Work Disability in Systemic Sclerosis

2009 ◽  
Vol 36 (11) ◽  
pp. 2481-2486 ◽  
Author(s):  
MARIE HUDSON ◽  
RUSSELL STEELE ◽  
YING LU ◽  
BRETT D. THOMBS ◽  
MURRAY BARON
Keyword(s):  
Systemic Sclerosis ◽  
Disease Severity ◽  
Work Disability ◽  
Disease Duration ◽  
Multisystem Disease ◽  
Cross Sectional ◽  
Diffuse Disease ◽  
Short Disease Duration ◽  
Medical Examinations ◽  
The Relationship

Objective.Systemic sclerosis (SSc) is a multisystem disease associated with significant morbidity and increased mortality. Little is known about work disability in SSc. We undertook this study to determine the prevalence and demographic and clinical correlates of work disability in a large cohort of patients with SSc.Methods.Cross-sectional, multicenter study of patients from the Canadian Scleroderma Research Group Registry. Patients were assessed with detailed clinical histories, medical examinations, and self-administered questionnaires. The primary outcome was self-reported work disability. Multiple logistic regression was used to assess the relationship between selected demographic and clinical variables and work disability.Results.Of the 643 patients available for this study, 133 (21%) reported that they were work disabled. Work disability in SSc was common, even in people with short disease duration, and increased steadily with increasing disease duration: among those who were ≤ 65 years and who reported being either disabled or working, 28.0% and 44.8% of patients with disease duration of < 2 and 10–15 years, respectively, reported that they were work-disabled. The significant correlates of work disability included co-morbidities, disease duration, diffuse disease, disease severity, pain, fatigue, and physical function.Conclusion.Work disability is prevalent, occurs early, and is associated with markers of disease severity and functional status. Further research is needed to identify other, potentially modifiable, risk factors for work disability in SSc.

Malnutrition Is Common in Systemic Sclerosis: Results from the Canadian Scleroderma Research Group Database

2009 ◽  
Vol 36 (12) ◽  
pp. 2737-2743 ◽  
Author(s):  
MURRAY BARON ◽  
MARIE HUDSON ◽  
RUSSELL STEELE
Keyword(s):  
Systemic Sclerosis ◽  
Nutritional Status ◽  
Disease Severity ◽  
Research Group ◽  
Disease Duration ◽  
Physician Global Assessment ◽  
Multisystem Disease ◽  
Cross Sectional ◽  
Oral Aperture ◽  
Gi Symptoms

Objective.Systemic sclerosis (SSc) is a multisystem disease associated with significant morbidity and increased mortality. Little is known about nutritional status in SSc. We investigated the prevalence and demographic and clinical correlates of nutritional status in a large cohort of patients with SSc.Methods.This was a cross-sectional multicenter study of patients (n = 586) from the Canadian Scleroderma Research Group Registry. Patients were assessed with detailed clinical histories, medical examinations, and self-administered questionnaires. The primary outcome was risk for malnutrition using the “malnutrition universal screening tool” (MUST). Multiple logistic regression was used to assess the relationship between selected demographic and clinical variables and MUST categories.Results.Of the 586 patients in the study, MUST scores revealed that almost 18% were at high risk for malnutrition. The significant correlates of high malnutrition risk included the number of gastrointestinal (GI) complaints, disease duration, diffuse disease, physician global assessment of disease severity, hemoglobin, oral aperture, abdominal distension on physical examination, and physician-assessed possible malabsorption. Among 14 GI symptoms, only poor appetite and lack of a history of abdominal swelling and bloating predict MUST. These factors accounted for 24% of the variance in MUST scores.Conclusion.The risk for malnutrition in SSc is moderate and is associated with shorter disease duration, markers of GI involvement, and disease severity. Patients with SSc should be screened for malnutrition, and potential underlying causes assessed and treated when possible.

The Association Between Disease Activity and Duration in Systemic Sclerosis

2010 ◽  
Vol 37 (11) ◽  
pp. 2299-2306 ◽  
Author(s):  
JENNIFER G. WALKER ◽  
RUSSELL J. STEELE ◽  
MIREILLE SCHNITZER ◽  
SUZANNE TAILLEFER ◽  
MURRAY BARON ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Disease Activity ◽  
Disease Duration ◽  
Activity Index ◽  
Disease Onset ◽  
Depression Scale ◽  
Disease Activity Index ◽  
Cross Sectional ◽  
Diffuse Disease ◽  
Patient Reported

Objective.The absence of a standardized disease activity index has been an important barrier in systemic sclerosis (SSc) research. We applied the newly derived Valentini Scleroderma Disease Activity Index (SDAI) among our cohort of patients with SSc to document changes in disease activity over time and to assess possible differences in activity between limited and diffuse disease.Methods.Cross-sectional study of a national cohort of patients enrolled in the Canadian Scleroderma Research Group Registry. Disease activity was measured using the SDAI. Depression scores were measured using the Centre for Epidemiologic Studies Depression Scale (CES-D).Results.A total of 326 out of 639 patients had complete datasets at the time of this analysis; 87% were female, of mean age 55.6 years, with mean disease duration 14.1 years. SDAI declined steeply in the first 5 years after disease onset and patients with diffuse disease had 42% higher SDAI scores than patients with limited disease with the same disease duration and depression scores (standardized relative risk 1.42, 95% CI 1.21, 1.65). Patients with higher CES-D scores had higher SDAI scores relative to patients with the same disease duration and disease subset (standardized RR 1.22, 95% CI 1.14, 1.31). Among the 10 components that make up the SDAI, only skin score (standardized OR 0.59, 95% CI 0.43, 0.82) and patient-reported change in skin (standardized OR 0.64, 95% CI 0.45, 0.92) decreased with increasing disease duration. High skin scores (standardized OR 32.2, 95% CI 15.8, 72.0) were more likely and scleredema (standardized OR 0.58, 95% CI 0.37, 0.92) was less likely to be present in patients with diffuse disease. High depression scores were associated with positive responses for patient-reported changes in skin and cardiopulmonary function.Conclusion.Disease activity declined with time and patients with diffuse disease had consistently higher SDAI scores. Depression was found to be associated with higher patient activity scores and strongly associated with patient self-response questions. The role of depression should be carefully considered in future applications of the SDAI, particularly as several components of the score rely upon patient recall.

scholarly journals POS1465-HPR THE RELATIONSHIP BETWEEN SEDENTARY BEHAVIOR AND SLEEP IN RHEUMATOID ARTHRITIS: A CROSS-SECTIONAL STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1017.2-1018
Author(s):  
N. Kelly ◽  
E. Hawkins ◽  
H. O’leary ◽  
K. Quinn ◽  
G. Murphy ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Physical Activity ◽  
Sleep Quality ◽  
Sedentary Behavior ◽  
Disease Duration ◽  
Cross Sectional Study ◽  
P Value ◽  
Poor Sleep ◽  
Cross Sectional ◽  
The Relationship

Background:Rheumatoid arthritis (RA) is a chronic, autoimmune inflammatory condition that affects 0.5% of the adult population worldwide (1). Sedentary behavior (SB) is any waking behavior characterized by an energy expenditure of ≤1.5 METs (metabolic equivalent) and a sitting or reclining posture, e.g. computer use (2) and has a negative impact on health in the RA population (3). Sleep is an important health behavior, but sleep quality is an issue for people living with RA (4, 5). Poor sleep quality is associated with low levels of physical activity in RA (4) however the association between SB and sleep in people who have RA has not been examined previously.Objectives:The aim of this study was to investigate the relationship between SB and sleep in people who have RA.Methods:A cross-sectional study was conducted. Patients were recruited from rheumatology clinics in a large acute public hospital serving a mix of urban and rural populations. Inclusion criteria were diagnosis of RA by a rheumatologist according to the American College of Rheumatology criteria age ≥ 18 and ≤ 80 years; ability to mobilize independently or aided by a stick; and to understand written and spoken English. Demographic data on age, gender, disease duration and medication were recorded. Pain and fatigue were measured by the Visual Analogue Scale (VAS), anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS), and sleep quality was assessed using the Pittsburgh Sleep Quality Index. SB was measured using the ActivPAL4™ activity monitor, over a 7-day wear period. Descriptive statistics were calculated to describe participant characteristics. Relationships between clinical characteristics and SB were examined using Pearson’s correlation coefficients and regression analyses.Results:N=76 participants enrolled in the study with valid data provided by N=72 participants. Mean age of participants was 61.5years (SD10.6) and the majority 63% (n = 47) were female. Participant mean disease duration was 17.8years (SD10.9). Mean SB time was 533.7 (SD100.1) minutes (8.9 hours per day/59.9% of waking hours). Mean sleep quality score was 7.2 (SD5.0) (Table 1). Correlation analysis and regression analysis found no significant correlation between sleep quality and SB variables. Regression analysis demonstrated positive statistical associations for SB time and body mass index (p-value=0.03846, R2 = 0.05143), SB time and pain VAS (p-value=0.009261, R2 = 0.07987), SB time and HADS (p-value = 0.009721, R2 = 0.08097) and SB time and HADSD (p-value = 0.01932, R2 = 0.0643).Conclusion:We found high levels of sedentary behavior and poor sleep quality in people who have RA, however no statistically significant relationship was found in this study. Future research should further explore the complex associations between sedentary behavior and sleep quality in people who have RA.References:[1]Carmona L, et al. Rheumatoid arthritis. Best Pract Res Clin Rheumatol 2010;24:733–745.[2]Anon. Letter to the editor: standardized use of the terms “sedentary” and “sedentary behaviours”. Appl Physiol Nutr Metab = Physiol Appl Nutr Metab 2012;37:540–542.[3]Fenton, S.A.M. et al. Sedentary behaviour is associated with increased long-term cardiovascular risk in patients with rheumatoid arthritis independently of moderate-to-vigorous physical activity. BMC Musculoskelet Disord 18, 131 (2017).[4]McKenna S, et al. Sleep and physical activity: a cross-sectional objective profile of people with rheumatoid arthritis. Rheumatol Int. 2018 May;38(5):845-853.[5]Grabovac, I., et al. 2018. Sleep quality in patients with rheumatoid arthritis and associations with pain, disability, disease duration, and activity. Journal of clinical medicine, 7(10)336.Table 1.Sleep quality in people who have RASleep variableBed Time N(%) before 10pm13(18%) 10pm-12pm43 (60%) after 12pm16 (22%)Hours Sleep mean(SD)6.56 (1.54)Fall Asleep minutes mean(SD)33.3(27.7)Night Waking N(%)45(63%)Self-Rate Sleep mean(SD)2.74 (0.90)Hours Sleep mean(SD)6.56 (1.54)Disclosure of Interests:None declared

An analysis of yield reduction caused by stripe rust in Rongotea wheat.

1991 ◽  
Vol 42 (1) ◽  
pp. 45 ◽  
Author(s):  
RE Gaunt ◽  
MJ Cole
Keyword(s):  
Disease Severity ◽  
Stripe Rust ◽  
Yield Components ◽  
Seed Treatment ◽  
Disease Duration ◽  
Puccinia Striiformis ◽  
Empirical Models ◽  
Yield Reduction ◽  
The Relationship ◽  
Action Levels

Natural field epidemics of stripe rust (Puccinia striiformis) were manipulated by seed treatment and foliar sprays to provide a range of disease severities and durations in several locations in three seasons. Yield in the absence of disease, disease severity and disease duration in the natural epidemics varied markedly between the three seasons. The effect of disease on yield and yield components was different in each season and there was no empirical model which consistently described the relationship between disease severity and yield reduction. Empirical models had little relation to the cause of yield reduction in specific crops and could not therefore be used for disease management purposes. The identification of action levels for management purposes based on mechanistic criteria is discussed.

scholarly journals Challenge and hope for parents who have cancer

2021 ◽  
Vol 3 (1) ◽  
pp. 136-147
Author(s):  
Yuko Akagawa ◽  
Sachiko Makabe ◽  
Tomoko Ito ◽  
Yutaka Kimura ◽  
Hideaki Andoh
Keyword(s):  
Disease Duration ◽  
Response Rate ◽  
Demographic Data ◽  
Current Status ◽  
Stress Coping ◽  
Parental Cancer ◽  
Cross Sectional ◽  
Coping Ability ◽  
The Mean ◽  
The Relationship

Parents who have cancer face particular problems in their relationships with children. This study aims to clarify 1) the current status of challenge/hope in parental cancer, 2) the factors related to challenge/hope, and 3) the relationship between challenge/hope and QOL/stress-coping ability. Cross-sectional national survey was conducted at designated cancer hospitals in Japan. Participants were undergoing cancer treatment and have children under 18 years old. The questionnaire included demographic data, QOL, ability to cope with stress, and challenge/hope. From 11 hospitals, 54 patients (response rate: 79.4%) participated. Majority of participants were female (72.2%) with the mean age of 39.3 ± 5.3 (SD). The total score was QOL (FACT-G: 50.4 ± 16.2), stress-coping ability (SOC: 46.7 ± 10.4). The main challenges were an inability to fulfill the parental role and children’s mental suffering due to loneliness. The main aspects of hope were the value of the children’s present self, being a parent, and strengthening family bonds. Gender and disease duration were significantly related with challenge/hope. Challenge was significantly related with QOL/stress-coping ability. Parents who have cancer derive hope from their relationship with their children, although they feel a gap between their ideal role/value as a parent and their current status.

scholarly journals Evaluation of thyroid volume in patients with systemic sclerosis; what did we find?

2021 ◽  
Author(s):  
Suade BADAK ◽  
Bozkurt GÜLEK ◽  
Esra KAYACAN ERDOĞAN ◽  
Hülya BİNOKAY ◽  
Eren ERKEN
Keyword(s):  
Systemic Sclerosis ◽  
Severity Score ◽  
Thyroid Dysfunction ◽  
Disease Duration ◽  
Thyroid Volume ◽  
Significant Negative Correlation ◽  
Skin Thickness ◽  
Cross Sectional ◽  
Skin Score ◽  
Modified Rodnan Skin Score

Introduction: Systemic sclerosis is a multisystemic disease. Thyroid involvement in systemic sclerosis is an issue that can be ignored. Our study aimed to evaluate the decreased thyroid volume in SSc. Also, we aimed to show the relationship between patients’ thyroid volume and severity score, clinical and laboratory parameters. Method: This was a single-center, cross-sectional study. Eighty-eight patients were included in the study. A radiologist evaluated patients’ thyroid volumes by ultrasonography. Demographic and clinical characteristics of the patients were recorded. Skin thickness was evaluated by the modified Rodnan skin score and the disease severity by the Medsger severity score. Findings were analyzed statistically. Results: Thyroid volume was in the atrophic range in 53.4% of the patients. There was a significant negative correlation between thyroid volume and mRSS, MSS, and disease duration. Logistic regression analysis showed that modified Rodnan skin score and disease duration were risk factors for thyroid atrophy. Conclusions: Many studies point out that thyroid autoantibodies are a cause of thyroid dysfunction in patients with SSc. However, in most of these studies, thyroid volume was not evaluated. As a result of our study, we saw that the major cause of thyroid dysfunction in our SSc patients was thyroid atrophy. Also, we observed that thyroid atrophy was more common in patients with ILD. We would like to draw attention to the fact that thyroid dysfunction and volume changes increase with the disease’s duration and severity in systemic sclerosis.

scholarly journals The relationship between health literacy and self-care behaviors in patients referred to Babol rural health center with type 2 diabetes

2020 ◽  
Keyword(s):  
Health Literacy ◽  
Health Center ◽  
Rural Health ◽  
Disease Duration ◽  
Self Care ◽  
Significant Relation ◽  
Cross Sectional ◽  
Rural Health Center ◽  
The Relationship ◽  
Care Behavior

Background and Purpose: Diabetes mellitus is an important health problem that leads to severe complication and death, health literacy (HL) is capacity of individual to obtain process and understand basic health information and services needed to make proper health decision that leads to empowering in self-care behavior. The purpose of this study was to determine the relationship between health literacy and self-care in patient with typ2 diabetes. Material and Method: This study was a cross sectional study conducted in 2017 on 390 patients with type2 diabetes referred to Babol rural health center. Data were collected using health literacy for Iranian Adults (HELIA) and Summary of Diabetes Self-Care Activities (SDSCA). Result: The result of study showed that mean average of HL was 48.56±16.31 and 55.9percent of patient had inadequate HL. The mean average of self-care in one week was 50.77±15.18. There was no significance association between HL and self-care behavior. HL was significant relation by sex, age, marriage, education, job, economic status and disease duration (p<0.05). Also there were significant relation between self-care behavior with number of family, education and disease duration. Conclusion: Considering that over 50% of patients have inadequate HL and demographic factor play an important role in HL and self-care behavior, it’s suggested that health care provider addressed this factor in order to designing appropriate program.

scholarly journals The Mediator Role of Body Image-Related Cognitive Fusion in the Relationship between Disease Severity Perception, Acceptance and Psoriasis Disability

2020 ◽  
Vol 10 (9) ◽  
pp. 142
Author(s):  
Vera Almeida ◽  
Ângela Leite ◽  
Diana Constante ◽  
Rita Correia ◽  
Isabel Filipa Almeida ◽  
...  
Keyword(s):  
Body Image ◽  
Disease Severity ◽  
Social Life ◽  
Chronic Health Condition ◽  
Cognitive Fusion ◽  
Cross Sectional ◽  
Self Compassion ◽  
Mediator Role ◽  
The Relationship

Psoriasis is a long-term skin disorder without a cure, whose patients are particularly susceptible to mental health diseases. Using a sample of patients diagnosed with psoriasis, this study aimed to: (1) identify the clinical and positive psychological variables that contribute the most to psoriasis disability and (2) assess the mediator role of body image-related cognitive fusion in the relation between disease severity perception and acceptance and self-compassion, on one hand, and psoriasis disability on the other. This is an initial cross-sectional exploratory study, with 75 patients diagnosed with psoriasis (males 52%; mean age 54.99 ± 13.72) answering a sociodemographic and a clinical questionnaire, the Psoriasis Disability Index (PDI), the Cognitive Fusion Questionnaire—Body Image (CFQ-BI), the Acceptance and Action Questionnaire—II (AAQ-II), and the Self-Compassion Scale (SCS). Descriptive and inferential statistics were used to characterize and assess the measures and the final model used. Through path analysis and a hierarchical multiple linear regression, it was found that the variables that significantly contributed to psoriasis disability were years of education, impact on social life and body image, explaining 70% of the variance. Body image-related cognitive fusion was a significant mediator in the relationship between disease severity and acceptance, and psoriasis disability. The implications of this study are considered to be extremely relevant, since it will allow additional information to be provided to psoriasis patients, appropriated to their educational level, aiming to reduce distorted perceptions of disease severity and intervene in the ability to accept this specific and important chronic health condition.

scholarly journals High prevalence of fatigue in contemporary patients with multiple sclerosis

2021 ◽  
Vol 7 (1) ◽  
pp. 205521732199982
Author(s):  
Line Broch ◽  
Cecilia Smith Simonsen ◽  
Heidi Øyen Flemmen ◽  
Pål Berg-Hansen ◽  
Åshild Skardhamar ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Disease Severity ◽  
Daytime Sleepiness ◽  
Disease Duration ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Disease Modifying Drugs ◽  
High Prevalence ◽  
The Mean ◽  
Anxiety Depression

Objective The prevalence of multiple sclerosis (MS)-related fatigue may have changed due to new diagnostic criteria and new disease modifying drugs. We aimed to assess the prevalence of fatigue in a contemporary MS cohort, and to explore associations between fatigue and clinical and demographic factors. Methods This is a cross-sectional study of the MS population in three Norwegian counties. Fatigue was assessed with the Fatigue Scale for Motor and Cognitive Functions (FSMC). We also assessed self-reported anxiety, depression and daytime sleepiness. Results The response rate was 64% (1599/2512). The mean age of the participants was 52 ± 13 years, median EDSS was 2.5 (IQR 1.5-3.0) and median disease duration from onset was 16 years (IQR 8-25). We found a prevalence of fatigue of 81%. Women had a higher prevalence of fatigue than men (83% vs 78%, p = 0.02). The prevalence increased with age (p < 0.001) and with increasing disease severity (p < 0.001), but in multivariate analyses, only sex and disease severity remained independent determinants of fatigue. Anxiety, depression, and daytime sleepiness were more prevalent in patients with fatigue than in those without fatigue (all p-values < 0.001). Conclusion The prevalence of fatigue is high in contemporary patients with MS. Fatigue is associated with female sex and level of disability, as well as with anxiety, depression and excessive daytime sleepiness.

scholarly journals THU0340 DURATION AND SYSTEMIC SCLEROSIS SUBTYPE ARE ASSOCIATED WITH DIFFERENT GUT MICROBIOME PROFILES

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 401.2-401
Author(s):  
Y. Braun-Moscovici ◽  
S. Ben Simon ◽  
K. Dolnikov ◽  
S. Giryes ◽  
D. Markovits ◽  
...  
Keyword(s):  
Species Richness ◽  
Systemic Sclerosis ◽  
Gut Microbiota ◽  
Disease Duration ◽  
Alpha Diversity ◽  
Rrna Gene ◽  
Digital Ulcers ◽  
Diffuse Disease ◽  
Probiotic Treatment ◽  
The Impact

Background:A growing body of evidence suggests that the gut microbiota plays a significant role in the development of autoimmune diseases. Altered microbiota composition was associated with gastrointestinal and extraintestinal features in systemic sclerosis (SSc) patients.Objectives:To look for differences in gut microbiota between SSc patients regarding disease duration, disease subset and occurrence of digital ulcers (DU).Methods:SSc patients seen at our center were recruited in a prospective study. The exclusion criteria included antibiotic or probiotic treatment during the month prior to recruitment, recent hospitalization, BMI>30, diabetes mellitus or concomitant inflammatory bowel disease. Fecal samples were processed and 16S rRNA gene sequences were analyzed using the QIIME2 packageWeighted (quantitative) and unweighted (qualitative) UniFrac distances, alpha diversity for richness and homogeneity, taxa plots for species and phyla and ANCOM analyses were performed.Results:During July 2018-May 2019, 26 SSc patients (mean age [SD] 53[12.7] years) and disease duration 8.8 [7.1] years) fulfilled the criteria and were willing to participate in the study. Thirteen patients had diffuse SSc, 16 patients had active DU, 8 patients had Raynaud’s phenomenon only without DU, 2 patients had past DU. The microbiota was significantly more similar between patients without active DU compared to those with active DU (P=0.024), but species richness did not differ. Patients with SSc duration less than 6 years had significantly different microbiota compared to long-lasting SSc (unweighted PCoA – q=0.031). Significant variations concerning quantitative and qualitative UniFrac distances (q=0.063, q=0.005) and species richness (q=0.009) were found among patients with diffuse compared to limited SSc. Limited SSc was associated with greater species richness. Taxa plot analysis revealed higher relative abundance of Firmicutes in diffuse disease and of Actinobacteria and Bacteroidetes in limited SSc.Conclusion:Disease duration, disease subset and active DU were associated with shifts in the microbiome of SSc patients. The impact of these changes on disease progression needs further elucidation.Figure:Disclosure of Interests:Yolanda Braun-Moscovici: None declared, Shira Ben Simon: None declared, Katya Dolnikov: None declared, Sami Giryes: None declared, Doron Markovits: None declared, Yonit Tavor: None declared, Kohava Toledano: None declared, Alexandra Balbir-Gurman Consultant of: Novartis, Omry Koren: None declared

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