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https://www.readbyqxmd.com/read/28063848/challenges-with-implementing-a-patient-centered-medical-home-model-for-women-veterans
#1
Emmeline Chuang, Julian Brunner, Selene Mak, Alison B Hamilton, Ismelda Canelo, Jill Darling, Lisa V Rubenstein, Elizabeth M Yano
BACKGROUND: The Veterans Health Administration (VA) Patient Aligned Care Team (PACT) initiative aims to ensure that all patients receive care consistent with medical home principles. Women veterans' unique care needs and minority status within the VA pose challenges to delivery of equitable, comprehensive primary care for this population. Currently, little is known about whether and/or how PACT should be tailored to better meet women veteran needs. METHODS: In 2014, we conducted semistructured interviews with 73 primary care providers and staff to examine facilitators and barriers encountered in providing PACT-principled care to women veterans...
January 4, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28063245/dosing-algorithms-for-vitamin-k-antagonists-across-vkorc1-and-cyp2c9-genotypes
#2
Ekaterina V Baranova, Talitha I Verhoef, Georgia Ragia, Saskia Le Cessie, Folkert W Asselbergs, Anthonius de Boer, Vangelis G Manolopoulos, Anke H Maitland-van der Zee
BACKGROUND: The multicenter, single-blind, randomized EU-PACT trial compared safety and efficacy of genotype-guided and non-genetic dosing algorithms for acenocoumarol and phenprocoumon in patients with atrial fibrillation or deep venous thrombosis. The trial showed no differences in the primary outcome between the two dosing strategies. OBJECTIVES: To explore possible reasons for the lack of differences between trial arms this secondary analysis of EU-PACT data evaluated the performance of both dosing algorithms across VKORC1-CYP2C9 genetic sub-groups...
January 7, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28048581/su-c-204-06-monte-carlo-dose-calculation-for-kilovoltage-x-ray-psoralen-activated-cancer-therapy-x-pact-preliminary-results
#3
S Mein, R Gunasingha, M Nolan, M Oldham, J Adamson
PURPOSE: X-PACT is an experimental cancer therapy where kV x-rays are used to photo-activate anti-cancer therapeutics through phosphor intermediaries (phosphors that absorb x-rays and re-radiate as UV light). Clinical trials in pet dogs are currently underway (NC State College of Veterinary Medicine) and an essential component is the ability to model the kV dose in these dogs. Here we report the commissioning and characterization of a Monte Carlo (MC) treatment planning simulation tool to calculate X-PACT radiation doses in canine trials...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047541/we-fg-bra-01-cancer-treatment-utilizing-photo-activation-of-psoralen-with-kv-x-rays
#4
M Oldham, S Yoon, B Meng, Z Fathi, W Beyer, J Adamson, D Alcorta, T Osada, K Lyerly, M Dewhirst, P Fecci, H Walder, N Spector
PURPOSE: This work investigates X-PACT (X-ray Psoralen Activated Cancer Therapy): a new approach for the treatment of cancer. X-PACT utilizes psoralen, a potent anti-cancer therapeutic with immunogenic anti-cancer potential. Psoralen therapies have been limited due to the requirement for psoralen activation by UVA light. X-PACT solves this challenge by activating psoralen with UV light emitted from novel non-tethered phosphors (co-incubated with psoralen) that absorb x-rays and reradiate (phosphoresce) at UV wavelengths...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28027338/effect-of-an-intensive-outpatient-program-to-augment-primary-care-for-high-need-veterans-affairs-patients-a-randomized-clinical-trial
#5
Donna M Zulman, Christine Pal Chee, Stephen C Ezeji-Okoye, Jonathan G Shaw, Tyson H Holmes, James S Kahn, Steven M Asch
Importance: Many organizations are adopting intensive outpatient care programs for high-need patients, yet little is known about their effectiveness in integrated systems with established patient-centered medical homes. Objective: To evaluate how augmenting the Veterans Affairs (VA) medical home (Patient Aligned Care Teams [PACT]) with an Intensive Management program (ImPACT) influences high-need patients' costs, health care utilization, and experience. Design, Setting, and Participants: Randomized clinical trial at a single VA facility...
December 27, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28007226/role-expansion-on-interprofessional-primary-care-teams-barriers-of-role-self-efficacy-among-clinical-associates
#6
Karleen F Giannitrapani, Lynn Soban, Alison B Hamilton, Hector Rodriguez, Alexis Huynh, Susan Stockdale, Elizabeth M Yano, Lisa V Rubenstein
BACKGROUND: Interprofessional team-based models of primary care that expand the role of clinical associates (CAs) are increasingly adopted in primary care practices. In this study we query team members of a newly implemented patient centered medical home (PCMH) to identify facilitators and barriers of occupational role self-efficacy, a belief of possessing the capacity to execute their new team based role effectively. METHODS: 79 key informants, members of primary care teams at six Veterans Health Administration (VA) clinics, were interviewed to assess their experiences with implementing expanded roles for CAs...
December 2016: Healthcare
https://www.readbyqxmd.com/read/27992949/age-stratified-outcome-of-genotype-guided-dosing-algorithm-for-acenocoumarol-and-phenprocoumon
#7
Yumao Zhang, Anthonius de Boer, Talitha I Verhoef, Felix Jm van der Meer, Saskia Le Cessie, Vangelis G Manolopoulos, Anke H Maitland-van der Zee
BACKGROUND: Age seemed to affect the interaction between coumarins and genotype in the acenocoumarol and phenprocoumon arm of the European pharmacogenetics of anticoagulant therapy (EU-PACT) trial. OBJECTIVES: To investigate the effect of genotype-guided dosing stratified by age and the potential factors causing a difference. PATIENTS/METHODS: Data from the acenocoumarol/phenprocoumon arm of the EU-PACT trial was used. The percentage of time below, above and in the therapeutic range (TTR) during the initial 12 weeks of therapy were compared between the genotype-guided group and the control group among younger (<75 years) and older (≥75 years) patients using independent t-test and adjust for sex, height, weight and co-medications using linear regression...
December 19, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27980029/risk-stratification-for-opioid-misuse-in-children-adolescents-and-young-adults-a-quality-improvement-project
#8
Rachel Thienprayoon, Kelly Porter, Michelle Tate, Marshall Ashby, Mark Meyer
BACKGROUND: The Pediatric Palliative and Comfort Care Team (PACT) at Cincinnati Children's Hospital Medical Center (CCHMC) provides opioids to a large population of patients in the ambulatory setting. Before this project, PACT had no reliable system to risk stratify patients for opioid misuse. METHODS: The global aim was safe opioid prescribing by the palliative care team. The specific, measurable, achievable, realistic, and timely aim was as follows: "In patients who present for follow up with PACT, we will use the "opioid bundle" to increase risk stratification for opioid misuse from 0% to 90% over 5 months...
January 2017: Pediatrics
https://www.readbyqxmd.com/read/27967328/a-novel-acenocoumarol-pharmacogenomic-dosing-algorithm-for-the-greek-population-of-eu-pact-trial
#9
Georgia Ragia, Vana Kolovou, Genovefa Kolovou, Stavros Konstantinides, Efstratios Maltezos, Anna Tavridou, Dimitrios Tziakas, Anke H Maitland-van der Zee, Vangelis G Manolopoulos
AIM: To generate and validate a pharmacogenomic-guided (PG) dosing algorithm for acenocoumarol in the Greek population. To compare its performance with other PG algorithms developed for the Greek population. PATIENTS & METHODS: A total of 140 Greek patients participants of the EU-PACT trial for acenocoumarol, a randomized clinical trial that prospectively compared the effect of a PG dosing algorithm with a clinical dosing algorithm on the percentage of time within INR therapeutic range, who reached acenocoumarol stable dose were included in the study...
January 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/27930824/a-rare-case-of-poisoning-with-a-volatile-substance-quantitative-determination-of-n-butane-in-postmortem-tissue
#10
Jean Hiquet, Emilie Christin, Florence Tovagliaro, Jean-Michel Gaulier, Veronique Dumestre-Toulet, Sophie Gromb-Monnoyeur
Poisoning with volatile substances remains exceptional. Authors report the case of a married couple who were found in a car with a butane gas bottle: the woman was dead and her husband alleged it was an unsuccessful suicide pact. A specific research of volatile substances on postmortem samples with headspace gas chromatography-mass spectrometry following a quantitative determination was performed. The n-butane concentrations detected were composed of 610 μg/L (cardiac blood), 50 μg/kg (brain), 134 μg/kg (lungs), 285 μg/kg (liver), and 4090 μg/kg (heart) and were compatible with the rare lethal concentrations evoked in the literature...
December 8, 2016: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/27922220/implementation-of-a-text-based-content-intervention-in-secondary-social-studies-classes
#11
Jeanne Wanzek, Sharon Vaughn
We describe teacher fidelity (adherence to the components of the treatment as specified by the research team) based on a series of studies of a multicomponent intervention, Promoting Acceleration of Comprehension and Content Through Text (PACT), with middle and high school social studies teachers and their students. Findings reveal that even with highly specified materials and implementing practices that are aligned with effective reading comprehension and content instruction, teachers' fidelity was consistently low for some components and high for others...
December 2016: New Directions for Child and Adolescent Development
https://www.readbyqxmd.com/read/27917691/impact-a-multifaceted-implementation-for-conversation-partner-training-in-aphasia-in-dutch-rehabilitation-settings
#12
Sandra Wielaert, Mieke W M E van de Sandt-Koenderman, Nina Dammers, Karen Sage
PURPOSE: Exploration of the clinical uptake of a novel conversation partner training (CPT) programme in aphasia in 10 Dutch rehabilitation facilities and identification of its perceived facilitators and barriers in service providers, and the evaluation of the implementation methods used. METHOD: Ten rehabilitation centres took part in a multifaceted implementation of CPT over 13 months. Each centre selected two speech and language therapists to act as knowledge brokers whose role was to raise awareness of CPT in the team and to facilitate getting partners of people with aphasia into the programme...
December 5, 2016: Disability and Rehabilitation
https://www.readbyqxmd.com/read/27909337/optimization-of-the-optical-transparency-of-rodent-tissues-by-modified-pact-based-passive-clearing
#13
Jiwon Woo, Mirae Lee, Jeong Min Seo, Hyo Suk Park, Yong Eun Cho
Recently, a bio-electrochemical technique known as CLARITY was reported for three-dimensional phenotype mapping within transparent tissues, allowing clearer whole-body and organ visualization with CB-perfusion (CUBIC) and leading to the development of whole-body clearing and transparency of intact tissues with the PACT (passive clarity technique) and PARS (perfusion-assisted agent release in situ) methodologies. We evaluated the structure-function relationships in circuits of the whole central nervous system (CNS) and various internal organs using improved methods with optimized passive clarity...
December 2, 2016: Experimental & Molecular Medicine
https://www.readbyqxmd.com/read/27890526/femoropopliteal-in-stent-restenosis-repair-midterm-outcomes-after-paclitaxel-eluting-balloon-use-plaisir-trial
#14
N Bague, P Julia, A Sauguet, J M Pernès, P Chatelard, J F Garbé, S Penillon, J M Cardon, P Commeau, O Planché, B Guyomarch, Y Gouëffic
OBJECTIVE: The aim was to assess 18 month outcomes of the paclitaxel eluting balloon (PEB) in patients with femoropopliteal (FP) in-stent restenosis (ISR). METHODS: In a national prospective and multicentre cohort study, symptomatic patients with femoropopliteal in-stent restenosis were included from January 2012 to June 2013. Patients were treated by paclitaxel eluting balloon angioplasty (In Pact Admiral, Medtronic, Santa Rosa, CA, USA). Clinical and duplex scan follow-up evaluations were performed at 1, 3, 6, 9, 12, and 18 months...
November 24, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27884360/cost-effectiveness-of-endovascular-femoropopliteal-intervention-using-drug-coated-balloons%C3%A2-versus-standard-percutaneous-transluminal-angioplasty-results-from-the-in-pact%C3%A2-sfa-ii-trial
#15
Adam C Salisbury, Haiyan Li, Katherine R Vilain, Michael R Jaff, Peter A Schneider, John R Laird, David J Cohen
OBJECTIVES: The aim of this study was to evaluate the cost-effectiveness of drug-coated balloon (DCB) angioplasty versus standard percutaneous transluminal angioplasty (PTA). BACKGROUND: Recent trials have reported lower rates of target lesion revascularization with DCB angioplasty versus standard PTA. However, the cost-effectiveness of DCB angioplasty is unknown. METHODS: A prospective economic study was performed alongside the IN.PACT SFA II (IN...
November 28, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27875650/military-genitourinary-trauma-policies-implications-and-ethics
#16
Wendy K Dean, Arthur L Caplan, Brendan Parent
The men and women who serve in the armed forces, in the words of Major General Joseph Caravalho, "sign a blank check, co-signed by their families, payable to the Army, Navy, Air Force, or Marines, up to and including their lives." It is human nature to consider such a pact in polarized terms; the pact concludes in either a celebratory homecoming or funereal mourning. But in reality, surviving catastrophic injury may incur the greatest debt. The small but real possibility of losing the ability to bear biological children due to genitourinary combat injury has been a topic of discussion in hushed tones, behind closed doors...
November 2016: Hastings Center Report
https://www.readbyqxmd.com/read/27869974/-evaluating-productivity-targets-achievement-in-dental-specialty-centers-from-maranh%C3%A3-o-state-brazil-2011
#17
Erika Bárbara Abreu Fonseca Thomaz, Grazianne Medeiros Carvalho de Sousa, Rejane Christine de Sousa Queiroz, Liberata Campos Coimbra
OBJECTIVE: to evaluate productivity targets achievement (PTA) in Dental Specialty Centers (DSCs) from Maranhão State, Brazil. METHODS: this was an ecologic study using secondary data; an indicator for PTA was created for each subgroup of procedures. RESULTS: 25 DSCs were evaluated; the PTA was higher for basic procedures (n=19), followed by endodontics (n=11), oral surgery (n=9) and periodontics (n=8); the best results were obtained at DSCs type II; higher PTA was associated with financial anticipation (basic procedures) and higher Human Development Index, life expectancy and social exclusion rate (endodontics); lower PTA was associated with larger population (endodontics/oral surgery), adherence to the Pact for Health (periodontics/endodontics), larger number of specialties (periodontics) and bigger DSC (oral surgery)...
October 2016: Epidemiologia e Servicos de Saude: Revista do Sistema Unico de Saude do Brasil
https://www.readbyqxmd.com/read/27861888/double-hanging-with-single-ligature-an-unusual-method-in-suicide-pact
#18
Chittaranjan Behera, Ravi Rautji, Rajesh Kumar, Shashank Pooniya, Piyush Sharma, Sudhir Kumar Gupta
A married casual labor couple was found hanging in their makeshift bedroom with each end of a single chunni (a cloth worn around the neck by Indian women) spread across an iron bar below the roof. They left their two children, daughter, and son of 4 and 3 yrs age, respectively, with their grandmother living separately nearby, and went to attend cremation of one of their relatives. They returned late in the evening and found hanging in their bedroom next morning by neighbors.
January 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/27848416/parent-led-early-intervention-can-reduce-symptom-severity
#19
(no author information available yet)
In the original Preschool Autism Communication Trial (PACT), published in 2010, 152 children aged 2-4 with autism were randomised to receive usual treatment or a 12-month early intervention.
November 9, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27846895/development-and-validation-of-a-prehospital-prediction-model-for-acute-traumatic-coagulopathy
#20
Ithan D Peltan, Ali Rowhani-Rahbar, Lisa K Vande Vusse, Ellen Caldwell, Thomas D Rea, Ronald V Maier, Timothy R Watkins
BACKGROUND: Acute traumatic coagulopathy (ATC) is a syndrome of early, endogenous clotting dysfunction that afflicts up to 30% of severely injured patients, signaling an increased likelihood of all-cause and hemorrhage-associated mortality. To aid identification of patients within the likely therapeutic window for ATC and facilitate study of its mechanisms and targeted treatment, we developed and validated a prehospital ATC prediction model. METHODS: Construction of a parsimonious multivariable logistic regression model predicting ATC - defined as an admission international normalized ratio >1...
November 16, 2016: Critical Care: the Official Journal of the Critical Care Forum
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