bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding ethnic disparities in the use of total joint arthroplasty: Application of the health belief model
Authors: Ang Dennis C. , Monahan Patrick O. , Cronan Terry A. 
Published: December 2007

AbstractObjectiveThe Health Belief Model holds promise in understanding patient‐related factors that may explain disparities in the use of total joint arthroplasty (TJA). We examined whether patients' health beliefs differ between African Americans and whites.MethodsIn a primary care clinic setting, 691 African Americans and whites with at least a moderately severe degree of osteoarthritis (OA) completed the Arthritis‐related Health Belief Instrument. The instrument has 4 scales: perceived benefits of TJA, perceived barriers to obtaining TJA, perceived severity of arthritis, and perceived susceptibility of arthritis to worsen.ResultsThe sample (40% women) consisted of 263 (38%) African Americans and 428 (62%) whites who were similar with respect to education, amount of insurance coverage, number of comorbidities, and self‐report OA severity score. The African American group was younger, had less men, had more participants who reported an annual income <$15,000, and had a higher body mass index than whites. After controlling for confounders, African Americans were almost 50% (odds ratio [OR] 0.60, 95% confidence interval [95% CI] 0.42–0.86, P = 0.005) as likely as whites to perceive that TJA is beneficial or helpful for their arthritis. Furthermore, African Americans were 70% (OR 1.7, 95% CI 1.18–2.44, P = 0.004) more likely than whites to recognize barriers (e.g., risky, etc.) to TJA. Race was not associated with either the perceived severity or the perceived susceptibility of arthritis to worsen.ConclusionAmong patients with at least moderately severe OA, African Americans were significantly less likely than whites to perceive the benefits of TJA and more likely to recognize barriers to TJA.
Asking the experts: Exploring the self‐management needs of adolescents with arthritis
Authors: Stinson Jennifer N. , Toomey Patricia C. , Stevens Bonnie J. , Kagan Susan , Duffy Ciarán M. , Huber Adam , Malleson Peter , McGrath Patrick J. , Yeung Rae S. M. , Feldman Brian M. 
Published: December 2007

AbstractObjectiveTo explore the self‐management needs of adolescents with juvenile idiopathic arthritis and the acceptability of a Web‐based program of self‐management aimed at improving quality of life.MethodsA descriptive qualitative design was used. A convenience sample of 36 adolescents (male and female) who varied in age, disease onset subtype, and disease severity were recruited from 4 Canadian tertiary care pediatric centers. Individual (n = 25) and 3 focus‐group (n = 11) interviews were conducted with adolescents using semistructured interview guides. After each interview session, the audiotaped interview data were transcribed verbatim. NUD*IST 6.0 was used to assist with the sorting, organizing, and coding of the data. Data were organized into categories that reflected emerging themes.ResultsAdolescents articulated how they developed effective self‐management strategies through the process of “letting go” from others who had managed their illness (health care professionals, parents) and “gaining control” over managing their illness on their own. The 2 strategies that assisted in this process were gaining knowledge and skills to manage the disease and experiencing understanding through social support. Five further subthemes emerged around skills to manage the disease, including knowledge and awareness about the disease, listening to and challenging care providers, communicating with the doctor, managing pain, and managing emotions.ConclusionAdolescents were united in their call for more information, self‐management strategies, and meaningful social support to better manage their arthritis. They believed that Web‐based interventions were a promising avenue to improve accessibility and availability of these interventions.
Sugar‐sweetened soft drinks, diet soft drinks, and serum uric acid level: The third national health and nutrition examination survey
Authors: Choi Jee Woong J. , Ford Earl S. , Gao Xiang , Choi Hyon K. 
Published: December 2007

AbstractObjectiveSugar‐sweetened soft drinks contain large amounts of fructose, which may significantly increase serum uric acid levels and the risk of gout. Our objective was to evaluate the relationship between sugar‐sweetened soft drink intake, diet soft drink intake, and serum uric acid levels in a nationally representative sample of men and women.MethodsUsing data from 14,761 participants age ≥20 years from the Third National Health and Nutrition Examination Survey (1988–1994), we examined the relationship between soft drink consumption and serum uric acid levels using linear regression. Additionally, we examined the relationship between soft drink consumption and hyperuricemia (serum uric acid level >7.0 mg/dl for men and >5.7 mg/dl for women) using logistic regression. Intake was assessed by a food‐frequency questionnaire.ResultsSerum uric acid levels increased with increasing sugar‐sweetened soft drink intake. After adjusting for covariates, serum uric acid levels associated with sugar‐sweetened soft drink consumption categories (<0.5, 0.5–0.9, 1–3.9, and ≥4 servings/day) were greater than those associated with no intake by 0.08, 0.15, 0.33, and 0.42 mg/dl, respectively (95% confidence interval 0.11, 0.73; P < 0.001 for trend). The multivariate odds ratios for hyperuricemia according to the corresponding sweetened soft drink consumption levels were 1.01, 1.34, 1.51, and 1.82, respectively (P = 0.003 for trend). Diet soft drink consumption was not associated with serum uric acid levels or hyperuricemia (multivariate P > 0.13 for trend).ConclusionThese findings from a nationally representative sample of US adults suggest that sugar‐sweetened soft drink consumption is associated with serum uric acid levels and frequency of hyperuricemia, but diet soft drink consumption is not.
Daily spiritual experiences of older adults with and without arthritis and the relationship to health outcomes
Authors: McCauley Jeanne , Tarpley Margaret J. , Haaz Steffany , Bartlett Susan J. 
Published: December 2007

AbstractObjectiveStrategies to improve coping with chronic disease are increasingly important, especially with the aging US population. For many, spirituality serves as a source of strength and comfort. However, little is known about the prevalence of daily spiritual experiences (DSE) and how they may relate to physical and mental health.MethodsWe surveyed older adults age >50 years with chronic health conditions seen in a primary care setting about their DSE, health perceptions, pain, energy, and depression.ResultsOf 99 patients, 80% reported DSE most days and many times per day. Women had significantly lower DSE scores than men (reflecting more frequent DSE, mean ± SD 37.3 ± 15.0 versus 45.8 ± 17.5; P = 0.012). African American women reported the most frequent DSE and white men reported the least frequent DSE (mean ± SD 35.9 ± 13.6 versus 52.2 ± 19.1). Frequent DSE were significantly associated with a higher number of comorbid conditions (P = 0.003), although not with age, education, or employment status. Persons with arthritis reported significantly more DSE than those without arthritis (mean ± SD 35.2 ± 12.1 versus 47.1 ± 18.6; P < 0.001). After adjustment for age, race, sex, pain, and comorbid conditions, more frequent DSE were associated with increased energy (P < 0.009) and less depression (P < 0.007) in patients with arthritis.ConclusionDSE are common among older adults, especially those with arthritis. Increased DSE may be associated with more energy and less depression. DSE may represent one pathway through which spirituality influences mental health in older adults.
Clinical remission and/or minimal disease activity in patients receiving adalimumab treatment in a multinational, open‐label, twelve‐week study
Authors: Burmester Gerd R. , Ferraccioli Gianfranco , Flipo René‐Marc , Monteagudo‐Sáez Indalecio , Unnebrink Kristina , Kary Sonja , Kupper Hartmut 
Published: December 2007

AbstractObjectiveTo evaluate the effect of adalimumab treatment on clinical remission and/or minimal disease activity (MDA) in 6,610 patients with active rheumatoid arthritis (RA) who were enrolled in the Research in Active RA trial, a multinational, open‐label, 12‐week study with an optional extension period.MethodsClinical remission was defined as a Disease Activity Score in 28 joints (DAS28) <2.6, Simplified Disease Activity Index (SDAI) score ≤3.3, or Clinical Disease Activity Index (CDAI) score ≤2.8. MDA required absence of tender and swollen joints plus erythrocyte sedimentation rate (ESR) ≤10 mm/hour; DAS28 score ≤2.85; or achievement of 5 of 7 core criteria for pain, swollen/tender joints, physical function, physician/patient global assessment, and ESR. Time to and time in remission/MDA and response predictors were analyzed using Kaplan‐Meier estimates and Cox proportional hazards regression analysis, respectively.ResultsA total of 38%, 24%, and 27% of patients achieved remission defined as DAS28 <2.6, SDAI ≤3.3, and CDAI ≤2.8, respectively. MDA was observed in 45% of patients by DAS28 ≤2.85, in 43% by the core set of criteria, and in 13% by absence of tender/swollen joints plus ESR ≤10 mm/hour. Median times in continuous remission and MDA were 3.4 and 4.4 months, respectively. Predictors for remission (DAS28 <2.6) and MDA (DAS28 ≤2.85) were male sex; younger age; concomitant disease‐modifying antirheumatic drug use; lower baseline DAS28, CRP concentration, and Health Assessment Questionnaire disease index score; ≤1 comorbidity; and tumor necrosis factor antagonist naivety.ConclusionDuring adalimumab treatment, 25% of patients experienced clinical remission and nearly half achieved MDA. To our knowledge, this analysis represents the largest prospective clinical trial data set to be assessed using Outcome Measures in Rheumatology Clinical Trials MDA criteria.
Responsiveness of exercise parameters in children with inflammatory myositis
Authors: Takken Tim , van der Net Janjaap , Engelbert Raoul H. H. , Pater Suzanne , Helders Paul J. M. 
Published: December 2007

AbstractObjectiveJuvenile dermatomyositis (DM) is an inflammatory myopathy in which the immune system targets the microvasculature of the skeletal muscle and skin, leading to significant muscle weakness and exercise intolerance, although the precise etiology is unknown. The goal of this study was to investigate the changes in exercise capacity in children with myositis during active and inactive disease periods and to study the responsiveness of exercise parameters.MethodsThirteen children with juvenile DM (mean ± SD age 11.2 ± 2.6 years) participated in this study. Patients performed a maximal exercise test using an electronically braked cycle ergometer and respiratory gas analysis system. Exercise parameters were analyzed, including peak oxygen uptake (VO2peak), peak work rate (Wpeak), and ventilatory anaerobic threshold (VAT). All children were tested during an active period of the disease and during a remission period. From these data, 4 different response statistics were calculated.ResultsThe children performed significantly better during a remission period compared with a period of active disease. Most exercise parameters showed a very large response. The 5 most responsive parameters were Wpeak, Wpeak (percent predicted), oxygen pulse, VO2peak, and power at the VAT.ConclusionWe found in our longitudinal study that children with active juvenile DM had significantly reduced exercise parameters compared with a remission period. Moreover, we found that several parameters had very good responsiveness. With previously established validity and reliability, exercise testing has been demonstrated to be an excellent noninvasive instrument for the longitudinal followup of children with myositis.
Missing data in randomized controlled trials of rheumatoid arthritis with radiographic outcomes: A simulation study
Authors: Baron Gabriel , Ravaud Philippe , Samson Adeline , Giraudeau Bruno 
Published: December 2007

AbstractObjectiveTo assess the impact, in terms of statistical power and bias of treatment effect, of approaches to dealing with missing data in randomized controlled trials of rheumatoid arthritis with radiographic outcomes.MethodsWe performed a simulation study. The missingness mechanisms we investigated copied the process of withdrawal from trials due to lack of efficacy. We compared 3 methods of managing missing data: all available data (case‐complete), last observation carried forward (LOCF), and multiple imputation. Data were then analyzed by classict‐test (comparing the mean absolute change between baseline and final visit) or F test (estimation of treatment effect with repeated measurements by a linear mixed‐effects model).ResultsWith a missing data rate close to 15%, the treatment effect was underestimated by 18% as estimated by a linear mixed‐effects model with a multiple imputation approach to missing data. This bias was lower than that obtained with the case‐complete approach (−25%) or LOCF approach (−35%). This statistical approach (combination of multiple imputation and mixed‐effects analysis) was moreover associated with a power of 70% (for a 90% nominal level), whereas LOCF was associated with a power of 55% and a case‐complete power of 58%. Analysis with thet‐test gave qualitatively equivalent but poorer quality results, except when multiple imputation was applied.ConclusionOur simulation study demonstrated multiple imputation, offering the smallest bias in treatment effect and the highest power. These results can help in planning trials, especially in choosing methods of imputation and data analysis.
Physical inactivity in patients with rheumatoid arthritis: Data from twenty‐one countries in a cross‐sectional, international study
Authors: Sokka Tuulikki , Häkkinen Arja , Kautiainen Hannu , Maillefert Jean Francis , Toloza Sergio , MØrk hansen Troels , Calvo‐Alen Jaime , Oding Rolf , Liveborn Margareth , Huisman Margriet , Alten Rieke , Pohl Christof , Cutolo Maurizio , Immonen Kai , Woolf Anthony , Murphy Eithne , Sheehy Claire , Quirke Edel , Celik Selda , Yazici Yusuf , Tlustochowicz Witold , Kapolka Danuta , Skakic Vlado , Rojkovich Bernadette , Müller Raili , Stropuviene Sigita , Andersone Daina , Drosos Alexandros A. , Lazovskis Juris , Pincus Theodore 
Published: December 2007

AbstractObjectiveRegular physical activity is associated with decreased morbidity and mortality. Traditionally, patients with rheumatoid arthritis (RA) have been advised to limit physical exercise. We studied the prevalence of physical activity and associations with demographic and disease‐related variables in patients with RA from 21 countries.MethodsThe Questionnaires in Standard Monitoring of Patients with Rheumatoid Arthritis (QUEST‐RA) is a cross‐sectional study that includes a self‐report questionnaire and clinical assessment of nonselected consecutive outpatients with RA who are receiving usual clinical care. Frequency of physical exercise (≥30 minutes with at least some shortness of breath, sweating) is queried with 4 response options: ≥3 times weekly, 1–2 times weekly, 1–2 times monthly, and no exercise.ResultsBetween January 2005 and April 2007, a total of 5,235 patients from 58 sites in 21 countries were enrolled in QUEST‐RA: 79% were women, >90% were white, mean age was 57 years, and mean disease duration was 11.6 years. Only 13.8% of all patients reported physical exercise ≥3 times weekly. The majority of the patients were physically inactive with no regular weekly exercise: >80% in 7 countries, 60–80% in 12 countries, and 45% and 29% in 2 countries, respectively. Physical inactivity was associated with female sex, older age, lower education, obesity, comorbidity, low functional capacity, and higher levels of disease activity, pain, and fatigue.ConclusionIn many countries, a low proportion of patients with RA exercise. These data may alert rheumatologists to motivate their patients to increase physical activity levels.
Effect of two contrasting types of physical exercise on chronic neck muscle pain
Authors: Andersen Lars L. , KjÆr Michael , SØgaard Karen , Hansen Lone , Kryger Ann I. , SjØgaard Gisela 
Published: December 2007

AbstractObjectiveThe prevalence of neck muscle pain has steadily increased and especially pain from the descending part of the trapezius muscle has been associated with monotonous work tasks such as computer work. Physical exercise is generally recommended as treatment, but it is unclear which type of training is most effective. Our objective was to determine the effectiveness of specific strength training of the painful muscle versus general fitness training without direct involvement of the painful muscle (leg bicycling) on work‐related neck muscle pain.MethodsWe conducted a randomized controlled trial and recruited subjects from 7 workplaces characterized by monotonous jobs (e.g., computer‐intensive work). Forty‐eight employed women with chronic neck muscle pain (defined as a clinical diagnosis of trapezius myalgia) were randomly assigned to 10 weeks of specific strength training locally for the affected muscle, general fitness training performed as leg bicycling with relaxed shoulders, or a reference intervention without physical activity. The main outcome measure was an acute and prolonged change in intensity of neck muscle pain (100‐mm visual analog scale [VAS]).ResultsA decrease of 35 mm (∼79%; P < 0.001) in the worst VAS pain score over a 10‐week period was seen with specific strength training, whereas an acute and transient decrease in pain (5 mm; P < 0.05) was found with general fitness training.ConclusionSpecific strength training had high clinical relevance and led to marked prolonged relief in neck muscle pain. General fitness training showed only a small yet statistically significant acute pain reduction.
Participation restrictions among older adults with osteoarthritis: A mediated model of physical symptoms, activity limitations, and depression
Authors: Machado Gustavo P. M. , Gignac Monique A. M. , Badley Elizabeth M. 
Published: December 2007

AbstractObjectiveResearch emphasizes the negative impact of osteoarthritis (OA) on social participation, yet few studies have examined the roles of symptoms, activity limitations, and depression in this relationship. The present longitudinal study tested a model that hypothesizes that the relationship between physical symptoms and later participation restrictions among older adults with OA is mediated by activity limitations and depressive symptoms.MethodsParticipants were 184 community‐dwelling senior adults (age ≥55 years) with a physician diagnosis of OA who were interviewed at 2 time points 18 months apart. Measures included demographic variables; a derived physical symptoms measure based on severity of pain, stiffness, and fatigue in the previous week; and depressive symptoms measured by the Center for Epidemiologic Studies Depression Scale. Measures of activity limitations and participation restrictions were derived by factor analysis of questions about difficulty in everyday life. Sequential multiple linear regression analyses controlling for demographic and illness‐related variables were used to test for mediation.ResultsSeverity of time 1 physical symptoms was associated with difficulties in participation 18 months later. Sequential introduction of variables showed that this relationship was partially mediated by time 1 activity limitations and time 1 depressive symptoms. When both of these variables were included in the model, the effect of symptoms severity was completely mediated.ConclusionThis study demonstrates the importance of taking into account both the physical (activity limitations) and psychological (depressive symptoms) consequences of OA symptoms and suggests that these factors act as a pathway to subsequent participation restrictions.
Pharmacokinetics of desethylamiodarone in the rat after its administration as the preformed metabolite, and after administration of amiodarone
Authors: Shayeganpour Anooshirvan , Hamdy Dalia A. , Brocks Dion R. 
Published: December 2007

AbstractThe pharmacokinetics of desethylamiodarone (DEA), the active metabolite of amiodarone (AM), were studied in the rat after administration of AM or preformed metabolite. Rats received 10 mg/kg of either intravenous or oral AM HCl or DEA base. Blood samples were obtained via a surgically implanted jugular vein cannula. Plasma concentrations were measured by a validated LC/MS method. In all AM treated rats, AM plasma concentrations greatly exceeded those of the formed DEA. The fraction of AM converted to DEA after i.v. administration was 14%. Amiodarone had a significantly lower (∼50%) clearance than DEA, although the volume of distribution and terminal phase half‐life did not differ significantly. The hepatic extraction ratio of DEA was 0.48, similar to that of AM (0.51). Oral AM demonstrated higher plasma AUC (5.6 fold) and higher Cmax (6.1 fold) than oral DEA and oral bioavailability of AM (46%) was greater than DEA (17%). The estimated fraction of the oral dose of AM converted to DEA was 4.5 fold higher than after i.v. administration, suggesting first‐pass formation of DEA from AM. Amiodarone and DEA differed in their pharmacokinetic characteristics mostly due to a higher CL of DEA. With oral dosing, AM appeared to undergo significant presystemic first‐pass metabolism within the intestinal tract. Copyright © 2007 John Wiley & Sons, Ltd.
Cognitive function and symptoms in adults and adolescents in relation to rf radiation from UMTS base stations
Authors: Riddervold Ingunn S. , Pedersen Gert F. , Andersen Niels T. , Pedersen Anders D. , Andersen Jørgen B. , Zachariae Robert , Mølhave Lars , Sigsgaard Torben , Kjærgaard Søren K. 
Published: December 2007

AbstractThere is widespread public concern about the potential adverse health effects of mobile phones in general and their associated base stations in particular. This study was designed to investigate the acute effects of radio frequency (RF) electromagnetic fields (EMF) emitted by the Universal Mobile Telecommunication System (UMTS) mobile phone base stations on human cognitive function and symptoms. Forty adolescents (15–16 years) and 40 adults (25–40 years) were exposed to four conditions: (1) sham, (2) a Continuous Wave (CW) at 2140 MHz, (3) a signal at 2140 MHz modulated as UMTS and (4) UMTS at 2140 MHz including all control features in a randomized, double blinded cross‐over design. Each exposure lasted 45 min. During exposure the participants performed different cognitive tasks with the Trail Making B (TMB) test as the main outcome and completed a questionnaire measuring self reported subjective symptoms. No statistically significant differences between the UMTS and sham conditions were found for performance on TMB. For the adults, the estimated difference between UMTS and sham was −3.2% (−9.2%; 2.9%) and for the adolescents 5.5% (−1.1%; 12.2%). No significant changes were found in any of the cognitive tasks. An increase in ‘headache rating’ was observed when data from the adolescents and adults were combined (P = 0.027), an effect that may be due to differences at baseline. In conclusion, the primary hypothesis that UMTS radiation reduces general performance in the TMB test was not confirmed. However, we suggest that the hypothesis of subjective symptoms and EMF exposure needs further research. Bioelectromagnetics 29:257–267, 2008. © 2007 Wiley‐Liss, Inc.