Wilkes University

About: Wilkes University is a education organization based out in Wilkes-Barre, Pennsylvania, United States. It is known for research contribution in the topics: Population & Pharmacy. The organization has 616 authors who have published 1032 publications receiving 21050 citations. The organization is also known as: Wilkes & Wilkes College.

A Randomized Telephone Intervention Trial to Reduce Primary Medication Nonadherence

Abstract: BACKGROUND: Primary medication nonadherence (PMN), defined as patients not picking up an initial prescription, can limit the effectiveness of therapy for chronic conditions. Effective interventions to reduce PMN have not been widely studied or implemented. OBJECTIVE: To evaluate the ability of an additional nurse-directed telephone intervention to reduce PMN in a cohort of patients with persistent nonadherence after repeated pharmacy-based outreach. METHODS: Patients in the Geisinger Health System receiving new (i.e., initially prescribed) prescriptions sent to CVS pharmacies for medications treating asthma, hypertension, diabetes, or hyperlipidemia were identified. As part of existing programs, all patients received 2 automated and 1 live call from CVS pharmacies encouraging them to pick up their prescriptions; those who had canceled their prescriptions or had not picked them up after the 3 pharmacy interventions were eligible for this study. Patients were then randomized, and the intervention group received telephone outreach from a nursing call center to assess reasons for PMN and encourage pickup of prescriptions, with up to 3 attempts to reach each patient. Medication pickup rates were compared across the intervention and control groups. RESULTS: Initial PMN rates in the overall population were 6%, lower than previously observed in other studies. A total of 290 patients had not picked up their prescriptions after 3 calls from the pharmacy and were enrolled in the study: 142 in the intervention group and 148 controls. The intervention did not change the rate at which patients picked up their prescriptions: 25% of intervention patients did so compared with 24% of control patients. Multivariate models adjusting for patient characteristics and medication classes did not change the results. CONCLUSIONS: In a population of patients who had not picked up new prescriptions after 3 calls from the pharmacy, additional nurse-directed outreach did not improve primary medication adherence. Re-engagement with the prescribing clinician may be needed to improve adherence in this patient population. The low rate of PMN in the overall population differed from prior studies in this setting and others and should be assessed in future research.

Environmental variation shifts the relationship between trees and scatterhoarders along the continuum from mutualism to antagonism.

Abstract: The conditional mutualism between scatterhoarders and trees varies on a continuum from mutualism to antagonism and can change across time and space, and among species. We examined 4 tree species (red oak [Quercus rubra], white oak [Quercus alba], American chestnut [Castanea dentata] and hybrid chestnut [C. dentata × Castanea mollissima) across 5 sites and 3 years to quantify the variability in this conditional mutualism. We used a published model to compare the rates of seed emergence with and without burial to the probability that seeds will be cached and left uneaten by scatterhoarders to quantify variation in the conditional mutualism that can be explained by environmental variation among sites, years, species, and seed provenance within species. All species tested had increased emergence when buried. However, comparing benefits of burial to the probability of caching by scatterhoarders indicated a mutualism in red oak, while white oak was nearly always antagonistic. Chestnut was variable around the boundary between mutualism and antagonism, indicating a high degree of context dependence in the relationship with scatterhoarders. We found that different seed provenances did not vary in their potential for mutualism. Temperature did not explain microsite differences in seed emergence in any of the species tested. In hybrid chestnut only, emergence on the surface declined with soil moisture in the fall. By quantifying the variation in the conditional mutualism that was not caused by changes in scatterhoarder behavior, we show that environmental conditions and seed traits are an important and underappreciated component of the variation in the relationship between trees and scatterhoarders.

Weight stigma facilitates unhealthy eating and weight gain via fear of fat.

Abstract: Objective Across two studies, we examine if the relationships between perceived weight stigma, maladaptive eating behaviors (Study 1 & 2) and weight gain (Study 2) are mediated by fear of fat (FOF). Method In Study 1, 189 participants completed measures of eating behavior (e.g., emotional and restrained eating), FOF, perceived weight stigma and height and weight. In Study 2, a longitudinal design, participants reported their perceived weight stigma, FOF and had their height and weight measured; they then returned 10 weeks later to complete measures of eating behaviors (e.g., flexible restraint, ridged restraint, and emotional eating) and height and weight. We examined the predictive value of weight stigma at session 1 on eating behavior and weight gain at session 2. Further, we examined FOF as a mediator of these relationships. Results In Study 1, we found that FOF significantly mediated the positive relationship between perceived weight stigma and restrained eating behavior (b=.13, CI: .09 to .19). In Study 2, we found that perceived weight stigma predicted weight gain over the 10-week period and that this relationship was mediated by both FOF (b=.31, CI: .03 to .78) and rigid restraint of eating (b=.07, CI: .002 to .28). Flexible restraint and emotional eating behavior were not mediators of the relationship between perceived weight stigma and weight gain. Conclusion Fear of fat may be one process through which perceptions of weight stigma lead to maladaptive eating behavior and weight gain. Understanding this important process may lead to more effective healthy weight interventions.