Intra-articular injection of etanercept versus glucocorticoids in rheumatoid arthritis patients

Clinical Rheumatology - This study was conducted to assess the safety and efficacy of intra-articular injection of etanercept and compare it with corticosteroid injection in rheumatoid arthritis...     

Psychosocial job adversity and health in Australia: analysis of data from the HILDA Survey

Objective: This study examines measures of psychosocial job quality developed from the Household Income and Labour Dynamics in Australia (HILDA) Survey, and reports on associations with physical and mental health. Methods: The study used seven waves of data from the HILDA Survey with 5,548 employed respondents. Longitudinal random‐intercept regression models assessed the association of time‐varying and between‐person measures of psychosocial job quality job adversity with physical and mental health. Results: Respondents’ specific experience of psychosocial job adversity, except marketability, was associated with increased risk of mental health problems, whereas the association between psychosocial job adversity and physical health was largely driven by differences between people. Conclusions and Implications: Moving into jobs with different psychosocial quality is associated with changes in mental health. In contrast, individuals with poor physical health show an increased propensity to work in poor‐quality jobs but it seems that changes in physical health are not as strongly tied to changes in job quality. Differences in the relationship between physical and mental health and psychosocial job quality have implications for the design of employment, health and social policy. The HILDA Survey is an important resource for policy development in Australia, and the availability of valid measures of psychosocial of job quality will enhance its use to better understand this important determinant and correlate of health.     

Poor mental health influences risk and duration of unemployment: a prospective study

Purpose

The current paper aims to investigate the role of mental health in determining future employment status. Much of the previous longitudinal and prospective research has focused on how unemployment adversely influences mental health, while the reverse causal direction has received much less attention.

Methods

This study uses five waves of data from 5,846 respondents in the HILDA survey, a nationally representative household panel survey conducted annually since 2001. Prospective analyses followed a group of respondents who were not unemployed at baseline across four subsequent years and investigated whether baseline mental health was associated with subsequent unemployment.

Results

Baseline mental health status was a significant predictor of overall time spent unemployed for both men and women. Decomposing this overall effect identified sex differences. For women but not men, baseline mental health was associated with risk of experiencing any subsequent unemployment whereas for men but not women mental health was associated with the duration of unemployment amongst those who experienced unemployment.

Conclusions

By following a group of respondents who were not unemployed over time, we showed that poor mental health predicted subsequent unemployment. On average, men and women who experienced symptoms of common mental disorders spent greater time over the next 4?years unemployed than those with better mental health but there were sex differences in the nature of this effect. These findings highlight the importance of mental health in the design and delivery of employment and welfare policy.     

The global financial crisis and psychological health in a sample of Australian older adults: a longitudinal study

Economic stress and uncertainty is argued to increase older adults' vulnerability to physical health decline and mental distress. Nevertheless, there is a paucity of research that examines the relationship between a large historical economic event, such as the recent global financial crisis (GFC), and health outcomes for older adults. This study provides a unique opportunity to compare self-reported health status and psychological functioning (number of depression and anxiety symptoms) in 1973 older Australian adults (mean age of 66.58 years (SD = 1.5)) prior to the GFC (2005-2006), with their status four years later during the GFC period (2009-2010). Latent difference score models revealed a significant difference in depression and anxiety symptoms over the two measurement occasions, indicating poorer psychological functioning for those who reported an impact as a result of the economic slowdown. These effects were not explained by demographic or socio-economic factors. Interaction effects showed that those participants who were surveyed within the acute salience period of the GFC (April to September 2009) were significantly less likely to report poorer psychological health over time compared to those who were surveyed after September 2009. This interesting timing effect is discussed in terms of potential time-lags in the negative effects of economic stress on health outcomes, as well as the possible protective effects of social norms that may be created by a large scale economic crisis.     

Dietary vitamin C and E modulates antioxidant levels in blood, brain, liver, muscle, and testes in diabetic aged rats

While tissue dysfunction is a well-recognized consequence of diabetes mellitus in aged people, the underlying mechanisms are poorly understood. Daily (VCE) supplementation of vitamins C and E can be beneficial to diabetic aged animals in reducing free radical production. The aim of this study was to investigate whether dietary VCE supplementation modulates oxidative stress and antioxidant redox systems in streptozotocin (STZ)-induced aged diabetic rats. Thirty aged rats (18 - 20 months) were randomly divided into three groups. The first group acted as a control and the second group was diabetic. VCE-supplemented feed was given to aged, diabetic rats, constituting the third group. Diabetes was induced using a single dose of intraperitoneal STZ. On the 21(st) day after STZ dosage, blood and tissue samples were taken from all animals. Glutathione peroxidase activity in liver, erythrocytes, muscle, and testes; catalase activity in plasma and erythrocytes; reduced glutathione levels in plasma; vitamin E concentration in plasma, liver, and muscle; b-carotene concentration in brain; and high-density lipoprotein (HDL)-cholesterol levels in plasma were lower in the diabetic group than in the control group. Lipid peroxidation (LP) levels in plasma, liver, brain, and muscle, and alanine aminotransferase (ALT), aspartate aminotransferase (AST), triacyglycerols, and total and low-density lipoprotein (LDL)-cholesterol values in plasma were higher in the diabetic group than in the control group. The LP, enzyme, vitamin, and lipid profile values levels were mostly restored by VCE treatment. Liver and testis weights did not change by diabetic status and VCE supplementation, although body weight was lower in the diabetic group than in the control group. In conclusion, brain, liver, and testes tissues seem most sensitive in aged diabetic rats to oxidative stress. We observed that VCE supplementation relieves oxidative stress in the blood and tissues of diabetic aged rats by modulating the antioxidant system and lipid profile.     

Multiple imputation was an efficient method for harmonizing the Mini-Mental State Examination with missing item-level data

Objective

The Mini-Mental State Examination (MMSE) is used to estimate current cognitive status and as a screen for possible dementia. Missing item-level data are commonly reported. Attention to missing data is particularly important. However, there are concerns that common procedures for dealing with missing data, for example, listwise deletion and mean item substitution, are inadequate.

Study Design and Setting

We used multiple imputation (MI) to estimate missing MMSE data in 17,303 participants who were drawn from the Dynamic Analyses to Optimize Aging project, a harmonization project of nine Australian longitudinal studies of aging.

Results

Our results indicated differences in mean MMSE scores between those participants with and without missing data, a pattern consistent over age and gender levels. MI inflated MMSE scores, but differences between those imputed and those without missing data still existed. A simulation model supported the efficacy of MI to estimate missing item level, although serious decrements in estimation occurred when 50% or more of item-level data were missing, particularly for the oldest participants.

Conclusions

Our adaptation of MI to obtain a probable estimate for missing MMSE item level data provides a suitable method when the proportion of missing item-level data is not excessive.     

The human chorionic gonadotropin molecule from patients with trophoblastic diseases has a high thyrotropic activity but is less active in the ovary

To examine the pathogenesis of hyperthyroidism in women with trophoblastic diseases, the biological activity of human chorionic gonadotropin (hCG) molecules in women with normal pregnancy (n?=?85) and in women with trophoblastic diseases (vesicular mole, n?=?30; and choriocarcinoma, n?=?12) was compared. Hyperthyroidism (thyroid stimulating hormone (TSH) <?0.3 mIU/l) was observed more frequently in women with trophoblastic diseases. All the sera were then subjected to Chinese hamster ovary cells transfected with the human TSH receptor (CHO-hTSHr cells) and cAMP production was compared. Sera from the women with choriocarcinoma showed the highest cAMP production. Interestingly, significant correlation between serum hCG level and cAMP production in CHO-hTSHr cells was observed only in women with trophoblastic disease. All the sera were then applied to CHO cells transfected with hCG/luteinizing hormone (LH) receptor (CHO-hCG/LHr cells). In contrast to the findings with the TSH receptor, sera from the women with normal pregnancy showed the highest cAMP production in these cells. Correlation between serum hCG level and cAMP production in CHO-hCG/LHr cells was significant only in normal pregnancy. These results indicate that the hCG molecule from women with trophoblastic diseases displays enhanced thyrotropic activity.