Miracle-dz/UniFAR-FTUs huggingface dataset:
Explaining the Gender Gap in the Caregiving Burden of Partner Caregivers

Abstract Objectives We examine gender differences in the experienced burden of partner caregivers using the stress-appraisal model. Gender differences can be explained by differences in conditions of burden (primary stressors, help from others, hours of caregiving, and secondary stressors) and how strong their effects are. Method The data are from the Netherlands’ Older Persons and Informal Caregivers Survey—Minimum Data Set (N = 1,611 caregivers). We examine mediation and moderation effects using structural equation modeling. Results Women experience greater partner caregiver burden than men, which is related to women experiencing more secondary stressors (relational and financial problems, problems combining different tasks). For women and men alike, there is a positive association between burden and more primary stressors (partner’s care need indicated by health impairment), help from other caregivers, and secondary stressors. For male caregivers, caregiving intensity also contributes to a greater burden. Discussion This study corroborates the structural impact of gender on the conditions of as well as their effects on the partner caregiver burden. Reducing the hours of caregiving for male caregivers in severe care situations and helping female and male caregivers deal emotionally with the caregiving situation can reduce the partner caregiver burden.
Briefly Trained Medical Students Can Effectively Identify Rheumatic Mitral Valve Injury Using a Hand‐Carried Ultrasound

Rheumatic heart disease (RHD) is common and remains a major cause of morbidity, particularly in developing countries. Its diagnosis relies on expertise‐dependent echocardiographic studies. We evaluated the accuracy of briefly trained examiners in identifying RHD utilizing a hand‐carried cardiac ultrasound (HCU) device.
Association Between Choice of Radical Prostatectomy, External Beam Radiotherapy, Brachytherapy, or Active Surveillance and Patient-Reported Quality of Life Among Men With Localized Prostate Cancer

Importance Patients diagnosed with localized prostate cancer have to decide among treatment strategies that may differ in their likelihood of adverse effects. Objective To compare quality of life (QOL) after radical prostatectomy, external beam radiotherapy, and brachytherapy vs active surveillance. Design, Setting, and Participants Population-based prospective cohort of 1141 men (57% participation among eligible men) with newly diagnosed prostate cancer were enrolled from January 2011 through June 2013 in collaboration with the North Carolina Central Cancer Registry. Median time from diagnosis to enrollment was 5 weeks, and all men were enrolled with written informed consent prior to treatment. Final follow-up date for current analysis was September 9, 2015. Exposures Treatment with radical prostatectomy, external beam radiotherapy, brachytherapy, or active surveillance. Main Outcomes and Measures Quality of life using the validated instrument Prostate Cancer Symptom Indices was assessed at baseline (pretreatment) and 3, 12, and 24 months after treatment. The instrument contains 4 domains—sexual dysfunction, urinary obstruction and irritation, urinary incontinence, and bowel problems—each scored from 0 (no dysfunction) to 100 (maximum dysfunction). Propensity-weighted mean domain scores were compared between each treatment group vs active surveillance at each time point. Results Of 1141 enrolled men, 314 pursued active surveillance (27.5%), 469 radical prostatectomy (41.1%), 249 external beam radiotherapy (21.8%), and 109 brachytherapy (9.6%). After propensity weighting, median age was 66 to 67 years across groups, and 77% to 80% of participants were white. Across groups, propensity-weighted mean baseline scores were 41.8 to 46.4 for sexual dysfunction, 20.8 to 22.8 for urinary obstruction and irritation, 9.7 to 10.5 for urinary incontinence, and 5.7 to 6.1 for bowel problems. Compared with active surveillance, mean sexual dysfunction scores worsened by 3 months for patients who received radical prostatectomy (36.2 [95% CI, 30.4-42.0]), external beam radiotherapy (13.9 [95% CI, 6.7-21.2]), and brachytherapy (17.1 [95% CI, 7.8-26.6]). Compared with active surveillance at 3 months, worsened urinary incontinence was associated with radical prostatectomy (33.6 [95% CI, 27.8-39.2]); acute worsening of urinary obstruction and irritation with external beam radiotherapy (11.7 [95% CI, 8.7-14.8]) and brachytherapy (20.5 [95% CI, 15.1-25.9]); and worsened bowel symptoms with external beam radiotherapy (4.9 [95% CI, 2.4-7.4]). By 24 months, mean scores between treatment groups vs active surveillance were not significantly different in most domains. Conclusions and Relevance In this cohort of men with localized prostate cancer, each treatment strategy was associated with distinct patterns of adverse effects over 2 years. These findings can be used to promote treatment decisions that incorporate individual preferences.
The Association Between Socioeconomic Status and Adult Mortality in a Developing Country: Evidence From a Nationally Representative Longitudinal Survey of Indonesian Adults

OBJECTIVES To estimate the association between socioeconomic status (SES) and adult mortality in Indonesia and determine the contribution of adult behavioral risk factors to SES differences in mortality. METHODS Discrete failure-time regression models and period life tables were used to estimate life expectancy at age 30 (e30) across wealth and consumption groups by sex and urban/rural residence. RESULTS For urban men, e30 increases by an average of 1.10 years per wealth quartile (p = .014) from 38.7 years (95% confidence interval (CI): 37.4-40.5) in the bottom wealth quartile to 42.1 years (95% CI: 40.3-44.1) in the top quartile; for rural men, e30 increases by an average of 1.35 years per quartile (p = .007) from 40.6 years (95% CI: 39.2-42.5) in the bottom wealth quartile to 44.3 years (95% CI: 42.4-46.6) in the top quartile. SES differences are smaller for women. Behavioral risk factors are inconsistently patterned across SES and do not explain SES differences in mortality. DISCUSSION The associations between SES and adult life expectancy in Indonesia are moderate when compared with developed countries and are not explained by traditional behavioral risk factors. In a context where behavioral risk factors are inconsistent across SES groups, mortality inequality may be driven by inequalities in health care access or other social factors.
Perceptions and beliefs about the role of physical activity and nutrition on brain health in older adults.

PURPOSE To examine older adults' perceptions of the link between physical activity (PA) and nutrition to the maintenance of cognitive health. DESIGN AND METHODS Forty-two focus groups (FGs) were conducted with 396 ethnically diverse (White, African American, American Indian, Chinese, Vietnamese, and Hispanic) community-dwelling older adults. FGs were audio recorded, transcribed verbatim, and coded using a constant comparison method. Responses pertaining to PA and nutrition were analyzed. RESULTS Participants noted a positive link between both PA and dietary practices and brain health, although some participants voiced skepticism regarding diet. Walking was most frequently cited as a recommended PA, but participants did not know the recommended frequency, duration, and intensity. Limiting portion sizes; preparing foods in healthier ways; eating more fish, fruits, vegetables, low-fat foods, and chicken; and eating less red meat and chicken with the skin were associated with brain health. Multiple dietary supplements were also discussed. More racial/ethnic differences were noted for PA than for diet. IMPLICATIONS Interventions and media campaigns may benefit from explicitly linking PA and dietary habits with brain health and helping older adults understand that cardiovascular risk factors are also dementia risk factors. Emphasizing the total diet (vs. specific nutrients) and providing clear messages regarding the frequency, duration, and intensity of recommended PA would also be useful.
Aromatherapy in Tinnitus: a Pilot Study

This study assesses the effects of aromatherapy on sixteen subjects with chronic tinnitus. The most common single perceived benefit was one of relaxation. When the benefits were grouped by category, the most common benefit was somatic ( n r = r 11), followed by relaxation ( n r = r 9), sleep ( n r = r 4), tinnitus ( n r = r 4), 'feel-good' ( n r = r 2) and psychological ( n r = r 2). Interestingly, only 9% (4/45) of the benefits listed by the patients referred directly to tinnitus. Among the shortcomings, the factor specified most frequently was that the effects of the aromatherapy were short lived ( n r = r 6). Aromatherapy may have had a negative impact on their ability to ignore the tinnitus. The results of this study indicate that, while the majority of the patients felt that they benefited from aromatherapy, the benefits were non-specific rather than being related directly to the tinnitus.
"You need a song to bring you through": the use of religious songs to manage stressful life events.

PURPOSE To explore in a sample of older African Americans how religious songs were used to cope with stressful life events and to explore the religious beliefs associated with these songs. DESIGN AND METHODS Sixty-five African American older adults residing in the Southeastern US participated in a qualitative descriptive study involving criterion sampling, open-ended semi-structured interviews, qualitative content analysis, and descriptive statistics. RESULTS Religion expressed through song was a coping strategy for participants experiencing stressful life events who described feelings of being comforted, strengthened, able to endure, uplifted, and able to find peace by turning to the types of religious songs described here. Five types of songs were used including those evoking Thanksgiving and Praise, Instructive, Memory of Forefathers, Communication with God, and Life after Death. IMPLICATIONS Religious songs are an important form of religious expression important to the mental health of older African Americans. The incorporation of religious songs into spiritual care interventions might enhance the cultural relevance of mental health interventions in this population.
Evaluation of an agency-based occupational therapy intervention to facilitate aging in place.

PURPOSE The United States faces a growing population of older adults and accompanying functional disabilities, coupled with constrained public resources and diminishing informal supports. A variety of interventions that aim to improve client outcomes have been studied, but to date, there is limited translational research that examines the efficacy of moving such interventions from clinical trials to agency settings. METHODS A randomized controlled trial was conducted to evaluate a restorative occupational therapy intervention relative to "usual care" among community-dwelling older adults. The intervention included a detailed assessment from a person-environment perspective and provision of adaptive equipment and home modifications where appropriate. The intervention (n = 31) and control groups (n = 29) were evaluated at 3 months and assessed for changes in functional status, home safety, falls, health-related quality of life (HRQoL; EQ5D), depression, social support, and fear of falling; a 4 subgroup analysis also examined outcomes by waiting list status. An informal economic evaluation compared the intervention to usual care. RESULTS Findings indicated improvements in home safety (p < .0005, b = -15.87), HRQoL (p = .03, b = 0.08), and fear of falling (p < .05, b = 2.22). Findings did not show improvement in functional status or reduction in actual falls. The intervention resulted in a 39% reduction in recommended hours of personal care, which if implemented, could result in significant cost savings. IMPLICATIONS The study adds to the growing literature of occupational therapy interventions for older adults, and the findings support the concept that restorative approaches can be successfully implemented in public agencies.
Bridging the Gap: Reflections on Teaching Interprofessional Communication to Undergraduate Paramedic and Nursing Students

Introduction The literature emphasises the vital importance of interprofessional communication during clinical handover as being paramount to patient safety. At Charles Sturt University we explored how simulation can be employed in an interprofessional education (IPE) exercise exposing paramedic and nursing students to a high-pressure emergency department wherein they must engage in patient handover. Methods Over a 4-day period in April 2012, 200 paramedic and nursing students participated in an intensive simulation exercise where they practised interprofessional communication. The project team subsequently debriefed all student and staff members to gain insight through the participants’ experiences. Results Our results demonstrated that students become more comfortable interacting and communicating with other team members during scenarios. In addition to experiencing first hand that IPE is an effective tool for developing communication skills, we determined that this could be successfully facilitated in a large-scale simulated IPE to help students develop a shared understanding between disciplines. Conclusion Academics can work horizontally across disciplines to employ IPE in simulation as an educational tool to teach vital communication skills; and with paramedicine now being taught alongside nursing in tertiary centres, universities are well positioned to support collaborative interprofessional practice and communication.
A tale of two community initiatives for promoting aging in place: similarities and differences in the national implementation of NORC programs and villages.

PURPOSE Villages and Naturally Occurring Retirement Community (NORC) Supportive Service Programs (NORC programs) are among the most prominent community-based models for promoting aging in place. To advance systematic understanding of their development, this study examined how these models have been implemented nationally and the models' similarities and differences. DESIGN AND METHODS A survey of program leaders representing 69 Villages and 62 NORC programs was conducted from January to June of 2012. Bivariate analyses compared measures of the initiatives' services/activities, beneficiaries, service delivery processes, and funding sources. RESULTS Village members were reportedly more likely than NORC program participants to be younger, to be less functionally impaired, to be more economically secure, and to reside in higher socioeconomic communities. Reflecting these differences in populations served, NORC programs reported offering more traditional health and social services, had more paid staff, and relied more on government funding than Villages. IMPLICATIONS Findings indicate that Villages and NORC programs both aim to promote aging in place by offering a diverse range of supports and services to older adults within a locally defined geographic area. Nevertheless, key differences were found in the means through which they seek to achieve these aims, as well as the populations likely to benefit from their efforts. These differences raise questions regarding the models' inclusivity, sustainability, expansion, and effectiveness and have implications for community aging in place initiatives more broadly.
A pooled analysis of adjuvant chemotherapy for resected colon cancer in elderly patients.

BACKGROUND Adjuvant chemotherapy is standard treatment for patients with resected colon cancer who are at high risk for recurrence, but the efficacy and toxicity of such treatment in patients more than 70 years of age are controversial. METHODS We performed a pooled analysis, based on the intention to treat, of individual patient data from seven phase 3 randomized trials (involving 3351 patients) in which the effects of postoperative fluorouracil plus leucovorin (five trials) or fluorouracil plus levamisole (two trials) were compared with the effects of surgery alone in patients with stage II or III colon cancer. The patients were grouped into four age categories of equal size, and analyses were repeated with 10-year age ranges (< or =50, 51 to 60, 61 to 70, and >70 years), with the same conclusions. The toxic effects measured in all trials were nausea or vomiting, diarrhea, stomatitis, and leukopenia. Patients in the fluorouracil-plus-leucovorin and fluorouracil-plus-levamisole groups were combined for the efficacy analysis but kept separate for toxicity analyses. RESULTS Adjuvant treatment had a significant positive effect on both overall survival and time to tumor recurrence (P<0.001 for each, with hazard ratios of death and recurrence of 0.76 [95 percent confidence interval, 0.68 to 0.85] and 0.68 [95 percent confidence interval, 0.60 to 0.76], respectively). The five-year overall survival was 71 percent for those who received adjuvant therapy, as compared with 64 percent for those untreated. No significant interaction was observed between age and the efficacy of treatment. The incidence of toxic effects was not increased among the elderly (age >70 years), except for leukopenia in one study. CONCLUSIONS Selected elderly patients with colon cancer can receive the same benefit from fluorouracil-based adjuvant therapy as their younger counterparts, without a significant increase in toxic effects.
Intensive diabetes therapy and carotid intima-media thickness in type 1 diabetes mellitus.

BACKGROUND Cardiovascular disease causes severe morbidity and mortality in type 1 diabetes, although the specific risk factors and whether chronic hyperglycemia has a role are unknown. We examined the progression of carotid intima-media thickness, a measure of atherosclerosis, in a population with type 1 diabetes. METHODS As part of the Epidemiology of Diabetes Interventions and Complications (EDIC) study, the long-term follow-up of the Diabetes Control and Complications Trial (DCCT), 1229 patients with type 1 diabetes underwent B-mode ultrasonography of the internal and common carotid arteries in 1994-1996 and again in 1998-2000. We assessed the intima-media thickness in 611 subjects who had been randomly assigned to receive conventional diabetes treatment during the DCCT and in 618 who had been assigned to receive intensive diabetes treatment. RESULTS At year 1 of the EDIC study, the carotid intima-media thickness was similar to that in an age- and sex-matched nondiabetic population. After six years, the intima-media thickness was significantly greater in the diabetic patients than in the controls. The mean progression of the intima-media thickness was significantly less in the group that had received intensive therapy during the DCCT than in the group that had received conventional therapy (progression of the intima-media thickness of the common carotid artery, 0.032 vs. 0.046 mm; P=0.01; and progression of the combined intima-media thickness of the common and internal carotid arteries, -0.155 vs. 0.007; P=0.02) after adjustment for other risk factors. Progression of carotid intima-media thickness was associated with age, and the EDIC base-line systolic blood pressure, smoking, the ratio of low-density lipoprotein to high-density lipoprotein cholesterol, and urinary albumin excretion rate and with the mean glycosylated hemoglobin value during the mean duration (6.5 years) of the DCCT. CONCLUSIONS Intensive therapy during the DCCT resulted in decreased progression of intima-media thickness six years after the end of the trial.
Primary teachers’ and primary pre-service teachers’ self-efficacy beliefs and attitudes toward teaching profession

Abstract The main purpose of this study is to compare the primary teachers and pre-service primary teachers’ self-efficacy beliefs and attitudes toward teaching profession in Turkey. Descriptive method was used in the study and the study was carried out on 180 first grade and 107 fourth grade primary pre-service teachers at the Faculty of Education in Rize University and 131 primary teachers working in the primary schools located in Cayeli (Rize) district. The Attitude Scale towards Teaching Profession (Ozgur, 1994) and the Turkish form of the Ohio State Teacher Efficacy Scale (Baloglu and Karadag, 2008) were used as data gathering instrument in the study. The study results revealed that the first grade primary pre-service teachers’ scores on the attitudes towards teaching professions were statistically higher than the scores of the fourth grade primary pre-service teachers and of the primary teachers. However, the study results indicated that the teaching self-efficacy scores of the first grade pre-service teachers were statistically lower than the teaching self-efficacy scores of the fourth grade pre-service teachers and primary teachers. On the other hand, the study results showed that females’ attitudes towards teaching profession were higher than the attitudes of their male counterparts whereas self-efficacy scores did not differentiate due to the gender of the primary pre-service teachers and primary teachers. Moreover, the study results indicated that there were not any significant correlation between the self-efficacy and attitudes scores of the pre-service teachers and primary teachers.
Changes in Leisure Activities and Dimensions of Depressive Symptoms in Later Life: A 12-Year Follow-Up.

PURPOSE OF STUDY Although leisure activities benefit the mental health of the elderly population, the effect of changes in leisure activities on dimensions of depressive symptoms remains unclear. This investigation examined the influences of changes in intellectual, social, and physical activities between waves on four dimensions of depressive symptoms at follow-up. DESIGN AND METHODS Random effects modeling was utilized with data from a nationwide longitudinal study conducted in Taiwan. The study data comprised 6,942 observations from 2,660 older adults over a 12-year period. RESULTS The results suggested that changes in physical activities contributed to depressive symptoms which reflected positive affect in the later wave. Increased social activities between waves predicted higher positive affect and lower interpersonal difficulties scores at follow-up. Increased intellectual activities between waves did not substantially affect any domain of depressive symptoms. In contrast, declines in intellectual activities between waves predicted higher scores in three depressive symptoms domains, including depressed mood, somatic symptoms, and interpersonal difficulties. IMPLICATIONS Engagement in a varied range of activities benefits mental health among elders more than participation in any single type of activity among elders. Reducing physical activities can lower positive affect, while the adverse effect may be balanced by increasing social activities. Also, the impact of decreasing intellectual activities on the interpersonal difficulties domain of depressive symptoms may be offset by increasing social activities.