bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of etanercept on fatigue in patients with recent or established rheumatoid arthritis
Authors: Moreland Larry W. , Genovese Mark C. , Sato Reiko , Singh Amitabh 
Published: March 2006

AbstractObjectiveTo assess the long‐term impact of etanercept on fatigue in patients with recent‐onset (mean duration 11 months) or established (mean duration 12 years) rheumatoid arthritis (RA).MethodsPatients participating in either of 2 multicenter, randomized, double‐blind clinical trials were included. In one trial, patients with recent‐onset RA received either etanercept 25 mg twice weekly or methotrexate in a double‐blind fashion for 12 months, then open label for 12 months. All patients then received open‐label etanercept. In the second trial, patients with established RA received etanercept 25 mg or placebo twice weekly for 6 months in a double‐blinded fashion, then open‐label etanercept. Up to 46 months of followup data were included. Fatigue was measured regularly using the Health Assessment Questionnaire vitality domain.ResultsPatients with recent‐onset RA who received etanercept had a significantly faster improvement in fatigue than those receiving methotrexate in the first 2 months. Subsequently, patients receiving etanercept and methotrexate had 23–29% and 17–24% reductions in fatigue scores, respectively. In the group with established RA, patients who received etanercept had significantly greater reductions in fatigue than those receiving placebo during the blinded period. Patients initially receiving etanercept sustained a mean fatigue reduction of 25–36% for the entire followup. Patients achieving clinically meaningful improvement in fatigue were more likely to meet the American College of Rheumatology improvement criteria.ConclusionEtanercept therapy reduces fatigue in patients with recent‐onset or established RA. Improvement in fatigue was sustained for up to 46 months, and correlated with other RA‐relevant outcomes.
Level of agreement between children, parents, and physicians in rating pain intensity in juvenile idiopathic arthritis
Authors: Garcia‐Munitis Pablo , Bandeira Marcia , Pistorio Angela , Magni‐Manzoni Silvia , Ruperto Nicolino , Schivo Ambra , Martini Alberto , Ravelli Angelo 
Published: March 2006

AbstractObjectiveTo investigate the level of agreement between patients, mothers, fathers, and physicians in rating pain intensity in juvenile idiopathic arthritis (JIA), and to identify factors explaining discrepancies between raters.MethodsNinety‐four children with JIA and their mothers and fathers were asked to rate independently the intensity of present pain and pain in the previous week on a visual analog scale. The physicians rated pain intensity after physical examination. Agreement between raters was determined using intraclass correlation coefficient and Bland and Altman method. Correlations of explanatory variables with discordance in rating pain intensity were determined by univariate and multivariate analyses. Explanatory variables included sex, age, JIA category, disease duration, results of study ratings, joint inflammation measures, and erythrocyte sedimentation rate.ResultsAgreement in rating present pain was moderate between children and mothers, but was poor between children and fathers and children and physicians. The agreement in rating pain in the previous week was moderate between children and mothers and children and fathers. Mother‐father agreement was good. Parents and physicians agreed at a moderate level. In multiple regression analyses, only intensity of present pain was significantly associated with discordance within child‐mother, child‐father, and child‐physician dyads.ConclusionChildren's ratings of pain were only in moderate agreement with those of their parents and were in poor agreement with those of the physicians, whereas the father and mothers agreed at a good level. The intensity of pain was the strongest determinant of discordance between children and other raters.
Population impact of arthritis on disability in older adults
Authors: Song Jing , Chang Rowland W. , Dunlop Dorothy D. 
Published: March 2006

AbstractObjectiveDisability threatens the independence of older adults and has large economic and societal costs. This article examines the population impact of arthritis on disability incidence among older Americans.MethodsThe present study used longitudinal data (1998–2000) from the Health and Retirement Study, a national probability sample of elderly Americans. Disability was defined by the inability to perform basic activities of daily living (ADL). A total of 7,758 participants ages ≥65 years with no ADL disability at baseline were included in the analyses. Multiple logistic regression was used to measure the impact of baseline arthritis (self reported) on incidence of subsequent ADL disability after controlling for baseline differences in demographics, health factors, health behaviors, and medical access.ResultsOlder adults who had baseline arthritis had a substantially higher incidence of ADL disability compared with those without arthritis (9.3% versus 4.5%). The strong relationship of arthritis and ADL disability was partially explained by demographic, health, behavioral, and medical access factors. However, even after adjusting for all other risk factors, arthritis remained as an independent and significant predictor for developing ADL disability (adjusted odds ratio 1.5, 95% confidence interval 1.2–1.8). Almost 1 in every 4 new cases of ADL disability was due to arthritis (adjusted population attributable fraction: 23.7%).ConclusionThe high frequency of incident ADL disability attributable to arthritis points to the importance of intervention programs that address the entire spectrum of health and functional problems in persons with arthritis to prevent disability.
Cost of treatment of childhood‐onset systemic lupus erythematosus
Authors: Brunner Hermine I. , Sherrard Tina M. , Klein‐Gitelman Marisa S. 
Published: March 2006

AbstractObjectiveTo determine the direct cost of care of children with childhood‐onset systemic lupus erythematosus (cSLE), and to determine the direct cost per quality‐adjusted life year (QALY) with cSLE.MethodsAdministrative databases from 2 large tertiary pediatric rheumatology centers in the United States were reviewed for all patients with cSLE (n = 119) diagnosed and regularly treated in these centers between January 2001 and April 2004. Health‐related quality of life estimates for patients with cSLE (n = 297) reported in the literature were used to calculate QALYs based on global health ratings of the Child Health Questionnaire (range 0–100).ResultsInformation on 3,184 patient‐months of followup was included in the analysis. During a mean ± SD followup of 27 ± 11.8 months, the direct cost of care for the cohort amounted to $3,965,048, excluding outpatient medications. Irrespective of patient sex, the mean ± SD cost of cSLE per month was $1,245 ± $2,352, or ∼$14,944 per year. Inpatient and day hospital care accounted for 28% of the cost, laboratory testing accounted for 21%, inpatient/day‐patient medication costs accounted for 13%, and dialysis accounted for 11%. Visits to the rheumatology clinic only contributed 9% to the direct cost of care. When including an estimated outpatient medication cost of $1,190, the direct cost of cSLE per QALY was $30,908.ConclusionChildren diagnosed with cSLE were found to have a considerable direct cost of care. The treatment of cSLE appears to be far more costly than that of adult SLE and juvenile idiopathic arthritis reported in the literature.
Reexamining the arthritis‐employment interface: Perceptions of arthritis‐work spillover among employed adults
Authors: Gignac Monique A. M. , Sutton Deborah , Badley Elizabeth M. 
Published: March 2006

AbstractObjectiveTo examine employed individuals' perceptions of arthritis‐work spillover (AWS), the reciprocal influence of arthritis on work and work on arthritis, and the demographic, illness, and work context factors associated with AWS.MethodsThe study group comprised 492 employed individuals with osteoarthritis or inflammatory arthritis. Participants completed an interview‐administered, structured questionnaire assessing AWS, demographic (e.g., age, sex), illness (e.g., disease type, pain, activity limitations), and work context (e.g., workplace control, hours of work) variables. Principal components analysis, reliability analysis, and multiple linear regression were used to analyze the data.ResultsA single factor solution emerged for AWS. The scale had an internal reliability of 0.88. Respondents were more likely to report that work interfered with caring for their arthritis than they were to report that their disease affected their work performance. Younger respondents, those with more fatigue and workplace activity limitations, and those working in trades and transportation reported more AWS. Individuals with more control over their work schedules reported less AWS.ConclusionThe results of this study extend research on arthritis by reexamining the interface between arthritis and employment. This study introduces a new measure of AWS that enhances the range of tools available to researchers and clinicians examining the impact of arthritis in individuals' lives.
Illness intrusion and psychological adjustment to rheumatic diseases: A social identity framework
Authors: Abraído‐Lanza Ana F. , Revenson Tracey A. 
Published: March 2006

AbstractObjectiveTo examine the extent to which arthritis intruded upon 4 social roles (spouse, homemaker, parent, worker). In accordance with propositions set forth by social identity theory and the identity‐relevant stress hypothesis, we hypothesized that 1) illness intrusion would predict psychological well‐being and 2) role importance would moderate the relationship between illness intrusion and psychological adjustment, such that intrusion into highly valued roles would be the most psychologically distressing.MethodsParticipants were recruited from the practices of rheumatologists affiliated with a major urban hospital. A total of 113 individuals (73% women) with diagnosed rheumatic disease completed a mailed questionnaire.ResultsFor all 4 roles, illness intrusion was related to decreased psychological well‐being. In the worker and parent roles, the effects of illness intrusion on adjustment were moderated by whether respondents valued these particular roles. For example, psychological well‐being was lowest among those individuals whose illness intruded greatly upon work and who highly valued their worker role identity.ConclusionThe findings highlight the advantages of assessing both domain‐specific illness intrusion and role importance in predicting psychological well‐being among persons with rheumatic diseases. Importantly, results also demonstrate the utility of applying a social identity framework in understanding adjustment processes among persons with chronic illness.
What factors account for referral delays for patients with suspected rheumatoid arthritis?
Authors: Suter Lisa G. , Fraenkel Liana , Holmboe Eric S. 
Published: March 2006

AbstractObjectiveRheumatoid arthritis (RA) is a common, costly, and disabling disease. Early referral and treatment reduce long‐term joint damage and improve functional outcomes. Despite efforts to improve referral, half of patients with RA are not referred in a timely manner. Our objective was to explore the factors influencing the decision of a primary care physician (PCP) to refer or not refer a patient with suspected RA, and to identify modifiable factors influencing timely referral.MethodsUsing qualitative methods and in‐depth, face‐to‐face interviews, we asked Connecticut PCPs to describe the last patient encounter where they suspected RA and the factors influencing referral and nonreferral. Participants represented a range of clinical experience, access to rheumatologists, and practice settings. Sample size was determined by thematic saturation. Transcripts were coded and analyzed using the constant comparative method of qualitative data analysis.ResultsWe interviewed 19 PCPs, 9 of whom were women. Our analysis identified clinical characteristics, patient preferences, access issues, clinical and administrative leadership, physician confidence and expectations, and interpersonal relationships as important domains influencing the referral decision. These domains interacted to impact timely referral and quality of care. Previously underappreciated factors, such as the magnitude of the effect of physician rapport, appeared to be critical in determining whether or not patients are promptly referred.ConclusionIssues such as physician rapport, as well as clinical and system issues, influence referral for suspected RA. To improve referral for RA, clinical guidelines, medical education, and quality improvement efforts should address all domains influencing the referral decision.
Expectations of recovery from revision knee replacement
Authors: Venkataramanan Viji , Gignac Monique A. , Mahomed Nizar N. , Davis Aileen M. 
Published: March 2006

AbstractObjectiveTo evaluate outcome expectations of patients undergoing revision total knee replacement (TKR) and to examine personal factors, patient functioning, previous experiences with knee replacement surgery, concerns about surgery, and general health as predictors of expectations.MethodsRevision TKR patients (n = 184, 54% women; mean age 69 years) completed a questionnaire up to 2 weeks before surgery. This included demographics, experience with previous knee surgery, concerns about surgery, the Life Orientation Test (LOT), the Arthritis Helplessness Scale, the Western Ontario and McMaster Universities Osteoarthritis Index, and a rating of overall health. Outcome expectations were evaluated as 5 questions assessing global benefit; relief of pain; ease of disability; expectations of having complications; and whether the person expected to be fully recovered from surgery in <6 months, 6–12 months, >12 months, or did not expect to recover. Predictors of each of the 5 outcome expectations were evaluated using univariable and multivariable regression analyses.ResultsExpectations are a multidimensional construct (Cronbach's α = 0.63). Expectation of global benefit of surgery was high, but was lower for benefits related to ease of pain and improved function. Concerns about surgery were a consistent predictor of all expectation outcomes in multivariable modeling. When concerns about surgery and general health were entered into the model as an interaction with expectation of recovery time as the outcome, past experience (P = 0.05), pain (P = 0.03), LOT (P = 0.03), and interaction between concerns about surgery and general health were significant predictors.ConclusionClinicians need to understand and help patients shape appropriate expectations for recovery from revision TKR.
Transitions to mobility difficulty associated with lower extremity osteoarthritis in high functioning older women: Longitudinal data from the Women's Health and Aging Study II
Authors: Ling Shari M. , Xue Qian Li , Simonsick Eleanor M. , Tian Jing , Bandeen‐roche Karen , Fried Linda P. , Bathon Joan M. 
Published: March 2006

AbstractObjectiveTo assess the impact of lower extremity osteoarthritis (OA) on transitions to mobility difficulty, and to assess the influence of pain, excess weight, and quadriceps strength on these transitions.MethodsWe analyzed longitudinal data acquired from 199 participants in the Women's Health and Aging Study II (ages 70–79 years) who initially reported no lower extremity limitation (e.g., difficulty walking one‐quarter mile) or difficulty in activities of daily living (ADL; e.g., transferring). Prevalent lower extremity OA was determined from validated algorithms encompassing multiple data sources. Markov transition models were created to analyze the first transition from no difficulty at baseline to lower extremity limitations, ADL difficulty, or both 18, 36, and 72 months later.ResultsCompared with women without OA (n = 140), a higher proportion of women with lower extremity OA (n = 59) initially reported pain on most days and more severe pain while walking (P< 0.05). Women with OA were also heavier, with a higher proportion being obese or overweight (P< 0.001). Lower extremity OA, higher body mass index, and lower knee extensor strength independently increased the risk of transition to combined lower extremity and ADL difficulty first over 72 months.ConclusionLower extremity OA increased the likelihood of developing difficulty in both lower extremity tasks and ADL over 72 months in a cohort of initially high functioning older women. Two modifiable factors, higher relative weight and lower knee extensor strength, substantially impacted these transitions, and therefore warrant increased attention in the management of lower extremity OA.
Maternal panic disorder and congenital abnormalities: A population‐based case‐control study
Authors: ács Nándor , Bánhidy Ferenc , Horváth‐Puhó Erzsébet , Czeizel Andrew E. 
Published: March 2006

AbstractBACKGROUNDMaternal panic disorder in pregnancy is the most common manifestation of anxiety disorders in Hungary. The association between panic disorder during pregnancy and structural birth defects, i.e., congenital abnormalities, was studied.METHODSThe prevalence of maternal panic disorder in cases with different congenital abnormalities was compared to that of matched controls in the population‐based Hungarian Case‐Control Surveillance System of Congenital Abnormalities.RESULTSOf 22,843 cases with congenital abnormalities, 210 (0.9%) had mothers with panic disorder during pregnancy compared to 187 (0.5%) of 38,151 controls (adjusted prevalence odds ratio [POR] 1.6; 95% CI, 1.3–2.0). Specific groups of congenital abnormalities were also assessed versus controls. Cases with isolated cleft lip with or without cleft palate (CL/P) (adjusted POR, 3.4; 95% CI, 1.3–9.0) and multiple congenital abnormalities (adjusted POR, 3.0; 95% CI, 1.2–7.2) were more likely to have had mothers with panic disorder during the study pregnancy. Notably, among mothers with panic disorders, the associations were found only in offspring of untreated mothers.CONCLUSIONSA higher rate of isolated CL/P and multiple congenital abnormalities may be caused by the direct biological effect of panic disorder or by the interaction of maternal panic disorder and lifestyle factors. Antipanic drug treatment seems to have a protective effect for isolated CL/P and multiple congenital abnormalities. Birth Defects Research (Part A), 2006. © 2006 Wiley‐Liss, Inc.
Alternative Anschlußbewehrung für im Fundament eingespannte Stützen und Wände
Authors: Zahn Franz A. , Köpfer Axel , Püschel Wolfram , Zehnle David 
Published: March 2006

AbstractEs wird eine alternative Ausführungsform der Fundamentanschlußbewehrung für am Fuß eingespannte Stützen und Wände diskutiert. Anstatt der üblichen, sich gegenseitig durchdringenden L‐förmigen Abbiegungen wird die Anschlußbewehrung schlaufenförmig ausgebildet, was zu erheblichen Erleichterungen bei der Ausführung führt. Das Verhalten der vorgeschlagenen Form der Anschlußbewehrung wurde in zwei Versuchsreihen sowie durch rechnerische Vergleiche mit Hilfe eines nichtlinearen Finite Element Programms untersucht, deren Ergebnisse hier diskutiert werden.
Flachdecken in Elementbauweise. Hinweise zum Durchstanznachweis nach DIN 1045‐1
Authors: Furche Johannes , Bauermeister Ulrich 
Published: March 2006

AbstractFlachdecken werden zunehmend aus vorgefertigten Stahlbetonplatten und einer aufbetonierten Ortbetonschicht hergestellt. Das Tragverhalten dieser Elementdecken mit Gitterträgern ist ähnlich dem reiner Ortbetondecken und das gilt prinzipiell auch für durchstanzgefährdete Bereiche. Dieses konnte in Bauteilversuchen gezeigt werden, welche als Grundlage für die Herleitung von Bemessungs‐ und Konstruktionsregelungen dienten. Jedoch sind bei der Bemessung und Konstruktion von Elementdecken gegenüber der von reinen Ortbetondecken einige Besonderheiten zu beachten. Die Umstellung von Zulassungen für Durchstanzsysteme auf das Konzept der neuen DIN 1045‐1 erfolgte zum Teil zeitgleich mit der Einführung einer neuen Durchstanzbewehrung für Elementdecken. Die erforderlichen Nachweise im Durchstanzbereich von Elementdecken werden für unterschiedliche Systeme zusammengestellt und erläutert.
Flachdecken mit Vorspannung ohne Verbund. Ein Beispiel aus der Praxis
Authors: Tremmel Ferdinand , Metzler Helmut 
Published: March 2006

AbstractVerbundlos vorgespannte Flachdecken ermöglichen gegenüber der konventionellen Bauweise einen größeren Gestaltungsfreiraum für Architekten und Nutzer. Anhand einer ausgeführten Produktionshalle werden Tragwerkskonzepte und Bemessungsansätze erläutert sowie Konstruktionsdetails dargestellt.
Genormte Nachhaltigkeit im Baubereich? Zum Zwischenstand der Normungsarbeiten bei ISO und CEN
Authors: Lützkendorf Thomas 
Published: March 2006

AbstractDie Umsetzung von Prinzipien einer nachhaltigen Entwicklung im Baubereich führt unter anderem zu einem wachsenden Bedarf an umwelt‐ und gesundheitsrelevanten Informationen zu Bauprodukten sowie an Ergebnissen einer Beurteilung der Umweltqualität von Gebäuden. Derartige Fragestellungen sind derzeit Gegenstand internationaler und europäischer Normungsaktivitäten bei ISO und CEN. Es wird der aktuelle Stand der Normung beschrieben, hinsichtlich möglicher Konsequenzen diskutiert und in einen Gesamtzusammenhang der Unterstützung einer nachhaltigen Entwicklung im Baubereich eingeordnet. Die intensive Beobachtung dieser Entwicklung sowie die normenkonforme und bedarfsgerechte Bereitstellung und Weitergabe von Informationen werden zum Wettbewerbsfaktor.
Erläuterungen zu einigen Auslegungen der DIN 1045‐1
Authors: Fingerloos Frank 
Published: March 2006

AbstractSeit der bauaufsichtlichen Einführung der Norm DIN 1045‐1 im Jahre 2002 in der Bundesrepublik Deutschland sind im Rahmen ihrer praktischen Umsetzung Fragen der planenden und ausführenden Ingenieure entstanden, die der Interpretation und Auslegung bedürfen. Der Normenausschuß Bauwesen (NABau) im DIN bearbeitet diese Fragen und veröffentlicht die Ergebnisse als offizielle Antworten zu Auslegungsfragen regelmäßig im Internet, um den Praktikern Hilfen zu geben und Unsicherheiten bei der Anwendung der Norm zu reduzieren. Zur weiteren Erhöhung der Normenakzeptanz sollen in diesem Beitrag Erläuterungen zu den Hintergründen einiger Auslegungen gegeben werden, die aufgrund des gebotenen reduzierten Antwortumfangs im Internet fehlen. Die angesprochenen Auslegungsthemen sind: Fundamentbemessung, Expositionsklassen, innerer Hebelarm bei der Querkraftbemessung, Verbundfuge und Stützenkonstruktionsregeln.
Massive Brücken in Mitteldeutschland
Authors: Weller Bernhard , Tasche Martin 
Published: March 2006

AbstractAnhand ausgewählter Brücken aus Sachsen, Thüringen und Sachsen‐Anhalt soll die Entwicklung des Massivbrückenbaus in Ausschnitten nachgezeichnet werden. Beginnend mit der frühen Steinbrücke über die Werra in Creuzburg, der bekannten Göltzschtalbrücke bei Netzschkau und der Syratalbrücke in Plauen werden mit einer Möllerbrücke und einem Visintini‐Träger zwei weniger bekannte Bauweisen aus den Anfängen des Stahlbetonbaus vorgestellt. Hervorzuheben ist die erste Spannbetonbrücke Deutschlands in Aue/Sachsen ebenso wie die Entwicklung der weltweit ersten textilbewehrten Brücke durch die Technische Universität Dresden.