Miracle-dz/UniFAR-FTUs huggingface dataset:
The employment transitions of mid-life women: health and care effects

ABSTRACT This article provides information on the movements into and out of paid work by mid-life women. This is a group whose representation in the paid workforce is growing as population ageing proceeds and as educational qualifications expand. It is also a group that will be critical to any labour supply response to the economic challenges posed by population ageing. However, current understandings of the needs and circumstances of mid-life women in paid work are limited. To help address this knowledge gap we use data from the first five waves of the Household, Income and Labour Dynamics in Australia survey (2001–2005) to identify the causal influences of health, care and other factors on the ability of mid-life women to remain in and re-enter paid work. The results show that poor health and/or substantial care roles have a negative impact on the employment chances of this group. However, importantly, there is asymmetry in these health and care effects, in that improvements in health and/or reductions in care roles do not increase the chances of returning to paid work. This finding indicates that many mid-life women who experience poor health and/or undertake large care roles face substantial long-term negative consequences for their employment chances and, thus, their retirement and pre-retirement incomes.
The Impact of acculturation and social support on mental health among Korean-American registered nurses

Division of Nursing Science, College of Health Sciences, Ewha Womans University, Seoul, KoreaPurpose: This study was to examine the impact of acculturation and social support on the mental health among Korean-American registered nurses. Methods: Data were collected with a convenience sample of 203 Korean- American registered nurses living in New York state and New Jersey state from 8th May to 25th August in 2012. The structured questionnaires measured the degree of acculturation, social support, and mental health. Data anal-ysis was conducted using t-test, ANOVA, Pearson correlation efficient, and Stepwise multiple regression. Results: Lower level of integration and higher level of marginalization were associated with the lower mental health. Social support was also positively related to mental health and had mediating effect on the relationship between accultur-ation and mental health. The five variables, including participants A educational backg round, work shi ft, integration, marginalization, and social support were significant to predict the level of mental health among Korean-American registered nurses, accounting for 41% of the variability. Conclusion: The results imply that higher level of social support and strong identity of both home and host culture will enable Korean-American registered nurses to main-tain sound mental health.
RNA interference therapy in lung transplant patients infected with respiratory syncytial virus.

RATIONALE Lower respiratory tract infections due to respiratory syncytial virus (RSV) are associated with development of bronchiolitis obliterans syndrome in lung transplant (LTX) recipients. ALN-RSV01 is a small interfering RNA targeting RSV replication. OBJECTIVES To determine the safety and explore the efficacy of ALN-RSV01 in RSV infection. METHODS We performed a randomized, double-blind, placebo-controlled trial in LTX recipients with RSV respiratory tract infection. Patients were permitted to receive standard of care for RSV. Aerosolized ALN-RSV01 (0.6 mg/kg) or placebo was administered daily for 3 days. Viral load was determined by quantitative reverse transcriptase-polymerase chain reaction on serial nasal swabs. Patients completed symptom score cards twice daily. Lung function, including the incidence of new-onset or progressive bronchiolitis obliterans syndrome, was recorded at Day 90. MEASUREMENTS AND MAIN RESULTS We enrolled 24 patients (ALN-RSV01, n = 16; placebo, n = 8); randomization was stratified by ribavirin use. ALN-RSV01 was well tolerated, with no drug-related serious adverse events or post-inhalation perturbations in lung function. Interpretation of viral measures was confounded by baseline differences between the two groups in viral load and time from symptom onset to first dose. Mean daily symptom scores were lower in subjects receiving ALN-RSV01, and the mean cumulative daily total symptom score was significantly lower with ALN-RSV01 (114.7 ± 63.13 vs. 189.3 ± 99.59, P = 0.035). At Day 90, incidence of new or progressive bronchiolitis obliterans syndrome was significantly reduced in ALN-RSV01 recipients compared with placebo (6.3% vs. 50%, P = 0.027). CONCLUSIONS ALN-RSV01 was safe and may have beneficial effects on long-term allograft function in LTX patients infected with RSV. Clinical trial registered with www.clinicaltrials. gov (NCT 00658086).
Administration of Methylprednisolone for 24 or 48 Hours or Tirilazad Mesylate for 48 Hours in the Treatment of Acute Spinal Cord Injury Results of the Third National Acute Spinal Cord Injury Randomized Controlled Trial

Objective. —To compare the efficacy of methylprednisolone administered for 24 hours with methyprednisolone administered for 48 hours or tirilazad mesylate administered for 48 hours in patients with acute spinal cord injury. Design. —Double-blind, randomized clinical trial. Setting. —Sixteen acute spinal cord injury centers in North America. Patients. —A total of 499 patients with acute spinal cord injury diagnosed in National Acute Spinal Cord Injury Study (NASCIS) centers within 8 hours of injury. Intervention. —All patients received an intravenous bolus of methylprednisolone (30 mg/kg) before randomization. Patients in the 24-hour regimen group (n=166) received a methylprednisolone infusion of 5.4 mg/kg per hour for 24 hours, those in the 48-hour regimen group (n=167) received a methylprednisolone infusion of 5.4 mg/kg per hour for 48 hours, and those in the tirilazad group (n=166) received a 2.5 mg/kg bolus infusion of tirilazad mesylate every 6 hours for 48 hours. Main Outcome Measures. —Motor function change between initial presentation and at 6 weeks and 6 months after injury, and change in Functional Independence Measure (FIM) assessed at 6 weeks and 6 months. Results. —Compared with patients treated with methylprednisolone for 24 hours, those treated with methylprednisolone for 48 hours showed improved motor recovery at 6 weeks (P=.09) and 6 months (P=.07) after injury. The effect of the 48-hour methylprednisolone regimen was significant at 6 weeks (P=.04) and 6 months (P=.01) among patients whose therapy was initiated 3 to 8 hours after injury. Patients who received the 48-hour regimen and who started treatment at 3 to 8 hours were more likely to improve 1 full neurologic grade (P=.03) at 6 months, to show more improvement in 6-month FIM (P=.08), and to have more severe sepsis and severe pneumonia than patients in the 24-hour methylprednisolone group and the tirilazad group, but other complications and mortality (P=.97) were similar. Patients treated with tirilazad for 48 hours showed motor recovery rates equivalent to patients who received methylprednisolone for 24 hours. Conclusions. —Patients with acute spinal cord injury who receive methylprednisolone within 3 hours of injury should be maintained on the treatment regimen for 24 hours. When methylprednisolone is initiated 3 to 8 hours after injury, patients should be maintained on steroid therapy for 48 hours.
A Comparison of Postexercise Heart Rates by Telemetry and Self-Pulse Palpation in Middle School-Age Boys

In this study, we investigated the accuracy of self-pulse counting as a method of measuring exercise intensity in middle school-age boys. Sixty-three boys (age = 12.7 ± 1.0 years; stature = 157.7 ± 7.0 cm; mass = 49.5 ± 12.4 kg; body fat = 19.1 ± 11.8%; VO2peak = 52.8 ± 7.8 ml · kg · min-1) from 15 different schools were instructed in carotid pulse palpation. Participants were instructed to use 2 fingers of either hand, allowed to palpate the carotid artery on either side of the neck, and given the opportunity to briefly practice. Following self-pulse counting instructions and practice, participants were connected to a telemetry system using a single-lead electrocardiogram recording (CM5). With instructions to walk as fast as possible, they then completed a 720-m shuttle walk on an 18-m course. Postwalk heart rates (HRs) were simultaneously measured via telemetry and self-pulse palpation for 15 sec, with results converted to beats (b)· min-1. The mean postexercise HR, as determined by telemetry and self-p.
Evaluating Risks from Antibacterial Medication Therapy

ABSTRACT EVALUATING RISKS FROM ANTIBACTERIAL MEDICATION THERAPY USING AN OBSERVATIONAL PRIMARY CARE DATABASE Sharon B. Meropol Joshua P. Metlay Virtually everyone in the U.S. is exposed to antibacterial drugs at some point in their lives. It is important to understand the benefits and risks related to these medications with nearly universal public exposure. Most information on antibacterial drug-associated adverse events comes from spontaneous reports. Without an unexposed control group, it is impossible to know the real risks for treated vs. untreated patients. We used an electronic medical record database to select a cohort of office visits for non-bacterial acute respiratory tract infections (excluding patients with pneumonia, sinusitis, or acute exacerbations of chronic bronchitis), and compared outcomes of antibacterial drug-exposed vs. -unexposed patients. By limiting our assessment to visits with acute nonspecific respiratory infections, we promoted comparability between exposed and unexposed patients. To further control for confounding by indication and practice, we explored methods to promote further comparability between exposure groups. Our rare outcome presented an additional analytic challenge. Antibacterial drug prescribing for acute nonspecific respiratory infections decreased over the study period, but, in contrast to the U.S., broad spectrum antibacterial prescribing remained low. Conditional fixed effects linear regression provided stable estimates of exposure effects on rare outcomes; results were similar to those using more traditional methods for binary outcomes. Patients with acute nonspecific respiratory infections treated with antibacterial drugs were not at increased risk of severe adverse events compared to untreated patients. Patients with acute nonspecific respiratory infections exposed to antibacterials had a small decreased risk of pneumonia hospitalizations vs. unexposed patients. This very small measurable benefit of antibacterial drug therapy for acute nonspecific respiratory infections at the patient level must be weighed against the public health risk of emerging antibacterial resistance. Our data provide valuable point estimates of risks and benefits that can be used to inform future decision analysis and guideline recommendations for patients with acute nonspecific respiratory infections. Ultimately, improved point-of-care diagnostic testing may help direct antibacterial drugs to the subset of patients most likely to derive benefit. Degree Type Dissertation Degree Name Doctor of Philosophy (PhD) Graduate Group Epidemiology & Biostatistics First Advisor Joshua P. Metlay, MD, PhD This dissertation is available at ScholarlyCommons: http://repository.upenn. edu/edissertations/424
Mental health and substance use

Coexisting mental health and substance use problems are highly prevalent, but psychiatric and addiction services often fail to identify them or provide integrated treatment (Weaver et al, 2002; Bell, 2007). In the health services, this association has been given a number of titles including dual diagnosis, comorbidity, concurrent or coexisting problems, and all of these will appear in this article.
Lessons about Work Readiness from Final Year Paramedic Students in An Australian University

Introduction Paramedic education is changing in Australia from a post-employment model in which in-house training is provided by state-based service providers to pre-employment Bachelor degree education in universities. Little is known about how well prepared final year paramedic students nearing the end of their university course perceive themselves to be to enter the workforce. The objective of the study was to investigate perceptions of preparedness for the workforce of final year paramedic students at Victoria University, Melbourne, Australia. Methods A survey was conducted with final year paramedic students in their last semester at Victoria University, Melbourne, Australia. The survey focussed on eight dimensions relating to paramedic practice: theoretical skills, clinical skills; practical skills; interpersonal skills; communication with colleagues and other professionals; coping skills; lifelong learning; and ethics and legal responsibilities. Part 1 of the survey required participants to choose from six possible responses on how well they believe their paramedic course has prepared them in relation to 64 statements. Part 2 consisted of 5 open- ended questions. Data from part 1 was analysed to find the mean ‘preparedness scores’ on the 8 dimensions of paramedic practice. Responses from part 2 of survey were transcribed and imported into NVivo8, where each part of the questions were analysed and grouped into themes. Results Response rate was 14% (n=23). Respondents felt ‘somewhat adequately’ to ‘adequately’ prepared for the workforce. Responses to Part 2 indicated a range of perceptions in relation to preparedness to enter the paramedic workforce, ranging from feeling unprepared to put knowledge into practice, prepared in some aspects but not in others, through to feeling prepared but with a realisation that there would be much to learn on the job. Respondents comments provide paramedic educators with some clear ideas about what final year students value in terms of preparing them for practice: whilst respondents valued the clinical practice opportunities they had had, they wanted more clinical placements with more variety, for example placements in different areas of healthcare. Conclusion This small survey provides paramedic educators with some clear ideas about what final year students value in terms of preparing them for practice. As Australian paramedic education moves from a post-employment training model to a pre-employment model, further consideration is needed of how courses will best address the development of clinical and practical skills of students and meet the requirements of ambulance service employers. Collegiate dialogue between employers, educators and students will assist in addressing this.
Knowledge, Attitude and Practice of Principles of Exercise Prescription among Physiotherapists in Nigeria. -

Background: A significant growth has been associated with the awareness and acceptability of physiotherapy and therapeutic exercise techniques in the past few decades, yet so little is reported in the literature about the Knowledge, Attitude and Practice of Exercise Prescription among Physiotherapists. This study was therefore aimed at assessing the Knowledge, Attitude and Practice of the Principles of Exercise Prescription among Physiotherapists in Nigeria. Methods: A total of 300 practicing physiotherapists completed a 31-item questionnaire data on socio-demographics, knowledge, attitude and practice of the principles of exercise prescription. Data was represented using pie charts, frequency and percentages while Chi –Square was used to determine the association between the variables. Results: Knowledge, attitude and practice of the principles of exercise prescription among Physiotherapists in Nigeria were high and no significant relationship was found between their level of education and knowledge of exercise prescription. Similarly, there was no significant relationship between their years of experience and knowledge of exercise prescription. Conclusion: Majority of physiotherapists in Nigeria have good knowledge, attitude and practice of the principles of exercise prescription. Years of practice experience and level of physiotherapy education did not affect their knowledge of exercise prescription.
Microvascular decompression in patients with isolated maxillary division trigeminal neuralgia, with particular attention to venous pathology.

OBJECT The authors have the clinical impression that patients with isolated V2, or maxillary division, trigeminal neuralgia (TN) are most often women of a younger age with atypical pain features and a predominance of venous compression as the pathology. The aim of this study was to evaluate a specific subgroup of patients with V2 TN. METHODS Among 120 patients who underwent microvascular decompression (MVD) for TN in 2007, data were available for 114; 6 patients were lost to follow-up. Patients were stratified according to typical (Burchiel Type 1), mixed (Burchiel Type 2a), or atypical (Burchiel Type 2b) TN. A pain-free status without medication was used to determine the efficacy of MVD. All patients were contacted in June 2008 and again in January 2009 at 12-24 months after surgery (median 18.4 months) and asked to rate their response to MVD as excellent (complete pain relief without medication), fair (complete pain relief with medication or some relief with or without medication), or poor (continued pain despite medication; that is, no change from their preoperative baseline pain status. RESULTS Of 114 patients, 14 (12%) had isolated V2 TN. Among these 14 were 2 typical (14%), 1 mixed (7%), and 11 atypical cases (79%) of TN. Among the remaining 100 cases were 37 typical (37%), 14 mixed (14%), and 49 atypical cases (49%) of TN. In the isolated V2 TN group, all patients were women as compared with 72% of women in the larger group of 100 patients (p = 0.05, chi-square test). The average age in the isolated V2 TN group was 51.2 years (median 48.1 years) versus 54.2 years (median 54.0 years) in the remainder of the group (p = NS, unpaired Student t-test). In the isolated V2 TN group, there was a predominance of atypical pain cases (79%) versus 49% in the remainder of the group, and this finding trended toward statistical significance (p = 0.07, chi-square test). Venous contact or compression (partly or wholly) was noted in 93% of the patients with isolated V2 versus 69% of the remainder of the group (p = 0.13, chi-square test). The likelihood of excellent outcomes in the patients with V2 TN (71%) was compared with that in typical pain cases (79%) among patients in the rest of the group (that is, the bestoutcome group), and no difference was found between the 2 groups (p = 0.8, chi-square test). CONCLUSIONS The authors confirmed that patients with isolated V2 TN were more likely to be female, tended toward an atypical pain classification with venous pathology at surgery, and fared just as well as those presenting with typical pain.
Interactive expressions of HtrA1 and VEGF in human vitreous humors and fetal RPE cells.

PURPOSE High-temperature requirement factor A1 (HtrA1) is associated with exudative age-related macular degeneration, an angiogenic retinal disease related to vascular endothelial growth factor (VEGF). This study investigates the interactive relationship between the expressions of HtrA1 and VEGF. METHODS; The vitreous humor levels of HtrA1, VEGF, and pigment epithelium-derived factor were determined in 55 unrelated Han Chinese patients who underwent ocular surgeries. Expressions of HTRA1 and VEGFA were studied interactively and under stress conditions in primary human fetal retinal pigment epithelial (RPE) cells to evaluate their regulations. RESULTS Vitreous levels of HtrA1 were significantly associated with that of VEGF in vitreous samples from all patients (Pearson's correlation coefficient test, r = 0.650, P = 7.91 × 10(-8)) and from patients with retinal detachment (r = 0.835, P = 2.14 × 10(-7)). On stress induction, HTRA1 and VEGFA were upregulated in human fetal RPE cells treated by tunicamycin and dithiothreitol, but reduced after treatment by MG132. However, HtrA1 and VEGF did not regulate each other in their expressions. CONCLUSIONS This study revealed an association between HtrA1 and VEGF in human vitreous humors and RPE cells. They are both related to stress and inflammatory conditions.
A meta-analysis of the feed intake and growth performance of broiler chickens challenged by bacteria.

The aim of this meta-analysis was to determine the effect of a bacterial immune challenge (Clostridium spp., Escherichia coli, and Salmonella spp.) on the ADFI, ADG, and nutrient partitioning (maintenance requirements and feed efficiency) of broiler chickens. The database used for the meta-analysis included 65 articles that were published between 1997 and 2012 concerning a total of 86,300 broilers and containing information on the feed intake, protein intake, methionine intake, and weight gain of broilers that were challenged with Clostridium spp. , E. coli, or Salmonella spp. and were fed or not fed feed additives. The results of the ADFI and the ADG of the challenged broilers were transformed into values relative to those obtained in control broilers (ADG and ADFI). The meta-analysis involved 3 sequential analyses: graphical, correlation, and variance-covariance analysis. The results obtained for the birds that were challenged with Clostridium spp. , E. coli, or Salmonella spp. indicated that the ADFI was reduced by 16, 7, and 9%, respectively, and the ADG was reduced by 40, 10, and 29%, respectively. When the results for the challenged birds that were treated or nontreated were compared, ADFI reductions of 26.0 and 26.5% and ADG reductions of 2.9 and 21.6% were observed, respectively. Regression analyses of the ADG as a function of the protein or methionine intake of the challenged birds suggested that nutrients were diverted to the immune system. The relationship between the ADG and the ADFI was quadratic in the challenged and nontreated or treated broilers, as well as for each disease. The intercept of the regression-based curves for the data from all of the challenges were different from zero and negative (-2.20, -0.70, and -3.37, respectively), indicating that all of the challenges increased the maintenance requirements. In general, this meta-analysis allowed for the quantification of the effects of bacteriological challenges on the maintenance and feed efficiency of broiler chickens, and the knowledge that was generated in this study is applicable to broiler nutrition and for modeling their nutritional requirements.
Influences on clinical judgement in mental health nursing

The judgements made by nurses in the clinical area will determine the nursing care received by patients. Clinical judgement is, therefore, a critical aspect of professional practice. This paper outlines part of a research study that explored the influences on the clinical judgement of nurses in a mental health setting. The design used a grounded theory approach, and a number of methods were used to collect data in order to identify influences. Through the data analysis a conceptual framework of clinical judgement in mental health nursing was generated. Three inter-related concepts emerged: the self, the client and the social system in which the nurse functions. Also identified were three sub-concepts: professional roles, healthcare roles and the nurse-patient relationship. The findings of the study indicate that clinical judgements made by mental health nurses are time- and situation-dependent and consequently are unique. The implications for nursing practice, research and education are discussed, and recommendations made.