General Practitioners' experiences with introduction and use of e-prescribing for multidose dispensed drugs: A qualitative Study (Preprint)

2021 ◽  
Author(s):  
Monika Knudsen Gullslett ◽  
Trine Bergmo Sr
Keyword(s):  
General Practitioners ◽  
Medication Management ◽  
Use Of Time ◽  
Start Up ◽  
The Everyday ◽  
Working Day ◽  
Audio Files ◽  
Time Expenditures ◽  
Depth Interviews

BACKGROUND Increased use of pharmaceuticals challenges both capacity and safety related to 1) medication management for patients and 2) changes in how General Practitioners and other health personnel interact with and follow-up of patients. E-prescribing of multidose dispensed drugs (eMDD) is one of the national measures that are being tested in Norway. OBJECTIVE The objective of this study was to reveal GPs´ experiences with the challenges and benefits of implementing eMDD in Norway. METHODS Qualitative in-depth interviews were conducted with a total of 25 GPs between 2018 and 2020. We used NVivo to conduct a step-by-step content analysis of audio files and transcribed text. RESULTS The study revealed that e-prescribing of MDD offers many benefits. At the same time, there are a number of challenges related to information, training and initiation, as well as to the responsibility for the medication, interactions and the risk of incorrect medication. An important activity in the start-up phase was an information meeting with pharmacies and technology suppliers, as well exchanging information and instructions with pharmacies on how to get started. The results are presented in four emergent analytic themes: 1) expectations, information and start-up with eMDD, 2) experiences with and need for training, 3) interaction—coordination of lists, security and efficiency, and 4) the working day with eMDD. CONCLUSIONS There is a variety in different GPs needs regarding training and information and considerable variation in competence and motivation related to the use of digital tools. There were also different degrees of understanding concerning the everyday work of the other actors in the medication chain. Especially the harmonization of medication lists related to both use of time, expenditures and challenges with technological solutions the introduction phase was emphasized as a challenge.

KINERJA APARATUR SIPIL NEGARA STUDI KASUS KANTOR KECAMATAN MOROTAI SELATAN KABUPATEN PULAU MOROTAI

2019 ◽  
Vol 4 (1) ◽  
pp. 8
Author(s):  
Ibnu Kanaha
Keyword(s):  
Work Performance ◽  
Working Hours ◽  
The South ◽  
Job Descriptions ◽  
Improve Performance ◽  
District Office ◽  
Use Of Time ◽  
State Apparatus ◽  
The Right ◽  
Depth Interviews

The purpose of this study was to determine the performance of employees (ASN) in the South Morotai District office. The form of this research is descriptive qualitative, with data collection techniques through observation and in-depth interviews with the subdistrict head, subdistrict head secretary, employees, and the community. This study concluded that employees at the South Morotai District Office were not disciplined in terms of time, both when they entered the office and after working hours. Employees are not able to make the best use of time to do productive work to improve performance. employees generally do not know and understand their respective fields of duty. The concept of the right man in the right place is not applied in the placement of employees. Performance evaluation of employees at the South Morotai District Office is difficult because of unclear job descriptions and division of tasks for the state apparatus. This causes the work performance is not measurable both in quality and quantity..

scholarly journals Pregnancy and neonatal outcomes in fresh and frozen cycles using blastocysts derived from ovarian stimulation with follitropin delta

2021 ◽  
Author(s):  
Jon Havelock ◽  
Anna-Karina Aaris Henningsen ◽  
Bernadette Mannaerts ◽  
Joan-Carles Arce ◽  
Keyword(s):  
Ovarian Stimulation ◽  
Implantation Rate ◽  
Neonatal Outcomes ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Relative Contribution ◽  
Follitropin Alfa ◽  
Start Up ◽  
Comparative Trials

Abstract Purpose To describe the pregnancy and neonatal outcomes using fresh and vitrified/warmed blastocysts obtained from ovarian stimulation with follitropin delta in controlled trials versus follitropin alfa. Methods This investigation evaluated the outcome from 2719 fresh and frozen cycles performed in 1326 IVF/ICSI patients who could start up to three ovarian stimulations in the ESTHER-1 (NCT01956110) and ESTHER-2 (NCT01956123) trials, covering 1012 fresh cycles and 341 frozen cycles with follitropin delta and 1015 fresh cycles and 351 frozen cycles with follitropin alfa. Of the 1326 first cycle patients, 513 continued to cycle 2 and 188 to cycle 3, and 441 patients started frozen cycles after the fresh cycles. Pregnancy follow-up was continued until 4 weeks after birth. Results The overall cumulative take-home baby rate after up to three stimulation cycles was 60.3% with follitropin delta and 60.7% with follitropin alfa (−0.2% [95% CI: −5.4%; 5.0%]), of which the relative contribution was 72.8% from fresh cycles and 27.2% from frozen cycles in each treatment group. Across the fresh cycles, the ongoing implantation rate was 32.1% for follitropin delta and 32.1% for follitropin alfa, while it was 27.6% and 27.8%, respectively, for the frozen cycles. Major congenital anomalies among the live-born neonates up until 4 weeks were reported at an incidence of 1.6% with follitropin delta and 1.8% with follitropin alfa (−0.2% [95% CI: −1.9%; 1.5%]). Conclusions Based on comparative trials, the pregnancy and neonatal outcomes from fresh and frozen cycles provide reassuring data on the efficacy and safety of follitropin delta. Trial registration ClinicalTrials.gov Identifier: NCT01956110 registered on 8 October 2013; NCT01956123 registered on 8 October 2013.

scholarly journals Narratives of Change: Identity and Recognition Dynamics in the Process of Moving Away From a Life Dominated by Drug Use

2021 ◽  
pp. 009145092110270
Author(s):  
Inger Eide Robertson ◽  
Hildegunn Sagvaag ◽  
Lillian Bruland Selseng ◽  
Sverre Nesvaag
Keyword(s):  
Drug Use ◽  
Identity Formation ◽  
Recovery Process ◽  
Way Of Life ◽  
Positive Identity ◽  
The Social ◽  
Changing Practices ◽  
Struggle For Recognition ◽  
Depth Interviews

The concepts of identity and recovery capital are recognized as being an embedded part of moving away from a life dominated by drug use. However, the link between these two concepts and the effect of broader social structures, and the normative assumptions underpinning the condition of recovery, is less explored. This article focuses on the social practices of everyday life in the foreground of identity formation, meaning that “who I am” is an inseparable part of “what I do.” A narrative approach was employed to analyze qualitative follow-up data extracted from 48 in-depth interviews with 17 males and females with drug-using experience that were conducted posttreatment on three separate occasions over a period of 2.5 years. Theories of identity formation were employed to analyze the interdependent dynamic between social structure, persona and social resources, and way of life and identity. The analyses identified four narratives related to how people present themselves through the process of changing practices. Following the work of Honneth, we argue that the positive identity formation revealed in these narratives is best understood as a struggle for recognition via the principle of achievement. However, the participants’ self-narratives reflected cultural stories—specified as formula stories—of “normality,” “addiction,” and the “addict,” which work into the concepts of self and confine options of storying experiences during the recovery process. This study demonstrate that the process of recovery is culturally embedded and constitutes a process of adaption to conventional social positions and roles. We suggest challenging dominant discourses related to “addiction as a disease” and “normality” in order to prevent stigma related to drug use and recovery. In so doing, it may contribute to broaden conditions for identity (trans)formation for people in recovery.

scholarly journals Experiences of recovery from colorectal cancer surgery after hospital discharge among the oldest old: A qualitative study

2021 ◽  
pp. 205715852199445
Author(s):  
Kristina Sundt Eriksen ◽  
Sissel Iren Eikeland Husebø ◽  
Hartwig Kørner ◽  
Kirsten Lode
Keyword(s):  
Colorectal Cancer ◽  
Thematic Analysis ◽  
Oldest Old ◽  
Healthcare Services ◽  
Hospital Data ◽  
Colorectal Cancer Surgery ◽  
Discharge From Hospital ◽  
Depth Interviews ◽  
Inductive Thematic Analysis

Colorectal cancer affects a large number of people aged ≥80 years. Little is known about how they manage after discharge from hospital. The aim of this study was to explore the experiences of individuals aged ≥80 years recovering from surgery for colorectal cancer, and the challenges they may encounter after discharge from hospital. Data were collected between January and March 2016 through in-depth interviews with ten participants approximately one month after surgery. Inductive thematic analysis was employed to analyse the data. The COREQ checklist was used in reporting this study. Two themes were identified: Managing the recovery from CRC surgery, and Insufficient follow-up from the healthcare services after CRC surgery. The findings indicate that older people treated for colorectal cancer manage surprisingly well after discharge despite challenges in their recovery; however, there are seemingly areas of improvement in their follow-up healthcare.

scholarly journals Contested or complementary healing paradigms? Women’s narratives of COVID-19 remedies in Mwanza, Tanzania

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Gerry Mshana ◽  
Zaina Mchome ◽  
Diana Aloyce ◽  
Esther Peter ◽  
Saidi Kapiga ◽  
...  
Keyword(s):  
Belief Systems ◽  
Emerging Infections ◽  
Community Members ◽  
Women's Narratives ◽  
Traditional Remedies ◽  
Traditional Therapies ◽  
Audio Files ◽  
Smart Mobile ◽  
Depth Interviews ◽  
African Setting

Abstract Background COVID-19 has caused worldwide fear and uncertainty. Historically, the biomedical disease paradigm established its dominance in tackling emerging infectious illnesses mainly due to innovation in medication and advances in technology. Traditional and religious remedies have emerged as plausible options for prevention and treatment of COVID-19, especially in Africa and Asia. The appeal of religious and traditional therapies against COVID-19 in the African setting must be understood within the historical, social, and political context. This study explored how women and community members dealt with suspected symptoms of COVID-19 in Mwanza, Tanzania. Methods This study was conducted in Nyamagana and Ilemela districts of Mwanza, Tanzania, between July and August 2020. We conducted 18 mobile phone in-depth interviews with a purposively selected sample of women aged 27–57 years participating in an existing longitudinal study. For safety reasons, smart mobile phones were used to collect the data. Each interview was audio recorded after obtaining verbal consent from the participants. The audio files were transferred to computers for analysis. Four researchers conducted a multistage, inductive analysis of the data. Results Participants reported wide use and perceived high efficacy of traditional remedies and prayer to prevent and treat suspected symptoms of COVID-19. Use was either alone or combined with public health recommendations such as hand washing and crowd avoidance. Despite acknowledging that a pathogen causes COVID-19, participants attested to the relevance and power of traditional herbal medication and prayer to curb COVID-19. Four main factors underline the symbolic efficacy of the traditional and religious treatment paradigms: personal, communal, and official reinforcement of their efficacy; connection to local knowledge and belief systems; the failure of biomedicine to offer a quick and effective solution; and availability. Conclusions In the context of emerging contagious illnesses, communities turn to resilient and trusted treatment paradigms to quell fear and embrace hope. To tackle emerging infections effectively, it is essential to engage the broader sociopolitical landscape, including communal considerations of therapeutic efficacy.

scholarly journals Understanding the Occupational Adaptation Process and Well-Being of Older Adults in Magallanes (Chile): A Qualitative Study

2019 ◽  
Vol 16 (19) ◽  
pp. 3640 ◽  
Author(s):  
Palma ­Candia ◽  
Hueso­Montoro ◽  
Martí-García ◽  
Fernández-Alcántara ◽  
Campos-Calderón ◽  
...  
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
Well Being ◽  
Self Esteem ◽  
Adaptation Process ◽  
Occupational Adaptation ◽  
Use Of Time ◽  
Low Levels ◽  
Interpretative Approach ◽  
Depth Interviews

Background: Aging and longevity are important topics nowadays. Purpose: To describe how older adults perform the occupational adaptation process in the extreme region of Magallanes (Chile), and to identify the factors that might contribute to successful occupational adaptation and well-being. Method: Qualitative study, with a phenomenological interpretative approach. In-depth interviews were carried out with 16 older adults, with high or low levels of well-being, assessed with the Ryff Scale. An inductive content analysis according to Elo and Kyngäs was performed. Findings: Resilience, self-esteem and interdependence with significant others are key elements that promote well-being. Participants develop strategies to minimize the effects of environmental factors. The occupation’s function in terms of socialization, use of time, and social participation is revealed as a conditioning factor of occupational adaptation. Implications: Interventions with older people to achieve a successful occupational adaptation process must take into consideration the commitment to meaningful activities.

scholarly journals Optimising medication management in children and young people with ADHD using a computerised test (QbTest): a feasibility randomised controlled trial

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Laura Williams ◽  
Charlotte L. Hall ◽  
Sue Brown ◽  
Boliang Guo ◽  
Marilyn James ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Young People ◽  
Controlled Trial ◽  
Medication Management ◽  
Control Group ◽  
Global Functioning ◽  
Children And Young People ◽  
Link Type ◽  
Randomised Controlled

Abstract Background Medication for attention deficit hyperactivity disorder (ADHD) should be closely monitored to ensure optimisation. There is growing interest in using computerised assessments of ADHD symptoms to support medication monitoring. The aim of this study was to assess the feasibility and acceptability of a randomised controlled trial (RCT) to evaluate the efficacy of one such computerised assessment, the Quantified Behavior (Qb) Test, as part of medication management for ADHD. Methods This feasibility multi-site RCT conducted in child and adolescent mental health and community paediatric settings recruited participants aged 6–15 years diagnosed with ADHD starting stimulant medication. Participants were randomised into one of two arms: experimental (QbTest protocol) where participants completed a QbTest at baseline and two follow-up QbTests on medication (2–4 weeks and 8–10 weeks later) and control where participants received treatment as usual, including at least two follow-up consultations. Measures of parent, teacher, and clinician-rated symptoms and global functioning were completed at each time point. Clinicians recorded treatment decision-making and health economic measures were obtained. Data were analysed using multi-level modelling and participants (children and parents) and clinicians were interviewed about their experiences, resulting data were thematically analysed. Results Forty-four children and young people were randomised. Completion of study outcome measures by care-givers and teachers ranged from 52 to 78% at baseline to 47–65% at follow-up. Participants reported the questionnaires to be useful to complete. SNAP-IV inattention scores showed greater reduction in the intervention than the control group (− 5.85, 95% CI − 10.33, − 1.36,). Engagement with the intervention ranged from 100% at baseline, to 78% follow-up 1 and 57% follow-up 2. However, only 37% of QbTests were conducted in the correct time period. Interview data highlighted that the objectivity of the QbTest was appreciated by clinicians and parents. Clinicians commented that the additional time and resources required meant that it is not feasible to use QbTest for all cases. Conclusion The trial design and protocol appear to be feasible and acceptable but could be improved by modifying QbTest time periods and the method of data collection. With these changes, the protocol may be appropriate for a full trial. Adding QbTest may improve symptom outcome as measured by SNAP-IV. Trial registration ClinicalTrials.gov, NCT03368573, prospectively registered, 11th December 2017, and ISRCTN, ISRCTN69461593, retrospectively registered, 10th April 2018

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