EULAR/eumusc.net standards of care for rheumatoid arthritis: cross-sectional analyses of importance, level of implementation and care gaps experienced by patients and rheumatologists across 35 European countries

2020 ◽  
Vol 79 (11) ◽  
pp. 1423-1431
Author(s):  
Rachelle Meisters ◽  
Polina Putrik ◽  
Sofia Ramiro ◽  
Monika Hifinger ◽  
Andras P Keszei ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Regression Models ◽  
European Countries ◽  
Standards Of Care ◽  
Implementation Barriers ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
European League Against Rheumatism ◽  
Care Gaps ◽  
The Difference

ObjectiveAs part of European League against Rheumatism (EULAR)/European Musculoskeletal Conditions Surveillance and Information Network, 20 user-focused standards of care (SoCs) for rheumatoid arthritis (RA) addressing 16 domains of care were developed. This study aimed to explore gaps in implementation of these SoCs across Europe.MethodsTwo cross-sectional surveys on the importance, level of and barriers (patients only) to implementation of each SoC (0–10, 10 highest) were designed to be conducted among patients and rheumatologists in 50 European countries. Care gaps were calculated as the difference between the actual and maximum possible score for implementation (ie, 10) multiplied by the care importance score, resulting in care gaps (0–100, maximal gap). Factors associated with the problematic care gaps (ie, gap≥30 and importance≥6 and implementation<6) and strong barriers (≥6) were further analysed in multilevel logistic regression models.ResultsOverall, 26 and 31 countries provided data from 1873 patients and 1131 rheumatologists, respectively. 19 out of 20 SoCs were problematic from the perspectives of more than 20% of patients, while this was true for only 10 SoCs for rheumatologists. Rheumatologists in countries with lower gross domestic product and non-European Union countries were more likely to report problematic gaps in 15 of 20 SoCs, while virtually no differences were observed among patients. Lack of relevance of some SoCs (71%) and limited time of professionals (66%) were the most frequent implementation barriers identified by patients.ConclusionsMany problematic gaps were reported across several essential aspects of RA care. More efforts need to be devoted to implementation of EULAR SoCs.

scholarly journals Associations between Intensity, Frequency, Duration, and Volume of Physical Activity and the Risk of Stroke in Middle- and Older-Aged Chinese People: A Cross-Sectional Study

2020 ◽  
Vol 17 (22) ◽  
pp. 8628
Author(s):  
Donghui Yang ◽  
Yuqian Bian ◽  
Zixin Zeng ◽  
Yiran Cui ◽  
Yafeng Wang ◽  
...  
Keyword(s):  
Physical Activity ◽  
Regression Models ◽  
Binary Logistic Regression ◽  
Total Sample ◽  
Cross Sectional Study ◽  
Chinese People ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Different Dimensions ◽  
The Difference

Context: Persuasive evidence has shown the inverse associations between physical activity (PA) and the risk of stroke. However, few studies have investigated the associations between different dimensions (intensity, frequency, duration, volume) of PA and the risk of stroke. Objective: To investigate the associations between different dimensions of PA and the risk of stroke in total participants and subgroups. Method: This study included 6250 individuals aged 45 years old and above from the China Health and Retirement Longitudinal Study (CHARLS). PA was divided into vigorous PA (VPA), moderate PA (MPA), and light PA (LPA), and described in different dimensions (intensity, frequency, duration, volume). Stroke was defined on the basis of self-reported diagnosis and related treatments. Binary logistic regression models were established to assess the associations between different dimensions of PA and the risk of stroke in total participants and subgroups stratified by sex. Results: Individuals taking VPA with a frequency of 3–5 d/w, duration of ≥240 min/d, volume of ≥300 min/w had lower risks of strokes in total participants (Odds ratio (OR) = 0.32, 95% confidence interval (CI): 0.13, 0.75; OR = 0.60, 95% CI: 0.38, 0.94; OR = 0.68, 95% CI: 0.46, 0.99, respectively). However, significant associations of VPA with the risk of stroke in men were only observed in the duration of ≥240 min/d and volume of ≥300 min/w (OR = 0.53, 95% CI: 0.30, 0.93; OR = 0.61, 95% CI: 0.38, 0.99, respectively) whereas no significance in women. Compared with individuals taking no MPA, inverse significant associations between the risk of stroke and any level of frequency, duration and volume in MPA were observed in total sample (OR ranging from 0.16–0.40, all p < 0.05), whereas significant associations between the risk of stroke and MPA were found in men except the duration of 10–29 min/d and volume of 150–299 min/w (OR ranging from 0.26–0.35, all p < 0.05), and in women except the frequency of 1–2 d/w and duration of ≥240 min/d (OR ranging from 0.14–0.49, all p < 0.05). No significant associations could be observed in total participants and subgroups between LPA and the risk of stroke. Conclusion: This study revealed some significant associations between different dimensions of PA, especially MPA, and the risk of stroke. Furthermore, the difference of association was observed in the groups with different sex. Further prospective study is needed to determine deeper associations between PA and the risk of stroke.

scholarly journals The multimorbidity of hypertension and osteoarthritis and relation with sleep quality and hyperlipemia/hyperglycemia in China’s rural population

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Li Ran ◽  
Qi Chen ◽  
Jingyi Zhang ◽  
Xinlong Tu ◽  
Xiaodong Tan ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Regression Models ◽  
Joint Effect ◽  
Cross Sectional Study ◽  
Poor Sleep ◽  
Sectional Study ◽  
Additive Interaction ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Remote Rural Area

AbstractHypertension (HTN) and osteoarthritis (OA) are frequent in middle-aged and elderly people, and the co-occurrence of these two diseases is common. However, the pathogenesis of the multimorbidity of both diseases and the relation with sleep quality, hyperlipemia, and hyperglycemia is unclear. We conducted a cross-sectional study to make sense of the multimorbidity of HTN and OA and the relation with sleep quality, hyperlipemia, and hyperglycemia. The relation between sleep quality and OA and its joint effect with hyperlipemia or hyperglycemia was evaluated with logistic regression models. The additive interaction was assessed with the relative excess risk due to interaction (REEI), the attributable proportion (AP), and the synergy index (S). According to this research in a remote rural area, approximately 34.2% of HTN patients are accompanied with OA and 49.1% are suffering poor sleep. Both hyperlipemia/hyperglycemia and sleep quality were related to OA prevalence with crude ORs of 1.43 (95% CI 1.014–2.029) and 1.89 (95% CI 1.411–2.519, P < 0.001) respectively. An observed additive effect was found greater than the sum of the effects of sleep quality and hyperlipemia/hyperglycemia posed on OA prevalence alone. This additive interaction was observed in females (OR = 3.19, 95% CI 1.945–5.237) as well as males ≥ 65 years old (OR = 2.78, 95% CI 1.693–4.557), with RERI, AP, and S significant. Therefore, poor sleep and hyperlipemia/hyperglycemia are associated with OA, and further studies on the additive interaction among females and males ≥ 65 are warranted.

Chronic disruptive pain in emerging adults with and without chronic health conditions and the moderating role of psychiatric disorders: Evidence from a population-based cross-sectional survey in Canada

2017 ◽  
Vol 17 (1) ◽  
pp. 30-36 ◽  
Author(s):  
Rana A. Qadeer ◽  
Lilly Shanahan ◽  
Mark A. Ferro
Keyword(s):  
Mental Health ◽  
Psychiatric Disorders ◽  
Emerging Adults ◽  
Regression Models ◽  
Daily Functioning ◽  
Moderating Effects ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Drug Disorders

AbstractBackground and aimsThere has been a growth in the proportion of emerging adults vulnerable to pain-related sequelae of chronic health conditions (CHCs). Given the paucity of research during this important developmental period, this study investigated the association between CHCs and chronic disruptive pain among emerging adults and the extent to which psychiatric disorders moderate this association.MethodsData come from the 2012 Canadian Community Health Survey - Mental Health (CCHS-MH). This cross-sectional survey included 5987 participants that were 15-30 years of age and self-reported their CHCs (n = 2460,41%) and the extent to which pain impacted daily functioning using items from the Health Utilities Index Mark 3 (HUI 3). Group comparisons between respondents with CHCs and healthy controls were made using chi-square tests. Odds ratios (OR) and 95% confidence intervals (CI) were computed from ordinal logistic regression models adjusting for sociodemographic covariates. Product-term interactions between CHCs and psychiatric disorders were included in the models to explore moderating effects. All analyses were weighted to maintain representativeness of the study sample to the Canadian population.ResultsThe mean age of participants was 23.5 (SE 0.1) years and 48% were female. Compared to healthy controls, a greater proportion of participants with CHCs reported having chronic pain (20.3% vs. 4.5%, p < 0.001). Among those with chronic pain, respondents with CHCs reported a greater number of activities prevented because of chronic disruptive pain (χ2 = 222.28, p< 0.001). Similarly, in logistic regression models, participants with CHCs had greater odds of reporting chronic disruptive pain (OR = 4.94, 95% CI = 4.08-5.99). Alcohol (β = –0.66; p = 0.025) and drug abuse/dependence disorders (β = –1.24; p = 0.012) were found to moderate the association between CHCs and chronic disruptive pain. Specifically, the probability of chronic disruptive pain was higher for emerging adults without CHCs and with alcohol or drug disorders; however, among participants with CHCs, probability was higher for those without these disorders.ConclusionsThere is a robust association between CHCs and chronic disruptive pain. The moderating effects suggest that alcohol or drug disorders are especially harmful for emerging adults without CHCs and contribute to higher levels of chronic disruptive pain; however, among those with CHCs, alcohol and illicit drugs may be used as a numbing agent to blunt chronic disruptive pain.ImplicationsFindings from this study have implications for the integration and coordination of services to design strategies aimed at managing chronic disruptive pain and preventing pain-related disabilities later in life. Within the health system, healthcare providers should engage in dialogues about mental health and substance use regularly with emerging adults, be proactive in screening for psychiatric disorders, and continue to monitor the impact of pain on daily functioning. Given the age range of emerging adults, there is tremendous opportunity for clinicians to work cooperatively with colleagues in the education system to support emerging adults with and without CHCs. Overall, clinicians, researchers, educators, and those in social services should continue to be mindful of the complex interrelationships between physical and mental health and chronic disruptive pain and work cooperatively to optimize health outcomes and prevent pain-related disabilities among emerging adults.

Physician Perceptions on Quality of Life and Resuscitation Preferences for Extremely Early Newborns

2021 ◽  
Author(s):  
Danielle LoRe ◽  
Christopher Mattson ◽  
Dalia M. Feltman ◽  
Jessica T. Fry ◽  
Kathleen G. Brennan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Logistic Regression ◽  
Regression Models ◽  
Mixed Effects ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Comfort Care ◽  
Logistic Regression Models ◽  
Extremely Preterm

Objective The study aimed to explore physician views on whether extremely early newborns will have an acceptable quality of life (QOL), and if these views are associated with physician resuscitation preferences. Study Design We performed a cross-sectional survey of neonatologists and maternal fetal medicine (MFM) attendings, fellows, and residents at four U.S. medical centers exploring physician views on future QOL of extremely early newborns and physician resuscitation preferences. Mixed-effects logistic regression models examined association of perceived QOL and resuscitation preferences when adjusting for specialty, level of training, gender, and experience with ex-premature infants. Results A total of 254 of 544 (47%) physicians were responded. A minority of physicians had interacted with surviving extremely early newborns when they were ≥3 years old (23% of physicians in pediatrics/neonatology and 6% in obstetrics/MFM). The majority of physicians did not believe an extremely early newborn would have an acceptable QOL at the earliest gestational ages (11% at 22 and 23% at 23 weeks). The majority of physicians (73%) believed that having an extremely preterm infant would have negative effects on the family's QOL. Mixed-effects logistic regression models (odds ratio [OR], 95% confidence interval [CI]) revealed that physicians who believed infants would have an acceptable QOL were less likely to offer comfort care only at 22 (OR: 0.19, 95% CI: 0.05–0.65, p < 0.01) and 23 weeks (OR: 0.24, 95% CI: 0.07–0.78, p < 0.02). They were also more likely to offer active treatment only at 24 weeks (OR: 9.66, 95% CI: 2.56–38.87, p < 0.01) and 25 weeks (OR: 19.51, 95% CI: 3.33–126.72, p < 0.01). Conclusion Physician views of extremely early newborns' future QOL correlated with self-reported resuscitation preferences. Residents and obstetric physicians reported more pessimistic views on QOL. Key Points

scholarly journals Stigmatisation and body image impairment in dermatological patients: protocol for an observational multicentre study in 16 European countries

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e024877 ◽  
Author(s):  
Florence J Dalgard ◽  
Anthony Bewley ◽  
Andrea W Evers ◽  
Uwe Gieler ◽  
Lars Lien ◽  
...  
Keyword(s):  
Body Image ◽  
Multicentre Study ◽  
Skin Disease ◽  
Skin Diseases ◽  
European Countries ◽  
Background Information ◽  
Psychosocial Burden ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
General Anxiety Disorder

IntroductionPatients with common skin diseases may have substantial psychosocial comorbidity and reduced quality of life. This study aims at exploring further the psychosocial burden of skin diseases by assessing stigmatisation and body image problems in a large sample of patients with skin disease across Europe.Methods and analysisThe study is an observational cross-sectional multicentre study across 16 European countries comparing stigmatisation and body image in patients with skin disease compared with controls. Consecutive patients will be recruited in outpatient clinics and will complete validated questionnaires prior to clinical examination by a dermatologist at each recruitment site. In addition to sociodemographic background information, the outcomes will be: mood disorders assessed by short versions of the Patient Health Questionnaire and the General Anxiety Disorder Assessment; general health assessed by the EuroQol-Visual Analogue Scale; stigmatisation experience assessed by the Perceived Stigmatisation Questionnaire; stress assessed by the Perceived Stress Scale and body image assessed by the Dysmorphic Concern Questionnaire. The main criteria for eligibility are to be 18 years old or more. The analysis will include comparison between patients and controls for the main outcomes using t-tests, analyses of covariance and multivariate logistic regression models adjusting for potential confounding factors.Ethics and disseminationThe study protocol is approved by the University of Giessen and by the local Ethical Committee in each recruitment centre. Informed consent will be given by each participant. The results of the study will be disseminated by publications in international peer-reviewed journals and presented at international conferences and general public conferences. Results will influence support intervention and management of patients with skin disease across Europe.Trial registration numberDRKS00012745; Pre-results.

scholarly journals Awareness, Attitudes, and Practices Toward Meningococcal B Vaccine among Pediatricians in Italy

Medicina ◽  
2018 ◽  
Vol 54 (6) ◽  
pp. 100
Author(s):  
Pietro Ferrara ◽  
Lucia Stromillo ◽  
Luciana Albano
Keyword(s):  
Regression Models ◽  
Positive Attitude ◽  
Daily Practice ◽  
Cross Sectional Study ◽  
Vaccination Schedule ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Attitudes And Practices ◽  
4Cmenb Vaccine

Background and objectives: Vaccination against bacterial pathogens is decisive for preventing invasive meningococcal disease and pediatricians play a pivotal role in vaccination compliance and coverage. The aim of this study was to investigate awareness, attitude, and practices toward the vaccine against Meningococcal B serogroup (4CMenB) among a sample of Italian pediatricians. Materials and Methods: A cross-sectional study was carried out using an online questionnaire from March to May 2015. Three multivariate logistic regression models were built to identify factors associated with the outcomes of interest. Results: The data showed that 95.5% of the interviewees correctly responded about the availability of 4CMenB vaccine in Italy, while only 28.0% knew the vaccination schedule for children aged two years or under. This knowledge was significantly higher in younger pediatricians and in those who worked a higher number of hours per week. Pediatricians self-reported a positive attitude toward the utility and safety of 4CMenB vaccine. Those pediatricians with a strong positive attitude toward the utility of the vaccine, who knew the vaccination schedules for children of two years or under, and who declared a satisfactory or good knowledge about the vaccine were more likely to inform parents about its availability in Italy, recommend the vaccination, and verify patients’ vaccination status, in their daily practice. Conclusions: The study highlights factors that currently influence pediatricians’ practices regarding the 4CMenB vaccine. The results showed the possible actions recommended to improve physicians’ awareness and behaviors in order to improve the vaccination compliance and invasive meningococcal diseases prevention.

scholarly journals Influence of the interaction between parental myopia and poor reading and writing habits on prevalence of myopia in school students in Urumqi, China

2021 ◽  
Author(s):  
Haonan Shi ◽  
Jing Fu ◽  
Xiaojing Liu ◽  
Yingxia Wang ◽  
Xianting Yong ◽  
...  
Keyword(s):  
Regression Models ◽  
Unconditional Logistic Regression ◽  
Cross Sectional Survey ◽  
School Students ◽  
Cross Sectional ◽  
Poor Reading ◽  
Reading And Writing ◽  
Multiplicative Interaction ◽  
Logistic Regression Models ◽  
Lying Down

Abstract Background: To evaluate the prevalence of myopia in school students in Urumqi, China, and explore the influence of the interaction between parental myopia and poor reading and writing habits on myopia to identify the at-risk population and provide evidence to help school students avoid developing myopia.Methods: A cross-sectional survey was conducted with 6,883 school students aged 7–20 years in Urumqi in December 2019. The Standard Eye Chart and mydriatic optometry were used to determine whether students had myopia. Falconer’s method was used to calculate the heritability of parental myopia. Multivariate unconditional logistic regression models were used to analyze the risk factors for myopia and the additive and multiplicative interaction of parental myopia and poor reading and writing habits.Results After standardizing the age of the 6,883 students, the overall prevalence rate of myopia was 47.50%. The heritability of parental myopia was 66.57% for boys, 67.82% for girls, 65.02% for the Han group, and 52.71% for other ethnicities. There were additive interactions between parental myopia and poor reading and writing habits; among them, parental myopia and poor reading and writing habits (1) (the distance between the eyes and book is less than 30 cm when reading and writing, fingers block the sight of one eye while holding the pen, and leaning one’s body when reading and writing) increased the risk of myopia by 10.99 times (odds ratio [OR]=10.99, 95% confidence interval [CI]=8.33–14.68), parental myopia and poor reading and writing habits (2) (reading while lying down, walking, or in the car) increased the risk of myopia by 5.92 times (OR=5.92, 95% CI=4.84–7.27). There was no multiplicative interaction between parental myopia and poor reading and writing habits (1) or (2) (OR=0.69, 95% CI=0.44–1.08; OR=0.89, 95% CI=0.66–1.21, respectively).Conclusion The prevalence of myopia among students in Urumqi, Xinjiang is relatively high. The risk of developing myopia is affected by parental myopia and poor reading and writing habits. In addition, parental myopia amplifies the harm caused by poor reading and writing habits, thereby increasing the risk of myopia. Students with parents who have myopia should be targeted during myopia prevention efforts.

scholarly journals Asymmetric Fixed Effects Models for Panel Data

2018 ◽  
Author(s):  
Paul D Allison
Keyword(s):  
Logistic Regression ◽  
Panel Data ◽  
Opposite Direction ◽  
Difference Method ◽  
Fixed Effects ◽  
Regression Models ◽  
Social Phenomena ◽  
Logistic Regression Models ◽  
Fixed Effects Models ◽  
The Difference

Standard fixed effects methods presume that effects of variables are symmetric: the effect of increasing a variable is the same as the effect of decreasing that variable but in the opposite direction. This is implausible for many social phenomena. York and Light (2017) showed how to estimate asymmetric models by estimating first-difference regressions in which the difference scores for the predictors are decomposed into positive and negative changes. In this paper, I show that there are several aspects of their method that need improvement. I also develop a data generating model that justifies the first-difference method but can be applied in more general settings. In particular, it can be used to construct asymmetric logistic regression models.

scholarly journals 1384Factors related to neck and shoulder pain during the COVID-19 pandemic in Japan

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Sayo Tanaka ◽  
Sachiko Ohde ◽  
Kota Katanoda ◽  
Sarah Krull Abe ◽  
Takahiro Tabuchi
Keyword(s):  
Shoulder Pain ◽  
Regression Models ◽  
Cross Sectional Study ◽  
Lifestyle Changes ◽  
Internet Survey ◽  
Cross Sectional ◽  
Shoulder Stiffness ◽  
Logistic Regression Models ◽  
Health Measures ◽  
Neck And Shoulder Pain

Abstract Background Shoulder stiffness is a common health issue in Japan. During the COVID-19 pandemic, people were forced to stay home which possibly escalated the development of shoulder stiffness. We aimed to assess associations of lifestyle changes and newly developed neck and shoulder pain (NSP) during the pandemic. Methods A cross-sectional study was conducted, analyzing the data from the Japan COVID-19 and Society Internet Survey (JACSIS), an internet survey conducted from August to September 2020. Data included sociodemographic, lifestyle and health measures related to NSP during the pandemic. Multivariable logistic regression models were fitted to calculate adjusted odds ratio (AOR) with 95% confidence interval (CI) for newly developed NSP with adjustment for lifestyle, physiological and psychosocial changes. Results After exclusion of participants with existing pain, 25,482 participants (12,673 male, 12,809 female) aged 15-79 years were included in the analysis. Of these, 4.1% reported newly developed NSP. Weight gain and long sedentary time were strongly associated with the NSP (AOR (95%CI): 2.4 (2.0-2.8) and 1.81 (1.4-2.3)). Stratified analyses of 1,751 students and 4,211 teleworkers showed significant associations (AOR (95%CI): 2.1 (1.4-2.8) and 2.5 (1.9-3.2)) compared to non-workers and non-teleworkers, respectively. Conclusions Students and teleworkers became prone to NSP during the pandemic. However, factors which were associated to pain did not differ during the pandemic compared with the previous studies. Key messages Preventive measures for NSP should be taken in students and teleworkers.

scholarly journals Differences in Sickness Allowance Receipt between Swedish Speakers and Finnish Speakers in Finland

2017 ◽  
Vol 52 ◽  
pp. 43-58 ◽  
Author(s):  
Kaarina S. Reini ◽  
Jan Saarela
Keyword(s):  
Regression Models ◽  
Health Condition ◽  
Logistic Regression Models ◽  
Individual Level ◽  
Objective Health ◽  
Language Groups ◽  
Health Measure ◽  
All Cause Mortality ◽  
The Difference ◽  
The Individual

Previous research has documented lower disability retirement and mortality rates of Swedish speakers as compared with Finnish speakers in Finland. This paper is the first to compare the two language groups with regard to the receipt of sickness allowance, which is an objective health measure that reflects a less severe poor health condition. Register-based data covering the years 1988-2011 are used. We estimate logistic regression models with generalized estimating equations to account for repeated observations at the individual level. We find that Swedish-speaking men have approximately 30 percent lower odds of receiving sickness allowance than Finnish-speaking men, whereas the difference in women is about 15 percent. In correspondence with previous research on all-cause mortality at working ages, we find no language-group difference in sickness allowance receipt in the socially most successful subgroup of the population.

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