Psychological correlates of self-reported functional limitation in patients with ankylosing spondylitis

Abstract Introduction Functional status is an integral component of health-related quality of life in patients with ankylosing spondylitis (AS). The purpose of this study was to investigate the role of psychological variables in self-reported functional limitation in patients with AS, while controlling for demographic and medical variables. Methods 294 AS patients meeting modified New York Criteria completed psychological measures evaluating depression, resilience, active and passive coping, internality and helplessness at the baseline visit. Demographic, clinical, and radiologic data were also collected. Univariate and multivariate analyses were completed to determine the strength of correlation of psychological variables with functional limitation, as measured by the Bath AS Functional Index (BASFI). Results In the multivariate regression analysis, the psychological variables contributed significantly to the variance in BASFI scores, adding an additional 24% to the overall R-square beyond that accounted by demographic and medical variables (R-square 32%), resulting in a final R-square of 56%. Specifically, arthritis helplessness, depression and passive coping beside age, ESR and the Bath AS Radiograph Index accounted for a significant portion of the variance in BASFI scores in the final model. Conclusions Arthritis helplessness, depression, and passive coping accounted for significant variability in self-reported functional limitation beyond demographic and clinical variables in patients with AS. Psychological health should be examined and accounted for when assessing functional status in the AS patients

Gender Gap in Parental Leave Intentions: Evidence from 37 Countries

Despite global commitments and efforts, a gender-based division of paid and unpaid work persists. To identify how psychological factors, national policies, and the broader sociocultural context contribute to this inequality, we assessed parental-leave intentions in young adults (18–30 years old) planning to have children (N = 13,942; 8,880 identified as women; 5,062 identified as men) across 37 countries that varied in parental-leave policies and societal gender equality. In all countries, women intended to take longer leave than men. National parental-leave policies and women’s political representation partially explained cross-national variations in the gender gap. Gender gaps in leave intentions were paradoxically larger in countries with more gender-egalitarian parental-leave policies (i.e., longer leave available to both fathers and mothers). Interestingly, this cross-national variation in the gender gap was driven by cross-national variations in women’s (rather than men’s) leave intentions. Financially generous leave and gender-egalitarian policies (linked to men’s higher uptake in prior research) were not associated with leave intentions in men. Rather, men’s leave intentions were related to their individual gender attitudes. Leave intentions were inversely related to career ambitions. The potential for existing policies to foster gender equality in paid and unpaid work is discussed.Gender Gap in Parental Leave Intentions: Evidence from 37 CountriespublishedVersio

Gender Gap in Parental Leave Intentions: Evidence from 37 Countries

Despite global commitments and efforts, a gender-based division of paid and unpaid work persists. To identify how psychological factors, national policies, and the broader sociocultural context contribute to this inequality, we assessed parental-leave intentions in young adults (18–30 years old) planning to have children (N = 13,942; 8,880 identified as women; 5,062 identified as men) across 37 countries that varied in parental-leave policies and societal gender equality. In all countries, women intended to take longer leave than men. National parental-leave policies and women’s political representation partially explained cross-national variations in the gender gap. Gender gaps in leave intentions were paradoxically larger in countries with more gender-egalitarian parental-leave policies (i.e., longer leave available to both fathers and mothers). Interestingly, this cross-national variation in the gender gap was driven by cross-national variations in women’s (rather than men’s) leave intentions. Financially generous leave and gender-egalitarian policies (linked to men’s higher uptake in prior research) were not associated with leave intentions in men. Rather, men’s leave intentions were related to their individual gender attitudes. Leave intentions were inversely related to career ambitions. The potential for existing policies to foster gender equality in paid and unpaid work is discussed

Guidelines for diagnosis and management of the cobalamin-related remethylation disorders cblC, cblD, cblE, cblF, cblG, cblJ and MTHFR deficiency

BACKGROUND: Remethylation defects are rare inherited disorders in which impaired remethylation of homocysteine to methionine leads to accumulation of homocysteine and perturbation of numerous methylation reactions. OBJECTIVE: To summarise clinical and biochemical characteristics of these severe disorders and to provide guidelines on diagnosis and management. DATA SOURCES: Review, evaluation and discussion of the medical literature (Medline, Cochrane databases) by a panel of experts on these rare diseases following the GRADE approach. KEY RECOMMENDATIONS: We strongly recommend measuring plasma total homocysteine in any patient presenting with the combination of neurological and/or visual and/or haematological symptoms, subacute spinal cord degeneration, atypical haemolytic uraemic syndrome or unexplained vascular thrombosis. We strongly recommend to initiate treatment with parenteral hydroxocobalamin without delay in any suspected remethylation disorder; it significantly improves survival and incidence of severe complications. We strongly recommend betaine treatment in individuals with MTHFR deficiency; it improves the outcome and prevents disease when given early

Harmonization, data management, and statistical issues related to prospective multicenter studies in Ankylosing spondylitis (AS): experience from the Prospective Study Of Ankylosing Spondylitis (PSOAS) cohort

Ankylosing spondylitis (AS) is characterized by inflammation of the spine and sacroiliac joints causing pain and stiffness and, in some patients, ultimately new bone formation, and progressive joint ankyloses. The classical definition of AS is based on the modified New York (mNY) criteria. Limited data have been reported regarding data quality assurance procedure for multicenter or multisite prospective cohort of patients with AS. Since 2002, 1272 qualified AS patients have been enrolled from five sites (4 US sites and 1 Australian site) in the Prospective Study Of Ankylosing Spondylitis (PSOAS). In 2012, a Data Management and Statistical Core (DMSC) was added to the PSOAS team to assist in study design, establish a systematic approach to data management and data quality, and develop and apply appropriate statistical analysis of data. With assistance from the PSOAS investigators, DMSC modified Case Report Forms and developed database in Research Electronic Data Capture (REDCap). DMSC also developed additional data quality assurance procedure to assure data quality. The error rate for various forms in PSOAS databases ranged from 0.07% for medications data to 1.1% for arthritis activity questionnaire-Global pain. Furthermore, based on data from a sub study of 48 patients with AS, we showed a strong level (90.0%) of agreement between the two readers of X-rays with respect to modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). This paper not only could serve as reference for future publications from PSOAS cohort but also could serve as a basic guide to ensuring data quality for multicenter clinical studies

New Population-Based Reference Values for Spinal Mobility Measures Based on the 2009-2010 National Health and Nutrition Examination Survey

Cilj: Utvrditi karakteristike ličnosti i stupanj empatije studenata prve godine zdravstvenih studija te ispitati doprinos osobina ličnosti u predviđanju empatije. Metode: U istraživanju je sudjelovalo 59 studenata svih pet studijskih smjerova Odjela zdravstvenih studija Sveučilišta u Splitu. Za vrijeme predavanja iz kolegija Komunikacijske vještine primijenjeni su mjerni instrumenti-E-upitnik za ispitivanje empatije i BFQ upitnik za ispitivanje pet osobina ličnosti (ekstraverzije, ugodnosti, savjesnosti, emocionalne stabilnosti i otvorenosti) uz upute za rješavanje testova, te napomenu da će identitet ispitanika biti poznat samo istraživaču te nakon usmenog pristanka ispitanika. Rezultati: Razina empatije kod studenata zdravstvenih studija mjerena E- upitnikom prosječno je ocijenjena ocjenom 2,9 u rasponu od 0 do 4, što ukazuje na visok stupanj empatije ispitanika. Osobine ličnosti mjerene BFQ upitnikom u ovom istraživanju su: ekstraverzija, ugodnost, savjesnost, emocionalna stabilnost i otvorenost. Od navedenih osobina ličnosti najniža razina zabilježena je za emocionalnu stabilnost-2,99, a najviša za savjesnost 3,42 ( u rasponu od 1 do 5 ). Za ekstraverziju, ugodnost i otvorenost zabilježene su sljedeće prosječne vrijednosti: ekstraverzija i ugodnost 3,35, a otvorenost 3,32, što ukazuje na visoku razinu ovih osobina kod ispitanika. Regresijska analiza pokazala je statistički značajnu povezanost između triju od pet ispitivanih osobina ličnosti-ekstraverzije, ugodnosti i savjesnosti, pri čemu je utjecaj ekstraverzije na empatiju negativan, a utjecaj ugodnosti i savjesnosti pozitivan. Najveći utjecaj na empatiju ima ugodnost. Zaključak: Postojanje empatije kao jedne od najvažnijih i najpoželjnijih karakteristika zdravstvenih djelatnika te njezinu razinu moguće je predvidjeti na osnovi ispitivanja glavnih osobina ličnosti ispitanika. Ekstrovertne osobe u prosjeku su manje empatične, dok savjesne i ugodne osobe iskazuju visok stupanj empatije. Utjecaj emocionalne stabilnosti i otvorenosti na empatiju nije zabilježen.Goal: To define the characteristics of personality and the degree of empathy of the first year students of heath study and to research the contribution of personality characteristics on the prediction of empathy. Metods: 59 students of all five study courses of the Health study department of the university of Split participated in the research. During the lecture of Communication skills the following measuring instruments were used: E-questionnaire for the analysis of empathy and BFQ questionnaire for the analysis of five characteristics of personality (extraversion, agreeableness, conscientiousness, emotional stability and openness) together with the instruction on how to solve the tests, and a note containing the information that the identity of the subject will be known only by the researcher after an informed consent of the subject. Results: The level of empathy of health study students measured by an E-questionnaire has had an average grade of 2.9 on the scale from 0 to 4, which indicates a high level of the empathy of subjects. The personality characteristics measured by BFQ questionnaire in this research are: extraversion, agreeableness, conscientiousness, emotional stability and openness. Emotional stability is located on the lowest level of the scale-2.99 and conscientiousness is located on the highest level of the scale-3,42 (on the scale from 1 to 5). Extraversion, agreeableness and openness have the following average values: extraversion and agreeableness 3,35, and openness 3,32, which indicates a high level of personality characteristics of subjects. Regressive analysis has shown a statistically important connection between three out of five analyzed characteristics of personality- extraversion,agreeableness and conscientiousness, with the negative influence of extraversion on the empathy, and the positive influence of agreeableness and conscientiousness. Conclusion: The existence and the level of empathy as one of the most important and desirable characteristics of health professionals is predictable on the basis of the analysis of personality characteristics of subjects. Extrovers are less emphatical , while conscientious and pleasant people show a high degree of empathy. The influence of emotional stability and openness on the empathy hasn't been recorded

Ethnicity and disease severity in ankylosing spondylitis a cross-sectional analysis of three ethnic groups

The purpose of this study is to compare disease severity in ankylosing spondylitis (AS) in three ethnic groups. We assessed 925 AS patients (57 Blacks, 805 Whites, 63 Latinos) enrolled in the longitudinal Prospective Study of Outcomes in AS (PSOAS) for functional impairment, disease activity, and radiographic severity. Comparisons of clinical characteristics and HLA-B27 frequency for each group were performed, in two multivariable regression models, we compared the baseline Bath Ankylosing Spondylitis Radiographic Index (BASRI) and modified Stokes Ankylosing Spondylitis Spine Score (mSASSS) by ethnicity, adjusting for covariates. Blacks had greater functional impairment (Bath Ankylosing Spondylitis Functional Index) (median 62.5 vs. 27.8 in Whites and 38.1 in Latinos; p < 0.0001); higher disease activity (Bath Ankylosing Spondylitis Disease Activity Index), (median 5.9 vs. 3.5 in Whites and 4.5 in Latinos; p < 0.0001), erythrocyte sedimentation rate (median 27.0 in Blacks vs. 10.0 in Whites and 17.0; p < 0.0001), and C-reactive protein levels (median 1.2 vs. 0.4 mg/dL in Whites and 0.9 in Latinos; p < 0.0001). Baseline BASRI and mSASSS were higher in Blacks (mean 9.5 and median 38.2, respectively) compared to Whites (7.3 and 6.4) and Latinos (7.3 and 8.1), (p = 0.004, 0.007), respectively, more significant as disease duration increased. HLA-B27 occurred in 62.5% of Blacks, 85.3% of Whites, and 86.7% of Latinos (p < 0.0001). On multivariable analysis, higher BASRI and mSASSS were associated with Black ethnicity, after adjusting for disease duration and gender as well as TNF inhibitor (TNFi) usage, smoking status, or education level. Blacks with AS have more severe disease compared to either Whites or Latinos