IWH Research Alert

OBJECTIVE: To synthesise, quantify and compare risks for incident myocardial infarction (MI) across five major types of arthritis in population-based studies. METHODS: A systematic search was performed in MEDLINE, EMBASE and CINAHL databases with additional manual/hand searches for populationbased cohort or case-control studies published in English of French between January 1980 and January 2015 with a measure of effect and variance for associations between incident MI and five major types of arthritis: rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), gout or osteoarthritis (OA), adjusted for at least age and sex. All search screening, data abstraction quality appraisals were performed independently by two reviewers. Where appropriate, random-effects meta-analysis was used to pool results from studies with a minimum of 10 events. RESULTS: We identified a total of 4, 285 articles; 27 met review criteria and 25 criteria for meta-analyses. In studies adjusting for age and sex, MI risk was significantly increased in RA (pooled relative risk (RR): 1.69, 95% CI 1.50 to 1.90), gout (pooled RR: 1.47, 95% CI 1.24 to 1.73), PsA (pooled RR: 1.41, 95% CI 1.17 to 1.69), OA (pooled RR: 1.31, 95% CI 1.01 to 1.71) and tended towards increased risk in AS (pooled RR: 1.24, 95% CI 0.93 to 1.65). Traditional risk factors were more prevalent in all types of arthritis. MI risk was attenuated for each type of arthritis in studies adjusting for traditional risk factors and remained significantly increased in RA, PsA and gout. CONCLUSIONS: MI risk was consistently increased in multiple types of arthritis in population-based studies, and was partially explained by a higher prevalence of traditional risk factors in all types of arthritis. Findings support more integrated cardiovascular (CV) prevention strategies for arthritis populations that target both reducing inflammation and enhancing management of traditional CV risk factors Walker TJ, Tullar JM, Diamond PM, Kohl HW, III, and Amick III BC. Association of self-reported aerobic physical activity, musclestrengthening physical activity, and stretching behavior with presenteeism. Journal of Occupational and Environmental Medicine. 2017; [Epub Ahead of Print]. http://dx.doi.org/10.1097/JOM.0000000000000978 Bengtsson S and Datta Gupta N. Identifying the effects of education on the ability to cope with a disability among individuals with disabilities. PLoS ONE. 2017; 12(3):e0173659. http://dx.doi.org/10.1371/journal.pone.0173659 [open access] Abstract: The literature on disability has suggested that an educated individual with a disability is more likely to better cope with her/his disability than those without education. However, few published studies explore whether the relationship between education and ability to cope with a disability is anything more than an association. Using data on disability and accommodation from a large Danish survey from 2012-13 and exploiting a major Danish schooling reform as a natural experiment, we identified a potential causal effect of education on both economic (holding a job) as well as social (cultural activities, visiting clubs/associations, etc.) dimensions of coping among individuals with a disability, controlling for background factors, functioning, and disability characteristics. We found that endogeneity bias was only present in the case of economic participation and more educated individuals with a disability indeed had higher levels of both economic and social coping. To some extent, having more knowledge of public support systems and higher motivation explained the better coping among the group of individuals with disabilities who were educated. Our results indicated, however, that a large part of the effect of education on the ability to cope with a disability among individuals with disabilities was suggestive of a causal relationship Besen E, Gaines B, Linton SJ, and Shaw WS. The role of pain catastrophizing as a mediator in the work disability process following acute low back pain. Journal of Applied Biobehavioral Research. 2017; 22(1):e12085. http://dx.doi.org/10.1111/jabr.12085 [open access] Abstract: The purpose of this study was to assess pain catastrophizing as a mediator in the relationships between pain and recovery expectations with work limitations and functional disability in a working population experiencing acute low back pain (LBP). Workers (n-á=-á241) with acute, work-related LBP completed measures of pain and injury at medical intake and then the Pain Catastrophizing Scale (PCS) shortly after the initial intake visit. At 3-months follow-up, measures of work limitations and functional disability were administered. Structural equation modeling was used to assess whether the PCS mediated longitudinal associations between pain and recovery expectations with perceived disability and work limitations. The PCS score completely mediated the relationship between initial pain intensity and 3-month perceptions of disability (40% explained) and work limitations (29% explained). The PCS also completely mediated the longitudinal relationship between pain recovery expectations and 3month disability (50% explained) and work limitations (40% explained). Effective clinical management during this acute phase of LBP might be improved by incorporating early interventions to reduce catastrophizing in cases-where pain catastrophizing may be especially problematic Chen L, Zhao N, Fan H, and Coyte PC. Informal care and labor market outcomes: evidence from Chinese married women. Research on Aging. 2017; 39(2):345-371. http://dx.doi.org/10.1177/0164027515611184 Abstract: Data were used from the 1991-2009 China Health and Nutrition Survey to examine the influence of informal care on labor market outcomes for married women of working aged, with emphasis on caregiving intensity. After accounting for potential endogeneity between caregiving and labor force participation (LFP) through simultaneous equations modeling, caregivers who provided more than 15 or 20 hr of caregiving per week were 4.5-7.7% less likely to be LFPs. Intensive caregivers who remained working had significantly lower (4.97-7.20) weekly hours of work. The significant positive effect of informal care on LFP only existed in the rural sample, and these women also had much lower hours of work than their urban counterparts. Opportunities exist for policy interventions that target intensive caregivers in order to allow them to balance both work and