Miracle-dz/UniFAR-FTUs huggingface dataset:
Nursing Research on Family Processes in Chronic Illness in Ethnically Diverse Families: A Decade Review

The aim of this article is to review the methods, innovations, and dilemmas reported in nursing research on chronic illness with ethnically diverse families. Articles published by nurse researchers were systematically searched using Medline, CINAHL, and PsychINFO for the years 1990 to 2000, with follow-up to methodological articles. Research was selected if it sampled families from diverse ethnicities living in the United States and employed family conceptualizations or measures. Four classes of research were identified that (a) examine the appropriateness of various research instruments for use with ethnically diverse families; (b) examine families of varied ethnicities, but report what is common, rather than unique to each ethnic group; (c) examine family processes in a single diverse ethnic group; and (d) compare family processes in at least two ethnic groups. Methodological recommendations for future research are offered.
Preexercise aminoacidemia and muscle protein synthesis after resistance exercise.

PURPOSE We have previously shown that the aminoacidemia caused by the consumption of a rapidly digested protein after resistance exercise enhances muscle protein synthesis (MPS) more than the amino acid (AA) profile associated with a slowly digested protein. Here, we investigated whether differential feeding patterns of a whey protein mixture commencing before exercise affect postexercise intracellular signaling and MPS. METHODS Twelve resistance-trained males performed leg resistance exercise 45 min after commencing each of three volume-matched nutrition protocols: placebo (PLAC, artificially sweetened water), BOLUS (25 g of whey protein + 5 g of leucine dissolved in artificially sweetened water; 1 × 500 mL), or PULSE (15 × 33-mL aliquots of BOLUS drink every 15 min). RESULTS The preexercise rise in plasma AA concentration with PULSE was attenuated compared with BOLUS (P < 0.05); this effect was reversed after exercise, with two-fold greater leucine concentrations in PULSE compared with BOLUS (P < 0.05). One-hour postexercise, phosphorylation of p70 S6K(thr389) and rpS6(ser235/6) was increased above baseline with BOLUS and PULSE, but not PLAC (P < 0.05); furthermore, PULSE > BOLUS (P < 0.05). MPS throughout 5 h of recovery was higher with protein ingestion compared with PLAC (0.037 ± 0.007), with no differences between BOLUS or PULSE (0.085 ± 0.013 vs. 0.095 ± 0.010%.h(-1), respectively, P = 0.56). CONCLUSIONS Manipulation of aminoacidemia before resistance exercise via different patterns of intake of protein altered plasma AA profiles and postexercise intracellular signaling. However, there was no difference in the enhancement of the muscle protein synthetic response after exercise. Protein sources producing a slow AA release, when consumed before resistance exercise in sufficient amounts, are as effective as rapidly digested proteins in promoting postexercise MPS.
Initial validation of an exercise "vital sign" in electronic medical records.

PURPOSE The objective of this study is to describe the face and discriminant validity of an exercise vital sign (EVS) for use in an outpatient electronic medical record. METHODS Eligible patients were 1,793,385 adults 18 yr and older who were members of a large health care system in Southern California. To determine face validity, median total self-reported minutes per week of exercise as measured by the EVS were compared with findings from national population-based surveys. To determine discriminant validity, multivariate Poisson regression models with robust variance estimation were used to examine the ability of the EVS to discriminate between groups of patients with differing physical activity (PA) levels on the basis of demographics and health status. RESULTS After 1.5 yr of implementation, 86% (1,537,798) of all eligible patients had an EVS in their electronic medical record. Overall, 36.3% of patients were completely inactive (0 min of exercise per week), 33.3% were insufficiently active (more than 0 but less than 150 min·wk), and 30.4% were sufficiently active (150 min or more per week). As compared with national population-based surveys, patient reports of PA were lower but followed similar patterns. As hypothesized, patients who were older, obese, of a racial/ethnic minority, and had higher disease burdens were more likely to be inactive, suggesting that the EVS has discriminant validity. CONCLUSIONS We found that the EVS has good face and discriminant validity and may provide more conservative estimates of PA behavior when compared with national surveys. The EVS has the potential to provide information about the relationship between exercise and health care use, cost, and chronic disease that has not been previously available at the population level.
Case Management: A Historical and Future Perspective of Its Influence on Outcome for Persons Who Have Sustained Spinal Cord Injury

With the development of model systems in the 1970s, dedicated teams of rehabilitation professionals initiated the concept of case management. This occurred at about the same time that casualty insurers began using independent case managers. Since then, it is believed that persons with spinal cord injury (SCI) who have had the benefit of a case manager achieve and maintain better outcomes regarding health status, return to work, and modification and removal of architectural barriers. In general, these individuals have reported less depression and a more fulfilling lifestyle. The growth of managed care, with resultant abbreviated length of stay and diminished hands-on case management, may have a noticeably negative impact on adherence to clinical pathways and consequent successful outcomes. It is hypothesized that, despite technological advances, without comprehensive case management during all phases of SCI care, many individuals will not reach or maintain community reintegration and autonomy.
Improving performance, perceived usability, and aesthetics with culturally adaptive user interfaces

When we investigate the usability and aesthetics of user interfaces, we rarely take into account that what users perceive as beautiful and usable strongly depends on their cultural background. In this paper, we argue that it is not feasible to design one interface that appeals to all users of an increasingly global audience. Instead, we propose to design culturally adaptive systems, which automatically generate personalized interfaces that correspond to cultural preferences. In an evaluation of one such system, we demonstrate that a majority of international participants preferred their personalized versions over a nonadapted interface of the same Website. Results show that users were 22% faster using the culturally adapted interface, needed fewer clicks, and made fewer errors, in line with subjective results demonstrating that they found the adapted version significantly easier to use. Our findings show that interfaces that adapt to cultural preferences can immensely increase the user experience.
Exercise training improves HR responses and V˙O2peak in predialysis kidney patients.

PURPOSE The current pilot and feasibility study was designed to examine the effect of 48 wk of moderate-intensity exercise training and dietary modification on kidney function and vascular parameters in chronic kidney disease (CKD) patients. METHODS Twenty-one stage 2-4 CKD patients (age, 18-70 yr) were randomly assigned to either the training group (TG, n = 10) or the usual care group (n = 11) for 48 wk. The TG received 48 wk of personal training (3 d·wk for up to 55 min per session at 50%-60% V˙O2peak) and dietary counseling, whereas individuals in the usual care group received standard of care and were instructed not to start a structured exercise program while in the study. V˙O2peak, estimated glomerular filtration rate (eGFR), resting and ambulatory HR, plasma lipids (total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides), and inflammatory markers (high-sensitivity C-reactive protein and interleukin 6) were assessed at baseline and weeks 24 and 48. An independent group's t-test was used to compare glomerular filtration rate slopes between groups, whereas all other data were analyzed with ANCOVA using the baseline value as the covariate. RESULTS There were no statistically significant differences in any of the parameters at baseline. The 48-wk intervention led to a significant increase in V˙O2peak, reductions in both resting and ambulatory HR, and increases in LDL cholesterol and in TG, but it had no effect on the rate of change of eGFR over time. CONCLUSIONS A 48-wk exercise training program, primarily focused on aerobic exercise, increases V˙O2peak and favorably alters autonomic function as evidenced by reductions in HR in stages 2-4 CKD patients. The exercise intervention had no effect on kidney function as assessed by eGFR.
Magnetic resonance imaging-derived right ventricular adaptations to endurance versus resistance training.

PURPOSE Although left ventricular (LV) adaptation to exercise training has been the focus of "athlete's heart" research to date, information regarding right ventricular (RV) adaptation is sparse because of its complex structure and imaging technique limitations. This is the first prospective, longitudinal randomized study exploring the effect of endurance (E) versus resistance (R) exercise training on RV morphology using magnetic resonance imaging. METHODS Twenty-three young untrained men completed a randomly assigned E (n = 10) or R training protocol (n = 13) for 6 months, which was progressive, supervised, and intensive. Repeated measures included body composition, aerobic fitness, muscular strength, RV morphology (magnetic resonance imaging) and function (speckle tracking echocardiography). RESULTS Total lean mass increased in both groups (E = +1.3 kg, 95% confidence interval [CI] = 0.3-2.3; R = +2.1 kg, 95% CI = 1.5-3.2), whereas aerobic fitness significantly improved in E (+3.7 mL·kg-1·min-1, 95% CI = 0.9-6.5) but not in R training. Strength improved in both groups, but to a greater extent in R-trained subjects (+53.8 kg, 95% CI = 46.7-60.9 vs +35.3 kg, 95% CI = 27.3-43.4). After training, RV mass increased by 2.7 g (95% CI = -0.4 to 5.8) after E and by 1.4 g (95% CI = -1.3 to 4.1) after R training. The RV end-diastolic volume increased after E (+13.8 mL, 95% CI = 1.9-25.7), with a smaller change after R exercise (+3.9 mL, 95% CI = -6.5 to 14.3). The LV-to-RV mass ratio and myocardial function did not change in either group. CONCLUSION Mild morphological RV adaptation occurred after 6 months of intense supervised E and R exercise training. The degree of change was slightly but not significantly larger after E training. RV changes mirrored those observed in the left ventricle.
Exercise-associated hyponatremia and hydration status in 161-km ultramarathoners.

PURPOSE This work combines and reanalyzes 5 yr of exercise-associated hyponatremia (EAH) research at 161-km ultramarathons in northern California with primary purposes to define the relationship between postrace blood sodium concentration ([Na]) and change in body weight; to examine the interactions among EAH incidence, ambient temperature, and hydration state; and to explore the effect of hydration status on performance. METHODS Prerace and postrace body weight and finish time data were obtained on 887 finishers, and postrace [Na] was also obtained on a subset of 669 finishers. RESULTS EAH incidence was 15.1% overall (range, 4.6%-51.0% by year) and had a significant positive relationship with ambient temperature. Of the runners with EAH, 23.8% were classified as overhydrated (weight change, ≥0), 40.6% were euhydrated (weight change, <0% to -3%), and 35.6% were dehydrated (weight change, <-3%) at the finish. There was a weak significant relationship (r = 0.17, P < 0.0001) between postrace [Na] and change in body weight such that a lower [Na] was more common with increased weight loss. Considering all finishers examined, 18.5% were dehydrated and 34.9% were overhydrated at the finish. There was a weak significant relationship (r = 0.092, P = 0.006) between change in body weight and performance in that faster runners tended to lose more weight. Top finishers varied in body weight change from ∼1% gain to ∼6% loss. CONCLUSIONS EAH incidence can be high in 161-km ultramarathons in northern California. In this environment, EAH is more common with dehydration than overhydration and is more common in hotter ambient temperature conditions. Because weight loss >3% does not seem to have an adverse effect on performance, excessive sodium supplementation and aggressive fluid ingestion beyond the dictates of thirst are ill advised.
Stent-Graft Limb Deployment in the External Iliac Artery Increases the Risk of Limb Occlusion Following Endovascular AAA Repair

Purpose To assess whether deployment of an endograft limb in the external iliac artery (EIA) increases the rate of limb occlusion following endovascular aneurysm repair (EVAR). Methods Interrogation of a prospectively maintained database identified 661 patients (596 men; median age 73 years, range 37–93) with infrarenal abdominal aortic aneurysm who underwent EVAR between 1996 and 2010 using Zenith stent-grafts predominately. Of these, 567 patients [56 (9.9%) women] had both endograft limbs deployed in the CIA (1203 limbs at risk), while 94 patients [9 (9.6%) women] had at least 1 limb in the EIA (22 bilateral; 116 limbs at risk). An adjunctive bare metal stent was used in 8 (9%) limbs deployed in the EIA. Results There were 31 limb occlusions, all unilateral: 17 (3%) patients in the CIA group had an occluded limb (1% of limbs at risk) vs. 14 (15%) patients in the EIA group (12% of limbs at risk; p<0.0001). The median time to occlusion was 3 months (0–60) in the CIA group and 1 month (0–36) in the EIA group. The majority of occlusions were treated by extra-anatomical revascularization, most often a femorofemoral crossover bypass. No legs were amputated following occlusion of a limb placed in the CIA, but there were 3 amputations in the EIA group (p=0.003). Conclusion Deployment of endograft limbs into the EIA led to a higher rate of occlusion and leg amputation. Increased tortuosity of the EIA and a smaller caliber vessel are likely to account for the increased risk.
Greater weight loss from running than walking during a 6.2-yr prospective follow-up.

PURPOSE This study aimed to test whether equivalent changes in moderate (walking) and vigorous exercise (running) produce equivalent weight loss under free-living, nonexperimental conditions. METHODS Regression analyses of changes (Δ) in body mass index (BMI) versus exercise energy expenditure (ΔMET-hours per day, 1 MET = 3.5 mL O2·kg·min) from survey questionnaires completed at baseline and 6.2 yr thereafter in 15,237 walkers and 32,216 runners were used in this study. RESULTS At baseline, walkers spent less energy walking than runners spent running (mean ± SD; males = 2.22 ± 1.65 vs 5.31 ± 3.12 MET·h·d, females = 2.15 ± 1.63 vs 4.76 ± 3.03 MET·h·d), and walkers were significantly heavier than runners (males = 26.63 ± 4.04 vs 24.09 ± 2.58 kg·m, females = 25.44 ± 5.14 vs 21.61 ± 2.49 kg·m). During follow-up, energy expenditure declined less for walking in walkers than for running in runners (males = -0.19 ± 1.92 vs -1.27 ± 2.87 MET·h·d, females = -0.30 ± 1.93 vs -1.28 ± 2.85 MET·h·d). ΔBMI was inversely related to both ΔMET-hours per day run and ΔMET-hours per day walked, but more strongly to ΔMET-hours per day run than walked in men and in heavier women. Specifically, the regression coefficient for ΔBMI versus ΔMET-hours per day was significantly more negative for running than walking in men in the first quartile (differences in slope ± SE: -0.06 ± 0.03, P = 0.01), second quartile (-0.10 ± 0.03, P = 0.001), third quartile (-0.17 ± 0.03, P < 10), and fourth quartile of BMI (-0.14 ± 0.03, P < 10) and in the fourth BMI quartile of women (-0.32 ± 0.04 kg·m per MET-hours per day, P < 10). This represented 90% greater weight loss per MET-hours per day run than walked in the fourth BMI quartile for both sexes. Age-related weight gain was attenuated by running in both sexes (P < 10) and by walking in women (P = 0.005). CONCLUSION Although ΔBMI was significantly associated with both ΔMET-hours per day run and walked, the ΔBMI was significantly greater for Δrunning than Δwalking.
Factors that affect software systems development project outcomes: A survey of research

Determining the factors that have an influence on software systems development and deployment project outcomes has been the focus of extensive and ongoing research for more than 30 years. We provide here a survey of the research literature that has addressed this topic in the period 1996–2006, with a particular focus on empirical analyses. On the basis of this survey we present a new classification framework that represents an abstracted and synthesized view of the types of factors that have been asserted as influencing project outcomes.
Thrombus Obliteration by Rapid Percutaneous Endovenous Intervention in Deep Venous Occlusion (TORPEDO) Trial: Midterm Results

Purpose To present midterm results from a randomized study comparing the safety and efficacy of percutaneous endovenous intervention (PEVI) + anticoagulation vs. anticoagulation alone in the reduction of venous thromboembolism (VTE) and post-thrombotic syndrome (PTS) in acute symptomatic proximal deep venous thrombosis (DVT). Methods The TORPEDO trial was a randomized study to demonstrate superiority of PEVI in the reduction of the VTE and PTS at 6 months; in that trial, 183 patients (103 men; mean age 61±11 years) with symptomatic proximal DVT were randomized to receive PEVI + anticoagulation (n=91) or anticoagulation alone (n=92). PEVI consisted of one or more of a combination of thrombectomy, balloon venoplasty, stenting, and/or local low-dose thrombolytic therapy. Results At 6 months, recurrent VTE developed in 2.3% of the PEVI + anticoagulation group vs. 14.8% in the anticoagulation only group (p=0.003); PTS developed in 3.4% vs. 27.2% (p<0.001), respectively. At a mean follow-up of 3065 months (range 12–41), 88 patients in the PEVI + anticoagulation group and 81 patients in the anticoagulation only group reached target follow-up. Recurrent VTE developed in 4 (4.5%) of the 88 PEVI + anticoagulation patients vs. 13 (16%) of the 81 patients receiving anticoagulation only (p=0.02). PTS developed in 6 (6.8%) of the PEVI + anticoagulation group vs. 24 (29.6%) of the anticoagulation only group (p<0.001). Conclusion In patients with proximal DVT, PEVI is superior to anticoagulation alone in the reduction of VTE and PTS. This benefit, which appears early in the course of treatment, extends to >2.5 years.
Drug-Eluting vs. Bare Metal Stents for Symptomatic Vertebral Artery Stenosis

Purpose To evaluate the immediate and long-term outcomes of drug-eluting stent (DES) vs. bare metal stent (BMS) for symptomatic vertebral artery stenosis (VAS). Methods From 2003 to 2010, 206 consecutive patients (158 men; mean age 66.8 years) underwent DES (sirolimus-eluting or paclitaxel-eluting) or BMS placement for symptomatic extracranial and intracranial stenoses in 219 vertebral arteries. The technical success, clinical success, periprocedural complications, target vessel revascularization (TVR), and overall survival were compared between the DES and BMS groups. Results The technical success rate was 98.3% (119/121) for the DES group vs. 100% for the BMS group (p=0.503). The clinical success rate was 95.5% (107/112) for the DES group vs. 97.9% (92/94) for the BMS group (p=0.592). No periprocedural death or stroke occurred. The overall periprocedural complication rate was 2.7% (3/112) in the DES group vs. 4.3% (4/94) in BMS group (p=0.813). The median follow-up was 43 months (range 3–95) for the DES group and 46 months (range 6–89) for BMS. At last follow-up, the TVR rate was 6.3% (7/112) for the DES group vs. 20.2% (19/94) for the BMS group (p=0.003); 4 (3.6%) patients in the DES group and 8 (8.5%) patients in the BMS group experienced a VBS stroke (p=0.132). By life-table analysis, the 5-year TVR rate was 4.5% (5/112) for the DES group vs. 19.1% (18/94) for the BMS group (p=0.001). No difference was detected in the overall survival curves between the groups (p=0.500). Conclusion Both DES and BMS are feasible, safe, and effective for symptomatic VAS. However, DES can significantly decrease the TVR rate in the long term compared with BMS.
Application of Adult-Learning Principles to Patient Instructions: A Usability Study for an Exenatide Once-Weekly Injection Device

M ore than 23 million individuals in the United States have diabetes, and ∼ 90% of those have type 2 diabetes. An important aspect of successful disease management for type 2 diabetes is effective use of the numerous pharmacological interventions that are available to target the metabolic defects contributing to the underlying pathology.1 After lifestyle modification and metformin, clinicians may consider many factors when selecting additional therapies. These include efficacy, safety, side effects, treatment complexity (i.e., dosing, administration, and convenience), unique patient characteristics (e.g., physical and cognitive capabilities, understanding of disease, comorbidities, and self-care involvement), and cost. Importantly, patients' ability to initiate and continue using a prescribed therapy is heavily dependent on the education they receive about the disease and its recommended treatments.2 Self-management education is an integral component of diabetes care and is emphasized in the American Diabetes Association's Standards of Medical Care in Diabetes3 and in the Chronic Care Model.4,5 Data support the positive impact of self-management education on quality of life, glycemic control, and psychological factors.6–9 Furthermore, self-management education raises patient awareness of the impact of poor disease management on the occurrence of disease-related complications, premature mortality, and morbidity.10 However, few patients are actually educated by trained professionals or have access to diabetes education training programs.11–14 Often, patients must rely on sources such as the Internet, lay and promotional materials, and peers to supplement the education received from providers who must balance patient needs with severe time and resource constraints.15 In addition, individual characteristics such as language, literacy, vision, comprehension of the need for a therapy, and willingness to try alternatives to managing the disease will influence understanding and subsequent use of any prescribed therapy.16,17 These education challenges also apply …