Surgical management of isolated tricuspid regurgitation (TR) is associated with high morbidity and mortality, thereby creating a significant need for a lower-risk transcatheter solution.
The ...single-arm, multicenter, prospective CLASP TR (Edwards PASCAL TrAnScatheter Valve RePair System in Tricuspid Regurgitation CLASP TR Early Feasibility Study) evaluated 1-year outcomes of the PASCAL transcatheter valve repair system (Edwards Lifesciences) to treat TR.
Study inclusion required a previous diagnosis of severe or greater TR and persistent symptoms despite medical treatment. An independent core laboratory evaluated echocardiographic results, and a clinical events committee adjudicated major adverse events. The study evaluated primary safety and performance outcomes, with echocardiographic, clinical, and functional endpoints. Study investigators report 1-year all-cause mortality and heart failure hospitalization rates.
Sixty-five patients were enrolled: mean age of 77.4 years; 55.4% female; and 97.0% with severe to torrential TR. At 30 days, cardiovascular mortality was 3.1%, the stroke rate was 1.5%, and no device-related reinterventions were reported. Between 30 days and 1 year, there were an additional 3 cardiovascular deaths (4.8%), 2 strokes (3.2%), and 1 unplanned or emergency reintervention (1.6%). One-year postprocedure, TR severity significantly reduced (P < 0.001), with 31 of 36 (86.0%) patients achieving moderate or less TR; 100% had at least 1 TR grade reduction. Freedom from all-cause mortality and heart failure hospitalization by Kaplan-Meier analyses were 87.9% and 78.5%, respectively. Their New York Heart Association functional class significantly improved (P < 0.001) with 92% in class I or II, 6-minute walk distance increased by 94 m (P = 0.014), and overall Kansas City Cardiomyopathy Questionnaire scores improved by 18 points (P < 0.001).
The PASCAL system demonstrated low complication and high survival rates, with significant and sustained improvements in TR, functional status, and quality of life at 1 year. (Edwards PASCAL TrAnScatheter Valve RePair System in Tricuspid Regurgitation CLASP TR Early Feasibility Study CLASP TR EFS; NCT03745313)
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The purpose of this study was to investigate if a significant difference existed between mathematics performances of chronically ill and non-chronically ill students in a mid-sized Southeast Texas ...school district as measured by the fifth grade portion of the Texas Assessment of Knowledge and Skills (TAKS). A non-experimental quantitative design, with a qualitative component was used to investigate this study. Thies (1999) believed the adverse effects of chronic conditions in children and teenagers cause students with chronic illnesses to encounter more academic hurdles than their healthy schoolmates. With the large number of students experiencing chronic illnesses in the school system, it was important to determine if significant differences exist in the academic performance of students with and without chronic illnesses. A total of 30 fifth grade students were used in the study, 15 female and 15 males. Ethnically, six were Hispanic, three were African American, one was Asian, and twenty were Caucasian. An independent sample t-test was conducted to determine if significant differences existed between chronically ill and non-chronically ill students. No significant differences were found between the two groups. Parent interviews were conducted for the qualitative piece of the study in order to identify the lived experiences and perceptions of parents who had chronically ill students. The common themes throughout the interviews were words like “helpless”, “frustration” “hurt” and “hopelessness”. Participants shared feelings and words that were common experiences in their lives. Much of the vocabulary used by the participants was common with disappointment and despair. The study may provide educators information to help improve the learning environment for students with chronic illnesses. The research could also highlight areas of improvements for entire school campuses and its staff.
The purpose of this study was to describe the effectiveness of a practical group dynamics-based physical activity (PA) intervention and determine the mechanisms of PA change. Participants (n =115) ...were randomly assigned to the three-month Move More intervention or Enhanced Standard Care control. Self-reported PA and proposed mediators were assessed at baseline, three and nine months. Participants from both conditions increased their PA during the initial three months, F(2,67) = 24.67, p < .01. A significant time by condition interaction, F(2,67) = 4.25, p < .05, demonstrated that participants in the group dynamics condition sustained or further increased PA at nine months while those in the Enhanced Standard Care did not. Change in self-efficacy, outcome expectation-satisfaction, PA goals, and institutional support, significantly predicted increases in PA (p < .05) at three months, but not at nine months. These findings demonstrate the potential of adopting efficacious group dynamics principles from intensive PA interventions into a practical and effective clinical model.
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Critical care nurses within acute care settings are responsible for providing healthcare to a wide variety of patients and, consequently, knowledge regarding how to care for a patient with acute ...necrotizing fasciitis is imperative. A case study is presented to evidence the need for a multidisciplinary approach. Necrotizing fasciitis is defined and treatment options are presented. Caring for this patient is very challenging and demands a multidisciplinary team to coordinate all aspects of care to promote better patient outcomes.
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7.
Designing for Dissemination Estabrooks, Paul; Almeida, Fabio; Schriener, Patti ...
Medicine and science in sports and exercise,
05/2006, Volume:
38, Issue:
Supplement
Journal Article
Within the busy clinic visit and multiple preventive guidelines to follow, the rate of physician referral for physical activity (PA) is disappointing. This study used an interrupted time-series ...design to determine the effect of a simple stimulus control strategy to increase physician referrals for PA when compared to standard care before and after exposure to the stimulus control intervention. The number of referrals (
N
= 218 total) per week was significantly higher during weeks when the stimulus control intervention was used (
p
< .01). Approximately 77% of participants referred during standard care weeks initiated a PA program while 67% of those referred during stimulus control weeks initiated PA. These rate differences were significant (
p
< .05). Nonetheless, the number of individuals who initiated PA was greater during stimulus control weeks than during usual care weeks (
p
< .05; 9.8 vs. 5.6), due to the larger total volume of referrals. We concluded that stimulus control interventions targeting physician referrals are a practical method for enhancing participation in PA programs.
Roles and Responsibilities - A successful relocation means a company must understand how to work effectively with its relocation partner. All parties have their responsibilities. For instance, ...employees must be instructed on collecting personal items and work materials for efficient packing and transfer. Facility common areas present a primary hidden cost that creates change orders. These areas are not the responsibility of a specific individual, but must be prepared for relocation.
