Publication Type: School Poster
Abstract: Objective: To provide a description of an advanced pharmacy practice experience (APPE) that enhances quality education and patient care by utilizing:
• transplant patient-centered care models;
• interdisciplinary education;
• evidence-based practice and research; and
• informatics (specifically utilizing OTTR© and Drug Assistant©).

Methods: Pharmacy students spend 5 weeks performing pharmaceutical care activities for transplant patients (TPs) with an interdisciplinary team of medical residents/fellows, pharmacists, pharmacy technicians, nurses, physician assistants, social workers, and physicians. During the APPE, students learn how to increase medication access and improve TPs’ health outcomes. Each student obtains over 200 direct patient care hours, performs pharmaceutical activities for over 400 TPs, learns the importance of using informatics to facilitate patient care activities, and participates in one research project. Over the last 6 years of the APPE, 17 students were given a pre- and post-APPE test concerning their knowledge of transplant medicine. To improve the quality of the APPE, standardized evaluations were used. Reports from the Medication Access Program (MAP) were used to document medications obtained for TPs.

Results: Post scores were statistically higher than pre-test scores (88.24 versus. 55.88; p<0.001). Students found this APPE enjoyable and believed it increased their knowledge concerning transplant medicine and patient care. MAP, along with pharmacy students, has provided over 550 TPs with over $12 million of medications.

Implications: APPEs should be designed to give pharmacy students experience with patient-centered care models, interdisciplinary education, activities related to evidence-based practice and research, and informatics.

Publication Type: Conference Paper/Unpublished Manuscript
Review Method: Peer Reviewed
Abstract: The 'New Labour' Party came into office in 1997 committed to 'modernise', among other institutions, UK local government. A 'flagship' policy in its modernisation agenda was to replace the traditional committee system with, for the first time in the UK, executive-based local government, headed preferably by directly elected executive mayors. The first section of this paper outlines the origins of this mayoral policy, its legislative embodiment in the Local Government Act 2000, and its implementation. It outlines the three executive models that constituted the restricted choice available to most local authorities and the consultations that councils were required to undertake, including the statutory referendums required prior to the introduction of a directly elected mayor. It concludes with the recent election of the first eight of these English mayors and the political embarrassment that several of the elections produced for the Government. The second main section of the paper reviews these events with reference to the main programme theme of APSA 2002: the contribution (or lack of it) of political science research to policy development. Its conclusion is that two obvious opportunities for lesson-drawing - learning from experience in other countries, including the US, and learning through experimentation and the piloting of different executive models in selected UK authorities - were largely ignored, and that this resistance to lesson-drawing has been at least one of the major reasons for the low and generally negative impact of the Government's mayoral policy to date. As for the rhetorical question in the sub-title, there was a moment when it looked possible that the chance injection of a 'Giuliani factor' following the events of 9/11 might stimulate public interest and acceptance of the idea of elected mayors … but it didn't!

Publication Type: Conference Paper/Unpublished Manuscript
Review Method: Peer Reviewed
Abstract: The present study answers the calls of many small group scholars to conduct empirical research on the communication interaction process of multidisciplinary medical teams operating within their own context and doing tasks that are meaningful to the participants. This investigation measured and compared use frequency of rhetorical devices used to discuss patient care during weekly multidisciplinary BMT outpatient and inpatient team meetings; and measured and compared use frequency of rhetorical devices that describe task and socio-emotional relationships within the multidisciplinary BMT outpatient and inpatient teams in their weekly meetings. Ten rhetorical devices were developed for this study and partitioned into three main groups: (a) Patient Centered rhetorical devices, (b) Group Centered rhetorical devices, and (c) Intermediary rhetorical devices. The data indicated that (a) Inpatient Clinical rhetorical devices were used significantly more frequently than Inpatient Non-clinical rhetorical devices; (b) Outpatient Clinical rhetorical devices were used significantly more frequently than Outpatient Non-clinical rhetorical devices; (c) Inpatient Task rhetorical devices were used significantly more frequently than Inpatient Socio-emotional rhetorical devices; and (d) Outpatient Task rhetorical devices were used significantly more frequently than Outpatient Socio-emotional rhetorical devices. Research implications and future directions are discussed.

This project was supported through a grant (#00-598) awarded by the Bayer Institute For Health Care Communication, West Haven, CT.

Publication Type: Conference Paper/Unpublished Manuscript
Review Method: Peer Reviewed
Abstract: Uncertainty has been recognized as a salient aspect of the experience of illness. This study was designed to systematically describe sources of uncertainty across the transplant trajectory. We interviewed 38 pre-transplant (n = 8) and post-transplant (n = 30) patients (16 men, 22 women). Participants reported medical, personal, and social forms of uncertainty. Prior to receiving a transplant, participants reported experiencing medical uncertainty related to (a) having insufficient information about their diagnosis, (b) complex decisions about going on the waiting list, (c) unknown organ availability, and (d) unclear expectations regarding medical procedures and outcomes. They reported that the medical uncertainty they experienced after the transplant was related to (a) complex medication regimens and (b) the unpredictability of their future health. Prior to receiving a transplant, participants may experience personal uncertainty related to (a) finding meaning in life despite illness, (b) current and anticipated role changes, and (c) unclear financial consequences. After receiving a transplant, they may experience uncertainty related to (a) conflicting emotions of gratitude and depression, (b) the inability to fulfill previous roles, and (c) unclear financial consequences. Finally, pre-transplant patients can experience social forms of uncertainty, including (a) questioning from others and (b) unclear relational implications. Post-transplant patients may experience uncertainty related to (a) negative interpersonal reactions and (b) unclear relational implications. These findings serve as a precursor to understanding uncertainty management among transplant patients, and lead us to suggest that health care professionals and supportive others cannot apply a “one-size-fits-all” solution when aiding others in uncertainty management.

Publication Type: Conference Paper/Unpublished Manuscript
Review Method: Peer Reviewed
Abstract: The aim of the paper is to develop and at least partially test hypotheses on the extent to which mafia groups migrate outside of the area where they originated. The hypotheses I consider are: level of social capital; supply of Mafiosi in the new area; size of the market/area they try to 'conquer'; demand for criminal services.
I present in-depth evidence on one instance, the failed attempt of the Solntsevo crime group to establish itself in Rome and use network-type data extracted from an extensive police report on this case. I also discuss two other cases of Mafia transplantation within Italy and a third case of Mafia transplantation from Moscow to Budapest.
I conclude by underplaying the role of social capital, while the demand for criminal protection and supply of Mafiosi in the new area best explain the cases of successful transplantation. Also, I suggest that, to the extent that the group changes its nature from that of a protection racket into an outlet for investing illegal capital in the legal economy, eradication is easier.