bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improved training of house officers in a rheumatology consult service
Authors: Mazzuca Steven A , Brandt Kenneth D , Katz Barry P 
Published: February 2007

AbstractThis study examined whether the clinical environment could be used to increase internal medicinehouse officers' adoption of care recommendations taught in a didactic conference. Subjects were11 internal medicine house officers who served 6‐week rheumatology elective rotations. At the start of each of four rotation periods, house officers attended a 1‐hour conference in which periarticular rheumatic disorders associated with knee pain (anserine bursitis, pseudothrombo‐phlebitis) and shoulder pain (bicipital tendinitis) were discussed. All house officers also practiced physical examination techniques on anatomic models simulating the disorders. During alternate rotation periods, reminder sheets were appended to the records of arthritis patients with histories of chronic knee or shoulder pain. The frequency with which house officers followed conference recommendationswas documented by direct observation (6 house officers in 17 encounters with reminders, 5 house officers in 30 encounters without reminders). Specific questioning about a recent history of knee or shoulder pain and the performance of four of five recommended physical examination maneuvers were increased significantly by reminder sheets in patients' charts (P < 0.05 for all). Although rheumatology faculty often have limited options available to increase the number of house officer trainees or to intensify clinical activity, qualitative improvements within existing logistic parameters are feasible by assuring that the clinical environment (e.g., patient records) contains salient cues that will prompt desired actions.
Medical student use of history and physical information in diagnostic reasoning
Authors: Gruppen Larry D , Palchik Nancy S , Wolf Fredric M , Laing Timothy J , Oh Mary S. , Davis Wayne K. 
Published: February 2007

AbstractClinical data gathering is central to clinical competence. Although research has demonstrated the value to experienced clinicians of information obtained from the history, little is known of how medical students use this information. In the present study, two case simulations (in rheumatoid arthritis and systemic lupus erythematosis) were developed to assess medical student information gathering and utilization. The results indicate that most of the students were already considering the correct diagnosis as a possibility after the presenting complaint and patient description. However, the medical history exerted the strongest influence on transforming the correct diagnosis from just another diagnostic possibility into the favored diagnostic candidate. Students who failed to list the correct diagnosis in the differential diagnosis after obtaining the history were significantly less likely to reach the correct diagnosis at the end of the case. These results confirm the critical importance of the history in medical problem solving.
Relationship of pain behavior to disease activity and health status in rheumatoid arthritis
Authors: Parker Jerry C , Callahan Charles D , Smarr Karen L , McClure Karla W , Stucky‐ropp Renég , Anderson Sharon K , Walker Sara E 
Published: February 2007

AbstractThe purpose of the study was to investigate the contributions of disease activity, health status, and self‐efficacy to the pain behavior exhibited by patients with rheumatoid arthritis. Measures included the Arthritis Impact Measurement Scales, the Arthritis Self‐Efficacy Scale, a visual analogue scale for pain, and the McGill Pain Questionnaire. Joint counts and ratings of pain behavior also were obtained. All measures were collected at both baseline and 6 months. Hierarchicalmultiple regression analyses revealed that disease activity, as measured by joint count, was significantly related to a modified pain behavior index at both time intervals. With joint count entered into the regression model, no other variable consistently increased the predictive accuracy of the model. There were no significant correlations between the modified pain behavior index and either the visual analogue scale for pain or the McGill Pain Questionnaire scores. The results suggest that painbehavior in male rheumatoid arthritis patients is more closely related to disease activity than to self‐reported pain, health status, or perceived self‐efficacy.
Use of self ‐ administered joint counts in the evaluation of rheumatoid arthritis patients
Authors: Abraham Noval , Blackmon Deborah , Jackson James R , Bradley Laurence A , Lorish Christopher D , Alarcón Graciela S 
Published: February 2007

AbstractThe validity and reliability of self‐administered joint counts are reported in a group of32 rheumatoid arthritis patients being followed at a university‐based practice located in theSoutheast region of the United States, serving low to middle income urban and rural patients. Adequate inter‐rater reliability among the patients' and the research assistant's joint counts was obtained for upper (r = 0.74), lower (r = 0.96), and upper and lower extremities (r = 0.89). Convergent validity correlations for pain, helplessness, and the Joint Alignment and Motion scale were found to be adequate. We conclude that rheumatoid arthritis patients can reliably assess their joint counts. Self joint counts along with other validated self‐reportsof health status may be applicable to busy outpatient settings, as well as in clinical research.
Comparison of peak isometric knee extensor torque in children with and without juvenile rheumatoid arthritis
Authors: Giannini Manuela Jasso , Protas Elizabeth J. 
Published: February 2007

AbstractThis study compared peak isometric knee extensor torque in children with juvenile rheumatoid arthritis (JRA) and healthy children. A secondary purpose was to determine the relationship between measures of articular disease severity and peak isometric knee extensor torque. Peak torque was measured with a computerized dynamometer. Twenty‐eight children with JRA and 28 children without JRAwere matched for age, sex, and body surface area. Peak isometric knee extensor torque was significantly lower among the children with JRA than their respective control (P < 0.05, paired Student's t‐test, one‐tailed). There was no relationship between peak torque and measures ofarticular disease severity among the children with JRA. Subjects complained of quadriceps muscle discomfort as a result of the isometric muscle test. One child with JRA complained of increased knee pain and swelling. Peak isometric knee extensor torque appears to be a useful variable for characterizing muscle function deficits in children with JRA. Isometric muscle performance did not correlate with articular disease severity. The results suggest that isometric strengthening programs are indicated for this patient population. We recommend that clinicians monitor patients for joint and muscle symptoms during exercise training sessions.
Differential strength decline in patients with osteoarthritis of the knee: revision of a hypothesis
Authors: Hall Kathy D , Hayes Karen W , Falconer Judith 
Published: February 2007

AbstractA quadriceps‐to‐hamstring isometric peak torque ratio (Q/H ratio) of approximately 2.0 is considered necessary for appropriate knee biomechanics. Lower ratios may affectthe function of persons with osteoarthritis (OA) and the progression of the disease. This study examined theisometric Q/H ratio in subjects with and without OA of the knee and explored the effect of age, pain, and joint enlargement on the ratio. Twenty‐one pairs of subjects (OA, control) were matched on age (X = 62.6 years; SD = 13.9), gender (F = 17, M = 4), and leg dominance (Dominant = 10, Nondominant = 11). Isometric quadriceps and hamstring peak torque, knee pain, and joint enlargement were measured. Paired t‐tests demonstrated that the OA group had significantly lower quadriceps peak torque than the control group but did not have significantly lower hamstring peak torque or gravity‐corrected isometric Q/H ratio. Age correlated with the ratio in subjects without OA (p = −0.46; P = 0.03) but not in subjects with OA. Pain was not significantly correlated with the ratio in either group. Joint enlargement correlated with the ratio in the OA group (p = −0.45; P = 0.03). The gravity‐corrected isometric Q/H ratio appears to decrease with age in subjects without OA. In subjects with OA, the Q/H ratio appears not to change with disease, pain, or age. Joint enlargement may decrease the ratio and merits further study.
Adapting the systemic lupus erythematosus self‐help (slesh) course for latino SLE patients
Authors: Robbins Laura , Allegrante John P , Paget Stephen A 
Published: February 2007

AbstractThe Systemic Lupus Erythematosus Self‐Help (SLESH) Course is an effective self‐management program that provides knowledge and enabling skills to people with systemic lupus erythematosus (SLE) and their families to assist them in coping with the disease. However, many acknowledge that the program has largely failed to meet the needs of people from diverse cultural backgrounds. In order to better understand how the SLESH Course can be more responsive to the needs of people from diverse cultural groups, we conducted a case study to analyze the content, process, and logistics of the course. The purpose of our study was to determine the essential variables to be considered in adapting the program for Latino SLE patients. Utilizing a three‐phase approach that involved keyinformant interviews, focus groups, and evaluation of skill‐building activities, we found that culturally determined health beliefs, language of preference, and outreach efforts are the key variables that must be considered in adapting the SLESH Course for the target population. Culturally determined health beliefs, such as the importance of family roles rather than individual need and an emphasis on the interdependency of family members, need to be considered in adapting self‐help programs like the SLESH Course for Latino SLE patients.
Is group physical therapy superior to individualized therapy in ankylosing spondylitis? A randomized controlled trial
Authors: Hidding Alita , van der Linden Sjef , Boers Maarten , Gielen Xandra , de Witte Luc , Kester Arnold , Dijkmans Ben , Moolenburgh Daniël 
Published: February 2007

AbstractPurpose. To study the effects of adding supervised group physical therapy to unsupervised individualized therapy in ankylosing spondylitis.Methods. One hundred forty‐four patients were randomized to exercises at home, or the same plus weekly group physical therapy for 9 months. Endpoints were spinal mobility, fitness[maximum work capacity by ergometry], functioning (Sickness Impact Profile, Health Assessment Questionnaire for the Spondylar‐thropathies, and Functional Index), and patient's global assessment of change on a 10‐cm visual analogue scale.Results. Thoracolumbar flexion and extension increased by an average of 0.5 cm (9%) after home exercises, and by 0.9 cm (16%) after group therapy. Maximum load in ergometry decreased by 2 W (1%) after home exercises, but increased by 7 W (4%) after group therapy. Global assessment improved by 0.3 (6%)after home exercises, and by 1.7 (34%) after group therapy. These three differenceswere statistically significant. There were no significant differences in chest expansion, cervical rotation, or the self‐assessments of functioning.Conclusions. Group physical therapy proved superior to individualized therapy in improving thoracolumbar mobility and fitness, and had an important effect on global health reported by the patients.
A musculoskeletal outreach screening, treatment, and education program for urban minority children
Authors: Kasper Mark J , Robbins Laura , Root Leon , Peterson Margaret G. E. , Allegrante John P 
Published: February 2007

AbstractPurpose. A hospital‐based outreach program was initiated to screen minority children in medically underserved areas of New York City for musculoskeletal diseases. We examine the number of such diseases in this population, and evaluate the program's success to facilitate referral and follow‐up of children with referral conditions.Methods. Screenings were conducted at schools and day‐care centers. Children requiringfurther evaluation were referred to the sponsoring hospital, a major referral center for musculoskeletal diseases. Bilingual educational strategies, transportation reimbursement, and coverage for uninsured children were used to foster participation and increase follow‐up.Results. A total of 2,523 children were screened, 168 (6.7%) of whom were referred forone of 45 different musculoskeletal disorders, including scoliosis and back problems, foot problems, in‐ and out‐toeing, knee or hip pain, and problems of joint range of motion. Sixtyseven percent of those referred had a follow‐up medical consultation.Conclusions. A substantial proportion of urban minority children have previously undiagnosed musculoskeletal disorders that, if left untreated, have the potential to lead to significant disability in later life. Targeted screening programs can be effective in identifying such disorders, and providing an apportunity for early diagnosis, treatment, and education.
Self‐care agency in persons with rheumatoid arthritis
Authors: Ailinger Rita L , Dear Margaret R 
Published: February 2007

AbstractUsing a framework based on Orem's self‐care deficit theory, five hypotheses related to conditioning factors in self‐care agency were tested. The study sample consisted of 60 outpatients with a diagnosis of rheumatoid arthritis in a large research hospital. Patients completed the Exercise of Self‐Care Agency instrument and the Health Assessment Questionnaire; a physician rated their arthritis severity. Twenty percent of subjects had high scores on self‐care agency, 63% had average scores, and 16% had low scores. The conditioning factor of age was not relatedto selfcare agency. However, education and the duration of illness were related to self‐care agency in this group of persons with rheumatoid arthritis.
Promoting self‐care in clients with arthritis
Authors: Neuberger Geri Budesheim , Smith Katharine Vogel , Black Sharon Oetker , Hassanein Ruth 
Published: February 2007

AbstractPreliminary work regarding the development and pilot study of an individualized instructionalprogram for rheumatoid arthritis clients is presented. The effect of the individualized instructional program was tested with 31 outpatients. Using analysis of covariance, the experimental group subjectsscored significantly higher on the knowledge post‐test when compared to scores of control group subjects (P = 0.0045). Analysis of variance for repeated measures revealed no significant difference in performance of tasks for the control group and experimental group (P = 0.08). In a follow‐up study, the effect of the self‐instructional program, practice time, and contracting were explored for their effect on adherence to self‐care activities. Experimentalgroups (n = 42) scored significantly better than the control group (n = 11) on the knowledge post‐test (P < 0.01), performance of joint protection practices (P = 0.01), range of motion exercises (P = 0.01), and adherence to joint protection practices at home (P < 0.01). Groups did not differ on adherence to range of motion exercises at home (P = 0.83).
Factors affecting unprescribed remedy use among people with self‐reported arthritis
Authors: Cronan Terry A , Kaplan Robert M , Kozin Franklin 
Published: February 2007

AbstractObjective. The purpose of the study is to determine the frequency and consequences of use of unprescribed remedies by people with self‐reported osteoarthritis, and to find methodsfor predicting such use.Methods. A random digit telephone survey was used to contact respondents. A 90‐item questionnaire evaluated demographic characteristics, type of disorder, area affected, severity of problem, and symptoms encountered.Results. Among 1,811 contacts, 21% had musculoskeletal complaints. Of those withself‐reported musculoskeletal disorders, 84% had used at least one unprescribed remedyduring the past 6 months. People with self‐reported rheumatoid arthritis used more such remedies than those with self‐reported osteoarthritis, and those with a greater degree of disability used more unprescribed remedies than those who were less affected. Unprescribed remedies were rated as effective as prescribed remedies.Conclusions. Unprescribed remedies are used frequently, particularly by those with painful and disabling arthritis. These remedies may be effective. Harmful and expensive remedies are used rarely.
Heat and cold in the management of rheumatoid arthritis
Authors: Hayes Karen W 
Published: February 2007

AbstractHeat and cold are used often in the management of patients with rheumatoid arthritis (RA). The primary uses of heat have been to relieve pain and improve the extensibility of periarticular tissuesprior to mobility exercises. Cold is also used as a means of reducing pain prior to exercise and functional activities and to reduce the effects of inflammation. The effects that occur with these agents may be beneficial symptomatically and may also have an effect on the pathological process. In spite of the fact that they are often used by both patients and health care providers with apparent success, there is not a substantial body of evidence attesting to the efficacy of heat or cold in patients with RA. The purposes of this review are to examine that evidence and summarize the effectiveness of heat and cold in the management of joint complaints of patients with RA.
Juvenile rheumatoid arthritis: pain‐related and psychosocial aspects and their relevance for assessment and treatment
Authors: Jaworsk Theresa M 
Published: February 2007

AbstractObjective. To review literature in the area of juvenile rheumatoid arthritis that has focused on pain experience, functional losses, and psychosocial functioning.Methods. This article provides a critical review of research addressing these three primary issues.Results. Subjective and behavioral measures have been developed to assess pain in juvenile rheumatoid arthritis patients, but further work is needed to determine the validity and reliability of these instruments. Tools to assess functional losses in juvenile rheumatoid arthritis patients also appear promising in preliminary studies. Patients can be at risk for difficulties in psychosocial functioning, although research suggests that there are a variety of family, parental, and childvariables that influence child and sibling adaptation. Methodologic shortcomings prevent definitive conclusions in this area.Conclusions. Although methodologic limitations have plagued this research in the past, new advances are facilitating improved understanding of children and adolescents with juvenile rheumatoid arthritis. Implications for future study with this challenging population are offered.
Physical interventions in the management of pain in arthritis an overview for research and practice
Authors: Minor Marian A , Sanford Marilyn K 
Published: February 2007

AbstractThis paper reviews arthritis‐related literature on the effectiveness of a number of physical interventions to reduce pain. Original research reports as well as information from principle texts and review articles of thermal agents, topical applications, phoresis, transcu‐taneous electrical nerve stimulation, cold laser, and exercise are included. Although the biophysical actions of many physical interventions are partially understood, their effects on pain and function have not been defined clearly. The results of studies of one or a combination of physical interventions were generally inconsistent and reflected a wide variety of research designs and methods. Most physical agents, used alone, had minimal effects on pain. Interventions that combined physical agents and exercise were more successful in attenuating pain and also decreasing impairment. Research and clinical experience have provided insights into appropriate selection of physical intervention and their effectiveness in achieving treatment goals in arthritis care. However, considerable investigation into the mechanismsof action, differential effects of dose, staging and treatment combinations, and the relation of pain, impairment, and function remains to be undertaken.
Cognitive‐behavioral treatment of rheumatoid arthritis pain maintaining treatment gains
Authors: Keefe Francis J , van Horn Yolanda 
Published: February 2007

AbstractObjective. This paper critically reviews research studies examining the long‐term effects of cognitive‐behavioral therapy interventions for managing pain in rheumatoid arthritis patients.Methods and Results. The first section of the paper evaluates long‐term results obtained in studies of cognitive‐behavioral therapy, arthritis education inter ventions, and combined cognitive‐behavioral therapy‐arthritis education interventions. These studies show that although some rheumatoid arthritis patients are able to maintain initial improvements inpain and disability, other rheumatoid arthritis patients do not. In the second section of this review, a cognitive‐behavioral model of maintenance of pain coping skills is presented. This modelmay be useful in increasing our understanding of the relapse process and in planning interventions toenhance and prolong cognitive‐behavioral therapy treatment gains. The final section of thispaper addresses important future directions for research. The need for empirical studies of relapse and maintenance processes is underscored.Conclusions. Controlled studies are needed to test the utility of new cognitive‐behavioral interventions designed to enhance the long‐term maintenance of treatment gains inRA patients. We suggest that a focus on issues of relapse and maintenance may be just as important for medical and surgical interventions for rheumatoid arthritis pain, as it is for cognitive‐behavioral therapy interventions.
Joint protection behavior in patients with rheumatoid arthritis following an education program a pilot study
Authors: Hammond Alison 
Published: February 2007

AbstractPurpose. Joint protection (JP) education is a common feature in rheumatoid arthritis (RA) treatment programs. However, no objective studies have been published demonstrating patients' behavior changes following such education. This study evaluated whether RA patients' hand movement patterns altered following a JP education program.Methods. An assessment procedure was constructed to assess application of four JP principles related to altering patterns of hand use during common everyday activities (making a hot drink and snack meal).Results. Eleven RA patients were assessed. There was no significant behavioral change at 6 weeks post‐JP education (t = 10; P > 0.1). In contrast, follow‐up interviews of self‐perceived JP behavior showed all subjects considered JP relevant for them and seven believed they had changed to using these techniques.Conclusions. This suggests education led to attitudi‐nal change but that behavioral change requires longer and more targeted input than is currently normally provided.
Evaluation of the Jebson hand function test for use in patients with rheumatoid arthritis
Authors: Sharma Siraj , Schumacher H. Ralph , McLellan A. Thomas 
Published: February 2007

AbstractPurpose. We have evaluated the Jebson hand function (JHF) test for use in patients with rheumatoid arthritis (RA).Methods. The JHF test was administered to 25 patients with RA. Results were compared to normative data and related to ability to perform activities of daily living (ADL), pain, and deformity.Results. The JHF test detects differences between patients with RA and normals; all components except for writing show correlations with ADL and deformity. There were no significant correlations with pain.Conclusions. The JHF test is a useful adjunct to evaluation of the hand in RA.