Our study quantifies the magnitude of analgesic treatment disparities in subgroups of minorities. The size of the difference was sufficiently large to raise not only normative but quality and safety concerns. The treatment gap does not appear to be closing with time or existing policy initiatives. A concerted strategy is needed to reduce pain care disparities within the larger quality of care initiatives.
To identify promising candidate genes linked to interindividual differences in the efficacy of interferon beta therapy. Recombinant interferon beta therapy is widely used to reduce disease activity in multiple sclerosis (MS). However, up to 50% of patients continue to have relapses and worsening disability despite therapy. Design: We used a genome-wide pharmacogenomic approach to identify single-nucleotide polymorphism (SNP) allelic differences associated with interferon beta therapy response.
a b s t r a c tObjective: To evaluate the psychometric characteristics of the Caregiver Preparedness Scale (CPS) in caregivers of stroke survivors. Background: Caregiver preparedness can have an important impact on both the caregiver and the stroke survivor. The validity and reliability of the CPS has not been tested for the stroke-caregiver population. Methods: We used a cross-sectional design to study a sample of 156 caregivers of stroke survivors. Construct validity of the CPS was evaluated by confirmatory factor analysis (CFA). Internal consistency and test-retest reliability were also evaluated. Results: Caregivers were, on average, 54 year old (SD ¼ 13.2) and most were women (64.7%). CFA supported the unidimensionality of the scale (comparative fit index ¼ 0.98). Reliability was also supported: item-reliability index and itemetotal correlations above 0.30; composite reliability index ¼ 0.93; Cronbach's alpha ¼ 0.94; factor score determinacy ¼ 0.97; and test-retest reliability ¼ 0.92. Conclusion: The CPS is valid and reliable in caregivers of stroke survivors. Scores on this scale may assist health-care providers in identifying caregivers with less preparedness to provide specific interventions.
Sleep disturbance can contribute to negative health outcomes. However, sleep complaints have been underrecognized and undertreated in caregivers of ill family members. This systematic review describes the impact of family caregiving on sleep and summarizes factors associated with sleep disturbance in caregivers. A literature search using PubMed, MEDLINE, PsycINFO, and CINAHL databases yielded 22 relevant research articles on family caregivers of ill adults. Analyses revealed that up to 76 % of caregivers reported poor sleep quality, and the proportion is considerably higher for female caregivers compared to male caregivers. Sleep measures indicated short sleep duration and frequent night awakenings. Characteristics of the care recipient, such as health status, and the caregiver's own health status and symptoms, such as depression, fatigue, and anxiety, were associated with sleep disturbance in caregivers. These factors may help clinicians identify caregivers at highest risk for developing sleep disturbance and guide the family toward additional support.
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