Assessment of health‐related family role functioning in systemic lupus erythematosus: Preliminary validation of a new measure

Objective Individuals with systemic lupus erythematosus (SLE) often experience symptoms that affect family relationships, which are important components of quality of life. To assess the impact of SLE on family role functioning, we developed a 6‐domain (Fatigue, Activity participation, Mental health, Isolation, Love and intimacy, and You/fulfilling family roles [FAMILY]) measure. The objectives of this study were to pilot test and achieve preliminary validation for the SLE‐FAMILY questionnaire. Methods This was a 3‐phase study. In phase 1 (development), domains were identified and items were generated for evaluation. During phase 2 (pilot test), a pilot test was conducted to assess the performance of candidate items. In phase 3 (initial validation), 52 individuals with SLE completed questionnaires, including the 6‐item SLE‐FAMILY. Data were analyzed for internal consistency reliability, and validity was assessed using correlations between the SLE‐FAMILY questionnaire and well‐validated measures. Results The SLE‐FAMILY had good test–retest reliability (0.82) and internal consistency (0.67). Reliability analysis of individual items revealed weakness in the performance of item 5. We reviewed raw data and determined that 9 individuals likely overlooked the reverse scoring of item 5, thus explaining its poor reliability. When these 9 individuals were excluded from analysis, Cronbach's alpha increased to 0.71, while test–retest reliability remained acceptable (0.75). Spearman's rho correlations supported the validity of the SLE‐FAMILY measure. A pilot test of the SLE‐FAMILY questionnaire without the reverse‐scored item was conducted; results suggested that the modified version is superior to the initial form. Conclusion The SLE‐FAMILY questionnaire is a promising new instrument for robust measurement of family role functioning.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/93567/1/21676_ftp.pd

Clinical Outcomes of Utilization of Stress Ulcer Prophylaxis in Hospitalized, Non-ICU Patients

Goal This study is a retrospective chart review that aims to measure the effect of stress ulcer prophylaxis in hospitalized non-ICU level patients to determine the clinical effect of the presence or absence of stress ulcer prophylaxis

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ABSTRACT. Objective. To determine whether men with gout may have an increased prevalence of erectile dysfunction (ED) as compared with men without gout. Methods. In this cross-sectional study, men aged 18-89 presenting to the rheumatology clinic between August 26, 2010, and May 13, 2013, were Erectile dysfunction (ED) is common in the general population, affecting about 50% of 40-to 70-year-old men 1 . The National Institutes of Health Consensus Development statement defined ED as the "inability of the male to attain and maintain erection of the penis sufficient to permit satisfactory sexual intercourse" 2 . The likelihood of ED increases with age, but is not an inevitable consequence of aging 2 . The importance of cardiovascular (CV) disease (CVD) as an underlying cause of ED is well established 3,4 . This is not surprising because CVD and ED share mutual risk factors such as diabetes mellitus (DM), hypertension (HTN), advanced age, hypercholesterolemia, obesity, metabolic syndrome, certain medications such as antidepressants, and tobacco abuse New evidence shows that hyperuricemia and inflammation may be independent risk factors for ED in addition to the established ones. In a recent study by Solak, et al 7 , of 312 men who underwent an exercise stress test because of chest pain, each 1 mg/dl increase in serum urate (SU) was associated with a 31% increased risk of ED. Compared with patients in the first quartile of SU level, those in the fourth quartile had a 2.6 times increased risk of ED. However, in an adjusted analysis for traditional CV risk factors, the relationship with SU was no longer significant. Another recent study, by Salem, et al 8 , evaluated SU level and the distribution of potential ED risk factors in 251 men with newly diagnosed ED versus 252 age-matched controls without ED. A significant difference was found between mean SU levels in men with ED (6.12 mg/dl) versus men without ED (4.97 mg/dl). The men in the highest tertile of SU level had a 6-fold increased risk of ED compared with men in the lowest tertile. Each 1 mg/dl increase in SU level was associated with a 2-fold increased risk of ED. Inflammation, too, plays an important role in ED 9,10 . Low levels of interleukin 6 (IL-6) and fibrinogen exclude the presence of ED in patients with coronary artery disease (CAD) or with unfavorable risk factor

The organization of prospective thinking: Evidence of event clusters in freely generated future thoughts

Recent research suggests that many imagined future events are not represented in isolation, but instead are embedded in broader event sequences—referred to as event clusters. It remains unclear, however, whether the production of event clusters reflects the underlying organizational structure of prospective thinking or whether it is an artifact of the event-cuing task in which participants are explicitly required to provide chains of associated future events. To address this issue, the present study examined whether the occurrence of event clusters in prospective thought is apparent when people are left to think freely about events that might happen in their personal future. The results showed that the succession of events participants spontaneously produced when envisioning their future frequently included event clusters. This finding provides more compelling evidence that prospective thinking involves higher-order autobiographical knowledge structures that organize imagined events in coherent themes and sequences

Erectile Dysfunction Is Common among Patients with Gout

Objective.To determine whether men with gout may have an increased prevalence of erectile dysfunction (ED) as compared with men without gout.Methods.In this cross-sectional study, men aged 18–89 presenting to the rheumatology clinic between August 26, 2010, and May 13, 2013, were asked to participate. The presence of ED was determined by the Sexual Health Inventory in Men (SHIM). SHIM classifies ED into 1 of 5 categories: absent (22–25), mild (17–21), mild to moderate (12–16), moderate (8–11), and severe (1–7). Patient’s history, physical examination, and recent laboratory studies were reviewed as well. Descriptive statistics and subgroup analyses were used to summarize the data.Results.Of the 201 men surveyed, 83 had gout (control, n = 118). A significantly greater proportion of patients with gout (63, 76%) had ED versus patients without gout (60, 51%, p = 0.0003). A significantly greater proportion of patients with gout (22, 26%) had severe ED versus patients without gout (17, 15%, p = 0.04). Patients with gout had an average SHIM score of 14.4 versus 18.48 in patients without gout (p &lt; 0.0001). There was a statistically significant association between gout and ED. The association remained significant after adjustment for age, hypertension, diabetes, and obesity.Conclusion.ED is present in most men with gout and is frequently severe. We propose that patients with gout be routinely screened for ED.</jats:sec