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BACKGROUND: Caring for a growing aging population using existing long-term care resources while simultaneously supporting and educating family caregivers, is a public health challenge. We describe the application of the Replicating Effective Programs (REP) framework, developed by the Centers for Disease Control Prevention and used in public health program implementation, to scale up an evidence-based family caregiver training intervention in the Veterans Affairs (VA) healthcare system. METHODS: From 2018 to 2020, clinicians at eight VA medical centers received REP-guided implementation including facilitation, technical assistance, and implementation tools to deliver the training program. The project team used the REP framework to develop activities across four distinct phases - (1) pre-conditions, (2) pre-implementation, (3) implementation, and (4) maintenance and evolution - and systematically tracked implementation facilitators, barriers, and adaptations. RESULTS: Within the REP framework, results describe how each medical center adapted implementation approaches to fit local needs. We highlight examples of how sites balanced adaptations and intervention fidelity. CONCLUSIONS: The REP framework shows promise for national expansion of the caregiver training intervention, including to non-VA systems of care, because it allows sites to adapt while maintaining intervention fidelity. TRIAL REGISTRATION: NCT03474380 . Date registered: March 22, 2018.

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OBJECTIVES: To explore gender-based differences in experiences with a telehealth-delivered intervention for reduction of cardiovascular risk. METHODS: We conducted 23 semi-structured qualitative interviews by telephone with 11 women and 12 men who received a 12-month, pharmacist-delivered, telephone-based medication and behavioral management intervention. We used content analysis to identify themes. RESULTS: We identified three common themes for both men and women: ease and convenience of phone support, preference for proactive outreach, and need for trust building in the context of telehealth. While both genders appreciated the social support from the intervention pharmacist, women voiced appreciation for accountability whereas men generally spoke about encouragement. CONCLUSIONS: Rapport building may differ between telehealth and in-person healthcare visits; our work highlights how men and women's experiences can differ with telehealth care and which can inform the development of future, purposeful rapport building activities to strengthen the clinician-patient interaction. PRACTICE IMPLICATIONS: Clinicians should seek opportunities to provide frequent and routine support for patients with chronic disease. Telehealth interventions may benefit from gender-specific tailoring of social support.

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A review of the available literature does not reveal a plausible explanation as to why the incisal edges of maxillary anterior teeth do not always mark clearly. Generally, the mandibular incisal edges do mark with some consistency. This paper demonstrates through test bites on skin that the answer lies in the position of the mandible.

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Bite mark evidence has been admitted in a vast number of cases in courts throughout the United States, as well as other countries. Because there is variation in the dentition of humans, if bite marks are noted in a victim, it is possible in many cases to determine the identity of the perpetrator depending on the quality of the bite mark, its age, lack of distortion and documentation. In other cases, facial injuries, including damage to the frenum and teeth in addition to the face, may point to nonaccidental injury if the history corroborates this condition.

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Many techniques are described in the literature for use in making impressions of bite mark indentations. A representative technique is presented in detail. Several types of dental materials common to many impression techniques are reviewed with regard to their accuracy, ease of use, and dimensional stability over time. Adherence of materials and a model pouring technique are also discussed.

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Skeletal remains were discovered in an unused cistern near the Omaha, Nebraska airport and were positively identified through comparison of antemortem and postmortem dental radiographs. Although nearly nine years had elapsed between death and discovery, the bones and teeth revealed evidence of the application of a corrosive substance at or about the time of death, as well as an unusual restricted response to sun exposure, that contributed to the prosecution and murder conviction of a member of Hell's Angels in the Omaha area.

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Forensic pathologists are often involved in the identification of unknown bodies. It is imperative, therefore, that they become aware of a national computerized identification system (NCIC) administered by the FBI. There is also a state system in California which has resulted in the identification of 59 individuals. This article describes the current methods available for dental identification and indicates the reasons pathologists must rely on odontologists. A brief description of human bite marks and their usual locations is also included, since forensic pathologists often encounter such important evidence during an autopsy.

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