Prevalence of cutaneous adverse events associated with long-term disease-modifying therapy and their impact on health-related quality of life in patients with multiple sclerosis: A cross-sectional study

Background: Glatiramer acetate (GA) and interferon-beta (IFN-β) are disease-modifying therapies (DMTs) for multiple sclerosis that are administered through subcutaneous (SC) or intramuscular (IM) injections. Skin reactions associated with DMTs are common and may influence patient's health-related quality of life (QoL). We aimed to determine the prevalence of cutaneous adverse events associated with long-term DMT use, and to assess the impact of cutaneous adverse events on QoL. Methods: A cross-sectional study among patients with multiple sclerosis who had been treated with their first DMT for at least 2 years. Cutaneous events were assessed from photographs of injection-sites by dermatologists blinded for DMT. Generic and dermatology-specific health-related QoL were assessed using validated patient-reported questionnaires. Results: A total of 229 patients were enrolled, of whom 156 (68%) had at least one skin reaction. The prevalence of cutaneous adverse events was higher for SC DMTs (75-82%) compared to IM DMT (41%) (P < 0.001). Erythema and lipoatrophy were the most common skin reactions, observed in 156 (68%) and 45 (20%) patients, respectively. Dermatology-specific, but not generic, QoL was significantly lower among patients with skin reactions compared to those without. Conclusions: The prevalence of cutaneous adverse events was high in long-term DMT-treatment. Patients with cutaneous adverse events had a lower perceived dermatology-specific QoL

The capability set for work - correlates of sustainable employability in workers with multiple sclerosis

BACKGROUND: The aim of this study was to examine whether work capabilities differ between workers with Multiple Sclerosis (MS) and workers from the general population. The second aim was to investigate whether the capability set was related to work and health outcomes. METHODS: A total of 163 workers with MS from the MS@Work study and 163 workers from the general population were matched for gender, age, educational level and working hours. All participants completed online questionnaires on demographics, health and work functioning. The Capability Set for Work Questionnaire was used to explore whether a set of seven work values is considered valuable (A), is enabled in the work context (B), and can be achieved by the individual (C). When all three criteria are met a work value can be considered part of the individual's 'capability set'. RESULTS: Group differences and relationships with work and health outcomes were examined. Despite lower physical work functioning (U = 4250, p = 0.001), lower work ability (U = 10591, p = 0.006) and worse self-reported health (U = 9091, p ≤ 0.001) workers with MS had a larger capability set (U = 9649, p ≤ 0.001) than the general population. In workers with MS, a larger capability set was associated with better flexible work functioning (r = 0.30), work ability (r = 0.25), self-rated health (r = 0.25); and with less absenteeism (r = - 0.26), presenteeism (r = - 0.31), cognitive/neuropsychiatric impairment (r = - 0.35), depression (r = - 0.43), anxiety (r = - 0.31) and fatigue (r = - 0.34). CONCLUSIONS: Workers with MS have a larger capability set than workers from the general population. In workers with MS a larger capability set was associated with better work and health outcomes. TRIAL REGISTRATION: This observational study is registered under NL43098.008.12: 'Voorspellers van arbeidsparticipatie bij mensen met relapsing-remitting Multiple Sclerose'. The study is registered at the Dutch CCMO register ( https://www.toetsingonline.nl ). This study is approved by the METC Brabant, 12 February 2014. First participants are enrolled 1st of March 2014

A Dutch validation study of the Multiple Sclerosis Work difficulties questionnaire in relapsing remitting multiple sclerosis

Health and self-regulatio

Self-reported occupational functioning in persons with relapsing-remitting multiple sclerosis: does personality matter?

Health and self-regulatio

2016 ACR-EULAR adult dermatomyositis and polymyositis and juvenile dermatomyositis response criteria-methodological aspects

Objective. The objective was to describe the methodology used to develop new response criteria for adult DM/PM and JDM. Methods. Patient profiles from prospective natural history data and clinical trials were rated by myositis specialists to develop consensus gold-standard ratings of minimal, moderate and major improvement. Experts completed a survey regarding clinically meaningful improvement in the core set measures (CSM) and a conjoint-analysis survey (using 1000Minds software) to derive relative weights of CSM and candidate definitions. Six types of candidate definitions for response criteria were derived using survey results, logistic regression, conjoint analysis, application of conjoint-analysis weights to CSM and published definitions. Sensitivity, specificity and area under the curve were defined for candidate criteria using consensus patient profile data, and selected definitions were validated using clinical trial data. Results. Myositis specialists defined the degree of clinically meaningful improvement in CSM for minimal, moderate and major improvement. The conjoint-analysis survey established the relative weights of CSM, with muscle strength and Physician Global Activity as most important. Many candidate definitions showed excellent sensitivity, specificity and area under the curve in the consensus profiles. Trial validation showed that a number of candidate criteria differentiated between treatment groups. Top candidate criteria definitions were presented at the consensus conference. Conclusion. Consensus methodology, with definitions tested on patient profiles and validated using clinical trials, led to 18 definitions for adult PM/DM and 14 for JDM as excellent candidates for consideration in the final consensus on new response criteria for myositis

Aplicação de deficientes físicos nas atividades da Polícia Militar do Paraná

Orientador: Ivan Santa MariaMonografia (Especialização) - Universidade Federal do Paraná,Setor de Ciências Sociais Aplicadas, Departamento de Contabilidade, Curso de Especialização em Administração PolicialResumo: O presente trabalho monográfico abordou o problema da aplicabilidade de policiais-militares em atividades consideradas meio na Organização, sendo que os mesmos poderiam ser substituídos por deficientes físicos em algumas funções básicas, como telefonista, recepcionista, digitador e outros, redundando num maior emprego de policiaismilitares nas ruas. Para tanto, buscou primeiramente retratar a realidade na PMPR; caracterizar atividades de cunho civil e de cunho militar na atividade meio; além de onde e como aplicar a pessoa portadora de deficiência física. Na parte do desenvolvimento, foram abordadas conceituações básicas, como atividade Policial Militar, atividades-meio e atividades-fim da Polícia Militar, cunho civil e militar na atividade-meio. Na seqüência, abordaram-se aspectos da pessoa portadora de deficiência, sendo navegado em assuntos a respeito da antigüidade, do renascimento, a política demográfica, deficiência em si, Programa Nacional de Direitos Humanos, a realidade social do deficiente e sua situação atual. Tratou-se também dos deficientes físicos e a Polícia Militar, em que buscou-se evidenciar o que existe em legislação peculiar e cargos privativos de militares. Quanto aos direitos dos deficientes, relatou-se a respeito dos tratados internacionais e a legislação brasileira. Ainda no capítulo referente ao desenvolvimento retratou-se a respeito do PSAV - Prestador de Serviço Auxiliar Voluntário (Deficientes Físicos); APR - Associação Paranaense de Reabilitação; ADFP -Associação dos Deficientes Físicos do Paraná; empresas que abrem caminhos para deficientes; uma importante matéria veiculada na Gazeta do Povo com o título "700 Deficientes podem Perder o Emprego", postura esta defendida pelo Estado como sendo o serviço prestado de grande importância econômica e social. Um capítulo tratou sobre a presença de pessoal civil na Polícia Militar, com seus fundamentos legais e doutrinários. Chegou-se ao final do desenvolvimento retratando como seria uma possível implantação da alocação de deficientes físicos em certas atividades-meio da Polícia Militar do Paraná Finalizou o presente estudo tratando das considerações finais, em que algumas propostas foram colocadas, ressaltando-se a importância de primeiramente serem readequadas as instalações físicas das Unidades Policiais-Militares para o ideal recebimento destes funcionário