Thesis (doctoral)--Westfälische Wilhelms-Universität zu Münster. / Includes bibliographical references (p. [25]-27).

Thesis (M.Sc.)--University of Alberta, 1997. / Submitted to the Faculty of Graduate Studies and Research in partial fulfilment of the requirements for the degree of Master of Science, Department of Medicine. Also available online.

Includes bibliographical references. / The diamino-diamide ligands have been investigated in an attempt to develop an antirheumatic drug. The ligands N,N'-di-(2-dimethylamino)ethyloxamide and N,N'di-(2-diethylamino)ethyloxamide, were synthesised and characterised using the physical techniques, NMR, mass- and infrared spectrometry. The stability constants of the complexes of Mg, Ca, Zn and several first transition metal-ions with the ligands were determined potentiometrically. The solution conformation of the CuII complexes were determined using visible spectrophotometry. Finally the physico-chemical studies were carried out. Firstly by studying the interaction of the copper complex with albumin at the physiological pH 7.4 using visible spectrophotometry. Secondly by determining the superoxide dismutase activity of the ligand by reduction of nitrobluetetrazolium using visible spectrophotometry. Lastly the ligands and the carr, CuII, MgII and ZnII metalions were monitored in vitro using the computer blood plasma model.

The purpose of this study was to investigate the effects of spouse participation in treatment on symptomatology in individuals suffering from fibrositis, a form of soft tissue rheumatism which has no identifiable, organic etiology and which represents a chronic, intractable pain disorder. While spouse participation has been widely advocated in the treatment of fibrositis and other chronic pain disorders, its effects as a unitary variable had not yet been objectively measured. In the present study, spouse participation consisted of a six-week, seven session group therapy program. Educational materials, counseling, and mutual support were utilized. Patients themselves were not directly exposed to treatment. Five patient-spouse diads were randomly assigned to each of the two treatment groups. Coincidental attrition resulted in the loss of one diad from each group. A time-series design was used in which treatment and nontreatment intervals were alternated for the two treatment groups. Six dependent measures were administered to the patients at pretest, posttest, and follow-up. The measures assessed were: pain intensity, functional activity, psychological adjustment, emotional dependency, and awareness of disability. The last two measures were also administered at pretest, posttest, and follow-up to the spouses. Significant results beyond the .05 level of confidence were yielded on psychological adjustment and awareness of disability for the patients. Analysis of individual subscales revealed that a significant reduction had occurred on the following scales: somatization, depression, obsessive-compulsiveness, psychoticism, and emotional reliance on others. Improvement did not reach a statistically significant level on pain intensity, functional activity, or overall dependency. Significant results were achieved only on the variable of awareness of disability for the spouses. The findings indicate that spouse participation in treatment had measurable, beneficial effects on symptomatology for the patients in this study, and support the application of similar interventions with other fibrositis and/or chronic pain patients.

Introduction Rheumatic disease is an autoimmune disorder with an unpredictable course of exacerbation and remission. There is no known cure for the disease at the moment. The patients’ conditions may progressively deteriorate despite intensive therapies, and runs an erratic course with the possibility of disfiguration and alteration in body image. Pain, disabilities and psychological distress are common. Rheumatic patients may respond differently to the same level of pain and physical symptoms. The understanding of the needs of rheumatic patients and how they successfully manage the disease and optimize psychological adjustment can help develop effective psychosocial interventions. Aims The aims of the study are (1) to identify the needs of rheumatic patients and perceptions of their disease, (2) to develop a conceptual framework for psychological adjustment, and (3) to identify factors associated with resilience in rheumatic patients. Methods The present study consisted of two phases. The first phase was a focus group interview, aiming to understand the patients’ feelings and to design a questionnaire. The second phase was a prospective questionnaire survey that includes a baseline study and a six-month follow-up study. Patients were recruited from support groups in Hong Kong. The baseline questionnaire was self-administrated, and the follow-up questionnaire was administrated by telephone interview. The self-regulation model was chosen as the basis for the conceptual framework for psychological adjustment. The questionnaire included demographics, illness representation, coping efforts, appraisal of coping efforts, sense of coherence, quality of care, functional disability, and health-related quality of life. The outcome measures were functional and psychological health, change in adjustment, and positive and negative resilience. Results Having a good and caring doctor, more information on the disease, and public understanding of the disease were the needs of rheumatic patients. The patients perceived that the disease was chronic, cyclical, and had poor consequences. They perceived that the disease caused great pain, stress, depression and anxiety, and affected their daily activities, appearance, and relationship with family and friends. Poor adjustment was associated with chronic and cyclical timeline, and poor perception of personal and treatment control. The analysis of resilience shows that positive perception of treatment control and disease consequence, correct understanding of disease causes, and high sense of own value and importance to the society, were protective. While those who lacked family support and blamed themselves or their families to be the cause of disease, were vulnerable. Discussion and conclusions The present study lends support to the validity of self-regulation model in psychological adjustment to disease, but coping efforts could only partially mediate the relationship of illness representation to appraisal of coping efforts, implying that the coping style might not sufficiently capture the underlying differences in individual coping styles. An effective psychosocial intervention can be developed based on the factors associated with better adjustment and resilience, and targeted at non-working older patients with rheumatoid arthritis. Last but not least, support from the community, and public understanding of the disease are important for rheumatic patients. / published_or_final_version / Psychiatry / Doctoral / Doctor of Philosophy

No description available.

MSc, Occupational Therapy, Faculty of Health Sciences, University of the Witwatersrand, 2008 / Purpose of this study was to develop an appropriate and valid hand function assessment: the Steinmann-Obermeyer questionnaire (SOQ) for clients attending the Rheumatology Clinic at Kalafong Hospital. To achieve this • the construct validity of the SOQ had to be examined by assessing the face and content validity. • the criterion –related validity of the SOQ was assessed using convergent, concurrent and discriminative validity compared to pain, severity of deformity and disease severity. • the criterion –related validity of the SOQ was further assessed using the predictive validity by assessing normal subjects with the SOQ. Objective: The objective of this study was to test the following null hypotheses: 1.4.1 The SOQ is not a valid method of evaluating the functional ability of rheumatology clients treated at Kalafong hospital out patient clinic. 1.4.2 There is no correlation between the severity of the rheumatic disease and the score obtained by the SOQ. 1.4.3 There is no correlation between the disease activity and the score obtained by the SOQ. 1.4.4 There is no correlation between the client’s assessment of their level of pain and the score obtained by the SOQ. Method. The SOQ consisted of 48 questions, was translated into Sotho and Zulu and was administered and analysed on 96 arthritic clients between 18 and 69 years of age. An occupational therapy assistant (OTA), who spoke both the tribal languages fluently, completed the questionnaire with each client. An interviewer-administered format was used because many of the clients were illiterate. Results. After the analyses were completed, three questions were excluded and the final questionnaire consisted of 45 questions. This questionnaire was found to be a valid method of evaluating the functional ability of rheumatology clients treated at Kalafong hospital. Clients with severe functional limitations scored high on the questionnaire and those with minimal functional difficulty scored low on the questionnaire. The questionnaire scores correlated significantly with the pain levels experienced by the clients and their disease activity. The statistical analyses also showed that there is no correlation between the questionnaire score and the deformities of the clients. Inter-rater reliability was established. Conclusion. The 45-question occupational performance evaluation was developed, analysed and proven to be valid and sensitive for use with rheumatology clients with hand function difficulties at the Kalafong rheumatology clinic.

<p>Vilka psykologiska processer som gör att vissa individer klarar sig bättre än andra i påfrestande situationer har väckt allt större intresse hos forskarna. Syftet med den här studien var att undersöka vilken betydelse socialt stöd har för anpassningen till kronisk reumatisk sjukdom. Studien utfördes i form av tolv halvstrukturerade intervjuer. Analys av materialet som helhet antydde att intervjupersonerna ansåg att socialt stöd från omgivningen hade hjälpt dem att anpassa sig till sjukdomen. Vården, i form av bland annat läkare, framstod som ett särskilt viktigt socialt stöd. Även stödet från andra individer med liknande sjukdom lyftes fram som betydelsefull. Den största anpassningen till sjukdomen verkar ske de första åren, men tycks också därefter pågå fortlöpande.</p>

Vilka psykologiska processer som gör att vissa individer klarar sig bättre än andra i påfrestande situationer har väckt allt större intresse hos forskarna. Syftet med den här studien var att undersöka vilken betydelse socialt stöd har för anpassningen till kronisk reumatisk sjukdom. Studien utfördes i form av tolv halvstrukturerade intervjuer. Analys av materialet som helhet antydde att intervjupersonerna ansåg att socialt stöd från omgivningen hade hjälpt dem att anpassa sig till sjukdomen. Vården, i form av bland annat läkare, framstod som ett särskilt viktigt socialt stöd. Även stödet från andra individer med liknande sjukdom lyftes fram som betydelsefull. Den största anpassningen till sjukdomen verkar ske de första åren, men tycks också därefter pågå fortlöpande.

ABSTRACT Background: Palindromic rheumatism (PR) is the rare disease that generally occurs with multiple recurring attacks of painful inflammation affecting joints and adjacent tissues. The thesis attempts to characterize the association in 10 instances of the single nucleotide polymorphisms (SNPs) of tumor necrosis factor genes (TNF-£\, TNFRSF1A and TNFRSF1B), Interleukin-1£] genes and Palindromic rheumatism (PR). Methods: The genetic polymorphisms of TNF-£\, TNFR£L, TNFR£S and IL-1£] genes cluster were investigated among 56 PR patients identified from the Kaohsiung Veterans General Hospital (VGHKS, Kaohsiung, Taiwan) and compared with one hundred healthy subjects. The genotypes for ten SNPs in the TNF-£\, TNFRSF1A, TNFRSF1B and IL-1£] genes among these 156 individuals were examined. Results: Experiments indicate significant count of the TNFRSF1A+36 AG genotype in PR patients (OR=4.8, 95%CI=1.8-13.0, p=0.002) and TNFRSF1A+36G allele (OR=3.94, 95%CI=1.59-9.79, p=0.003).The results also have remarkable correlation with TNFRSF1B haplotype +676/+1663 T/A (OR=2.12, CI=1.2-3.8, p=0.010). However, on significant differences were found for all the TNF-£\and IL-1£]polymorphisms. Conclusions: Genetic polymorphisms in TNF-£\ receptors are associated with susceptibility and severity of the inflammatory response in the PR patients.