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1.  The impact of frequent injections for hematopoietic growth factor support on patients receiving chemotherapy: an observational study 
BMC Nursing  2003;2:2.
Background
Quality of life may be affected by daily injections of supportive hematopoietic growth factor medication, which is frequently required by patients with cancer undergoing chemotherapy. The objective of the study was to identify areas where long-acting derivatives of current proteins, which require less frequent administration, may provide advantages over existing therapies that require more frequent administration.
Methods
An observational study was conducted to assess the impact of daily injections of Filgrastim (Neupogen®; Amgen Inc.) on patients' quality of life. A Subject Outcome Questionnaire was administered to patients after chemotherapy on 2 consecutive cycles. Time spent for treatment and patient attitude towards injection frequency were measured. The effect on patients' daily activities, including their ability to work, was analyzed.
Results
Thirty patients completed the first, and 24 the second, administration of the Questionnaire across 3 participating sites in the United States. The average patient time commitment for each daily injection was 78 minutes. Forty-five percent of patients were moderately to extremely bothered by travel during the first chemotherapy cycle, which increased to 59% during the second cycle. Forty-four percent and 18% of patients reported having to rearrange their daily schedules and take time off from work to accommodate each injection at least some of the time, respectively. Eighty-nine percent of the patients reported a preference for a longer-acting drug that required fewer injections.
Conclusion
Results indicate that frequent injections represent a significant burden on patients' lives and that the majority would prefer longer-acting medications that require less frequent administration and potentially fewer clinic visits.
doi:10.1186/1472-6955-2-2
PMCID: PMC222915  PMID: 14498996
2.  Reexamining age, race, site, and thermometer type as variables affecting temperature measurement in adults – A comparison study 
BMC Nursing  2003;2:1.
Background
As a result of the recent international vigilance regarding disease assessment, accurate measurement of body temperature has become increasingly important. Yet, trusted low-tech, portable mercury glass thermometers are no longer available. Thus, comparing accuracy of mercury-free thermometers with mercury devices is essential. Study purposes were 1) to examine age, race, site as variables affecting temperature measurement in adults, and 2) to compare clinical accuracy of low-tech Galinstan-in-glass device to mercury-in-glass at oral, axillary, groin, and rectal sites in adults.
Methods
Setting 176 bed accredited healthcare facility, rural northwest US
Participants Convenience sample (N = 120) of hospitalized persons ≥ 18 years old.
Instruments Temperatures (°F) measured at oral, skin (simultaneous), immediately followed by rectal sites with four each mercury-glass (BD) and Galinstan-glass (Geratherm) thermometers; 10 minute dwell times.
Results
Participants averaged 61.6 years (SD 17.9), 188 pounds (SD 55.3); 61% female; race: 85% White, 8.3% Native Am., 4.2% Hispanic, 1.7 % Asian, 0.8% Black. For both mercury and Galinstan-glass thermometers, within-subject temperature readings were highest rectally; followed by oral, then skin sites. Galinstan assessments demonstrated rectal sites 0.91°F > oral and ≅ 1.3°F > skin sites. Devices strongly correlated between and across sites. Site difference scores between devices showed greatest variability at skin sites; least at rectal site. 95% confidence intervals of difference scores by site (°F): oral (0.142 – 0.265), axilla (0.167 – 0.339), groin (0.037 – 0.321), and rectal (-0.111 – 0.111). Race correlated with age, temperature readings each site and device.
Conclusion
Temperature readings varied by age, race. Mercury readings correlated with Galinstan thermometer readings at all sites. Site mean differences between devices were considered clinically insignificant. Still considered the gold standard, mercury-glass thermometers may no longer be available worldwide. Therefore, mercury-free, environmentally safe low-tech Galinstan-in-glass may be an appropriate replacement. This is especially important as we face new, internationally transmitted diseases.
doi:10.1186/1472-6955-2-1
PMCID: PMC166172  PMID: 12807535

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