Prescriber and Dispenser Perceptions About Antibiotic Use in Acute Uncomplicated Childhood Diarrhea and Upper Respiratory Tract Infection in New Delhi: Qualitative Study

DiarrhoeaOBJECTIVE: The objective of the study was to explore the prescribing practices, knowledge, and attitudes of primary care doctors and community pharmacists, regarding antibiotic use in acute upper respiratory tract infections (URTI) and diarrhea in children to better understand causes of misuse and identify provider suggestions to change such behavior. MATERIALS AND METHODS: Two focus group discussions (FGDs) each were conducted with primary care government doctors (GDs), private general practitioners (GPs), pediatricians, and community pharmacists in Delhi. Each FGD had 8–12 participants and lasted 2 h. Furthermore, 22 individual face‑to‑face semi‑structured interviews were conducted with providers of varying type and experience at their workplaces. Thematic and summative qualitative content analysis was done. RESULTS: All groups admitted to overusing antibiotics, GPs appearing to use more antibiotics than GDs and pediatricians for URTI and diarrhea in children. Pharmacists copy the prescribing of neighborhood doctors. Antimicrobial resistance (AMR) knowledge was poor for all stakeholders except pediatricians. Causes for prescribing antibiotics were patient pressure, profit motive, lack of follow‑up and in addition for GDs, workload, no diagnostic facility, and pressure to use near‑expiry medicines. Knowledge was gained through self‑experience, copying others, information from pharmaceutical companies, and for some, training, continuous medical education/conferences. All groups blamed other professional groups/quacks for antibiotic overuse. Interventions suggested were sensitizing and empowering prescribers through training of providers and the public about the appropriate antibiotic use and AMR and implementing stricter regulations. CONCLUSIONS: A package of interventions targeting providers and consumers is urgently needed for awareness and change in behavior to reduce inappropriate community antibiotic use

Re-thinking technology and its growing role in enabling patient empowerment

© The Author(s) 2018. The presence and increase of challenges to eHealth in today’s society have begun to generate doubts about the capability of technology in patient empowerment, especially within the frameworks supporting empowerment. Through the review of existing frameworks and articulation of patient demands, weaknesses in the current application of technology to support empowerment are explored, and key constituents of a technology-driven framework for patient empowerment are determined. This article argues that existing usage of technology in the design, development and implementation of patient empowerment in the healthcare system, although well intentioned, is insufficiently constituted, primarily as a result of fragmentation. Systems theory concepts such as holism and iteration are considered vital in improving the role of technology in enabling patient empowerment

Characteristics and Subjective Evaluation of an Intelligent Empowering Agent for Health Person Empowerment

Empowerment is a process through which people acquire the necessary knowledge and self-awareness to understand their health conditions and treatment options, self-manage them, and make informed choices. Currently, few stand-alone applications for patient empowerment exist and people/patients often go on the Web to search for health information. Such information is mainly obtained through generic search engines and it is often overwhelming, too generic, and of poor quality. Intelligent Empowering Agents (IEA) can filter such information and assist the user in the understanding of health information about specific complaints or health in general. We have designed and developed a first prototype of an IEA that dialogues with the user in simple language, collects health information from the Web, and provides tailored, easily understood, and trusted information. It empowers users to create their own comprehensive and objective opinion on health matters that concern them. The paper describes the IEA main characteristics and presents the results of subjective tests carried out to assess the effectiveness of the IEA. Twenty-eight Master students in Digital Health filled an online survey presenting questions on usability, user experience and perceived value. Most respondents found the IEA easy to use and helpful. They also felt that it would improve communication with their doctors

Evaluating empowerment and control of HE e-learning in a secure environment

With the increased spread of HE distance learning into a wide variety of contexts it is important for us to understand the factors involved in its successful deployment for students. E-learning has a great potential to support effective and empowering HE distance learning (Wilson, 2007; Adams, 2005; Hughes, 2005). However, within two secure environments, prisons and health service, the factors involved are complex. This paper reviews HE e-learning technology perceptions within these two contrasting contexts from 225 students' and stakeholders' perspectives. Previous research has detailed literature limitations on obtaining students' perspectives of e-learning (Conole et al, 2006). These limitations are compounded when other stakeholder perceptions are not integrated (Sun et al, 2007; Adams et al, 2005; Millen at al, 2002). This paper developed and applied an e-learning framework for student and stakeholder perceptions. This social psychological framework, is based on previous practice based e-learning studies and is used here to synthesise two large-scale case studies. The framework focuses on three concepts learner Access (e.g. learning design, technology design, physical access), Awareness (e.g. of resources, their usage and support for e-learning tasks) and Acceptability (e.g. trust, privacy, aesthetics, engagement). Students' and stakeholders' perceptions identified high levels of students' empowerment through e-learning whilst still requiring a further pedagogical tailoring and an awareness of support. However, serious problems within these contexts have identified blocks to e-learning through stakeholders perceptions and fears of acceptability (i.e. issues of risk and trust). Ultimately, through understanding competing perceptions and needs within these complex environments we can support the effective technological development, pedagogical design and deployment of e-learning systems

Design-thinking, making, and innovating: Fresh tools for the physician\u27s toolbox

Medical school education should foster creativity by enabling students to become \u27makers\u27 who prototype and design. Healthcare professionals and students experience pain points on a daily basis, but are not given the tools, training, or opportunity to help solve them in new, potentially better ways. The student physician of the future will learn these skills through collaborative workshops and having dedicated \u27innovation time.\u27 This pre-clinical curriculum would incorporate skills centered on (1) Digital Technology and Small Electronics (DTSE), (2) Textiles and Medical Materials (TMM), and (3) Rapid Prototyping Technologies (RPT). Complemented by an on-campus makerspace, students will be able to prototype and iterate on their ideas in a fun and accessible space. Designing and making among and between patients and healthcare professionals would change the current dynamic of medical education, empowering students to solve problems in healthcare even at an early stage in their career. By doing so, they will gain empathy, problem-solving abilities, and communication skills that will extend into clinical practice. Our proposed curriculum will equip medical students with the skills, passion, and curiosity to impact the future of healthcare

Linking Disability and Intercultural Studies: the adaptation journey of the visually impaired migrant in Ireland

This study focuses on the lived experiences of the visually impaired migrant in Ireland and this is the first study to document the lives of these members of Irish society. It examines how visually impaired migrants are simultaneously adapting to their disability and a new cultural environment while living in Ireland. In so doing this study aims to link the two academic fields of Intercultural Studies and Disability Studies and theoretical underpinnings for this study are drawn and woven together from both fields. As such this study draws from the development of theories relating to disability as well as the intercultural aspects of migration. Qualitative in-depth semi-structured interviews were conducted with 22 participants living in the larger Dublin region, which comprised of two groups; migrant users and providers of services for the visually impaired. Data analysis was assisted through the software package Atlas.ti. A grounded theory approach to collecting and analysing data was adopted as this facilitates the flow from raw data to codes to concepts. Purposive sampling was employed and the typical method of grounded theory of constant comparison was not used, rather interviews were analysed individually once they were all completed then compared. Research findings indicate that the cultural perceptions of disability may help or hinder the individual’s adaptation process both to their visual impairment and to living and integrating into a new culture in Ireland. Findings cluster around the three areas of cultural perceptions of disability, support networks and cultural barriers to adaptation. Synergising theoretical concepts and data steered the development of a new integrative model which identifies the inhibitors and facilitators for the process of adaptation to visual impairment for a migrant in Ireland

Tailored retrieval of health information from the web for facilitating communication and empowerment of elderly people

A patient, nowadays, acquires health information from the Web mainly through a “human-to-machine” communication process with a generic search engine. This, in turn, affects, positively or negatively, his/her empowerment level and the “human-to-human” communication process that occurs between a patient and a healthcare professional such as a doctor. A generic communication process can be modelled by considering its syntactic-technical, semantic-meaning, and pragmatic-effectiveness levels and an efficacious communication occurs when all the communication levels are fully addressed. In the case of retrieval of health information from the Web, although a generic search engine is able to work at the syntactic-technical level, the semantic and pragmatic aspects are left to the user and this can be challenging, especially for elderly people. This work presents a custom search engine, FACILE, that works at the three communication levels and allows to overcome the challenges confronted during the search process. A patient can specify his/her information requirements in a simple way and FACILE will retrieve the “right” amount of Web content in a language that he/she can easily understand. This facilitates the comprehension of the found information and positively affects the empowerment process and communication with healthcare professionals

Development Through Empowerment: Delivering Effective Public Services - A Literature Review

This paper reviews the channels through which empowerment may improve the efficiency and quality of public service delivery, particularly in developing Asia. Departing from a macro perspective, we focus and revisit microeconomic evidence for three broad measures aimed at empowering the poor: empowerment through voice, empowerment through exit, and empowerment through information

Barriers, control and identity in health information seeking among African American women

Qualitative research methods were used to examine the role of racial, cultural, and socio-economic group (i.e., communal) identities on perceptions of barriers and control related to traditional and internet resources for seeking health information. Eighteen lower income, African American women participated in training workshops on using the internet for health, followed by two focus groups. Transcripts were analyzed using standardized coding methods. Results demonstrated that participants perceived the internet as a tool for seeking health information, which they believed would empower them within formal healthcare settings. Participants invoked racial, cultural, and socio-economic identities when discussing barriers to seeking health information within healthcare systems and the internet. The findings indicate that the internet may be a valuable tool for accessing health information among lower income African American women if barriers are reduced. Recommendations are made that may assist health providers in improving health information seeking outcomes of African American women