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1. A Descriptive Study of the Illinois International Education Policy Study Committee: A State Mandated Committee To Develop a Policy for the Illinois Higher Education International Education Act.

Author

Garavalia, Brian J.

Abstract

This monograph examines policy formation practices of the Illinois International Education Policy Study Committee (PSC) concerning implementation of the Illinois Higher Education International Education Act. In the first section, a review of the literature on various aspects of policy and policy considerations is offered including a definition of policy, the needs and purposes of policy, its sources, data for consideration when developing policy, internal policy prods to action, and the impact of politics on policy. The second section describes four policy authors' policy processes and combines them into one 10-step policy process. The third section presents observations on the PSC's five consolidated meetings including a description of the PSC's methods to policy formation and the implications of each policy formation step. The conclusion identifies those actions seen to be responsible for successful policy formation in the PSC policy process. These include: (1) having one impartial person coordinating and controlling the entire policy process; (2) obtaining the support of a wide array of policy agents and policy agents (such as state level officials) and policy target populations (individual institutions); (3) knowledge contributions by policy agents and policy target populations; and (4)ensuring the capacity of both policy agent and target population groups to implement the policy. (Contains 16 references.) (CK)

Published
1996

2. Administrative Perspectives on Community College Leadership.

Author

Garavalia, Brian J. and Miller, Michael T.

Abstract

Despite the importance of community college administrative positions and the recognition of their stressful nature, they have traditionally received little scholarly or professional attention. Recently, however, professional associations have been developed solely for the purpose of providing professional development opportunities to college administrators. The literature that does exist suggests that administrators have traditionally come from faculty ranks, and that since 1970, fewer administrators have come from outside the community colleges. Personal characteristics of effective administrators include responsibility, integrity, and intellectual efficiency, while professional skills are related to planning, organization, and office management. The most important ability appears to be having strong interpersonal skills. It has been suggested that college administrators must move toward more open and less inhibiting methods of reaching decisions in order to provide opportunities for faculty and others to become involved in leadership. While the literature on community college administrators contains few empirical studies addressing needs, skills, challenges, and roles, it is fairly clear that as the demographic composition of the United States changes, so too will the leadership of community colleges. Finally, there is a tremendous need to develop administrative research directly applicable to performance and to develop meaningful dialogue throughout higher education about roles and functions of different educational bodies. (Contains 17 references.) (HAA)

Published
1996

3. International Education: How It Is Defined by U.S. Students and Foreign Students.

Author

Garavalia, Brian J.

Abstract

Compares United States students' perceptions of international education and related competencies with similar perceptions of foreign students. Finds that the comments of the two groups were remarkably similar in content--though the members of the two groups were reared in different cultures, each group expressed the same fundamental intentions. (RS)

Published
1997

4. Exploring patients' reasons for discontinuance of heart medications

Author

Garavalia, Linda, Garavalia, Brian, Spertus, John A., and Decker, Carole

Subjects
Heart attack -- Care and treatment, Heart attack -- Prevention, Heart attack -- Research, Medicine, Preventive -- Research, Preventive health services -- Research, Patient compliance -- Research, Business, Health, Health care industry
Published
2009

7. Patient-Centered Decision Support in Acute Ischemic Stroke

Author

Decker, Carole, primary, Chhatriwalla, Emily, additional, Gialde, Elizabeth, additional, Garavalia, Brian, additional, Summers, Debbie, additional, Quinlan, Miriam E., additional, Cheng, Eric, additional, Rymer, Marilyn, additional, Saver, Jeffrey L., additional, Chen, Er, additional, Kent, David M., additional, and Spertus, John A., additional

Published
2015
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10. Exploring barriers to optimal anticoagulation for atrial fibrillation: interviews with clinicians

Author

Decker,Carole, Garavalia,Linda, Garavalia,Brian, Simon,Teresa, Loeb,Matthew, Spertus,John A, Daniel,William C, Decker,Carole, Garavalia,Linda, Garavalia,Brian, Simon,Teresa, Loeb,Matthew, Spertus,John A, and Daniel,William C

Abstract

Carole Decker,1 Linda Garavalia,2 Brian Garavalia,1 Teresa Simon,3 Matthew Loeb,4 John Spertus6, William Daniel51Mid America Heart Institute at Saint Luke's Hospital in Kansas City Missouri, University of Missouri-Kansas City School of Nursing, 2University of Missouri-Kansas City School of Pharmacy, Kansas City, MO, 3Bristol-Myers Squibb, Princeton, NJ, 4Plaza Primary Care and Geriatrics, 5Saint Luke's Cardiovascular Consultants, Kansas City, MO, 6Mid America Heart Institute at Saint Luke's Hospital in Kansas City Missouri, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USABackground: Warfarin, the most commonly used antithrombotic agent for stroke prophylaxis in atrial fibrillation (AF), requires regular monitoring, frequent dosage adjustments, and dietary restrictions. Clinicians' perceptions of barriers to optimal AF management are an important factor in treatment. Anticoagulation management for AF is overseen by both cardiology and internal medicine (IM) practices. Thus, gaining the perspective of specialists and generalists is essential in understanding barriers to treatment. We used qualitative research methods to define key issues in the prescription of warfarin therapy for AF by cardiology specialists and IM physicians.Methods and results: Clinicians were interviewed to identify barriers to warfarin treatment in a large Midwestern city. Interviews were conducted until thematic saturation occurred. Content analysis yielded several themes. The most salient theme that emerged from clinician interviews was use of characteristics other than the patient's CHADS2 score to enact a treatment plan, such as the patient's social situation and past medication-taking behavior. Other themes included patient knowledge, real-world problems, breakdown in communication, and clinician reluctance.Conclusion: Warfarin treatment is associated with many challenges. The barriers identified by clinicians highlig

Published
2012

11. Clopidogrel-taking behavior by drug-eluting stent patients: Discontinuers versus continuers

Author

Decker,Carole, Garavalia,Linda, Garavalia,Brian, Spertus,John A, Decker,Carole, Garavalia,Linda, Garavalia,Brian, and Spertus,John A

Abstract

Carole Decker1, Linda Garavalia2, Brian Garavalia1, John A Spertus11Mid America Heart Institute, Saint Luke’s Hospital, Kansas City, MO, USA; 2Department of Psychology, University of Missouri, Kansas City, MO, USABackground: Each day, patients make choices whether or not to take their prescribed medications. Previous research has shown that 1 in 7 myocardial infarction (MI) patients discontinued thienopyridines within 1 month of receiving a drug-eluting stent (DES) with serious consequences. This qualitative research study explored in depth the clopidogrel-taking behavior among DES-treated patients who quit taking clopidogrel 1 month after treatment and those who continued therapy.Methods: Sequential patients from a prospective MI registry who reported discontinuing clopidogrel within 30 days of DES treatment (N = 11) were matched with continuers (N = 11). Both groups underwent detailed qualitative phone interviews. Coding and thematic representation using directed qualitative content analysis by 3 PhD researchers was done.Results: Patients were 41–77 years old and the majority was Caucasian and male. Multiple barriers were described by discontinuers that were not reported by continuers. The most frequently cited barrier was misunderstanding the intended duration of treatment. Discontinuers also described system weaknesses that contributed to early discontinuance such as gaps in the transition to primary care.Conclusions: While premature discontinuation of a prescribed therapy is viewed by clinicians as a willful disregard for medical advice, early stopping of clopidogrel is influenced greatly by processes of care and system issues.Keywords: medication discontinuance, drug-eluting stent post-care, myocardial infarction

Published
2008

13. Abstract 215: Differing Perspectives Between Physicians, Patients And Caregivers On The Value Of An Individualized Estimate Of The Benefits Of Thrombolysis At The Time Of Acute Ischemic Stroke: Designing The Resolve (Rapid Evaluation for Stroke Outcomes using Lytics in Vascular Event) Decision Aid

Author

Decker, Carole J, primary, Chhatriwalla, Emily, additional, Garavalia, Brian, additional, Spertus, John A, additional, Chen, Er, additional, and Gialde, Elizabeth, additional

Published
2013
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14. Abstract 334: Listening to a Diversity of Patient Voices To Design a High-Quality Peripheral Arterial Disease Registry Focusing on Patient-Centered Outcomes

Author

Smolderen, Kim, primary, Decker, Carole, additional, Garavalia, Brian, additional, Scott, Kathryn M, additional, Chhatriwalla, Emily G, additional, Nugent, Karen, additional, Daniel, William C, additional, Rivas-Gotz, Carlos, additional, Mena, Carlos, additional, Spatz, Erica, additional, Stilp, Erik, additional, and Spertus, John A, additional

Published
2013
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22. Exploring barriers to optimal anticoagulation for atrial fibrillation: interviews with clinicians.

Author

Decker, Carole, Garavalia, Linda, Garavalia, Brian, Simon, Teresa, Loeb, Matthew, Spertus, John A., and Daniel, William C.

Subjects
WARFARIN, STROKE, ANTICOAGULANTS, FIBRINOLYTIC agents, CARDIOLOGY
Abstract

Background: Warfarin, the most commonly used antithrombotic agent for stroke prophylaxis in atrial fibrillation (AF), requires regular monitoring, frequent dosage adjustments, and dietary restrictions. Clinicians' perceptions of barriers to optimal AF management are an important factor in treatment. Anticoagulation management for AF is overseen by both cardiology and internal medicine (IM) practices. Thus, gaining the perspective of specialists and generalists is essential in understanding barriers to treatment. We used qualitative research methods to define key issues in the prescription of warfarin therapy for AF by cardiology specialists and IM physicians. Methods and results: Clinicians were interviewed to identify barriers to warfarin treatment in a large Midwestern city. Interviews were conducted until thematic saturation occurred. Content analysis yielded several themes. The most salient theme that emerged from clinician interviews was use of characteristics other than the patient's CHADS2 score to enact a treatment plan, such as the patient's social situation and past medication-taking behavior. Other themes included patient knowledge, real-world problems, breakdown in communication, and clinician reluctance. Conclusion: Warfarin treatment is associated with many challenges. The barriers identified by clinicians highlight the unmet need associated with stroke prophylaxis in AF and the opportunity to improve anticoagulation treatment in AF. Social and lifestyle factors were important considerations in determining treatment. [ABSTRACT FROM AUTHOR]

Published
2012
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24. Abstract NS19.

Author

Gialde, Elizabeth, Spertus, John, Chhatriwalla, Emily, Garavalia, Brian, Summers, Debbie, Rymer, Marilyn, and Decker, Carole

Published
2014

25. Abstract 334

Author

Smolderen, Kim, Decker, Carole, Garavalia, Brian, Scott, Kathryn M, Chhatriwalla, Emily G, Nugent, Karen, Daniel, William C, Rivas-Gotz, Carlos, Mena, Carlos, Spatz, Erica, Stilp, Erik, and Spertus, John A

Abstract

Background:While peripheral arterial disease (PAD) greatly impacts patients’ health status (symptoms, function and quality of life) and risk for cardiovascular events, no prospective studies have examined the impact of treatments in routine clinical practice on these outcomes. To create a future, multi-center PAD registry focused on health status outcomes over time, we prospectively engaged PAD patients in a qualitative study to explore the optimal study design.

Published
2013

26. Abstract 215

Author

Decker, Carole J, Chhatriwalla, Emily, Garavalia, Brian, Spertus, John A, Chen, Er, and Gialde, Elizabeth

Abstract

Background:Explaining the risks and benefits of recombinant tissue plasminogen activator (rt-PA) occurs in a hurried conversation in the emergency department and may not be fully grasped by patients and their caregivers. Risk models describing the heterogeneity of benefits from rt-PA in acute ischemic stroke (AIS) have been created, but are not used in routine clinical practice. To develop a tool (RESOLVE) for modeling each patient’s benefits and risks for rt-PA, we conducted qualitative interviews with survivors, their caregivers and emergency physicians to inform the design and improve usability.

Published
2013

27. Abstract P57

Author

Garavalia, Linda S, Gosch, Kensey, Garavalia, Brian J, Ho, Michael, Spertus, John A, and Decker, Carole

Published
2011

28. Abstract P56

Author

Decker, Carole J, Garavalia, Brian, Spertus, John A, and Garavalia, Linda S

Published
2011

29. Abstract P57

Author

Garavalia, Linda S, Gosch, Kensey, Garavalia, Brian J, Ho, Michael, Spertus, John A, and Decker, Carole

Abstract

Purpose:Given the importance of medication non-adherence, a compelling need exists for simple screening questions that can identify patients who are not adherent to their medicines. We compared the prevalence of reported nonadherence for 3 types of adherence questions (general, unintentional, and intentional) among a cohort of recovering MI patients.

Published
2010

30. Abstract P56

Author

Decker, Carole J, Garavalia, Brian, Spertus, John A, and Garavalia, Linda S

Abstract

Background:Adherence to evidence-based therapies has emerged as a critical challenge in translating discoveries to clinical care. In particular, nonadherence to secondary prevention medications reduces the potential to optimize patients' outcomes. We conducted serial qualitative research studies to define relevant domains, from patients' perspectives, associated with discontinuing cardiac medications (clopidogrel or cholesterol lowering therapy) and developed a brief tool to identify myocardial infarction (MI) patients' risk of discontinuing medications.

Published
2010

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