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Fanning J, Nicklas B, Furlipa J, Rejeski WJ. The impact of Dietary Weight loss, Aerobic Exercise, and Daylong Movement on Social Cognitive Mediators of Long-term Weight loss. J Behav Med 2022:10.1007/s10865-022-00359-6. [PMID: 36215000 PMCID: PMC9548422 DOI: 10.1007/s10865-022-00359-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 08/17/2022] [Indexed: 11/24/2022]
Abstract
This report contrasts the impact of a dietary weight loss intervention (WL) paired with aerobic exercise (EX) and/or sitting less and moving throughout the day (SL) on self-efficacy for walking (hereafter walking self-efficacy) and satisfaction with physical functioning (hereafter satisfaction). Additional analyses examined dose-response associations between change in weight and changes in these key outcomes. Older adults (N = 112; age = 70.21[Formula: see text]4.43) were randomized to 6 months of WL+EX, WL+SL, or WL+EX+SL followed by a 12-month maintenance period. All groups reported increases in walking self-efficacy at month 6 with greater improvements in WL+EX and WL + EX+SL. Only WL+SL demonstrated improved walking self-efficacy at month 18. All conditions demonstrated improved satisfaction scores at both time points. Changes in walking self-efficacy and satisfaction were negatively associated with change in weight over the 6-month intervention and after the maintenance period. These results support the utility of WL + SL for improving key social cognitive outcomes in aging.
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Affiliation(s)
- Jason Fanning
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA.
| | - Barbara Nicklas
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC USA
| | - Joy Furlipa
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC USA
| | - W. Jack Rejeski
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC USA
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Withers MH, Gonzalez LT, Karpouzas GA. Identification and Treatment Optimization of Comorbid Depression in Rheumatoid Arthritis. Rheumatol Ther 2017; 4:281-291. [PMID: 28815445 PMCID: PMC5696284 DOI: 10.1007/s40744-017-0072-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Indexed: 12/20/2022] Open
Abstract
Patients with rheumatoid arthritis (RA) suffer from high rates of depression but depression often remains undiagnosed and untreated among RA patients. Because of its high prevalence and its profound impact on functional disability and health-related quality of life, prompt recognition and management of comorbid depression is urgently needed in patients with RA. Rheumatologists face the challenge of addressing depression in their clinical interactions with patients. The purpose of this paper is to present the prevalence of comorbid depression in RA, to delineate the consequences of depression among RA patients, to discuss the barriers to the identification of depression among RA patients, and to outline a set of recommendations to identify and treat comorbid depression that could be implemented within the rheumatology clinic setting. A comprehensive approach to the management of both physical and mental health needs of RA patients can aid in improving patient overall quality of life. New clinical protocols should be developed to include routine depression screening as part of the rheumatology visit. Patient education to address misconceptions, knowledge gaps, and destigmatize depression is also recommended. More counseling resources, including emotional support groups, are necessary to provide treatment for those suffering from depression. Such interventions could help mitigate disability, improve quality of life, patient function, and overall satisfaction.
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Affiliation(s)
- Mellissa H Withers
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Louella T Gonzalez
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Fanning J, Walkup MP, Ambrosius WT, Brawley LR, Ip EH, Marsh AP, Rejeski WJ. Change in health-related quality of life and social cognitive outcomes in obese, older adults in a randomized controlled weight loss trial: Does physical activity behavior matter? J Behav Med 2017; 41:299-308. [PMID: 29168052 DOI: 10.1007/s10865-017-9903-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 11/15/2017] [Indexed: 01/17/2023]
Abstract
This article compared the effect of dietary weight loss administered alone (WL) or in combination with aerobic training (WL + AT) or resistance training (WL + RT) on health related quality of life, walking self-efficacy, stair climb self-efficacy, and satisfaction with physical function in older adults with cardiovascular disease or the metabolic syndrome. Participants (N = 249; M age = 66.9) engaged in baseline assessments and were randomly assigned to one of three interventions, each including a 6-month intensive phase and a 12-month follow-up. Those in WL + AT and WL + RT engaged in 4 days of exercise training weekly. All participants engaged in weekly group behavioral weight loss sessions with a goal of 7-10% reduction in body weight. Participants in WL + AT and WL + RT reported better quality of life and satisfaction with physical function at 6- and 18-months relative to WL. At month 6, WL + AT reported greater walking self-efficacy relative to WL + RT and WL, and maintained higher scores compared to WL at month 18. WL + AT and WL + RT reported greater stair climbing efficacy at month 6, and WL + RT remained significantly greater than WL at month 18. The addition of either AT or RT to WL differentially improved HRQOL and key psychosocial outcomes associated with maintenance of physical activity and weight loss. This underscores the important role of exercise in WL for older adults, and suggests health care providers should give careful consideration to exercise mode when designing interventions.
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Affiliation(s)
- Jason Fanning
- Department of Health and Exercise Science, Wake Forest University, PO Box 7868, Winston-Salem, NC, 27106, USA.
- Section on Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - Michael P Walkup
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Walter T Ambrosius
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Lawrence R Brawley
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Edward H Ip
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Anthony P Marsh
- Department of Health and Exercise Science, Wake Forest University, PO Box 7868, Winston-Salem, NC, 27106, USA
| | - W Jack Rejeski
- Department of Health and Exercise Science, Wake Forest University, PO Box 7868, Winston-Salem, NC, 27106, USA
- Section on Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
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White DK, Neogi T, Zhang Y, Niu J, Katz PP. Association of Slow Gait Speed With Trajectories of Worsening Depressive Symptoms in Knee Osteoarthritis: An Observational Study. Arthritis Care Res (Hoboken) 2017; 69:209-215. [PMID: 27158972 DOI: 10.1002/acr.22928] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 03/15/2016] [Accepted: 04/26/2016] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To investigate the association of slow gait speed, defined as walking slower than is necessary for the community, with trajectories of depressive symptoms over 7 years among people with or at high risk of knee OA. METHODS Using data from the Osteoarthritis Initiative, we described trajectories of depressive symptoms measured annually with the Center for Epidemiologic Studies Depression Scale. We categorized speed during a 20-meter walk of <1.2 meters/second as slow gait speed. We used a group-based method to agnostically identify homogeneous clusters of depressive symptom trajectories. We then examined the association of slow gait speed with depressive symptom trajectories, using multinomial logistic regression adjusted for potential confounders. RESULTS From the 3,939 participants included (mean ± SD age 61.4 ± 9.2 years, body mass index 28.4 ± 4.7, 58% women, and 63% with a college degree), we identified 5 trajectories. The first 3 were stable over time and included 74% of the sample. The remainder had worsening depressive symptoms over time. Slow gait speed was associated with 2.1 times the odds of having the worst depressive symptoms trajectory compared to those without slow gait speed. CONCLUSION Slow gait speed may represent an important risk factor for worsening depressive symptoms over time in people with or at high risk of knee OA, and may signal the need for rehabilitation.
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Affiliation(s)
| | - Tuhina Neogi
- Boston University School of Medicine, Boston, Massachusetts
| | - Yuqing Zhang
- Boston University School of Medicine, Boston, Massachusetts
| | - Jingbo Niu
- Boston University School of Medicine, Boston, Massachusetts
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Feel the Fatigue and Be Active Anyway: Physical Activity on High‐Fatigue Days Protects Adults With Arthritis From Decrements in Same‐Day Positive Mood. Arthritis Care Res (Hoboken) 2015; 67:1230-1236. [DOI: 10.1002/acr.22582] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 02/23/2015] [Accepted: 03/10/2015] [Indexed: 11/07/2022]
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Godoy-Ramírez AM, Pérez-Verdún MÁ, Doménech-del Rio A, Prunera-Pardell MJ. [Caregiver burden and social support perceived by patients with chronic obstructive pulmonary disease]. ACTA ACUST UNITED AC 2014; 29:320-4. [PMID: 25523163 DOI: 10.1016/j.cali.2014.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 10/14/2014] [Accepted: 11/11/2014] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To analyse the psycho-emotional state of the primary caregiver, the burden of the usual care in patients with exacerbations of COPD and perceived social support on the part of the patient. MATERIAL AND METHODS The study included patients and caregivers who came for a specific visit to the COPD clinic of the Chest Diseases Department the Regional Hospital of Malaga. A total of 151 patients with severe/very severe COPD according to the functional classification of severity by Global Initiative for Chronic Obstructive Lung Disease (GOLD) and 96 caregivers were followed-up over a year. The Zarit burden scale (caregiver burden interview) was used, as well as the Duke-UNC questionnaire, validated in Spanish to determine the burden of the caregiver and the social support as perceived by the patient, respectively. The demographic variables recorded were, sex, age, population, cohabitation, relationship and work activity. RESULTS The mean age of patients was 66.1 ± 9 years versus their caregivers 60.2 ± 11.5 years. All of the patients, of whom 88.1% were males, were occupationally inactive. The large majority (76.8%) were living with a caregiver, generally a wife or daughter. The social support was perceived as normal by 79.5%, and 19% perceived the social support as low. No burden or mild burden was reported by 79.2% with the Zarit questionnaire. CONCLUSIONS The mean age of the patients, as well as their primary caregivers, was over 60 years of age. The score on perceived social support showed normal values, except for patients who live alone in rural areas. The Zarit questionnaire gave results of mild or no burden. There was no statistically significant correlation between the Zarit questionnaire and the patient health status, rural or urban area, relationship, or age of the caregiver.
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Affiliation(s)
- A M Godoy-Ramírez
- Unidad de Gestión Clínica de Rehabilitación (UGC) y Medicina Física, Hospital Regional Universitario Carlos Haya, Málaga, España
| | - M Á Pérez-Verdún
- Unidad de Gestión Clínica de Rehabilitación (UGC) y Medicina Física, Hospital Regional Universitario Carlos Haya, Málaga, España.
| | - A Doménech-del Rio
- Servicio de Neumología, Hospital Regional Universitario Carlos Haya, Málaga, España
| | - M J Prunera-Pardell
- Servicio de Neumología, Hospital Regional Universitario Carlos Haya, Málaga, España
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Sverker A, Östlund G, Thyberg M, Thyberg I, Valtersson E, Björk M. Dilemmas of participation in everyday life in early rheumatoid arthritis: a qualitative interview study (The Swedish TIRA Project). Disabil Rehabil 2014; 37:1251-9. [PMID: 25243767 DOI: 10.3109/09638288.2014.961658] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE To explore the experiences of today's patients with early rheumatoid arthritis (RA) with respect to dilemmas of everyday life, especially regarding patterns of participation restrictions in valued life activities. METHODS A total of 48 patients, aged 20-63, three years post-RA diagnosis were interviewed using the Critical Incident Technique. Transcribed interviews were condensed into meaningful units describing actions/situations. These descriptions were linked to ICF participation codes according to the International Classification of Functioning, Disability and Health (ICF) linking rules. RESULTS Dilemmas in everyday life were experienced in domestic life, interpersonal interactions and relationships, community, social and civic life. Most dilemmas were experienced in domestic life, including participation restrictions in, e.g. gardening, repairing houses, shovelling snow, watering pot plants, sewing or walking the dog. Also many dilemmas were experienced related to recreation and leisure within the domain community, social and civic life. The different dilemmas were often related to each other. For instance, dilemmas related to community life were combined with dilemmas within mobility, such as lifting and carrying objects. CONCLUSIONS Participation restrictions in today's RA patients are complex. Our results underline that the health care needs to be aware of the patients' own preferences and goals to support the early multi-professional interventions in clinical practice. Implications of Rehabilitation Today's rheumatoid arthritis (RA) patients experience participation restrictions in activities not included in International Classification of Functioning, Disability and Health (ICF) core set for RA or in traditionally questionnaires with predefined activities. The health care need to be aware of the patients' own preferences and goals to meet the individual needs and optimize the rehabilitation in early RA in clinical practice.
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Affiliation(s)
- Annette Sverker
- Department of Rehabilitation and Department of Medical and Health Sciences, Linköping University , Linköping , Sweden
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Rathbun AM, Harrold LR, Reed GW. Temporal associations between the different domains of rheumatoid arthritis disease activity and the onset of patient-reported depressive symptoms. Clin Rheumatol 2014; 34:653-63. [PMID: 25156674 DOI: 10.1007/s10067-014-2759-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 07/22/2014] [Accepted: 08/03/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND Depression is a frequently occurring comorbid condition in patients with rheumatoid arthritis (RA), and research into the temporal relationships regarding its onset has mainly focused on functional status. The study aim was to examine temporal associations of the diverse measures of RA disease activity with incident self-reports of depressive symptoms. METHODS RA patients from the Consortium of Rheumatology Researchers of North America (CORRONA) registry were utilized. Cox regression was used to assess the lagged time-varying association of RA disease activity with the incident onset of depressive symptoms as measured using a single-item depression question. Predictor variables included joint counts, global assessments, pain, function, serum biomarkers, and composite disease activity. Hazard ratios (HRs) comparing categorical quintiles were estimated with 95 % confidence intervals. RESULTS Every metric of disease activity, except inflammatory markers, were significantly associated with the self-reported onset of depressive symptoms. Adjusted HRs comparing fifth quintiles to first quintiles were the following: CDAI = 2.3 [2.1-2.7]; pain = 2.3 [2.0-2.6]; SJC = 1.4 [1.4-1.6]. When examining successive self-reports (two consecutive), the magnitude of the associations greatly increased: CDAI = 3.6 [2.5-5.0]. CONCLUSIONS The data suggest depressive symptom onset in RA patients is related to measures reported by the patient: pain, functional status, and global disease activity; and measures reported by providers, rather than biological markers. The magnitude of the associations, however, were greater for the patient-reported measures when compared to physician assessments, implying that patients' experience of their disease activity may be a precipitating factor of depression onset.
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Affiliation(s)
- Alan M Rathbun
- University of Maryland School of Medicine, 655 West Baltimore Street, Baltimore, MD, 21201, USA,
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Abstract
The purpose of this study was to examine men’s and women’s experiences living with rheumatoid arthritis (RA). Using semi-structured, in-depth telephone interviews, nine women and seven men who were recently diagnosed with RA (disease duration < four years) were interviewed about their experiences adjusting to RA. Line-by-line coding using thematic analysis was used to identify themes. Findings from the qualitative analysis revealed six categories emerging from the data: 1. degree of severity of the impact of the disease, 2. appraisal about what the illness means to me, 3. availability of social support, 4. perception of self-efficacious behaviours, 5. use of coping strategies, and 6. RA’s effect on valued life activities. A number of participants described positive thinking about managing their RA; whereas others described negative thinking. Individuals’ appraisals and perceptions about their illness coupled with how their illness affected their ability to fulfill their role responsibilities were important in their adjustment to RA. Social support was also identified as key in learning to live with RA. For individuals with RA, the impact of the disease on their ability to maintain normal life is important, and as such it is vital that healthcare professionals have a better understanding of the perceptions and experiences that individuals have living with RA.
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10
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Assessment of the patient with osteoarthritis and measurement of outcomes. Rheumatology (Oxford) 2011. [DOI: 10.1016/b978-0-323-06551-1.00176-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Psychological Vulnerability Predicts Increases in Depressive Symptoms in Individuals With Rheumatoid Arthritis. Nurs Res 2010; 59:140-6. [DOI: 10.1097/nnr.0b013e3181d1a6f6] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Overview of the aims and management of rheumatological conditions. Rheumatology (Oxford) 2010. [DOI: 10.1016/b978-0-443-06934-5.00001-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Applying psychological interventions in rheumatic disease. Rheumatology (Oxford) 2010. [DOI: 10.1016/b978-0-443-06934-5.00011-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] Open
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Wikström I, Arvidsson B, Nilsson K, Roos E, Jacobsson LTH. Reliability, validity and responsiveness of a new leisure index: the Patient-Specific Leisure Scale (PSLS). Musculoskeletal Care 2009; 7:178-193. [PMID: 19191254 DOI: 10.1002/msc.150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVES To investigate the reliability, validity and responsiveness of a new Patient-Specific Leisure Scale (PSLS), constructed to identify goals and outcomes for individual patients with rheumatoid arthritis (RA). METHODS Forty-nine patients with RA were used to evaluate test-retest reliability, and 100 consecutive RA patients were used for construct validity. Twenty-five RA patients, commencing with treatment on tumour necrosis factor (TNF) inhibitors, were evaluated before the start and after three months of therapy, to test responsiveness. The most important leisure activity (as judged by the patients) was used when evaluating reliability and validity. The perceived difficulty with each activity was scored from 0 to 10 (0 = able to perform activity without difficulty, 10 = unable to perform activity). RESULTS Test-retest reliability indicated a good agreement (0.62-0.87) using weighted kappa. Construct validity was demonstrated by modest positive correlation between leisure activity and Health Assessment Questionnaire (HAQ) (r(s) = 0.27, p = 0.005) visual analogue scale (VAS) pain (r(s) = 0.28, p = 0.004) VAS global (r(s) = 0.22, p = 0.027), VAS fatigue (r(s) = 0.24, p = 0.013), joint index of 28 swollen joints (r(s) = 0.22, p = 0.027) and negative correlations with short-form-36 (SF-36) physical functioning (r(s) = -0.18, p = 0.008), bodily pain (r(s) = -0.31, p < 0.001), general health (r(s) = -0.23, p = 0.019), vitality (r(s) = -0.31, p < 0.001), social function (r(s) = -0.24, p = 0.016) and role-emotional (r(s) = -0.28, p = 0.005). Mean improvement for the most important leisure activity was 1.36, (p = 0.036, 95% confidence interval 0.10-2.62). Standardized response mean and effect size for the most important activity in PSLS was 1.05 and 0.72, respectively, and for HAQ 0.34 and 0.28, respectively. CONCLUSIONS PSLS appears to be feasible, reliable, valid and responsive for measuring leisure activities in RA. It provides both an individual result which is useful in clinical work, and results at a group level.
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Affiliation(s)
- Ingegerd Wikström
- Department of Rheumatology, Malmö University Hospital, Malmö, Sweden.
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Sandqvist G, Eklund M. Daily occupations – performance, satisfaction and time use, and relations with well-being in women with limited systemic sclerosis. Disabil Rehabil 2009; 30:27-35. [PMID: 17852220 DOI: 10.1080/09638280701190083] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE To describe activity level, operationalized as ADL capacity and performance of occupations, and occupational balance, operationalized as time use and satisfaction with occupations, in women with limited systemic sclerosis, and to investigate the relationship between these occupational factors and disease characteristics, demographic variables and wellbeing. METHOD Forty-four women of working age and with long-standing limited systemic sclerosis were assessed regarding occupational factors, clinical variables, sociodemographic characteristics and well-being. RESULTS The women exhibited a generally high activity level and were satisfied with their daily occupations. More time spent working was related to spending less time on household chores, greater satisfaction with occupations in general and greater well-being. Symptoms such as breathlessness, fatigue and pain, influenced ADL capacity and satisfaction with occupations negatively. CONCLUSIONS Work seems to be an important factor for satisfaction with occupations and well-being. This emphasizes the importance of investigating risk factors for work disability in people with systemic sclerosis, and of developing strategies for people with a work disability to enable them to maintain routines and a structured day. The findings also demonstrate the importance of reinforcing performance in satisfying occupations in order to maintain a feeling of well-being.
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Affiliation(s)
- Gunnel Sandqvist
- Department of Rheumatology, Lund University Hospital, Lund, Sweden.
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Johnsson PM, Sandqvist G, Bengtsson A, Nived O. Hand function and performance of daily activities in systemic lupus erythematosus. ACTA ACUST UNITED AC 2008; 59:1432-8. [DOI: 10.1002/art.24108] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Katula JA, Rejeski WJ, Marsh AP. Enhancing quality of life in older adults: a comparison of muscular strength and power training. Health Qual Life Outcomes 2008; 6:45. [PMID: 18554394 PMCID: PMC2443114 DOI: 10.1186/1477-7525-6-45] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2007] [Accepted: 06/13/2008] [Indexed: 11/24/2022] Open
Abstract
Background Although progressive resistance strength training (ST) has been found to improve various measures of physical functioning in older adults, the benefit to quality of life is unclear. Additionally, recent evidence suggests that high velocity power training (PT) may be more beneficial for physical functioning than ST, but it is not known whether this type of training impacts quality of life. The purpose of this study was to compare changes in multiple measures of quality of life resulting from ST vs. PT in older adults. A no exercise group was also included as control comparison condition. Methods Forty-five older adults (M age = 74.8 years; SD = 5.7) were randomly assigned to either a) PT, b) ST, or c) control group (no exercise). Measures of self-efficacy (SE), satisfaction with physical function (SPF), and the Satisfaction with Life Scale (SWL) were assessed at baseline and following training. The resistance training conditions met 3 times per week for 12 weeks at an intensity of 70% 1 repetition maximum. Results A series of ANCOVA's comparing between group differences in change and controlling for baseline values revealed significant group differences in all three measures: SE (F(2,31) = 9.77; p < .001); SPF (F(2,32) = 3.36; p = .047); SWL (F(2,31) = 4.76; p = .016). Follow up analyses indicated that the PT group reported significantly more change in SE, SPF, and SWL than the control group whereas the ST group reported greater change than the control group only in SE. Conclusion These pilot data indicate that high velocity power training may influence multiple levels of quality of life over and above the benefits gained through traditional strength training.
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Affiliation(s)
- Jeffrey A Katula
- Department of Health & Exercise Science, Wake Forest University, Winston-Salem, NC, USA.
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Rejeski WJ, King AC, Katula JA, Kritchevsky S, Miller ME, Walkup MP, Glynn NW, Pahor M. Physical activity in prefrail older adults: confidence and satisfaction related to physical function. J Gerontol B Psychol Sci Soc Sci 2008; 63:P19-26. [PMID: 18332190 DOI: 10.1093/geronb/63.1.p19] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We examined the hypothesis that physical activity will have favorable effects on measures of self-efficacy for a 400-m walk and satisfaction with physical functioning in older adults 70+ years of age who have deficits in mobility. We randomized a total of 412 adults aged 70-89 years at elevated risk for mobility disability to either a physical activity or a successful aging educational control intervention for 12 months. Participants in the physical activity intervention had more favorable changes in both outcomes as a result of treatment than those in the successful aging intervention. Gender, age, and scores on a short physical performance battery did not moderate these effects. Physical activity is an effective means of intervening on self-efficacy and satisfaction with physical function in older adults with impaired lower extremity functioning. This is an important finding in light of the importance of these process variables in behavior change and quality of life.
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Affiliation(s)
- W Jack Rejeski
- Department of Health and Exercise Science, Box 7868, Wake Forest University, Winston-Salem, NC 27109, USA.
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LARSSON G, VON ESSEN L, SJÖDÉN PO. Are importance–satisfaction discrepancies with regard to ratings of specific health-related quality-of-life aspects valid indicators of disease- and treatment-related distress among patients with endocrine gastrointestinal tumours? Eur J Cancer Care (Engl) 2007; 16:493-9. [DOI: 10.1111/j.1365-2354.2007.00781.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Treharne GJ, Lyons AC, Booth DA, Kitas GD. Psychological well-being across 1 year with rheumatoid arthritis: coping resources as buffers of perceived stress. Br J Health Psychol 2007; 12:323-45. [PMID: 17640450 DOI: 10.1348/135910706x109288] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES Using the transactional model of stress and coping, the present study investigated whether specific coping resources act as buffers of the relationship between perceived stress and psychological well-being among rheumatoid arthritis (RA) patients. DESIGN A longitudinal observational study was carried out with assessments at baseline, 6 months and 1 year. METHODS Measures of perceived stress, coping resources (optimism/pessimism, social support and explicit active coping strategies) and psychological well-being (anxiety, depression and life satisfaction) were completed by 134 RA patients. Demographics, RA duration, pain, fatigue, functional disability, antidepressant use and physical comorbidities were recorded and statistically controlled for. RESULTS Perceived stress had the strongest relationship with psychological well-being at baseline, and affected anxiety after 6 months. Optimism and pessimism predicted psychological well-being across 1 year. Active behavioural coping buffered an association of stress with depression at baseline, while baseline active cognitive coping buffered the effect of baseline stress on life satisfaction after 6 months. CONCLUSIONS Patients with RA under greater perceived stress who do not use active coping strategies appear to be at risk of psychological comorbidity and may therefore benefit from interventions teaching specific active coping strategies. Larger observational studies and interventions are required to confirm and extend these findings.
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Wikström I, Jacobsson LT, Arvidsson B. How people with rheumatoid arthritis perceive leisure activities: a qualitative study. Musculoskeletal Care 2007; 3:74-84. [PMID: 17041996 DOI: 10.1002/msc.28] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To explore how people with rheumatoid arthritis (RA) perceive leisure activities. METHOD A phenomenographic approach using semi-structured interviews to explore the impact of RA on leisure pursuits was used. RESULTS Three descriptive categories containing 11 conceptions emerged: (1) Experiencing constraints included four conceptions: seeing limitations, needing time, finding balance, being dependent. (2) Experiencing coherence included four conceptions: accepting feelings participating in a social context, being active, having insight. (3) Finding solutions included three conceptions: choosing, planning, and adapting. CONCLUSIONS This study emphasizes the limited choices and problems people with RA had participating in leisure activities, as well as its impact on self-esteem.
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Machado GPM, Gignac MAM, Badley EM. Participation restrictions among older adults with osteoarthritis: A mediated model of physical symptoms, activity limitations, and depression. ACTA ACUST UNITED AC 2007; 59:129-35. [DOI: 10.1002/art.23259] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Wikström I, Book C, Jacobsson LTH. Difficulties in performing leisure activities among persons with newly diagnosed rheumatoid arthritis: a prospective, controlled study. Rheumatology (Oxford) 2006; 45:1162-6. [PMID: 16531435 DOI: 10.1093/rheumatology/kel080] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To compare leisure activities and associated factors in a group with recent onset RA and matched community derived controls, to examine whether leisure activities are altered during the early years of disease and to seek predictors. METHODS One hundred and forty-seven consecutive persons with early RA were followed for 0.9-5.9 yr. One hundred and forty-four RA patients were compared cross-sectionally at baseline with community-derived controls matched for age, gender and residential area. Leisure activities were evaluated with an interest checklist (20 domains). Socio-demographic variables, disease activity (DAS) and disability (HAQ) were evaluated as possible predictors for loss of participation in leisure activities at baseline and longitudinally (using area under the curve analyses). RESULTS At baseline (mean disease duration 7 months) RA patients performed less (8.2 vs 9.9 domains, P < 0.001) but did not have significantly less interest (10.9 vs 11.4 domains, P = 0.15) in leisure activities compared with controls. Decrease in performed leisure activities was only significant in those with a low level of education. At baseline, in RA patients, low education (P = 0.035), age (P = 0.019) and HAQ (P < 0.001) significantly predicted performed leisure activity. No loss in performed leisure activities was seen during follow-up and no significant predictors were found for individual change. CONCLUSION Loss of performed leisure activities occurs early in RA and chiefly in those with low formal education. Disability was associated with early loss, but not with change during follow-up. Other factors, possibly related to individual personality and resources, may be more important for predicting changes in leisure activities.
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Affiliation(s)
- I Wikström
- Department of Rheumatology, Malmö University Hospital, S. Förstadsgatan 101, S-205 02 Malmö, Sweden.
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Kjeken I, Dagfinrud H, Slatkowsky-Christensen B, Mowinckel P, Uhlig T, Kvien TK, Finset A. Activity limitations and participation restrictions in women with hand osteoarthritis: patients' descriptions and associations between dimensions of functioning. Ann Rheum Dis 2005; 64:1633-8. [PMID: 15829571 PMCID: PMC1755278 DOI: 10.1136/ard.2004.034900] [Citation(s) in RCA: 148] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To describe the functional consequences of hand osteoarthritis, and analyse associations between personal factors, hand impairment, activity limitations, and participation restrictions within the framework of the International Classification of Functioning (ICF). METHODS 87 women with hand osteoarthritis completed a clinical examination including recording of sociodemographic data, measures of hand impairment, and completion of self reported health status measures. The function subscale of the AUSCAN Osteoarthritis Hand Index was used as a measure of hand related activity limitations, while the Canadian Occupational Performance Measure (COPM) was used to describe and measure activity limitations and participation restrictions as perceived by the individual. The study variables were categorised using the dimensions in the ICF framework and analysed using bivariate and multivariate statistical approaches. RESULTS The patients described problems in many domains of activity and participation. The most frequently described hand related problems were activities requiring considerable grip strength combined with twisting of the hands. On the impairment level, the patients had reduced grip force and joint mobility in the hands, and resisted motion was painful. Regression analyses showed that hand related activity limitations were associated with measures of hand impairment, while activity and participation (as measured by the COPM) were more strongly associated with personal factors than with hand impairment. CONCLUSIONS Hand osteoarthritis has important functional consequences in terms of pain, reduced hand mobility and grip force, activity limitations, and participation restrictions. Rehabilitation programmes should therefore be multidisciplinary and multidimensional, focusing on hand function, occupational performance, and coping strategies.
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Affiliation(s)
- I Kjeken
- Diakonhjemmet Sykehus, Boks 23 Vinderen, 0319 Oslo, Norway.
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25
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Kjeken I, Slatkowsky-Christensen B, Kvien TK, Uhlig T. Norwegian version of the Canadian Occupational Performance Measure in patients with hand osteoarthritis: Validity, responsiveness, and feasibility. ACTA ACUST UNITED AC 2004; 51:709-15. [PMID: 15478169 DOI: 10.1002/art.20522] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To test the Norwegian version of the Canadian Occupational Performance Measure (COPM) for validity, responsiveness, and feasibility in patients with hand osteoarthritis. METHODS Seventy-nine patients completed a COPM interview and several self-reported health status questionnaires, including Arthritis Impact Measurement Scales 2, modified Health Assessment Questionnaire; Western Ontario and McMaster Universities Osteoarthritis Index, and the Australian/Canadian Osteoarthritis Hand Index. Rescoring of the same instruments was performed 4 months later, after an intervention. RESULTS The COPM detected a great variability of occupational performance problems. The hypotheses for testing validity were confirmed. Mean COPM change was 1.51 (P < 0.001) in performance score, and 2.22 (P < 0.001) in satisfaction score. The median time spent on the COPM interview was 30 minutes (range 10-70 minutes). The patients found the questions easy to understand, but 37% reported problems performing the scoring procedure. CONCLUSIONS The Norwegian version of the COPM is a valid and responsive instrument for use in clinical practice in osteoarthritis patients. It may serve as an instrument to promote a client-centered approach and as a supplement to other health measures in the planning and evaluating of interventions. Feasibility regarding scoring needs to be improved.
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26
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Katz PP, Yelin EH, Eisner MD, Earnest G, Blanc PD. Performance of valued life activities reflected asthma-specific quality of life more than general physical function. J Clin Epidemiol 2004; 57:259-67. [PMID: 15066686 DOI: 10.1016/j.jclinepi.2003.08.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2003] [Indexed: 11/28/2022]
Abstract
OBJECTIVE We examined the prevalence of disability in valued life activities (VLAs) among a group of adults with asthma and the impact of general physical function and performance of VLAs on asthma-specific quality of life (QOL). STUDY DESIGN AND SETTING Interview data collected from two waves of a longitudinal cohort study were used to examine the prevalence of disability in VLAs, the cross-sectional association of general function and performance of VLAs with QOL, and the longitudinal association of changes in general function and changes in performance of VLAs with changes in QOL. General function was assessed with the SF-12; VLAs were assessed with a newly developed measure. RESULTS A substantial portion of subjects reported disability in VLAs. VLA function was a stronger predictor of QOL than general physical function in cross-sectional and longitudinal analyses. CONCLUSION Performance of VLAs is more closely tied to asthma-specific QOL than is general physical function.
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Affiliation(s)
- Patricia P Katz
- Department of Medicine, University of California-San Francisco, 350 Parnassus Ave., Suite 609, San Francisco, CA 94143-0924, USA.
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27
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Katula JA, Rejeski WJ, Wickley KL, Berry MJ. Perceived difficulty, importance, and satisfaction with physical function in COPD patients. Health Qual Life Outcomes 2004; 2:18. [PMID: 15056389 PMCID: PMC420256 DOI: 10.1186/1477-7525-2-18] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2004] [Accepted: 03/31/2004] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research suggests that patients' satisfaction with their physical functioning (SPF) is a critical component of HRQL. This study was designed to examine the extent to which perceptions of physical function and the value placed on physical function are related to satisfaction ratings. The sample consisted of older adults suffering from a progressively debilitating disease, chronic obstructive pulmonary disease (COPD). METHODS During baseline assessments, COPD patients participating in a randomized controlled physical activity trial completed measures of SPF, perceived difficulty, and perceived importance. RESULTS An ANCOVA controlling for age and gender indicated that perceived difficulty, perceived importance, and their interaction accounted for 43% of the variance in SPF. Additionally, participants were most satisfied with important tasks that they performed with little difficulty. Participants were least satisfied with important tasks that they perceived as highly difficult. CONCLUSION The results of the present study indicate that not being able to perform valued tasks produces discontent that is reflected in lower rating of satisfaction with physical functioning. Clearly, the significance of loss in function to individual patients is related to the importance of the functional activities that may be compromised. These data have implications for the scope of patient assessment in clinical care and for the conceptual basis of future research in the area of physical functioning.
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Affiliation(s)
- Jeffrey A Katula
- Department of Health & Exercise Science, Wake Forest University, PO Box 7868 Reynolda Station, Winston-Salem, NC 27109, 27402-6169, USA
| | - W Jack Rejeski
- Department of Health & Exercise Science, Wake Forest University, PO Box 7868 Reynolda Station, Winston-Salem, NC 27109, 27402-6169, USA
| | - Katie L Wickley
- Department of Health & Exercise Science, Wake Forest University, PO Box 7868 Reynolda Station, Winston-Salem, NC 27109, 27402-6169, USA
| | - Michael J Berry
- Department of Health & Exercise Science, Wake Forest University, PO Box 7868 Reynolda Station, Winston-Salem, NC 27109, 27402-6169, USA
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A Longitudinal Examination of Causal Attributions and Depression Symptomatology in Rheumatoid Arthritis. Rehabil Psychol 2004. [DOI: 10.1037/0090-5550.49.2.126] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Plach SK, Heidrich SM, Waite RM. Relationship of social role quality to psychological well-being in women with rheumatoid arthritis. Res Nurs Health 2003; 26:190-202. [PMID: 12754727 DOI: 10.1002/nur.10087] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The purpose of this study was to examine the mediating and moderating effects of women's social role quality on the psychological well-being of women with rheumatoid arthritis (RA). One hundred and fifty-six women with a diagnosis of RA (M age = 59, SD = 11) completed self-report measures of arthritis history, physical health, psychological well-being, and role quality. Hierarchical multiple regression analyses indicated that role quality mediated the effects of physical health on depression and purpose in life, moderated the effects of health on depression, and moderated the effects of pain on purpose in life. Women in poor health with high role quality were significantly less depressed than women in poor health with poor role quality. Women with high levels of pain and high role quality had more purpose in life than women with high levels of pain and low role quality. Despite difficulties with their physical health, women who had high role quality had higher levels of psychological well-being. Findings from this study may aid in the development of meaningful interventions to help women with RA manage their daily lives to optimize well-being.
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Affiliation(s)
- Sandra K Plach
- School of Nursing, University of Wisconsin-Milwaukee and Froedtert Hospital, Milwaukee, WI 53226, USA
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Neugebauer A, Katz PP, Pasch LA. Effect of valued activity disability, social comparisons, and satisfaction with ability on depressive symptoms in rheumatoid arthritis. Health Psychol 2003; 22:253-62. [PMID: 12790252 DOI: 10.1037/0278-6133.22.3.253] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This longitudinal study identified a model through which function affects the psychologicalwell-being of individuals with rheumatoid arthritis (RA). Results of hierarchical linear regression analyses (N = 436) demonstrated that greater physical impairment resulted in greater disability in valued activities and engagement in unfavorable social comparisons. All 3 factors--greater physical impairment, greater disability in valued activities, and unfavorable comparison evaluations--predicted low satisfaction with abilities. Low satisfaction with abilities was the most important predictor of higher depressive symptoms and mediated the impact of physical impairment, valued activity disability, and unfavorable comparisons on depressive symptoms. Results highlight the role of personal meaning attached to changes in functional status in predicting the long-term psychological well-being of individuals with chronic illnesses such as RA.
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Affiliation(s)
- Alyson Neugebauer
- Department of Medicine, Division of Rheumatology, Rosalind Russell Medical Research Center for Arthritis, University of California, San Francisco 94143-0920, USA
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