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Item Children with chronic conditions: perspectives on condition management(Elsevier, 2015-02) Beacham, Barbara L.; Deatrick, Janet A.; IU School of NursingThis qualitative study described children's (8-13 years old) perspectives of their chronic health conditions (e.g., asthma, diabetes, cystic fibrosis): how they perceived their condition, its management, and its implications for their future. The study used the family management style framework (FMSF) to examine child perspectives on the joint venture of condition management between the child and family. Children within this age group viewed condition management in ways similar to their parents and have developed their own routines around condition management. Future studies of this phenomenon comparing child and parent perspectives would further our understanding of the influence of family management.Item Diagnosis and Management of Uncomplicated Chlamydia trachomatis Infections in Adolescents and Adults: Summary of Evidence Reviewed for the 2021 Centers for Disease Control and Prevention Sexually Transmitted Infections Treatment Guidelines(Oxford University Press, 2022) Geisler, William M.; Hocking, Jane S.; Darville, Toni; Batteiger, Byron E.; Brunham, Robert C.; Medicine, School of MedicineTo prepare for the development of the 2021 Centers for Disease Control and Prevention (CDC) sexually transmitted infections treatment guidelines, the CDC convened a committee of expert consultants in June 2019 to discuss recent abstracts and published literature on the epidemiology, diagnosis, and management of sexually transmitted infections.This paper summarizes the key questions, evidence, and recommendations for the diagnosis and management of uncomplicated Chlamydia trachomatis (CT) infections in adolescents and adults that were reviewed and discussed for consideration in developing the guidelines. The evidence reviewed mostly focused on efficacy of doxycycline and azithromycin for urogenital, rectal, and oropharyngeal CT infection, CT risk factors in women, performance of CT nucleic acid amplification tests on self-collected meatal specimens in men, and performance of newer CT point-of-care tests.Item Immunization Status and the Management of Febrile Children in the Pediatric Emergency Department: What Are We Doing?(Wolters Kluwer, 2023) Curtis, Molly; Kanis, Jessica; Wagers, Brian; Coffee, R. Lane, Jr.; Sarmiento, Elisa; Grout, Sarah; Johnson, Olivia; DiGregory, Sydney; Grout, Randall; Emergency Medicine, School of MedicineObjectives: Widespread Haemophilus influenzae and Streptococcus pneumoniae immunization has decreased occult bacteremia and bacterial meningitis rates. Practice has evolved in pediatric emergency departments (PEDs) to favor fewer diagnostic tests for and empiric treatment of invasive bacterial infection. We lack evidence-based guidance on evaluation and treatment of unimmunized (UnI) or underimmunized (UnderI) febrile children. This study aims to determine how parental report of immunization status in febrile PED patients impacts rates of diagnostic testing, interventions, and hospital admissions. Methods: This is a retrospective cohort study with chart review of encounters of children aged 3 to 36 months presenting to an academic, tertiary care PED in 2019 using International Classification of Diseases-10 code for fever (R50.9). Inclusion criteria were documented fever of 38°C and higher and well appearance. Encounters were excluded if there was a history of chronic illness or documentation of ill appearance or hemodynamic instability. Encounters were grouped by provider-documented immunization status. Fischer exact test and logistic regression compared rates of diagnostic testing (serum, urine or cerebrospinal fluid laboratory studies, and chest radiographs), interventions (intravenous fluid bolus, intravenous antibiotic or steroid administration, respiratory support, or breathing treatment), and hospital admissions between UnderI, UnI, and fully immunized (FI) groups. Results: Of the 1813 encounters reviewed, 1093 (60%) included provider-documented immunization status and 788 (43%) met final inclusion criteria: 23 (2.1%) UnI, 44 (5.8%) UnderI, and 721 (92.1%) FI. The UnderI and UnI children experienced significantly higher rates of laboratory evaluation including complete blood count and blood culture, medical intervention, and antibiotic prescriptions while in the PED. No significant differences were observed for rates of chest radiographs, hospital admissions, or 72-hour PED return visits. Conclusions: Higher rates of laboratory testing and interventions were observed in UnderI and UnI versus FI febrile patients at a PED, likely demonstrating increased clinical suspicion for invasive bacterial infection in this group despite lacking national guidelines. Given continued vaccine hesitancy, further studies are needed for guiding management of febrile UnI and UnderI children presenting for emergency care.Item Impact of Supervisor's Implicit Person Theory and Commitment of Performance Management Behaviors(2020-12) Wolfred, Brad; Williams, Jane; Stockdale, Peggy; Andel, StephaniePerformance management is not a new area within IO psychology research, however recently there has been growing interest with how to increase its effectiveness. Scholars are calling for more research to examine the antecedents of actual performance management behaviors that managers enact on a daily basis. The current study addresses this gap by utilizing Implicit Person Theory to understand the effect of supervisor perceptions on their behaviors that contribute towards the goal(s) of performance management. Previous research has suggested that Implicit Person Theory leads to more coaching behaviors, however, has failed to identify an explanatory mechanism. The current study relies on the three-component model of commitment to offer a mediating variable between Implicit Person Theory and differing degrees of performance management behaviors due to its more proximal relationship to the target behaviors compared to the broad antecedent of perception of others. The researchers tested this mediation using survey data from a broad sample of supervisors across the United States. Managers’ Incrementalism was positively and significantly related to discretionary performance management behaviors via affective commitment to performance management, however the relationship between Incrementalism and focal performance management behaviors via continuance commitment was non-significant. This research extends previous performance management research by providing evidence for the influence of key supervisor attitudes and implicit beliefs on varying levels of performance management behaviors. Theoretical contributions, limitations and future research directions are discussed.Item Interpreting Clinical Reaction Time Change and Recovery After Concussion: A Baseline Versus Norm-Based Cutoff Score Comparison(National Athletic Trainers' Associaton, 2021) Caccese, Jaclyn B.; Eckner, James T.; Franco-MacKendrick, Lea; Hazzard, Joseph B.; Ni, Meng; Broglio, Steven P.; McAllister, Thomas W.; McCrea, Michael A.; Pasquina, Paul F.; Buckley, Thomas A.; Psychiatry, School of MedicineContext: Preseason testing can be time intensive and cost prohibitive. Therefore, using normative data for postconcussion interpretation in lieu of preseason testing is desirable. Objective: To establish the recovery trajectory for clinical reaction time (RTclin) and assess the usefulness of changes from baseline (comparison of postconcussion scores with individual baseline scores) and norm-based cutoff scores (comparison of postconcussion scores with a normative mean) for identifying impairments postconcussion. Design: Case-control study. Setting: Multisite clinical setting. Patients or other participants: An overlapping sample of 99 participants (age = 19.0 ± 1.1 years) evaluated within 6 hours postconcussion, 176 participants (age = 18.9 ± 1.1 years) evaluated at 24 to 48 hours postconcussion, and 214 participants (age = 18.9 ± 1.1 years) evaluated once they were cleared to begin a return-to-play progression were included. Participants with concussion were compared with 942 control participants (age = 19.0 ± 1.0 years) who did not sustain a concussion during the study period but completed preseason baseline testing at 2 points separated by 1 year (years 1 and 2). Main outcome measure(s): At each time point, follow-up RTclin (ie, postconcussion or year 2) was compared with the individual year 1 preseason baseline RTclin and normative baseline data (ie, sex and sport specific). Receiver operating characteristic curves were calculated to compare the sensitivity and specificity of RTclin change from baseline and norm-based cutoff scores. Results: Clinical reaction time performance declined within 6 hours (18 milliseconds, 9.2% slower than baseline). The decline persisted at 24 to 48 hours (15 milliseconds, 7.6% slower than baseline), but performance recovered by the time of return-to-play initiation. Within 6 hours, a change from baseline of 16 milliseconds maximized combined sensitivity (52%) and specificity (79%, area under the curve [AUC] = 0.702), whereas a norm-based cutoff score of 19 milliseconds maximized combined sensitivity (46%) and specificity (86%, AUC = 0.700). At 24 to 48 hours, a change from baseline of 2 milliseconds maximized combined sensitivity (64%) and specificity (61%, AUC = 0.666), whereas a norm-based cutoff score of 0 milliseconds maximized combined sensitivity (63%) and specificity (62%, AUC = 0.647). Conclusions: Norm-based cutoff scores can be used for interpreting RTclin scores postconcussion in collegiate athletes when individual baseline data are not available, although low sensitivity and specificity limit the use of RTclin as a stand-alone test.Item Non-Transfusion-Dependent Thalassemia: An Update on Complications and Management(MDPI, 2018-01-08) Sleiman, Joseph; Tarhini, Ali; Bou-Fakhredin, Rayan; Saliba, Antoine N.; Cappellini, Maria Domenica; Taher, Ali T.; Medicine, School of MedicinePatients with non-transfusion-dependent thalassemia (NTDT) experience many clinical complications despite their independence from frequent transfusions. Morbidities in NTDT stem from the interaction of multiple pathophysiological factors: ineffective erythropoiesis, iron overload (IOL), and hypercoagulability. Ineffective erythropoiesis and hemolysis are associated with chronic hypoxia and a hypercoagulable state. The latter are linked to a high prevalence of thromboembolic and cerebrovascular events, as well as leg ulcers and pulmonary hypertension. IOL in NTDT patients is a cumulative process that can lead to several iron-related morbidities in the liver (liver fibrosis), kidneys, endocrine glands (endocrinopathies), and vascular system (vascular disease). This review sheds light on the pathophysiology underlying morbidities associated with NTDT and summarizes the mainstays of treatment and some of the possible future therapeutic interventions.Item A Review on Strategies to Manage Physician Burnout(Cureus, 2019-06-03) Patel, Rikinkumar S.; Sekhri, Shiana; Bhimanadham, Narmada Neerja; Imran, Sundus; Hossain, Sadaf; Neurology, School of MedicinePhysician burnout is an emerging condition that can adversely affect the performance of modern-day medicine. Its three domains are emotional exhaustion, depersonalization, and a sense of reduced accomplishment among physicians, with the Maslach Burnout Inventory (MBI) being the gold standard questionnaire used to scale physician burnout. This concern not only impacts physicians but the entire healthcare system in general. There is growing awareness regarding the mental health of physicians and the consequences faced by the healthcare system as a result of burnout. According to a recent study, more than 50% of physicians reported suffering from at least one burnout symptom. In this review article, we aim to identify the causes leading to burnout, its impact on physicians, and hospital management as well as interventions to reduce this work-related syndrome. Some contributing factors leading to burnout are poor working conditions with long work shifts, stressful on-call duties, lack of appreciation, and poor social interactions. Burnout can lead to adverse consequences, such as depression, substance use, and suicidal ideation in physicians and residents. This can result in poor patient care increasing total length of stay, re-admissions, and major medical errors. Due to increased scrutiny of patient and healthcare costs, along with increased lawsuits as a result of major medical errors, it is crucial for both the hospital management and physicians to recognize and address burnout among physicians. Comprehensive professional training such as Cognitive behavioral therapy (CBT), stress-reducing activities such as mindfulness and group activities, and strict implementation of work-hour limitations recommended by Accreditation Council for Graduate Medical Education (ACGME) for residents are a few methods that may help to manage burnout and increase productivity in hospitals.Item Surgical Neuro-Oncology: Management of Glioma(Elsevier, 2022) Mitchell, Dana; Shireman, Jack M.; Dey, Mahua; Pediatrics, School of MedicineGliomas are the most common intrinsic brain tumor in adults. Although maximal tumor resection improves survival, this must be balanced with preservation of neurologic function. Technological advancements have greatly expanded our ability to safely maximize tumor resection and design innovative therapeutic trials that take advantage of intracavitary delivery of therapeutic agents after resection. In this article, we review the role of surgical intervention for both low-grade and high-grade gliomas and the innovations that are driving and expanding the role of surgery in this therapeutically challenging group of malignancies.Item Understanding Management and General Expenses in Nonprofits(2001) Pollak, Thomas; Rooney, Patrick; Hager, MarkThere has been growing coverage by the press and the accounting profession about how nonprofits report their management and general costs. There has also been growing attention by some donors, perhaps made most famously by claims by some donors that nothing should go to administration. While this area of nonprofit management has caught the attention of the public, it has largely escaped the research lens of scholars. This paper is a first step to understanding and explaining what management and general costs look like in the nonprofit sector and whether or not various institutional characteristics such as mission, size, age, sources of revenues, and/or accounting practices can help explain some of the variation in management and general expenses. We find that these institutional characteristics do matter quite a bit in explaining differences in management and general costs in nonprofits.Item Utilizing Modern Fleet Management Technologies to Track and Manage Indiana University Landscape Services’ Grounds Equipment Fleet(2023-08-01) Johnson, Tristan Beck; Ray, Matthew VetoTechnology integration is critical to the successful operation of any business or municipality. In today’s modern era of sophisticated machinery, smart sensors, and data tracking software, teams must develop a comprehensive software suite that caters to their needs as an industry. In the case of a large user group such as a municipality or higher education environment, these points are even more important. These large entities, unlike a business or production facility, function as small-to-medium-sized cities. Multiple divisions, multiple accounting methodologies, and multiple management teams are the norm for major universities. Ensuring that the university adopts and adheres to a widely adaptable set of operating procedures ensures that these various divisions can all work in a similar format while still allowing each team to adapt their procedures to their unique needs. One of the most difficult tasks of any university is the upkeep and maintenance of its physical assets. These can include the academic buildings, the infrastructure that heats and cools those buildings, and the equipment used to perform those maintenance duties for the physical assets of a university. This task is typically handled by a fleet management division. These fleet management divisions rely heavily on the latest technology to ensure their vehicular and equipment assets are maintained properly, replaced on schedule and ultimately can perform the duties of the workers who utilize them on a daily basis. In the same way that modern technology can improve the everyday functions of so many tasks in daily life, the proper fleet management software can handle many of the important tasks of a facility and fleet manager. Data acquisition can be largely automated, resulting in an accurate inventory of even the most sophisticated equipment fleets. The purpose of this study is to examine the potential optimization of a fleet management system at IU Landscape Services by examining the current framework of existing technologies available to Indiana University. The outcome of this exercise will be a proposed new direction to help accomplish these goals.