsBetween September and November 2022, we conducted an online survey that was disseminated to eligible participants via email, text messages and social media platforms across India. The survey aimed to gather the perspectives of Indian healthcare providers regarding key factors related to the rollout of paediatric COVID-19 vaccines. Descriptive statistics were used to analyse participant demographics and responses on knowledge about paediatric COVID-19 vaccines, perceived risks and benefits, and vaccine rollout strategies.ResultsThe survey yielded 805 respondents from 23 Indian states; 63.5% were men, 97.3% were paediatricians, median age was 44 years (IQR 25–81). Eighty-one per cent and 65.2% respondents had heard about the most common paediatric COVID-19 vaccines in India, Covaxin and Corbevax, but only 52.9%, 53.7% and 62.1% felt adequately informed about their safety, efficacy and vaccination schedules, respectively. Thirty per cent of respondents were unaware of vaccination guidelines. Eighty-five per cent of respondents felt that vaccines would reduce the incidence of severe disease, hospitalisation and deaths, and 60.6% felt children with comorbidities should be prioritised for vaccination. Perceived supply side barriers included lack of enforcement of guidelines (45.2%) and adverse effects following immunisation monitoring systems (37.6%), and on the demand side, parental vaccine hesitancy (64.4%). Eighty-one per cent believed that school-based vaccination strategies would be highly effective in increasing uptake.ConclusionsMost respondents were in support of the COVID-19 paediatric vaccination, although just over half did not feel adequately informed. Concerns about vaccine hesitancy among caregivers were the leading reported barrier. Targeted interventions are needed to provide adequate knowledge support to healthcare providers and evidence-based public health messaging to reduce vaccine hesitancy among caregivers.
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Castle, Jennifer T., Brittany E. Levy und Aman Chauhan. „Pediatric Neuroendocrine Neoplasms: Rare Malignancies with Incredible Variability“. Cancers 14, Nr. 20 (15.10.2022): 5049. http://dx.doi.org/10.3390/cancers14205049.
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Neuroendocrine neoplasms (NENs) encompass a variety of neuroendocrine tumors (NETs) and neuroendocrine carcinomas (NECs) which can arise anywhere in the body. While relatively rare in the pediatric population, the incidence of NENs has increased in the past few decades. These neoplasms can be devastating if not diagnosed and treated early, however, symptoms are variable and can be indolent for many years. There is a reported median of 10 years from the appearance of the first symptoms to time of diagnosis. Considering some of these neoplasms have a mortality rate as high as 90%, it is crucial healthcare providers are aware of NENs and remain vigilant. With better provider education and easily accessible resources for information about these neoplasms, awareness can be improved leading to earlier disease recognition and diagnosis. This manuscript aims to provide an overview of both the most common NENs as well as the rarer NENs with high lethality in the pediatric population. This review provides up to date evidence and recommendations, encompassing recent changes in classification and advances in treatment modalities, including recently completed and ongoing clinical trials.
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D’Agostino, Thomas A., Abenaa M. Brewster, Susan K. Peterson, Isabelle Bedrosian und Patricia A. Parker. „Discussions about contralateral prophylactic mastectomy among surgical oncology providers and women with sporadic breast cancer: a content analysis“. Translational Behavioral Medicine 10, Nr. 2 (18.12.2018): 347–54. http://dx.doi.org/10.1093/tbm/iby098.
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Abstract Rates of contralateral prophylactic mastectomy (CPM) have risen substantially, yet little is known about how and to what extent CPM is discussed within surgical oncology visits at the time of treatment decision-making. We examined CPM discussions in naturally occurring interactions between sporadic breast cancer patients and their surgical oncology providers. Women with early-stage unilateral disease were recruited before their first surgical visit and completed brief questionnaires to determine study eligibility and interest in treatment options. After their visits, enrolled patients and their providers completed questionnaires assessing discussion of and interest in CPM. Audio-recorded visits from 36 unique patients were randomly selected, transcribed, and analyzed. A CPM discussion was present in 28 transcripts. Approximately half of CPM discussions were initiated by the patient or the oncology provider. The topic of CPM was most frequently introduced while reviewing available treatment options. Patients were most interested in pursuing CPM to reduce the risk of future breast cancer. Providers most frequently responded by offering information (e.g., about risk of contralateral disease). A high level of agreement was found among patient, provider, and observer ratings of whether or not CPM was discussed. CPM discussions were consistently present within our sample. Results can be used to build providers' skills and bring provider–patient communication more in line with best practices and recommendations from leading professional medical societies.
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Stuck, Rachel E., und Wendy A. Rogers. „Older Adults’ Perceptions of Supporting Factors of Trust in a Robot Care Provider“. Journal of Robotics 2018 (2018): 1–11. http://dx.doi.org/10.1155/2018/6519713.
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The older adult population is increasing worldwide, leading to an increased need for care providers. An insufficient number of professional caregivers will lead to a demand for robot care providers to mitigate this need. Trust is an essential element for older adults and robot care providers to work effectively. Trust is context dependent. Therefore, we need to understand what older adults would need to trust robot care providers, in this specific home-care context. This mixed methods study explored what older adults, who currently receive assistance from caregivers, perceive as supporting trust in robot care providers within four common home-care tasks: bathing, transferring, medication assistance, and household tasks. Older adults reported three main dimensions that support trust: professional skills, personal traits, and communication. Each of these had subthemes including those identified in prior human-robot trust literature such as ability, reliability, and safety. In addition, new dimensions perceived to impact trust emerged such as the robot’s benevolence, the material of the robot, and the companionability of the robot. The results from this study demonstrate that the older adult-robot care provider context has unique dimensions related to trust that should be considered when designing robots for home-care tasks.