bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing the psychosocial impact of stammering on work
Authors: Parsons V , Ntani G , Muiry R , Madan I , Bricker-Katz G 
Published: November 2021

Abstract

Background
Stammering (stuttering) is a speech condition with high heterogeneity, affecting approximately 1% of adults. Research shows it can limit career progression, impact job performance and quality of life.

Aims
To assess the psychosocial impact of stammering among healthcare workers and to develop a new workplace support intervention.

Methods
A cross-sectional questionnaire of healthcare workers who stammer with qualitative work and a survey of occupational health (OH) usual care to assess the need for a workplace intervention.

Results
Data from 470 staff questionnaires and 32 OH clinicians were analysed. Eighty-four per cent rated their stammering severity as mild-to-moderate, with the majority reporting adverse impact on job performance and career progression. Most experienced a high degree of anxiety and embarrassment at work, with avoidance behaviours commonplace. Four per cent of respondents sought OH advice for work difficulties. Qualitative data highlighted practical challenges staff experience in the workplace. Sixty-five per cent supported the proposal for a new workplace intervention. We found workplace stress and anxiety were the most common reasons for OH referrals, and we found wide variation in the scope of OH assessments and work adjustments recommended. Most OH respondents reported insufficient clinical knowledge of speech disorders and their impact on work.

Conclusions
Stammering can have a negative impact of workers’ job performance and job satisfaction. This can precipitate feelings of stress and anxiety, and can affect self-identity at work. We found wide variation in the provision of OH usual care. The results informed the development of a new workplace intervention.
Eastern-breeding Lesser Yellowlegs are more likely than western-breeding birds to visit areas with high shorebird hunting during southward migration
Authors: McDuffie Laura A , Christie Katherine S , Harrison Autumn-Lynn , Taylor Audrey R , Andres Brad A , Laliberté Benoit , Johnson James A 
Published: November 2021

AbstractShorebirds have experienced a precipitous reduction in abundance over the past four decades. While some threats to shorebirds are widespread (e.g., habitat alteration), others are regional and may affect specific populations. Lesser Yellowlegs (Tringa flavipes) are long-distance migrants that breed across the North American boreal biome and have declined in abundance by 60–80% since the 1970s. The documented harvest of Lesser Yellowlegs in the Caribbean and northeastern South America during southward migration is a possible limiting factor for the species, but it is unknown to what extent birds from different breeding origins may be affected. To address the question of differential occurrence in harvest zones during southward migration, we used PinPoint GPS Argos transmitters to track the southward migrations of 85 adult Lesser Yellowlegs from across the species’ breeding range and 80° of longitude from Anchorage, Alaska, USA, to the Mingan Archipelago, Quebec, Canada. We classified migratory locations as inside or outside three zones with high levels of harvest (Caribbean, coastal Guianas, and coastal Brazil) and then fit generalized additive mixed models to estimate the probability of occurrence of Lesser Yellowlegs in harvest zones according to their breeding origin. Individuals from the Eastern Canada population had a higher probability of occurrence within one or more harvest zones and remained in those zones longer than individuals breeding in Alaska and western Canada. Linear regressions also suggested that longitude of the breeding origin is an important predictor of occurrence in harvest zones during southward migration. Lastly, our findings, combined with other sources of evidence, suggest that current estimated harvest rates may exceed sustainable limits for Lesser Yellowlegs, which warrants further investigation.
Party Quotas and Gender Differences in Candidate Experience in Australia: 1987–2016
Authors: Beauregard Katrine , Taflaga Marija 
Published: November 2021

AbstractWhile previous investigations have demonstrated that legislative gender quotas can disrupt traditional recruitment networks to level women’s and men’s political experience, little is known about the impact of party quotas. Using the Australian Candidate Survey, we find that gender party quotas can help close the experience gap between male and female candidates, but also between women. Before the adoption of party quotas, Coalition female candidates had more experience than Labor female candidates. This party gap disappears along with gender gaps amongst Labor candidates after the Labor Party adopted gender quotas. We find that party quotas made little impact on the experience levels of male Labor candidates or Coalition candidates’ of both sexes. We identify the professionalisation of politics and women-centric networks as factors shaping how quotas impact candidate selection processes.
La prise en charge des nourrissons, des enfants et des adolescents vulnérables à l’infection par le virus de l’hépatite C
Authors: Bitnun Ari 
Published: November 2021

Abstract
L’infection par le virus de l’hépatite C touche de 0,5 % à 1,0 % de la population canadienne. La plupart des infections pédiatriques découlent d’une transmission verticale ou, chez les adolescents et les jeunes adultes, de comportements à haut risque comme l’utilisation de drogues injectables et les activités sexuelles non protégées. Il est désormais recommandé que tous les nourrissons, les enfants et les adolescents qui présentent au moins un facteur de risque soient soumis au dépistage de l’infection par le virus de l’hépatite C. Il est démontré que le traitement de la forme chronique de cette infection au moyen d’antiviraux à action directe provoque une suppression virologique soutenue chez 97 % à 100 % des enfants dès l’âge de trois ans. Les pédiatres et les médecins de famille ont un rôle important à jouer pour informer les adolescents des risques et des modes de prévention de l’infection par le virus de l’hépatite C, ainsi que pour revendiquer, auprès du gouvernement et des autorités sanitaires, l’adoption de stratégies d’intervention globales de réduction des méfaits ciblant les jeunes à risque, des traitements accessibles et le dépistage prénatal systématique de ce virus.
P016 Updated Clinical Practice Guidelines for JIA management adopting Treat to Target approach: the Egyptian College of Paediatric Rheumatology initiative
Authors: El Miedany Y , Hassan M , Salah S , Lotfy H , Abdulhady H , Salah H , El Gaafary M , Abd El-Latif E , Farag Y , Eissa M , Esam Maher S , Radwan A , El-Shanawany Amira T , Medhat B M , El Mikkawy D , Mosa D M , El Deriny G , Mortada M , Osman N S , Fouad N A , Elkaraly N E , SMohamed S , Tabra S , Hassan W A , Amer Y , Nasef S I 
Published: November 2021

Abstract

Background
There is an unmet need from paediatric rheumatologists and rheumatologists, managing children with JIA, for a well formulated guidelines aiming at achieving better outcomes of their patients. To establish adequate and easily adopted guidelines in management of different variants of JIA in a relatively low resources country.

Method
This study was carried out to achieve an Egyptian expert consensus on a treat-to-target management strategy for Juvenile Idiopathic Arthritis using Delphi technique. The preliminary scientific committee identified a total of 17 key clinical questions according to the Patient/Population, Intervention, Comparison, and Outcomes (PICO) approach. An evidence-based, systematic, literature review was conducted to compile evidence for the benefits and harms associated with JIA treatments. The core leadership team identified researchers and clinicians with expertise in JIA management in Egypt upon which Experts were gathered from different governorates and health centres across Egypt. Delphi process was implemented (2-rounds) to reacha consensus on the management recommendations of Egyptian JIA patients. Results: An online questionnaire were sent to expert panel (n = 27), of whom 26 participated in the two rounds. At the end of round 2, a total of eighteen (18) recommendation items, categorized into 4 sections to address the main 4 JIA categories, were obtained. Agreement with the recommendations (rank 7–9) ranged from 83.2–100% (average 86.8%). Consensus was reached (i.e. ≥75% of respondents strongly agreed or agreed) on the wording of all the 18 clinical standards identified by the scientific committee. Algorithms for the management of JIA polyarthritis, oligoarthritis and systemic JIA have been suggested.

Conclusion
A wide and representative panel of experts established a consensus regarding the management of JIA in Egypt. The developed guidelines provide a comprehensive approach to the management of JIA for ll Egyptian healthcare professionals who are involved in its management for follow up and frequent evaluation of these guidelines.
P020 The male gender predicts the hip involvement among JIA patients
Authors: Yasmine Makhlouf , Ferjani Hanene , Triki Wafa , Maatallah Kaouther , Ben Nessib Dorra , Kaffel Dhia , Hamdi Wafa 
Published: November 2021

Abstract

Background
Juvenile idiopathic arthritis (JIA) represents a heterogeneous group of chronic arthritides that affect children aged 16 years and under. Regardless of the clinical presentation, hip involvement ranges between 20% to50% of cases [1]. The aim of the present study was to examine the role of gender and disease onset in coxitis involvement.

Methods
We conducted a cross-sectional study including children with JIA according to the International League of Associations for Rheumatology (ILAR)). Transcribed data included age, sex and the characteristics of the disease (subtype of JIA, disease duration). Regarding coxitis, we collected radiographs, ultrasound (US) and magnetic resonance imaging (MRI) of the hip when performed. Coxitis was defined by clinical (limited range of motion) and/or radiographic findings (destruction, synovitis, bone marrow oedema).
We divided patients into two groups: G1: presence of coxitis and G2: absence of coxitis.

Results
The study included 62 patients with a male perdominance: sex ratio was 2.3. The mean age of onset of the disease was 11.4 years [3–16]. The frequency of each JIA subset was as follows: polyarticular with rheumatoid factor (n = 2), polyarticular without rheumatoid factor (n = 4), systemic (n = 1), enthesitis-related arthritis (n = 44), oligoarthritis (n = 8), psoriatic arthritis (n = 3). A Hip involvement was reported in 71% of cases and was bilateral in 81% of patients. Coxitis was not correlated with the disease duration (P = 0.7). A positive correlation was found between the age of onset of the disease and the presence of coxitis (12.2 vs 9.6, P = 0.005). However, hip involvement was higher among males without significant difference (76.7% vs 58%, P = 0.132).

Conclusion
Unlike the literature data, our study showed a high frequency of hip involvement in Tunisian children with JIA. We found an association between the male gender and coxitis involvement without significant difference. However, coxitis was more frequent in later onset of the disease.
P025 Risk assessment of covid 19 in patients with Juvenile Idiopathic Arthritis
Authors: Ines Cherif , Ben Nessib Dorra , Maatallah Kaouther , Ferjani Hanene , Triki Wafa , Kaffel Dhia , Hamdi Wafa 
Published: November 2021

Abstract

Background
On March 11th, 2020 the World Health Organization declared the coronavirus outbreak a global pandemic. Since then, the world has faced multiple flares. In March 2021, the third wave hit Tunisia, resulting in a total of 331 674 confirmed cases and 12 089 Covid-19 related deaths (on May 19th, 2021). Among these reported cases, &gt;6000 were children under the age of 18.
Patients with inflammatory rheumatic diseases undergoing immunosuppressive treatment are considered immunocompromised. Therefore, it is only fair to question whether children suffering from juvenile idiopathic arthritis (JIA) are specially at risk during this pandemic. Our objective was to assess the impact of the Covid -19 pandemic on patients with JIA.

Methods
We conducted a cross-sectional study including patients with JIA, all fulfilling the International League of Associations for Rheumatology (ILAR) criteria. We prepared a questionnaire evaluating the clinical data of our patients during the outbreak. We asked whether the child had been infected with the virus or whether he had contact histories with confirmed cases, and if so, had the child developed any symptoms (such as fever, respiratory, digestive or osteoarticular symptoms, myalgia, asthenia) or required any specific care.
For all patients, we collected the following data: age, age of onset, the duration of the disease, JIA subtype, and the current treatment.

Results
We included 25 JIA patients, mean age at disease onset was 7.6 +/- 3.8 years [1–11]. Among them, 17 were female. The mean duration of the disease was 4.9 +/- 3 years [0–15]. Three patients were on biological disease-modifying anti-rheumatic drugs (bDMARDs) and six on conventional synthetic DMARDs (csDMARDs). Sixteen patients had no background treatment.
None of the children had a positive PCR test nor symptoms suggestive of Covid-19.
There were only 2 children with contact histories with confirmed cases: one with his cousin and one with his grandfather. Both patients were on NSAIDS with no DMARDS, and both followed social distancing rules. Neither one of them developed any symptoms.
There have been no reports of absenteeism from school or medical checkups or disruption of treatment due to this pandemic, outside of the government-imposed lockdown period.

Conclusion
None of our patients contracted the corona virus or developed any symptoms, during the deadliest wave in Tunisia to date. These results align with different research and the hypothesis that children with JIA under treatment do not have an increased susceptibility to COVID-19 compared with healthy children. Our study, however, had its limitations due to the small number of patients. Further research with larger sample size are, therefore, required.
P031 Adherence with Methotrexate in Tunisian Juvenile Idiopathic Arthritis Patients
Authors: Bettaieb Hiba , Triki Wafa , Maatallah Kaouther , Ferjani Hanene , Ben Nessib Dorra , Kaffel Dhia , Hamdi Wafa 
Published: November 2021

Abstract

Background
Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in the pediatric population. Methotrexate (MTX) has been considered as the cornerstone of treatment of poly and oligoarticular subtypes of JIA. However, this treatment is supposed to be for long term, which may involve an obstacle for adherence. The aims of the study were to evaluate adherence of Tunisian JIA patients to MTX and to identify factors associated with high adherence to MTX.

Methods
A cross-sectional study including patients with confirmed JIA diagnosis, according to the International League of Associations for Rheumatology (ILAR) criteria, was performed. Demographic data as well as disease characteristics were obtained from medical records. Laboratory markers including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were collected. Adherence was measured, for patients under MTX for &gt;3 months, using the 5-item Compliance Questionnaire Rheumatology (CQR5) (1). Patients were divided into two groups: group 1: High adherence (HA) for patients having a CQR5 ≥ 80% and group 2: low adherence (LA) for patients having CQR5 &lt; 80%. A p inferior to 0.05 was considered statistically significant.

Results
The study included 29 patients (10 males and 19 females) with a mean age at disease onset of 9.1 ± 3.4 years. The mean disease duration was 61 ± 79 months [7–336]. JIA subtypes were in decreasing order of frequency as follows: enthesitis-related arthritis (n = 13), oligoarticular (n = 8), Polyarticular without rheumatoid factor (n = 4), Polyarticular with rheumatoid factor (n = 2), systemic (n = 1) and, psoriatic arthritis (n = 1).
A biologic inflammatory syndrome was found in 48.3% (n = 14) of cases. The mean ESR and CRP were 20 mm/h ± 11.3 [3–98] and 5 ± 17.8 mg/l [0–56] respectively. Nineteen (65.5%) patients had coxitis. Overall, 55.17% of patients (n = 16) were treated with MTX with a mean weekly dose of 9.2 ± 3.2 mg [5–15]. MTX was orally administrated in all patients. NSAIDs and prednisone were prescribed in 51.7% (n = 15) and 17.2% (n = 5) of cases respectively. The MTX was associated with biological DMARDs in five patients (17.2%). It was about Etanercept in 4 patients and Tocilizumab in 1 patient. Mean CQR5 score was 70.8% ± 18 [25–100]. Only seven patients (43.8%) showed high adherence to MTX. The statistical study revealed no difference between HA and LA in term of gender (P = 0.84), age at disease onset (P = 0.39), disease duration (P = 0.9), prednisone use (P = 0.22), the occurrence of coxitis (P = 0.2), ESR (P = 0.83) and CRP (P = 0.033) rates.

Conclusion
In this study, less than one half of JIA patients were highly adherent to MTX according to CQR5. Low adherence should be considered before declaring MTX treatment failure.
P032 Methotrexate and hepatic tolerance in Juvenile Idiopathic Arthritis
Authors: Miladi S , El Mabrouk Y , Fazaa A , Souabni L , Sallemi M , Ouenniche K , Kassab S , Chekili S , Ben Abdelghani K , Laatar A 
Published: November 2021

Abstract

Background
Methotrexate (MTX) is considered as the main treatment for some juvenile idiopathic arthritis (JIA) subtypes. The hepatic toxicity of MTX has been reported in numerous studies in rheumatoid arthritis which have shown that prolonged treatment can induce hepatic fibrosis and a disturbance of the liver biologic tests. In patients with JIA, the potential hepatic toxicity of MTX needs to be confirmed.

Methods
A retrospective study of patients followed for JIA and treated with MTX was conducted. The results of the hepatic assessment looking for cytolysis or cholestasis performed during the pre-treatment assessment and then during regular checks were noted.

Results
Thirty-nine JIA patients were included. The mean age of disease onset was 8 years [1.5–17 years]. The JIA subtype was systemic in 11 cases, enthesitis related arthritis in 5 cases, rheumatoid factor seronegative polyarthritis in 15 cases and rheumatoid factor seropositive polyarthritis in 2 cases, and oligoarthritis in 2 cases. Patients were treated with low doses of corticosteroids (0.2–0.4 mg/kg) in majority of cases (82%). Non steroid anti-inflammatory drugs were used in 51% of cases. MTX was prescribed as monotherapy in 20 cases, in combination with Sulfasalazine in 6 cases and Anti TNF alpha in 12 cases. MTX has been used on average for 11 years [2 months-26 years]. This drug was stopped for ineffectiveness in 7 cases, for digestive intolerance in 2 cases and in one case for severe hepatic cytolysis after 2 years of treatment with a progressive normalization of hepatic laboratory tests after 6 months. During regular monitoring, no further disturbances of liver function were observed.

Conclusion
MTX hepatotoxicity appears to be very mild and rare in JIA. These results are reassuring given that MTX is a highly effective treatment in JIA.
P035 Hip involvement in Tunisian Juvenile Idiopathic Arthritis patients
Authors: Yasmine Makhlouf , Triki Wafa , Maatallah Kaouther , Ferjani Hanene , Ben Nessib Dorra , Kaffel Dhia , Hamdi Wafa 
Published: November 2021

Abstract

Background
Juvenile idiopathic arthritis (JIA) is characterized by a widely variable clinical course and outcome. If uncontrolled, joint damage may occur. In this context, coxitis is a feared complication. The aim of our study was to determine the prevalence and patterns of hip involvement in Tunisian JIA patients.

Methods
A retrospective study including children with JIA according to the International League of Associations for Rheumatology (ILAR)) was conducted between 2012and 2021. Sociodemographic data as well as disease characteristics were collected. Laboratory markers including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were recorded. Hip involvement was assessed clinical exam and imaging (standard radiograph, ultrasound or magnetic resonance imaging (MRI)). We compared these parameters between the two groups: G1: presence of coxitis and G2: absence of coxitis.

Results
The study included 40 patients with a male predominance: sex ratio was 1.6. The mean age was 11.1 years-old [3–16]. The mean age at onset of the disease was 18.1 years old [8–30]. The distribution of the different subsets was as follows: polyarticular with rheumatoid factor (n = 1), polyarticular without rheumatoid factor (n = 2), enthesitis-related arthritis (n = 29), oligoarthritis (n = 7), psoriatic arthritis (n = 1). Extra-articular manifestations were found in 21.2% of cases: ocular (n = 4), pulmonary (n = 2) and cardiovascular (n = 1). The mean ESR and CRP was 30.9 mm/h [2–90] and 15.8 mg/l [1–70] respectively. A high ESR or CRP were found in 67% of cases. Hip involvement concerned 70% of the patients and was bilateral in 67.9% of them. Hip radiographs were normal in 50% of cases. Ultrasound was performed in 9 patients and revealed a positive Doppler synovitis (n = 2), a negative Doppler synovitis (n = 7) and joint effusion (n = 2). MRI was performed in 20% of cases and revealed synovitis (67%) and joint effusion (33%). Overall, 79.3% of patients had medical treatment combining NSAIDs and rehabilitation, 39% of the patients had had local infiltration with Hexatrione and only two patients had hip replacement. Hip involvement was not correlated with age at onset (P = 0.2), subtype (P = 0.8), sex (P = 0.7), extraarticular manifestations (P = 0.4). Similarly, there was no correlation between the presence of coxitis and ESR (P = 0.07) as well as CRP (P = 0.5).

Conclusion
Our study showed that hip involvement is frequent among Tunisian patients with JIA. Although not correlated with disease characteristics, hip involvement should be assessed frequently and carefully.