Medication Utilization Evaluation of Dabigatran and Rivaroxaban within a Large, Multicenter Health System.

Objective. The objective of this medication utilization evaluation (MUE) was to determine the appropriateness of dabigatran and rivaroxaban while also reviewing outcomes for safety and effectiveness within a large, multi-center health system. Methods. A retrospective chart review was performed using the system’s electronic medical record. A data inquiry was requested and generated for dabigatran usage from July 28, 2011 through July 28, 2012 and for rivaroxaban from March 1, 2012 to July 31, 2012 at eight health system hospitals. All patients receiving at least one dose were eligible for inclusion in the MUE. Results. For dabigatran, 78 of 390 unique patient encounters were analyzed (20%). All 62 rivaroxaban encounters were included in the analysis. Dabigatran was used for appropriate indications in 94% of encounters and 82% for rivaroxaban. Based on indication and renal function, 87% of dabigatran patients and 92% of rivaroxaban patients received correct dosing. For patients transitioning to or from another anticoagulant, appropriate transitions occurred in 44% of dabigatran transitions and 48% of rivaroxaban transitions. At discharge, 83% of dabigatran and 86% of rivaroxaban therapy was continued. There were no reported strokes or systemic embolism with dabigatran, but one reported deep vein thrombosis occurred during hospitalization with rivaroxaban therapy. Documented bleeds in 5% of dabigatran and 3% of rivaroxaban patients. Patient education was documented for 37% of dabigatran and 26% of rivaroxaban patients receiving therapeutic anticoagulation. Conclusion. This MUE revealed the appropriate use of dabigatran and rivaroxaban therapy with few safety outcomes within a large, multi-center health system

Association Between Applications Scores and Positive Onsite Interviews of Pharmacy Residency Applicants

Application to pharmacy residency programs has become increasingly competitive over the past several years. Although successful candidates must excel in the various stages of the application process, preparing written applications and securing onsite interviews are early and arguably the most difficult steps. Residency programs vary in the criteria used for offering onsite interviews. The majority of insight into this topic comes from surveys of residency program directors, but corresponding analyses of interview offers have been minimal..

Polaron Formation in the Three-Band Peierls-Hubbard Model for Cuprate Superconductors

Exact diagonalization calculations show a continuous transition from delocalized to small polaron behavior as a function of intersite electron-lattice coupling. A transition, found previously at Hartree-Fock level [Yonemitsu et al., Phys. Rev. Lett. {\bf 69}, 965 (1992)], between a magnetic and a non magnetic state does not subsist when fluctuations are included. Local phonon modes become softer close to the polaron and by comparison with optical measurements of doped cuprates we conclude that they are close to the transition region between polaronic and non-polaronic behavior. The barrier to adiabatically move a hole vanishes in that region suggesting large mobilities.Comment: 7 pages + 3 poscript figures, Revtex 3.0, MSC-199

Oceanography and engineering

I have been greatly honored by the invitation to this gathering and to the dedication of this newest and most impressive implement to the study of the province of oceanography

The ball-breaker, a deep water bottom signalling device

A simple device for signalling the arrival of a deep cast on bottom has been developed and is now in routine use. The device is used either in line with corers or is suspended below as a pilot. When contact of either the ball-breaker or other apparatus is made with the bottom, a small glass sphere in the former is imploded and the resultant signal at the surface is amplified and reproduced over a loud speaker system. The device has been used successfully at depths to 2,700 fathoms

The influence of exposure to community violence on adolescents' sense of hope within a disadvantaged community in Cape Town

Magister Psychologiae - MPsychViolent crime has proven to have profound negative effects, particularly on those living within communities where violence is a dominant feature. The victims often tend to be adolescents, who, while striving for a better future, are often quite vulnerable to its effects. The present study addresses this important social phenomenon which faces the youth of South Africa. There is a growing need to understand the manner in which the ever-increasing exposure of adolescents living in communities which have high rates of violence affects its victims as well as determine those factors which could provide resiliency against those devastating effects. Moreover, this study focuses on adolescents’ sense of hope as a resiliency factor. The purpose of this research study was to ascertain adolescents' understanding of and the meaning they give to exposure to community violence and the extent to which that exposure affects their sense of hope. In this qualitative study, data was collected by means of two, one hour focus groups comprising a total of 14 participants, 14-15 years of age, residing in a community with high rates of violence. The format of the discussion was semi-structured and conducted in English. Various theories were used in order to better describe the information, such as the social learning theory, feminist theory and Bronfenbrenner’s ecological model, but the epistemological framework utilized was social constructionism. Ethical principles such as confidentiality and obtaining informed consent were strictly adhered to. The information received from the participants was analyzed using Braun and Clarke's (2006) thematic analysis and presented in two thematic categories with corresponding themes discussed accordingly.South Afric

The Issacs Poster

This item contains: 1 PDF file and 1 JPG fileThis item is a poster advertising a upcoming concert by The Issacs in Brooks County Georgia

Evaluation of a standard provision versus an autonomy promotive exercise referral programme: rationale and study design

Background The National Institute of Clinical Excellence in the UK has recommended that the effectiveness of ongoing exercise referral schemes to promote physical activity should be examined in research trials. Recent empirical evidence in health care and physical activity promotion contexts provides a foundation for testing the utility of a Self Determination Theory (SDT) -based exercise referral consultation. Methods/Design Design: An exploratory cluster randomised controlled trial comparing standard provision exercise on prescription with a Self Determination Theory-based (SDT) exercise on prescription intervention. Participants: 347 people referred to the Birmingham Exercise on Prescription scheme between November 2007 and July 2008. The 13 exercise on prescription sites in Birmingham were randomised to current practice (n=7) or to the SDT-based intervention (n=6). Outcomes measured at 3 and 6-months: Minutes of moderate or vigorous physical activity per week assessed using the 7-day Physical Activity Recall; physical health: blood pressure and weight; health status measured using the Dartmouth CO-OP charts; anxiety and depression measured by the Hospital Anxiety and Depression Scale and vitality measured by the subjective vitality score; motivation and processes of change: perceptions of autonomy support from the advisor, satisfaction of the needs for competence, autonomy, and relatedness via physical activity, and motivational regulations for exercise. Discussion This trial will determine whether an exercise referral programme based on Self Determination Theory increases physical activity and other health outcomes compared to a standard programme and will test the underlying SDT-based process model (perceived autonomy support, need satisfaction, motivation regulations, outcomes) via structural equation modelling. Trial registration The trial is registered as Current Controlled trials ISRCTN07682833