Miracle-dz/UniFAR-FTUs huggingface dataset:
The Patient Care Monitor-Neutropenia Index: development, reliability, and validity of a measure for chemotherapy-induced neutropenia.

PURPOSE/OBJECTIVES To provide an initial evaluation of the psychometric properties of the Patient Care Monitor 1.0 Revised-Neutropenia Index (PCM-N), a symptom-based assessment tool designed to measure health-related quality-of-life (HRQOL) changes associated with chemotherapy-induced neutropenia. DESIGN Known-groups methodology and self-report instrument validation. SETTING A large community oncology practice in Memphis, TN. SAMPLE 424 patients with cancer in four samples. METHODS All patients in the first three samples were assessed at baseline of chemotherapy administration and at a point analogous to midcycle. The fourth sample underwent a cross-sectional evaluation of the ability of the PCM-N to distinguish patients with febrile neutropenia, severe afebrile neutropenia, and no neutropenia. MAIN RESEARCH VARIABLES PCM-N score, grade of neutropenia, and febrile status. FINDINGS Internal consistency reliability and factor analysis supported the single additive scale structure of the 13 items of the PCM-N. The PCM-N demonstrated good known-groups validity and was able to distinguish patients with grades 3-4 neutropenia from those with grades 0-2. The tool also was able to distinguish patients with febrile neutropenia, severe afebrile neutropenia, and no neutropenia. Receiver operating characteristic analyses provided a psychometrically based threshold score. CONCLUSIONS The PCM-N is a reliable and valid instrument sensitive to changes in HRQOL associated with moderate-to-severe chemotherapy-induced neutropenia. IMPLICATIONS FOR NURSING Nurses can use the PCM-N as a rapid and cost-effective tool for monitoring symptoms of neutropenia in patients with cancer.
Hypertension in adult survivors of child abuse: observations from the Nurses' Health Study II

Background Limited research has shown a possible association between exposure to physical or sexual abuse prior to age 18 and the risk of developing hypertension as an adult. The factors mediating this relationship are unknown. Methods Questionnaire data from 68 505 female participants in the Nurses' Health Study II were analysed regarding exposure to physical and sexual abuse prior to age 18. Cox proportional hazards regression was used to assess the relationship between abuse exposure and hypertension. Results 64% of the participants (n=41 792) reported physical and/or sexual abuse prior to age 18; 17% reported hypertension. All forms of abuse had a dose-response relationship with hypertension. Adjustments for smoking, alcohol, family history of hypertension, exercise and oral contraceptives did not alter risk estimates. Adjustment for body mass index (BMI) significantly attenuated the associations between abuse and risk of hypertension and accounted for approximately 50% of the observed association between abuse exposure and hypertension. Women experiencing forced sexual activity as a child and as an adolescent had a 20% increased risk for developing hypertension (95% CI 8% to 32%) that was independent of BMI. Similarly, women reporting severe physical abuse in childhood and/or adolescence had risk estimates ranging from 14% (95% CI 5% to 24%) to 22% (95% CI 11% to 33%). Conclusion Early interpersonal violence may be a widespread risk factor for the development of hypertension in women. BMI is a significant mediator in the relationship between early abuse and adult hypertension.
Identifying family members who are likely to perceive benefits from providing care to a person with a primary malignant brain tumor.

PURPOSE/OBJECTIVES To identify changes in positive aspects of care (PAC) from the time of diagnosis to four months following the diagnosis in family caregivers of care recipients with primary malignant brain tumors. DESIGN Longitudinal. SETTING Dyads were recruited from neurosurgery clinics in Pittsburgh, PA, at the time of care recipients' diagnosis with a primary malignant brain tumor. A second data collection took place four months following the diagnosis. SAMPLE 89 caregiver and care recipient dyads. METHODS Paired t tests were used to examine change in PAC, univariate analyses were used to determine predictors of PAC at four months, Mann-Whitney U tests and t tests were used to examine associations between categorical predictor variables and PAC at four months, and univariate linear regressions were used to examine associations between continuous predictors and PAC at four months. MAIN RESEARCH VARIABLES The impact of sociodemographic factors, caregiver-perceived social support, mastery, neuroticism, and marital satisfaction on PAC. FINDINGS Caregivers' PAC scores during the first four months following diagnosis appeared to remain stable over time. Significant differences were found between the care recipient reasoning domain group at diagnosis and PAC score. Care recipients who scored below average were associated with caregivers with higher PAC scores. Caregiver PAC at four months following diagnosis was significantly predicted by care recipient reasoning and caregiver social support. CONCLUSIONS PAC scores appear to remain stable over time, although levels of PAC may be related to care recipients' level of functioning. Future research should focus on the development of interventions for caregivers who report low levels of PAC at the time of diagnosis in an attempt to help these individuals identify PAC in their caregiving situation. IMPLICATIONS FOR NURSING Findings have clinical and research implications. Clinicians may be able to better identify caregivers who are at risk for negative outcomes by understanding the risks faced by caregivers of patients with milder symptoms in addition to those caring for more profoundly affected care recipients.
Contribution of material, occupational, and psychosocial factors in the explanation of social inequalities in health in 28 countries in Europe

Objectives To analyse the associations between socio-economic status (SES), measured using occupation, and self-reported health, and to examine the contribution of various material, occupational and psychosocial factors to social inequalities in health in Europe. Methods This study was based on data from the European Quality of Life Survey (EQLS) carried out in 2003. The total sample consisted of 6038 and 6383 working men and women in 28 countries in Europe (response rates: 30.3–91.2%). Each set of potential material, occupational and psychosocial mediators included between eight and 11 variables. Statistical analysis was performed using multilevel logistic regression analysis. Results Significant social differences were observed for self-reported health, manual workers being more likely to be in poor health (OR=1.89, 95% CI 1.46 to 2.46 for men, OR=2.18, 95% CI 1.71 to 2.77 for women). Strong social gradients were found for almost all potential mediating factors, and almost all displayed significant associations with self-reported health. Social differences in health were substantially reduced after adjustment for material, occupational and psychosocial factors, with material factors playing a major role. The four strongest contributions to reducing these differences were found for material deprivation, social exclusion, financial problems and job reward. Taking all mediators into account led to an explanation of the social differences in health by 78–100% for men and women. Conclusion The association between SES and poor health may be attributed to differential distributions of several dimensions of material, occupational and psychosocial conditions across occupational groups. Interventions targeting different dimensions might result in a reduction in social inequalities in health.
The effect of re-employment on perceived health

Background The relationship between unemployment and poor health has been well established. Unemployment causes poor health, and poor health increases the probability of unemployment. Methods A prospective study with 6 months' follow-up was conducted among unemployed participants receiving social security benefits who were capable of full-time employment and were referred to a re-employment training centre. Re-employment was defined as ending social security benefits for at least 3 months because of starting with paid employment. Health-related quality of life was measured by the 36-Item Short-Form Health Survey. A Cox proportional hazards analysis was used to determine the factors that predicted re-employment during follow-up. The influence of re-employment on changes in perceived health was investigated with linear regression analysis. Results Unemployed participants with a poor health at baseline were less likely to return to paid employment during follow-up. Almost all dimensions of health at baseline had an influence on the likelihood of becoming employed. Among the re-employed participants, general health, physical functioning, social functioning, vitality, mental health, bodily pain and role limitations due to emotional or physical problems improved, with an effect size varying from 0.11 to 0.66. Conclusions This study provides evidence that re-employment leads to improvement of self-perceived health within a short time window. This suggests that labour force participation should be considered as therapeutic intervention within health promotion programmes among unemployed persons.
Socioeconomic position and incidence of acute myocardial infarction: a meta-analysis

Background A negative socioeconomic gradient is established for coronary heart disease (CHD) mortality and survival, while socioeconomic patterning of disease incidence is less well investigated. To study socioeconomic inequalities in the incidence of acute myocardial infarction (AMI), the major component of CHD, a meta-analysis was undertaken to summarise existing evidence on the issue. Methods A systematic search was performed in PubMed and EMBASE databases for observational studies on AMI incidence and socioeconomic position (SEP), published in English to April 2009. A random-effects model was used to pool the risks estimates from the individual studies. Results Among 1181 references, 70 studies fulfilled the inclusion criteria. An overall increased risk of AMI among the lowest SEP was found for all three indicators: income (pooled RR 1.71, 95% CI 1.43 to 2.05), occupation (pooled RR 1.35, 95% CI 1.19 to 1.53) and education (pooled RR 1.34, 95% CI 1.22 to 1.47). The strongest associations were seen in high-income countries such as USA/Canada and Europe, while the results were inconsistent for middle and low-income regions. Conclusion AMI incidence is associated with low SEP. The nature of social stratification at the level of economic development of a country could be involved in the differences of risk of AMI between social groups.
Reduction of gastric cancer mortality by endoscopic and radiographic screening in an isolated island: A retrospective cohort study.

OBJECTIVE To evaluate the efficacy of endoscopic and radiographic screening for gastric cancer. DESIGN A retrospective cohort study. SETTING Community in an isolated island. PARTICIPANTS The study involved 186 patients (131 men, 55 women) diagnosed with gastric cancer between 2000 and 2005. INTERVENTIONS Endoscopic and radiographic screening. MAIN OUTCOME MEASUREMENTS The odds ratio of death from gastric cancer in participants versus non-participants of screening, the cumulative survival rate of the gastric cancer patients. RESULTS The odds ratio of death from gastric cancer in the participants versus non-participants of screening was 0.091 (95% confidence interval (CI) 0.027-0.308; P < 0.0001). The cumulative survival rate of the gastric cancer patients in the screening group was higher than that in the non-screening group (P < 0.0001). In the endoscopic screening district, the odds ratio of death from gastric cancer among the participants versus non-participants of endoscopic screening was 0.117 (95% CI 0.013-1.056; P = 0.0525), while in the radiographic screening district, it was 0.086 (95% CI 0.020-0.376; P < 0.0001). The cumulative survival rates were higher in both the screening groups as compared with the non-screening group (endoscopy, P = 0.0302; radiography, P = 0.0012). CONCLUSION The results suggest that both radiographic and endoscopic screening may prevent gastric cancer deaths.
Socio-demographic determinants of worsening in frailty among community-dwelling older people in 11 European countries

Background The rapid increase of frail older people worldwide will have a substantial impact on healthcare systems. The frailty process may be delayed or even reversed, which makes it attractive for early interventions. However, little is known about the determinants of frailty state changes. The aim of this study is to compare socio-demographic determinants of worsening in frailty state in 11 European countries. Methods Data of 14 424 community-dwelling persons aged ≥55 years, enrolled in 2004 in the Survey of Health, Ageing and Retirement in Europe, were analysed. Three frailty states were identified (non-frail, pre-frail and frail) using Fried's criteria, and frailty state changes over a 2-year period were determined. Multinomial regression analyses adjusted for baseline frailty state were conducted to investigate whether sex, age, marital status and level of education determined a worsening in frailty state in the total and country-specific European population. Results Of all individuals, 22.1% worsened, 61.8% showed no change and 16.1% improved in frailty state. Women, those aged ≥65 years, and lower educated persons showed an increased risk of worsening in frailty state. In Southern European countries, there was an earlier and larger increase in risk of worsening in frailty state in life, which was more pronounced in women compared with men. Conclusions In Europe, persons aged ≥65 years, women and lower educated persons are at increased risk of worsening in frailty state. Differences between countries indicate that interventions aimed at delaying the frailty process in Southern European countries should start earlier with more attention towards women.
The association between lung function and fatal stroke in a community followed for 4 decades

Background Previous studies, all of <20 years of follow-up, have suggested an association between lung function and the risk of fatal stroke. This study investigates the stability of this association in a cohort followed for 4 decades. Methods The Bergen Clinical Blood Pressure Survey was conducted in Norway in 1964–1971. The risk of fatal stroke associated with forced expiratory volume after one second (FEV1) was estimated with Cox proportional hazards regression, making progressive adjustment for potential confounders. Results Of 5617 (84%) participants with recorded baseline FEV1, 462 died from stroke over 152 786 subsequent person-years of follow-up according to mortality statistics of 2005; mean (SD) follow-up was 27 (12) years. An association between baseline FEV1 (L) and fatal stroke was observed; HR=1.38 (95% CI 1.11 to 1.71) and HR=1.62 (95% CI 1.22 to 2.15) for men and women, respectively (adjusted for age and height). The findings were not explained by smoking, hypertension, diabetes, atherosclerosis, socioeconomic status, obstructive lung disease, physical inactivity, cholesterol or body mass index and persisted in subgroups of never-smokers, subgroups without respiratory symptoms and survivors of the first 20 years of follow-up. For male survivors with a valid FEV1 at follow-up (1988–1990) (n=953), baseline FEV1 (L) indicated a possible strong and independent association to the risk of fatal stroke after adjustments for individual changes in FEV1 (ml/year) (HR 1.95 (95% CI 0.98 to 3.86)). Conclusion There is a consistent, independent and long-lasting association between lung function and fatal stroke, probably irrespective of changes during adult life.
Psychosocial trajectories of men monitoring prostate-specific antigen levels following surgery for prostate cancer.

PURPOSE/OBJECTIVES To describe the psychosocial trajectories of men treated surgically for prostate cancer after monitoring their prostate-specific antigen (PSA) levels until 24 months post-treatment. DESIGN Descriptive longitudinal study. SETTING Urology clinic at Duke University Health System. SAMPLE 12 men diagnosed and treated for prostate cancer. METHODS Men were interviewed in their homes at baseline and at 24 months and via telephone at 6, 12, and 18 months. Scores from the Profile of Mood States, Mishel Uncertainty in Illness Scale, Self-Control Schedule, and Cantril's Ladder were entered into a database for analysis. Graphs of individual participants' scores were plotted. MAIN RESEARCH VARIABLES PSA values, mood state, cognitive reframing, impact of event, quality of life, illness uncertainty, and growth through uncertainty were measured. FINDINGS Three trajectories were identified (i.e., stable, unstable, and mixed) and graphed using a typological or health pattern approach. CONCLUSIONS Monitoring PSA levels is critical for men treated for prostate cancer. This study provides preliminary data on the psychological trajectories of men during the first 24 months postprostatectomy. IMPLICATIONS FOR NURSING Rising PSA levels that are associated with the recurrence of disease can cause psychosocial distress among men with prostate cancer.
The role of poverty in explaining health variations in 7-year-old children from different family structures: findings from the UK Millennium Cohort Study

Background Despite rises in reconstituted and lone-parent families, relatively little is known about how the health of children in different family types varies, and the extent to which any differences might be explained by poverty. The authors examined this using cross-sectional data on 13 681 seven-year-olds from the Millennium Cohort Study. Methods The authors estimated RRs and 95% CIs for having poor physical (general health, long-standing illness, injury, overweight, asthma, fits) and mental health (using strengths and difficulties scores) according to family structure using Poisson regression. The authors adjusted for confounders (aRR) and then investigated the role of poverty as a mediator by entering a poverty score (based on income, receipt of benefits, subjective poverty and material deprivation) into the main model. Results Children living in reconstituted and lone-parent families were at a slight increased risk of poor health compared with those living with two natural parents. Adjusting for poverty tended to remove the elevated risk of poor physical health in children living in lone-parent and reconstituted families. However, for the mental health outcomes, poverty tended to remove the elevated risk for lone parents but not for reconstituted families. For example, the aRR for borderline–abnormal total difficulties fell from 1.45 (1.22 to 1.72) to 1.34 (1.13 to 1.59) in children living in reconstituted families and from 1.29 (1.14 to 1.45) to 1.05 (0.92 to 1.19) in those living with lone parents. Conclusions Poor physical and mental health was slightly more prevalent in children living in lone-parent or reconstituted families. Poverty reduction may help to reduce these differences, especially for children living with lone parents; however, alternative mechanisms should be also explored, particularly for children living in reconstituted families.
The Halls Creek Community Families Program: Elements of the role of the child health nurse in development of a remote Aboriginal home visiting peer support program for families in the early years.

OBJECTIVE To undertake an evaluation of elements of the role of the child health nurse in the development of peer support for Aboriginal families with young children in a remote setting. DESIGN The Halls Creek Community Families Program uses expertise of peer support workers to support parents of young families. In stage one, participatory action research was used. The program facilitator, who was a child health nurse, undertook action learning sets where issues were explored relating to home visiting strategies to families. Additionally, the facilitator maintained a reflective practice diary. Outcomes contributed to stage two, where an independent researcher evaluated program changes.This report relates to stage one, which used descriptive qualitative data from interviews with peer support workers and community support agencies, and the facilitator's reflective diary. Data were analysed by thematic analysis, focusing on elements of the role of the facilitator in program development. SETTING A remote Aboriginal community in the Kimberley region of Western Australia. PARTICIPANTS Eight peer support workers and five health and welfare professionals from community support agencies. MAIN OUTCOME MEASURES This study measures changes in participants' understanding of the role and scope of practice of the child health nurse facilitator, thereby supporting improved support for Aboriginal families with young children. RESULTS Thematic analysis identified three major changes in understanding the child health nurse facilitator role: working in partnership, communication strategies and education and organisational strategies. CONCLUSION Findings suggest empowering benefits for Aboriginal peer support workers from the facilitating role of the child health nurse.
Association of objectively measured physical activity with established and novel cardiovascular biomarkers in elderly subjects: every step counts

Objective To analyse the relationship between objectively measured daily walking duration and cardiovascular biomarkers of inflammation, cardiac dysfunction and renal impairment. Methods Between March 2009 and April 2010, physical activity was assessed in 1253 community-dwelling individuals living in Germany aged ≥65 years (57% men) over 1 week using a thigh-worn accelerometer. C reactive protein (CRP), white blood cells (WBC), N-terminal pro-brain natriuretic peptide, high-sensitive troponin T (hsTnT), creatinine (Cr) and cystatin C (CysC) were also measured. Least-square means of daily walking duration were calculated for quartiles of each biomarker adjusted for sex, age, pre-existing cardiovascular disease and smoking status. Results After adjustment for covariates, statistically significant linear associations with walking duration were observed for WBC, hsTnT, Cr and CysC. CRP quartiles 1 and 2 showed no significant difference followed by a significant inverse dose–response relationship. A similar pattern, but less pronounced, was seen for N-terminal pro-brain natriuretic peptide. Mean differences between the first two quartiles of CRP and its fourth quartile were 17 min. Between categories 1 (more beneficial) and 4 of WBC, hsTnT, Cr and CysC the differences were 15, 12, 23 and 20 min, respectively. Conclusion Increased walking duration is associated with a more favourable profile of cardiovascular biomarkers in elderly subjects.