bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hand splinting in rheumatoid arthritis. A perspective on current knowledge and directions for research
Authors: Falconer Judith 
Published: February 2007

AbstractA theoretical rationale for the use of hand splints in rheumatoid arthritis and selected literature relevant to the efficacy of splints in the acutely inflamed or chronic rheumatoid joint are briefly reviewed. The purposes of this review are to provide a broad perspective on nonsurgical hand splinting and to suggest some directions for future research based on this perspective.
Coping strategies and affect in rheumatoid and psoriatic arthritis relationship to pain and disability
Authors: Stewart Malcolm W. , Knight Robert G. 
Published: February 2007

AbstractAffective state and utilization of coping strategies are factors that may be related to pain and disability in chronic disease, but may also be interrelated. The relationship of coping strategies and affect to both concurrent and 18‐month follow‐up pain and disability was studied in 60 women with rheumatoid or psoriatic arthritis of <8 years' duration. The type of coping strategy used was not associated with concurrent mood level. After accounting for physical variables, mood and strategy use were significantly, and largely independently, related to concurrent pain and disability measures. Future disability was not predicted by either mood or coping strategy use. These results show that mood and use of coping strategies are significantly related to concurrent function but, perhaps due to the variable nature of the disease process, are not predictive of future function. The clinical implications of this study are that interventions to promote better adjustment for people with rheumatoid or psoriatic arthritis should target both mood and coping strategies, as both may contribute independently to adjustment.
Aerobic capacity in juvenile rheumatoid arthritis patients and healthy children
Authors: Giannini Manuela Jasso , Protas Elizabeth J. 
Published: February 2007

AbstractThis study compared aerobic capacity and highest work load completed by children with juvenile rheumatoid arthritis (JRA) and healthy children during bicycle ergometer exercise. A secondary purpose was to determine the relationship between measures of disease severity and (a) aerobic capacity and (b) highest work load completed among the JRA patients. Aerobic capacity was measured using an open‐circuit computerized gas analysis system. Sixteen patients with JRA and 16 healthy children were matched for age, sex, and body surface area. The healthy children achieved a significantly higher aerobic capacity than their respective control (p < 0.001, paired test, two‐tailed). The healthy children were able to complete higher work loads than their respective control (p < 0.01, Wilcoxon matchedpairs signed‐rank test). There was no relationship between measures of articular disease severity and (a) aerobic capacity and (b) highest work load completed among the JRA patients. Results of this study provide specific direction to clinicians to initiate aerobic conditioning programs for children with JRA soon after diagnosis. Additionally, an individual's functional exercise capacity is not directly related to the severity of the articular disease.
Assessing the impact of self‐efficacy beliefs on adaptation to rheumatoid arthritis
Authors: Schiaffino Kathleen M. , Revenson Tracey A. , Gibofsky Allan 
Published: February 2007

AbstractThis article examines the influence of self‐efficacy beliefs on problem‐solving coping, functional disability, and psychological well‐being for 101 recently diagnosed adult patients with rheumatoid arthritis (RA). Data were drawn from a longitudinal study of psychosocial adaptation to the onset of RA. Self‐efficacy beliefs were associated with less functional disability assessed concurrently and 1 year later. Self‐efficacy beliefs were also associated with greater use of problem‐solving coping 1 year later. There was an interaction between pain and self‐efficacy beliefs in the prediction of depression 1 year later: at low pain, self‐efficacy beliefs were unrelated to depression, but at higher levels of pain, greater self‐efficacy was related to greater depression. Finally, problem‐solving coping mediated the relationship between disability and initial self‐efficacy beliefs. The distinct patterns that emerge for pain, self‐efficacy beliefs, and coping, with respect to functional status as compared to psychological status, are discussed.
Patterns of change over time in learned response to chronic illness among participants in a systemic lupus erythematosus self‐help course
Authors: Braden Carrie Jo 
Published: February 2007

AbstractThe findings of this descriptive study of learned response to chronic illness over time of 291 persons having a diagnosis of systemic lupus erythematosus (SLE) who had attended a series of self‐management classes demonstrated significant change in learned response over time. Self‐help model variables that significantly contributed to the change were uncertainty, depression, enabling skill, self‐efficacy, and self‐worth. Uncertainty and depression decreased over time while enabling skill, self‐efficacy, and self‐worth increased. Subjects also demonstrated significant increases in self‐help course tied variables of SLE knowledge and both the range and number of rest, relaxation, heat, and exercise activities.
Adolescents with chronic disease. Transition to adult health care
Authors: Rettig Patty , Athreya Balu H. 
Published: February 2007

AbstractOlder adolescents are in the midst of many life changes related to physical and emotional development, education and career choices, family and peer relationships. The presence of a chronic disease adds an additional burden. At this stage of development, transfer of care to an adult facility becomes a major challenge for the adolescent, parents, and pediatric and adult care providers. This article describes an interdisciplinary transition program from pediatric to adult health care for older adolescents with rheumatic diseases. Care is transferred to an internist‐rheumatologist who collaborates closely with the pediatric team. Scope of the program includes pretransitional assessments and interventions, including education, counseling, and referral around career, postsecondary education, sexuality, and other transitional issues. Benefits of and barriers to a structured transition program are discussed.In broad terms the adult seeks care, the child receives care. The developmentally immature adult in the adult system of care is a victim since he or she is assumed to be autonomous.
Going beyond demographic characteristics in arthritis research: Reflections on process in the experience of arthritis
Authors: Fifield Judith , Reisine Susan 
Published: February 2007

AbstractWhen the disease began I didn't know what it was. I was sitting at a sewing machine for forty hours a week. I was thinking of taking off some time and having it checked out but the kind of job I did have, there wasn't any coverage, no insurance or anything, so if I did leave I would lose the income. It wasn't a big‐paying job. I make $150 per week, and take home $130, so I have to be careful and take in the forty hours in order to come home with something. I was turned down for disability (1).
Gender and psychological well‐being of persons with rheumatoid arthritis
Authors: Dowdy Sharon W. , Dwyer Kathleen A. , Smith Craig A. , Wallston Kenneth A. 
Published: February 2007

AbstractObjective.This study examined the relationship of gender and psychological well‐being (PWB) in community‐dwelling persons with rheumatoid arthritis (RA).Method.Data from the first wave of two longitudinal panel studies of persons with RA were examined (93 men and 276 women in panel 1; 60 men and 147 women in panel 2). Subjects completed self‐report questionnaires on behavioral aspects of RA. Psychological well‐being was assessed in both panels by the Center for Epidemiologic Studies‐Depression Scale, using its 4 subcomponents, including positive and negative affect. Panel 2 had additional measures of PWB, namely the Positive and Negative Affect Schedule and the Satisfaction With Life Scale. Potential explanatory variables were then examined in an attempt to account for the observed gender differences.Results.Gender differences were found for negative indicators of PWB, while positive indicators of PWB showed no significant differences by gender. As with other community samples, women reported higher levels of depressive symptoms and negative mood than men. Quality of emotional support, passive pain coping, and physical functional impairment could only partially explain the observed gender differences in this study.Conclusion.The relationship of gender to negative indicators of PWB cannot easily be diminished or dismissed. The mechanisms by which gender differentially affects PWB need to be further explored in order to intervene appropriately to help men and women with RA achieve an optimal quality of life.
Formal education and five‐year mortality in rheumatoid arthritis: Mediation by helplessness scale scores
Authors: Callahan Leigh F. , Cordray David S. , Wells George , Pincus Theodore 
Published: February 2007

AbstractObjective. To analyze scores on a scale designed to measure helplessness, a cognitive variable, as a possible mediator of the association between formal education level and mortality over 5 years in patients with rheumatoid arthritis (RA).Methods. A cohort of 1,416 patients with RA from 15 private practices in 6 states and Washington, DC was monitored for over 5 years. Demographic, socioeconomic, therapy, functional status, and psychological variables were analyzed as possible predictors of mortality in univariable and multivariable Cox Proportional Hazards models.Results. In a 5‐year followup, 1,384 patients were accounted for (97.3%), including 174 who died versus 111 expected (standardized mortality ratio = 1.54). Higher mortality was associated significantly with low formal education, high age, poor scores for activities of daily living (ADL) on a modified health assessment questionnaire (MHAQ), and poor scores on a helplessness scale (all P < 0.01) in univariable analyses. High age, few years of formal education, and poor MHAQ ADL scores were all significant independent predictors of mortality when analyzed simultaneously in a Cox Proportional Hazards model. When helplessness scale scores were included in a model, scores greater than 2.4 (on a scale of 1 to 4), higher age, male gender, and increased MHAQ ADL difficulty scores were all independently significantly predictive of 5‐year mortality (P < 0.05), while years of education was no longer a significant predictor.Conclusion. Scores on a helplessness scale appear to mediate a component of the association between formal education level and 5‐year mortality in these patients with RA. Health professionals and policy makers might consider interventions directed at modification of helplessness as adjunctive to standard interventions to improve outcomes in RA.
Ethnic differences in self‐reported functional status in the rural south: The johnston county osteoarthritis project
Authors: Jordan Joanne M. , Luta Gheorghe , Renner Jordan B. , Dragomir Anca , Hochberg Marc C. , Fryer John G. 
Published: February 2007

AbstractObjective. We examined ethnic differences in self‐reported functional status in a rural, population‐based sample in North Carolina.Methods. Data from 1,197 African‐American and Caucasian participants, aged 45 and older, in the Johnston County Osteoarthritis Project were analyzed using multiple logistic regression to examine ethnic differences in difficulty performing tasks of the Health Assessment Questionnaire (HAQ) and in risk factor profiles associated with difficulty.Results. Forty‐three percent reported difficulty in one or more HAQ tasks. African‐Americans were more likely than Caucasians to report difficulty performing 3 tasks (P < 0.04); these differences were minimal after adjustment for confounders. For some tasks, risk factor profiles included body mass index in African‐Americans only, and age and female gender more often in Caucasians. Low educational attainment was part of the risk factor profile for walking in African‐Americans.Conclusions. Differences in proportions of African‐Americans and Caucasians reporting difficulty in performance of HAQ tasks were minimal, but risk factor profiles for difficulty appeared to vary by ethnicity.
Effects of exercise on knee joints with osteoarthritis: A pilot study of biologic markers
Authors: Bautch Judith C. , Malone Daniel G. , Vailas Arthur C. 
Published: February 2007

AbstractObjective. To determine the effects of low intensity weight‐bearing exercise on osteoarthritis (OA) of the knee.Methods. Synovial fluid keratan sulfate (KS) and hydroxyproline were measured as markers of cartilage degradation. The Arthritis Impact Measurement Scales (AIMS) were used to measure health status, and a visual analog scale for pain assessment was used before and after intervention. An exercise (EX) group (n = 15) received a thrice‐weekly 12‐week low intensity exercise program and a weekly educational program, and a minimal treatment (Min RX) group (n = 15) received only the education program.Results. Pain levels declined in the EX group, and the Min RX group showed improvement on the AIMS. Synovial fluid was obtained in 11 subjects before and after the intervention. Levels of KS and hydroxyproline did not change.Conclusion. Further study of exercise effects should include both clinical and biologic parameters to examine the outcome of exercise as a therapeutic intervention in OA of the knee.
Self‐efficacy for arthritis pain: Relationship to perception of thermal laboratory pain stimuli
Authors: Keefe Francis J. , Lefebvre John C. , Maixner William , Salley Alfred N. , Caldwell David S. 
Published: February 2007

AbstractObjective. To examine how self‐efficacy for arthritis pain relates to the perception of controlled laboratory pain stimuli.Methods. Forty patients with osteoarthritis completed self‐report measures of self‐efficacy for arthritis pain. They then participated in a single experimental session in which measures of thermal pain threshold and tolerance were collected, as well as measures of the perceived intensity and unpleasantness of a range of thermal pain stimuli.Results. Correlational analyses revealed that patients reporting high self‐efficacy for arthritis pain rated the thermal pain stimuli as less unpleasant than those reporting low self‐efficacy. When subjects scoring very high and very low in self‐efficacy were compared, it was found that subjects scoring high on self‐efficacy for arthritis pain had significantly higher pain thresholds and pain tolerance than those scoring low on self‐efficacy.Conclusions. These results in dicate that self‐efficacy for arthritis pain is related to judgments of thermal pain stimuli. Implications for the understanding of arthritis pain and for future laboratory research are discussed.
The experience of rheumatoid arthritis pain and fatigue: Examining momentary reports and correlates over one week
Authors: Stone Arthur A. , Broderick Joan E. , Porter Laura S. , Kaell Alan T. 
Published: February 2007

AbstractObjective. To evaluate the daily experience of patients with rheumatoid arthritis (RA) in an ecologically valid manner; Ecological Momentary Assessment (EMA) was employed. Diurnal cycles and within‐day variation of self‐reported pain and fatigue were examined as were relationships between pain, fatigue, daily stressful events, and sleep.Methods. Thirty‐five patients with RA were alerted with an electronic beep 7 times per day for 7 consecutive days. Assessments were recorded at each beep. Upon awakening each day, sleep information was reported.Results. There were large individual differences in variation of pain and fatigue. Stressors were associated with increased pain but not fatigue. Subjects with poor sleep had higher levels of pain and fatigue. Diurnal cycles of pain and fatigue were found, yet were observed for only some patients (37% and 34%, respectively).Conclusion. The use of EMA deepens our understanding of the pain and fatigue experienced by RA patients. This method may help identify subgroups of patients who are highly “psychoreactive” to environmental stimuli and/or who have diurnal patterns to their symptoms. It may also be used to improve existing instruments.
Measurement of depression in mexican patients with rheumatoid arthritis: Validity of the beck depression inventory
Authors: Suárez‐Mendoza Aldo A. , Cardiel Mario H. , Caballero‐Uribe Carlo V. , Ortega‐Soto Hector A. , Márquez‐Marin Mirella 
Published: February 2007

AbstractObjective. To validate a Spanish version of the Beck Depression Inventory (BDI) in Mexican patients with rheumatoid arthritis (RA).Methods. Thirty‐five patients with RA seen in our outpatient clinic were included. A semistructured psychiatric interview was applied, and the following instruments were administered: the BDI, the Hospital Anxiety and Depression Scale (HAD), and the Health Assessment Questionnaire Disability Index. Diagnostic properties of the BDI for both full‐length and smaller versions taking out somatic items were compared against a gold standard. The gold standard for comparison was the diagnosis of depression according to the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised criteria.Results. Thirty‐seven percent of RA patients had a diagnosis related to depression, most of which were major depression or dysthymia. The original BDI showed a high sensitivity (92%) and a high correlation with the HAD (r = 0.83). Exclusion of somatic items in modified versions of the BDI had a similar performance.Conclusions. The original BDI is a suitable instrument to detect depression in Mexican RA patients. Nevertheless, shorter versions without some of the somatic items also show an adequate performance.
Off‐the‐shelf orthopedic footwear for people with rheumatoid arthritis
Authors: Fransen Marlene , Edmonds John 
Published: February 2007

AbstractObjectives. To assess the effectiveness of off‐the‐shelf orthopedic footwear for people with rheumatoid arthritis (RA) reporting chronic foot pain, in terms of self‐reported pain and physical function, as well as objectively measured gait variables using an electric footswitch walkway.Methods. A small, randomized, controlled trial followed by a larger repeated measures analysis was used.Results. The control group (n = 15) demonstrated no significant changes over a 2‐month period in pain, physical function, or gait scores. In contrast, after supply of the footwear both the original footwear group (n = 15) and the control group demonstrated significant improvements, with small to large effect sizes, in weight‐bearing pain scores, physical function, gait velocity, and gait stride length without increases in use of arthritis medications or walking aids.Conclusion. These data suggest that off‐the‐shelf orthopedic footwear is beneficial for people with RA even when subjects were unselected on basis of age, sex, disease duration, or disability as measured by the Stanford Health Assessment Questionnaire.
Users evaluate lupusline a telephone peer counseling service
Authors: Horton Roberta , Peterson Margaret G. E. , Powell Susan , Engelhard Enid , Paget Stephen A. 
Published: February 2007

AbstractObjective. To assess the impact of LupusLine during its pilot phase of operation by determining patterns of utilization and user satisfaction. LupusLine is a peer counseling service designed to provide ongoing emotional support from home to home by telephone appointment.Methods. One hundred fifty‐three respondents were surveyed, using a 72‐item structured questionnaire administered over the telephone by interviewers separately trained and hired specifically for this purpose. The questionnaire was pilot tested on 10 volunteers with systemic lupus erythematosus (SLE), and a panel of related health professionals reviewed the questionnaire for face validity.Results. Most users were women (94.5%) who had SLE themselves (87.5%) and who called the service because of recent changes in their physical functioning and reported feelings of depression and anxiety about their illness. Forty‐one percent of respondents made 6 or more calls to their assigned peer counselor. Respondents reported high levels of satisfaction across 5 highly correlated measures, with 92% of callers reporting at least moderate satisfaction with the service. Over 60% of respondents who reported a change in 6 “feeling” categories attributed this change to using LupusLine. Fewer users reported a change in 4 specific behaviors since using the service, but more respondents attributed changes, when they occurred, to LupusLine.Conclusions. Based on these initial findings, we believe that telephone networks similar to the LupusLine model maybe able to offer substantial benefit to people coping with the complex, ongoing psychosocial challenges of SLE. Further, the at‐home accessibility and low cost of such volunteer‐based interventions may play an ever more needed role in the present health care environment.
Comparison of general internists, family physicians, and rheumatologists managing patients with symptoms of osteoarthritis of the knee
Authors: Mazzuca Steven A. , Brandt Kenneth D. , Katz Barry P. , Dittus Robert S. , Freund Deborah A. , Lubitz Robert , Hawker Gillian , Eckert George 
Published: February 2007

AbstractObjective. To evaluate the nature, risks, and benefits of osteoarthritis (OA) management by primary care physicians and rheumatologists.Methods. Subjects were 419 patients followed for symptoms of knee OA by either a specialist in family medicine (FM) or general internal medicine (GIM) or by a rheumatologist (RH). Management practices were characterized by in‐home documentation by a visiting nurse of drugs taken to relieve OA pain or to prevent gastrointestinal side effects of nonsteroidal anti‐inflammatory drugs (NSAIDs) and by patient report (self‐administered survey) of nonpharmacologic treatments. Changes in outcomes (knee pain and physical function) over 6 months were measured with the Western Ontario and McMaster Universities Osteoarthritis Index.Results. Patients of RHs were 2‐3 years older (P = 0.035) and tended to exhibit greater radiographic severity of OA (P = 0.064) and poorer physical function (P = 0.076) at baseline than the other 2 groups. In all 3 groups, knee pain and physical function improved slightly over 6 months; however, between‐group differences were not significant. Compared to drug management of knee pain by FMs or RHs, that by the GIMs was distinguished by greater utilization of acetaminophen and nonacetylated salicylates (P = 0.008), lower prescribed doses of NSAIDs (P = 0.007), and, therefore, lower risk of iatrogenic gastroenteropathy (P < 0.001). In contrast, patients of RHs were more likely than those of FMs and GIMs to report that they had been instructed in use of isometric quadriceps and range‐of‐motion exercises (P ≦ 0.001), application of heat (P = 0.051) and cold (P < 0.001) packs, and in the principles of joint protection (P = 0.016). Neither physician specialty nor specific management practices accounted for variations in patient outcomes.Conclusion. This observational study identified specialty‐related variability in key aspects of the management of knee OA in the community (i.e., frequency and dosing of NSAIDs, use of nonpharmacologic modalities) that bear strong implications for long‐term safety and cost. However, changes in knee pain and function over 6 months were unrelated to variations in management practices.