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Education-Based Intervention to Decrease Unnecessary Antibiotic Prescribing for Uncomplicated Acute Bronchitis
Get PDFBackground and Purpose: Antibiotic resistance is a serious health problem in Oregon and across the United States. The increased incidence is partly due to inappropriate outpatient antibiotic use, especially for uncomplicated acute bronchitis.
Methods: In an effort to decrease unnecessary antibiotic prescribing, a 30-minute education seminar for providers was implemented. The content focused on antibiotic stewardship and management of bronchitis using a printed decision support (PDS) guideline algorithm, Wait and See Prescription (WASP) method, and motivational interviewing (MI). The intervention was monitored through eight weeks of data collection, using ICD-10 codes from the electronic health record and a paper-based survey.
Conclusions: In the first month, there were no antibiotics prescribed for acute bronchitis, while one was prescribed in the second month. The WASP method was used the most by providers, but the PDS algorithm was perceived to be more helpful. MI was used the least and perceived to be the least helpful. Following the education seminar, 77% of providers felt like they prescribed fewer antibiotics for acute bronchitis.
Implications for Practice: When compared to baseline data, there were no significant differences in antibiotic prescribing, suggesting that providers were prescribing antibiotics judiciously at baseline. Variations in provider coding may have impacted the results. Recommendations for the future include extending the data collection period and obtaining information about narrow and broad-spectrum antibiotic use to identify trends and provider education needs
Creating Intercultural Competency: Justification and Design of a Church Leader Intercultural Encounter Workshop
Get PDFThis paper aims to explore, understand, and put to practice a set of guided questions designed to instill the necessary intercultural communication skills one needs when partaking in some sort of an intercultural interaction within a Christian church mission environment. Through the accumulation and dissection of past literature this paper has created a set of linear questions for church officials to read, understand, and apply to their training prior to and action in mission work across borders. This paper describes and supports a workshop that will allow said church officials to create, improve, and better understand their intercultural competencies, which will, in turn, help them be more efficient in their mission work and will help them get more enjoyment out of the way they are able to interculturally interact
Language Acquisition Versus Language Development: An Investigation of Teachers\u27 Beliefs of How English Learners Acquire a Language and How These Beliefs Translate into Practice
Get PDFWith the increased demands of the new Common Core State Standards (CCSS), the New Generation Science Standards (NGSS), and the revised English Language Proficiency Standards (ELPs); the traditional approach to teaching English Learners (ELs) needs to shift to align with the expectations of these new standards. Therefore, the researcher engaged in a study to determine how professional development (PD) that supports the new standards impacted beliefs of educators in the district and ultimately, classroom practice. The purpose of this qualitative study was twofold: (1) To determine if the Arwood Neuroeducation Model (ANM) supports the pedagogical shifts recommended by Heritage, Walqui, and Linquanti (2015); and (2) If those district educators with and without a professional background in both the pedagogical shifts and in educating ELs based on the ANM show beliefs about language development and/or language acquisition that are aligned with their classroom practices.
The first part of the study involved reviewing the pedagogical shifts and then aligning each shift to components of ANM to determine which elements of the shifts aligned to the model and which ones were missing. The key finding from this part of the study was that ANM has a place in the Second Language Acquisition (SLA) literature and that the model supports and enhances the pedagogical shifts.
The second part of the study was to investigate educators’ beliefs about language acquisition and development aligned to their classroom practice, which was conducted using a combination of an open and closed-ended survey as well as a classroom visit by an educator with this neuroeducation background with no relationship to the district in which the data was collected. The survey was sent to 500 general educators in a large district such as administrators, school psychologists, speech language pathologists, self-contained teachers, English Language Development (ELD) teachers, and content teachers of which 350 responded. The same survey was sent to eight select ELD teachers. Four of the ELD teachers received professional development or PD on the pedagogical shifts for SLA and on the differences between language development and language acquisition and four of the teachers did not receive any training. The eight ELD teachers were also observed once using an observation tool aligned to ANM. The findings for the second part of the study suggest an alignment between beliefs and practice for the group that received PD but not for the group that did not receive the same PD. The data also suggest that when PD was provided on language acquisition, teachers’ beliefs and classroom practice aligned to the literature on language acquisition. When PD was not provided, the beliefs aligned to the literature on language acquisition but classroom practice aligned to the literature on language development. Also, PD around neuroeducation supported the shift in alignment of practice
Intercultural Romantic Relationship Management
Get PDFThis is a study of intercultural romantic relationships, studied through the theoretical lenses of Relational Dialectics theory and Social Identity theory. Supporting literature reveals patterns of integrating the use of Mark Knapp’s Relational Development model, identity negotiation and the use of Intercultural Communication Competence. An analysis of interviews with six women who were/are involved in intercultural romantic relationships were interviewed in a one time interview that consisted of a series of open ended questions. This study analyzes how each couple manages conflicts in the relationship that emerge from differences in culture, revealing patterns of affirmation, cultural engagement, passivity and the use of constructive relationship strategies. These findings are useful for the study of intercultural couples, given that there is very little research conducted thus far
Love Actually Modeling Amor in Augustine’s De catechizandis rudibus: in Augustine on Heart and Life: Essays in Honor of William Harmless, S.J.
Get PDFA Carthaginian deacon named Deogratias asked Augustine for advice on how to improve his teaching for inquirers. Augustine obliged by writing De catechizandis rudibus (On Instructing Beginners), a masterful survey of need-to-know essentials on the story of salvation, the unity of Scripture, and their deep center in Christ. But the work did more than teach the basics of faith. Augustine saw that the deacon needed not only more information but also more assiduous practice in giving his learners the humble Christian love that he was teaching about. Beginning with descriptions of God’s accommodating love to humanity in Christ, Augustine demonstrated the crucial role of love in the work of a Christian teacher by displaying it literarily to Deogratias by his kindly approach and way of writing. Not merely giving commands or spouting theories, Augustine’s De catechizandis rudibus subtly offered a model of love itself for the beginning teacher Deogratias to imitate
Generating Stable Bioluminescent Cell Lines by Retroviral Transduction
Get PDFThis project focuses on improving tumor in vivo imaging techniques. It is difficult to accurately in vivo image orthotopic tumors using CT scans alone. Muriglo provides the capability to visualize in vivo bioluminescent signals emanating from intact tissues. We can coregister CT scans captured with the SARRP with luciferase signals captured with the Muriglo and locate tumor isocenters for image-guided radiation. We may then direct radiation to neoplastic tissue while also sparing the maximum amount of healthy tissue. To do this we must genetically engineer cells to express luciferase. We propose a protocol to use a retrovirus to create stable cell lines that express firefly luciferase for bioluminescence. We will also determine the optimal dosage of the G418 antibiotic for selection
Maximizing the Educational Investment with a Required Personal and Professional Development Program for Business Majors
Get PDFHigher-education institutions have been asked to go beyond the classroom and provide a better return on investment for students. With no line item in the budget, the Pamplin School of Business of the University of Portland linked both formation of the person and professional development by creating a mechanism of a credit-based program designed to marry theoretical, self-assessment, and experiential learning. Students engage in a series of holistic processes and professional development coursework challenging them to find and fulfill their potential while effectively exploring the core question of the university, “Who am I?” Between 2012 and 2016, 93 percent of business students acquired a vocational career position within six months of graduation, maximizing their education investment.
This article is dedicated to the student workers who were instrumental in assisting in the development and implementation of the program. This program could not have been developed without them. These workers include Dani Remy Baker, Jasmine Dudley, Larissa Woods, Brooke Murphy, Cole Preece, and Amanda Stowe. The graphics in the paper are by Cole Preec
Improving Adult BMI Assessment Metric Coding in a Small, Urban Primary Care Setting
Get PDFBackground: The Adult Body Mass Index (BMI) Assessment measure is defined as the percentage of patients, age 18 to 74, with a documented BMI and weight within the past two years. It is measured using claims data based on current diagnoses coding. The clinic benchmark for this measure is 93%. Baseline data showed the participating clinic (PPCC) to be at 3.6%. A practice improvement project was initiated with the goal of improving Adult BMI Assessment coding from 3.6% to 50%.
Method: The intervention included creation of a coding cheat sheet, placement of BMI charts with ICD-10 BMI codes in examination rooms, and education of providers and Medical Assistants (MA) concerning Adult BMI Assessment coding and its importance for patients and reimbursement. Chart review was used to identify the number of patients seen, the number of patients with a documented height/weight/BMI, and the number of patients with a documented ICD-10 BMI code during an 8-week period between September 2016 and November 2016. Percentages of patients with a documented ICD-10 BMI code were calculated each week.
Results: Throughout implementation, the percentage of patients with a documented ICD-10 BMI code fluctuated. In week 7, the goal of 50% was obtained with 52% of patients having a documented ICD-10 BMI code.
Discussion: Use of ICD-10 code cheat sheets can improve documentation and increase metric scores to improve reimbursement opportunities
Updating Primary Care Providers’ Management of Persistent Pain
Get PDFPersistent pain impacts the quality of life of millions of adults and is fiscally draining on the American healthcare system. National recognition of the problem is shifting persistent pain management recommendations. Historically, opioids have played a large role in the management of acute and chronic pain, but the current opioid epidemic in the United States creates an urgent need for clinicians to alter their practice to include new recommendations. Additionally, Medicare has approved changes in reimbursement, to enforce new pain management recommendations, that will make it increasingly difficult for patients with ongoing non-cancer pain to receive continuing opioid medication therapy. However, many clinicians feel unprepared to adequately manage patients with persistent pain. A multidisciplinary primary care clinic that had experienced an influx of opioid dependent chronic pain patients initiated a practice change project to increase provider adherence to current pain management guidelines. Clinicians were offered an onsite workshop. Following the educational interventions, the assessed prescription and referral practices were found to have: 1) reduced opioid prescribing, including in combination with benzodiazepines; 2) increased the number of referrals for interdisciplinary care; and 3) greater use of other classifications of drugs to manage patients’ pain. The providers’ change in practice reflected better understanding of the multifaceted aspects of persistent pain