Plos One
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African American women in the state of Arkansas have high breast cancer mortality rates. Breast cancer risk assessment tools developed for African American underestimate breast cancer risk. Combining African American breast cancer associated single-nucleotide polymorphisms (SNPs) into breast cancer risk algorithms may improve individualized estimates of a woman's risk of developing breast cancer and enable improved recommendation of screening and chemoprevention for women at high risk. ⋯ For 5-year risk OR per standard deviation increased from 1.84 to 2.08 with the addition of the polygenic risk score and from 1.79 to 2.07 for the lifetime risk score. Reclassification analysis indicated that 13% of cases had their 5-year risk increased above the 1.66% guideline threshold (NRI = 0.020 (95% CI -0.040, 0.080)) and 6.3% of cases had their lifetime risk increased above the 20% guideline threshold by the addition of the polygenic risk score (NRI = 0.034 (95% CI 0.000, 0.070)). Our data confirmed that discriminatory accuracy of BCRAT is improved for African American women in Arkansas with the inclusion of specific SNP breast cancer risk alleles.
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Clinical Trial
The impact of being bullied at school on psychological distress and work engagement in a community sample of adult workers in Japan.
The aim of this study was to investigate the long-term impact of being bullied at school on current psychological distress and work engagement in adulthood among Japanese workers. We hypothesized that workers who had been bullied at school could have higher psychological distress and lower work engagement compared to those who had not been bullied. ⋯ Being bullied at school was positively associated with both psychological distress and work engagement in a sample of workers. Being bullied at school may be a predisposing factor for psychological distress, as previously reported. The higher levels of work engagement among people who experienced being bullied at school may be because some of them might have overcome the experience to gain more psychological resilience.
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Observational Study
Mid regional pro-adrenomedullin for the prediction of organ failure in infection. Results from a single centre study.
Biomarkers are widely used to confirm the presence of infection. However, it would be of the greatest importance to predict in advance the occurrence or worsening of organ dysfunction in infected patients allowing timely antibiotic escalation. This study investigates the ability of procalcitonin (PCT) and MR-proADM to predict the transition to sepsis in infected patients. ⋯ This was a pivotal study conducted in a single neurointensive centre on a limited number of patients, and as such it does not provide definitive conclusions. PR-proADM predicted occurrence and worsening of organ failure in critically ill patients with and without infection. The combination with infection diagnostic biomarkers such as PCT would allow predicting evolution to sepsis in infected patients.
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Nurses play an important role in maintaining patients' dignity. How to measure patients' dignity and dignity-related distress is an important issue in nursing care. Use of a reliable and valid tool assessing dignity-related distress in patients is necessary. ⋯ As a result of the factor analysis, four factors, including existential distress, loss of support and sense of meaning, symptom distress, and loss of autonomy. Concurrent validity showed that the PDI-MV was significantly correlated with the PHQ-9 (r = 0.25-0.54), DS-MV (r = 0.30-0.58) and the RSES (r = - 0.08 to-0.30), Cronbach's alpha coefficients for the PDI-MV and four factors were 0.95, 0.95, 0.84, 0.83, and 0.89 respectively. The PDI-MV is a psychometrically sound instrument assessing a broad range of dignity-related distress issues in cancer patients.
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Polymyositis and dermatomyositis (PM/DM) are systemic autoimmune diseases with multiple organ involvements that manifest as muscular and cutaneous disorders, interstitial lung disease (ILD) and malignancies. However, information concerning the outcomes and associated factors for PM/DM patients who are hospitalized is limited. ⋯ PM/DM patients continue to display high in-hospital mortality. Pulmonary infection is the strongest predictor of poor prognosis in PM/DM patients, followed by pneumomediastinum, Gottron's papules, and elevated ESR.