The Relationship between Socioeconomic Status and Narrative Abilities in a Group of Italian Normally Developing Children

OBJECTIVE: Only limited and conflicting information is available regarding the relationship between socioeconomic status (SES) and narrative abilities. Besides, the role fathers' SES plays in the development of their children's narrative abilities has never been investigated. The aim of this study was to analyze the relationship between fathers' and mothers' SES and narrative abilities of their children assessed with the Italian version of the Bus Story Test (I-BST). SUBJECTS AND METHODS: A total of 505 normally developing Italian children were enrolled in the study. Information regarding parents' educational level and employment was collected for each child. Narrative abilities were evaluated using the I-BST. The relationships between parents' employment, educational level, and I-BST scores were analyzed by univariate and multivariate regression analysis. RESULTS: In univariate analysis, both fathers' and mothers' education and employment were associated with most I-BST subscale scores, especially when higher educational and employment levels were contrasted with the lowest educational and employment levels. In multiple regression analysis, significant associations were found only between the fathers' working status and educational level and I-BST subscale scores. CONCLUSIONS: Parental education and employment might impact narrative abilities of children. When both fathers' and mothers' SES variables are considered together, only fathers' education and working status seemed to be associated with I-BST scores

Impact of gender, work, and clinical presentation on diagnostic delay in Italian patients with primary ankylosing spondylitis

The variability of demographic, social, genetic, and clinical factors might influence the time between the onset of symptoms and the diagnosis [diagnostic delay (DD)] of ankylosing spondylitis (AS) in different geographic areas. Different clinical manifestations in men and women affected by AS might indicate a possible role of gender in DD. The aim of the present study was to investigate the influence of demographic, social, genetic, and clinical factors on DD and the differences of DD between men and women related to the presence of different demographic, social, clinical, and genetic parameters in an Italian cohort of primary AS patients. A total of 135 Italian primary AS patients (45 female and 90 male, 27.9 ± 0.89 years old at onset) were studied. The DD, gender, education and work (manual or non-manual) levels, and type of first clinical presentation (inflammatory back pain, arthritis, enthesitis) at onset, family history of AS, and HLA B27 presence were analyzed. The DD (8.744 mean ±0.6869) was significantly higher in men (p = 0.0023), in axial presentation (p = 0.0021), and in manual work (even if with low significance, p = 0.047). The lower DD in women in comparison to that in men was likely related to higher education (p = 0.0045) and work (p = 0.0186) levels, peripheral involvement (p = 0.0009), and HLA B27 positivity (p = 0.0231). DD was higher in AS patients: male, employed in manual jobs, and with axial symptoms at onset. In men, DD seemed to be negatively influenced by lower level of education and work, axial clinical presentation, and HLA B2

VALUTAZIONE DELL’ASTENIA IN PAZIENTI AFFETTI DA SPONDILOARTRITE

Introduzione. L’astenia rappresenta uno dei sintomi che più influisce sulla qualità di vita dei pazienti affetti da spondiloartrite (SpA), come riferito dalla maggior parte di essi. Studi hanno dimostrato l’associazione tra astenia e differenti parametri quali: dolore, rigidità, funzionalità fisica, attività di malattia, depressione e ansia, stato generale di salute ed età. Scopo del Lavoro. Valutare i livelli di astenia, stato generale di salute e stato ansioso o depressivo in una popolazione di pazienti affetti da SpA. Materiali e Metodi. A 45 pazienti consecutivi (29 con artrite psoriasica, 16 con spondilite anchilosante) afferenti all’ambulatorio delle SpA delle Università di Pisa e di Firenze (età media 55 anni, M:F27:18) sono stati somministrati inerenti l’attività di malattia (BASDAI), l’astenia (FACIT-F e item 1 BASDAI), lo stato generale di salute (HAQ modificato per SpA), l’ansia (HADS-A) e la depressione (HADS-D). Un punteggio BASDAI >4 è stato considerato indice di malattia attiva. BASDAI >5 (per l’item relativo alla stanchezza) e FACIT- F >8 sono stati utilizzati, indipendentemente, come cutoff per l’astenia. SpA-HAQ è stato considerato nella norma per valori 8 e >11. Sulla base del risultato dei questionari per la fatica, i pazienti sono stati suddivisi nei sottogruppi: astenia certa, astenia probabile e non astenia. Risultati. In Tabella I sono riportati i risultati medi dei questionari. Il 37,8 (17/45) dei pazienti è risultato avere un BASDAI fatica >5; in 14 di essi (82,3) si aveva anche un FACIT- F >8. In tabella II sono riportati i risultati dei vari questionari nei tre sottogruppi. Conclusioni. Come dalla Tabella II, il gruppo con astenia certa evidenzia un deterioramento della qualità di vita, mentre il gruppo con astenia probabile presenta un punteggio HAQ migliore ma comunque superiore a quello dei non astenici (sebbene in linea con la popolazione generale). L’associazione con ansia e depressione risulta più forte nel gruppo con astenia certa (con prevalenza dell’ansia per quanto riguarda la “probabilità” di malattia, mentre per la “possibilità” risultano alla pari), mentre negli altri gruppi l’associazione non risulta significativa

Reliability, validity and normative data of the Italian version of the Bus Story test

OBJECTIVES: Evaluation of the reliability and the validity of the Italian version of the Bus Story Test (I-BST), providing normative data in Italian children. METHODS: A total of 552 normally developing children (278 males and 274 females) aged 3; 6 to 9; 0 years, were enrolled. Test-retest, intra- and inter-rater reliability were analysed on a sample of respectively 145, 178 and 178 children. Normative data were gathered from all the enrolled children and estimate centiles according to the CG-LMS method provided. The children were divided into 11 age classes of six months each; percentile scores and standard error measurement were analysed in children from age class 4; 0-4; 5 years to age class 8; 6-811 years. Age effects on I-BST were analysed. RESULTS: Results showed high test-retest, intra- and inter-rater reliability scores. A significant age effect on I-BST scores emerged from the ANOVA test analysis; in particular, as age increases, so do I-BST scores. CONCLUSION: The I-BST is a reliable and valid tool. The availability of normative data for Italian speaking children may help clinicians during clinical assessment

Diagnostic delay in italian patients with ankylosing spondylitis (AS)

Background. The early diagnosis of AS, essential to modify the natural course of disease and to reduce disability (1,2) is often missed and markedly delayed (3). Objective. To investigate the influence of demographic, social and clinical features at onset on diagnostic delay (DD) in an Italian cohort of AS patients. Methods. In 135 AS patients (45 female and 90 male, 36,5±10,2 years old at diagnosis and 28,3±10,2 at onset) with disease onset between 1950 and 2008, were investigated: the time between onset and diagnosis, demographic (age at onset of the disease 16 years old, sex) and social character- istics (level of instruction, manual work or not), HLA 27 (pre- sent/absent), first symptoms at onset (peripheral arthritis/enthesitis/spondiloarthritis/uveitis), familiarity (for AS, psoriasis and psoriatic arthritis [PsA], inflammatory bowel disease [IBD]) Results. The DD since onset of symptoms to diagnosis was 9±8 years (range 1-47). In table I. demographic, social and clinical features of AS patients are shown in Table 1. DD was significantly different between genders (higher in male p0,03), but was not correlated with age, social factors and HLA B27 positivity. Conclusions. In our Italian cohort, DD was significantly lower in axial onset and higher in male, but was not influenced by age, social factors and HLAB27

VALUTAZIONE DEL SONNO IN PAZIENTI CON SPONDILOARTRITE

Introduzione. L’astenia rappresenta una delle manifestazioni cliniche dei pazienti affetti da spondiloartrite (SpA). Scopo del Lavoro. Valutare se i disturbi del sonno (DS) correlano con l’astenia nei pazienti con SpA. Materiali e Metodi. Sono stati studiati 45 pazienti consecutivi (26 con artrite psoriasica, 19 con spondilite anchilosante) afferenti all’ambulatorio delle SpA delle Università di Pisa e di Firenze (età media 55 anni, M:F27:18). Tutti i pazienti, interrogati circa la qualità del sonno, sono stati suddivisi in tre gruppi: “difficoltà ad addormentarsi” (A), “risvegli frequenti” (B) e “risveglio precoce” (C). I pazienti hanno inoltre compilato questionari per valutare l’attività di malattia (BASDAI), l’astenia (FACIT-F e item 1 BASDAI), lo stato generale di salute: (HAQ modificato per SpA), l’ansia (HADS-A) e la depressione (HADS-D). Un punteggio BASDAI >4 è stato considerato indice di malattia attiva. BASDAI >5 (per l’item relativo alla stanchezza) e FACIT-F >8 sono stati utilizzati, indipendentemente, come indice di astenia. SpA-HAQ è stato considerato nella norma per valori 8 e >11. Sulla base del risultato dei questionari per la fatica, i pazienti sono stati suddivisi nei sottogruppi: astenia certa, astenia probabile e non astenia. Tabella I Disturbi del A B C sonno (N; ) (N; ) (N; ) (N; ) Astenia (N14) 7; 50 2; 14,3 4; 28,6 0 Astenia 3; 33,3 2; 20 2; 20 0 probabile (N10) Non astenia 6; 28,5 2; 9,5 3; 14,3 2; 9,5 (N21) Risultati. DS sono stati riscontrati in 14/45 pazienti. La frequenza dei DS nei sottogruppi dell’astenia sono riportati in tabella I. Nessuna differenza è stata riscontrata per quanto riguarda BASDAI, HADS-A e HADS-D nel confronto tra pazienti con o senza DS. Conclusioni. La presenza di DS correla con l’astenia; difficoltà ad addormentarsi e risvegli frequenti risultano comuni in tutti i sottogruppi studiati (con astenia certa, probabile o assente), mentre ciò non accade per il risveglio precoce

Ankylosing spondylitis: how diagnostic and therapeutic delay have changed over the last six decades

OBJECTIVES: Ankylosing spondylitis (AS) is a chronic, progressive, and disabling disease, but the diagnosis is often missed and markedly delayed. An early diagnosis is important to establish a treatment to reduce disability and modify the natural course of disease. The aim of this study was to investigate the diagnostic (DD) and therapeutic (TD) delay according to the decade of diagnosis. The DD and TD correlation with radiological severity score and the new imaging techniques used in diagnosis (magnetic resonance [MRI], computerised tomography, scintigraphy for sacroiliac joints) were also investigated. METHODS: 135 AS patients (45 female and 90 male, 36.5±10.2 years old at diagnosis) with disease onset between 1950 and 2008, were investigated; the time from onset to diagnosis (DD) and treatment (TD), the New York and ASAS criteria fulfilment, the New York sacroiliac radiological score, bamboo spine presence at first visit and the new imaging technique used at diagnosis were recorded and their correlations were analysed. RESULTS: The New York and ASAS criteria were met at the first visit, by 87% and 96%, respectively. The delay from onset of symptoms to diagnosis and treatment was 9±8 and 12±11 years, respectively, but decreased significantly between different decades (p0.001 and p<0.05, respectively). CONCLUSIONS: DD and TD were correlated to radiological severity; they progressively decreased over 6 decades