Demographic, clinical and antibody characteristics of patients with digital ulcers in systemic sclerosis: data from the DUO Registry

OBJECTIVES: The Digital Ulcers Outcome (DUO) Registry was designed to describe the clinical and antibody characteristics, disease course and outcomes of patients with digital ulcers associated with systemic sclerosis (SSc). METHODS: The DUO Registry is a European, prospective, multicentre, observational, registry of SSc patients with ongoing digital ulcer disease, irrespective of treatment regimen. Data collected included demographics, SSc duration, SSc subset, internal organ manifestations, autoantibodies, previous and ongoing interventions and complications related to digital ulcers. RESULTS: Up to 19 November 2010 a total of 2439 patients had enrolled into the registry. Most were classified as either limited cutaneous SSc (lcSSc; 52.2%) or diffuse cutaneous SSc (dcSSc; 36.9%). Digital ulcers developed earlier in patients with dcSSc compared with lcSSc. Almost all patients (95.7%) tested positive for antinuclear antibodies, 45.2% for anti-scleroderma-70 and 43.6% for anticentromere antibodies (ACA). The first digital ulcer in the anti-scleroderma-70-positive patient cohort occurred approximately 5 years earlier than the ACA-positive patient group. CONCLUSIONS: This study provides data from a large cohort of SSc patients with a history of digital ulcers. The early occurrence and high frequency of digital ulcer complications are especially seen in patients with dcSSc and/or anti-scleroderma-70 antibodies

Environmental Sensibility and Human Values as Factors for Forming European Ecotourist Market Segments

This study examines the relationship between environmental attitudes and human value sets in forming an eco-tourist market segment within the European region. Different studies indicated that environmental attitudes reflected in general motivations were closely and positively related. Some findings showed that the examination of environmental attitudes that concern psychological factors (motivation) could be more powerful and meaningful than socio-demographic characteristics. The purpose of this study is to examine if human values that indicate basic motivational aspects, when inter-related with high environmental sensibility shared by different people from Europe, could be used for the creation of a specific market segmentation model. The findings identified three main factors that determine tourist values, while at the same time, the multiple discriminant analysis indicated the existence of several clusters, allowing for an identification of ‘eco-friendly’ tourist segments. By using data collections from the European Social Survey, the model also allowed comparability between surveyed countries by crosschecking multiple psycho-sociological and demographic factors, focusing on the environmentally sensitive groups, the so-called ‘eco-careful’ (hard) and ‘eco-sensible’ (soft) tourists. Furthermore, the study looked at potential demand markets that are interested in preserved nature, recreation, and adventure tours. The study confirmed that basic human values play an important role in explaining motivation aspects in tourism-related choices

Towards a Benefits Theory of Leisure Well-Being

We view leisure well-being as satisfaction in leisure life that contributes to subjective well-being. The model we propose focuses on how leisure activities contribute to leisure well-being. We surmise that a leisure activity contributes to leisure well-being by satisfying a set of basic needs (benefits related to safety, health, economic, sensory, escape, and/or sensation/stimulation needs) and growth needs (benefits related to symbolic, aesthetic, moral, mastery, relatedness, and/or distinctiveness needs). Also, further amplification occurs when certain benefits of leisure activities match corresponding personality traits and goals of the participants; safety consciousness, health consciousness, price sensitivity, hedonism, escapism, sensation seeking, status consciousness, aestheticism, moral sensitivity, competitiveness, sociability, and need for distinctiveness, respectively

Functional impairment of systemic scleroderma patients with digital ulcerations: results from the DUO Registry

Objective. Digital ulcers (DUs) are frequent manifestations of systemic scleroderma (SSc). This study assessed functional limitations due to DUs among patients enrolled in the Digital Ulcer Outcome (DUO) Registry, an international, multicentre, observational registry of SSc patients with DU disease. Methods. Patients completed at enrolment a DU-specific functional assessment questionnaire with a 1-month recall period, measuring impairment in work and daily activities, and hours of help needed from others. Physician-reported clinical parameters were used to describe the population. For patients who completed at least part of the questionnaire, descriptive analyses were performed for overall results, and stratified by number of DUs at enrolment. Results. This study included 2327 patients who completed at least part of the questionnaire. For patients with 0, 1-2, and DUs at enrolment, mean overall work impairment during the prior month among employed/self-employed patients was 28\%, 42\%, and 48\%, respectively. Across all included patients, ability to perform daily activities was impaired on average by 35\%, 54\%, and 63\%, respectively. Patients required a mean of 2.0, 8.7, and 8.8 hours of paid help and 17.0, 35.9, and 63.7 hours of unpaid help, respectively, due to DUs in the prior month. Patients with DUs had more complications and medication use than patients with no DUs. Conclusion. With increasing number of DUs, SSc patients reported more impairment in work and daily activities and required more support from others