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1 – 10 of 55Steven A. Blackwell, Gary M. Ciborowski, David K. Baugh and Melissa A. Montgomery
The purpose of this paper is to examine rates of potentially inappropriate prescribing in a population dually eligible for Medicare and Medicaid using the new 2003 Fick update…
Abstract
Purpose
The purpose of this paper is to examine rates of potentially inappropriate prescribing in a population dually eligible for Medicare and Medicaid using the new 2003 Fick update, which revises the previous 1997 Beers list.
Design/methodology/approach
Cross sectional retrospective review of 2003 Centers for Medicare and Medicaid Service (CMS) Medicaid Pharmacy claims data. Claims data submitted for outpatient and nursing home residents for elderly enrollees dually eligible for Medicare and Medicaid were analyzed. Potentially inappropriate drug use was assessed using the 2003 Fick update to the previous 1997 Beers list. Inappropriate use was identified based on these criteria for drugs independent of diagnosis.
Findings
Of enrollees with drug use, 34 percent received an inappropriate drug per the 1997 Beers list; 47 percent per the 2003 Fick update. Hispanics had the highest percentage of drug recipients receiving an inappropriate drug in the Northeast region per the 2003 Fick update. Within therapeutic category, the number of inappropriate genitourinary products dispensed to total genitourinary products ranked the highest at 20 percent per the 2003 Fick update.
Practical implications
This study examines variations in Beers drug use in the elderly dually eligible Medicare and Medicaid population in 2003 by applying the 2003 Fick et al. update of the 1997 Beers list to one of the nation's largest sources of person‐specific data on prescribed drugs. Inappropriate use was identified for drugs independent of diagnosis. Of enrollees with drug use, 34 percent received an inappropriate drug per the 1997 Beers list; 47 percent per the 2003 Fick update. Within therapeutic category, the number of inappropriate genitourinary products dispensed to total genitourinary products ranked the highest at 20 percent per the 2003 Fick update. The paper's findings provide evidence that the potential use of inappropriate drugs in Hispanics should be considered separately from other ethnicity groups.
Originality/value
A markedly higher rate of potentially inappropriate drug use in the elderly Medicaid population exists following the Fick update. These findings provide evidence that the potential use of inappropriate drugs in Hispanics should be considered separately from other ethnicity groups. By comparing drug use based on therapeutic category, genitourinary products were found to have the highest potential for inappropriate prescribing.
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Steven A. Blackwell, David K. Baugh, Melissa A. Montgomery, Gary M. Ciborowski and Jesse M. Levy
The purpose of this paper is to identify the probability of the occurrence of an analgesic medication injury when controlling for potential risk factors, as well as gain a better…
Abstract
Purpose
The purpose of this paper is to identify the probability of the occurrence of an analgesic medication injury when controlling for potential risk factors, as well as gain a better understanding of which risk factors appear more problematic.
Design/methodology/approach
Cross‐sectional retrospective review of 2004 Centers for Medicare and Medicaid Service Medicaid Pharmacy claims data. Logistic regression analysis performed to examine the risk of injury‐related emergency room (ER) visits following the use of analgesics controlling for potential risk factors.
Findings
Methadone, an agent to treat severe pain, and propoxyphene, an agent to treat non‐severe pain, are problematic opioids in the elderly. White origin, male gender, and increased disease burden are potential risk factors influencing injury‐related ER visits for elderly analgesic recipients. Increased age in the elderly is a potential risk factor for severe pain analgesics; decreased age for non‐severe pain analgesics.
Research limitations/implications
The study uses administrative data which, by its nature, makes conducting outcomes research on inappropriate medication use problematic. A number of confounders are present.
Practical implications
Appropriate drug therapy in an elderly patient is complicated by age‐related changes in pharmacokinetics as well as chronic disorders that affect drug response. Knowing of additional risk factors that may place the patient at greater odds of having an adverse outcome should improve prescribing practices.
Originality/value
The findings add to the literature by identifying problematic risk factors associated with injury among elderly recipients of analgesics.
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Leo Yat Ming Sin and Suk‐ching Ho
Looks at consumer research in Greater China including Mainland China, Hong Kong and Taiwan. Maps out the contributions within this area and guides future research. Examines the…
Abstract
Looks at consumer research in Greater China including Mainland China, Hong Kong and Taiwan. Maps out the contributions within this area and guides future research. Examines the state of the art over the 1979‐97 period, with particular emphasis on the topics that have been researched, the extent of the theory development in the field and the methodologies used in conducting research. Uses content analysis to review 75 relevant articles. Suggests that, while a considerable breadth of topics have been researched, there remains much to be done, there is further room for theoretical development in Chinese consumer behaviour studies; and the methodologies used need improvement and further refinement.
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The immigration conundrum to craft policy that ensures border security and safeguards human rights is grave and complex. Individuals fleeing religious persecution made finding…
Abstract
The immigration conundrum to craft policy that ensures border security and safeguards human rights is grave and complex. Individuals fleeing religious persecution made finding refuge part of our heritage since colonial times. This American tradition has enshrined our values to the world. This essay is limited to summarizing the asylum process and recent events through the summer of 2018 which affect it. Policy changes are ongoing. The asylum process is complicated by illegal immigration. The surge in migrants arriving at and/or crossing the border has led to controversial policies over the years. Unlike those who illegally cross the border and remain unknown to law enforcement, everyone who makes an affirmative asylum claim to a United States Citizenship and Immigration Services (USCIS) officer, or a defensive asylum claim in immigration court, has been thoroughly vetted through identity, criminality, and terrorism background checks. Granting refuge to those fleeing persecution reaffirms the values of a country that is, as Lincoln richly stated, the last best hope of Earth. Comprehensive immigration reform is needed on many immigration issues, two of which are to ensure border security and safeguard the asylum-seeking process.
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S. Gayle Baugh and Sherry E. Sullivan
This special issue seeks to examine mentoring relationships and offer new perspectives and frameworks, suggesting exciting avenues for future research on mentoring and career…
Abstract
Purpose
This special issue seeks to examine mentoring relationships and offer new perspectives and frameworks, suggesting exciting avenues for future research on mentoring and career development.
Design/methodology/approach
In the last two decades, the workplace has been dramatically transformed. Individuals traditionally had careers entrenched in organizations, relying on the paternalistic firm for career development. Increasingly now, individuals are enacting careers outside organizational boundaries, defining career success on their own terms rather than by the organizational measures of salary and rank. Rapid technological change and globalization have intensified the decoupling of individual careers from organizations, putting more emphasis on individuals for their own career development and creating an even greater need for mentoring.
Findings
Although much research has been done on the impact of mentoring on subjective and objective career success, there are still many unexamined and under‐explored aspects of mentoring. This collection of ten articles tackles some of these areas, providing new insights and offering new avenues for research and practice.
Originality/value
These articles are authored by individuals from a variety of disciplines (e.g. organizational behavior, psychology, health care), and countries (e.g. USA, UK, Nigeria), with each article bringing a unique lens to the study of mentoring and careers. Individually, each article makes a contribution to the better understanding of how mentoring has evolved and is enacted today. Together, this collection of articles provides important insights that it is hoped encourage even further research into the complexities of developmental relationships and their impact on career development.
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Yaw A. Debrah and Ian G. Smith
Presents over sixty abstracts summarising the 1999 Employment Research Unit annual conference held at the University of Cardiff. Explores the multiple impacts of globalization on…
Abstract
Presents over sixty abstracts summarising the 1999 Employment Research Unit annual conference held at the University of Cardiff. Explores the multiple impacts of globalization on work and employment in contemporary organizations. Covers the human resource management implications of organizational responses to globalization. Examines the theoretical, methodological, empirical and comparative issues pertaining to competitiveness and the management of human resources, the impact of organisational strategies and international production on the workplace, the organization of labour markets, human resource development, cultural change in organisations, trade union responses, and trans‐national corporations. Cites many case studies showing how globalization has brought a lot of opportunities together with much change both to the employee and the employer. Considers the threats to existing cultures, structures and systems.
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