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Objective: To investigate and compare trends in incidence rates (IRs) of seropositive and seronegative rheumatoid arthritis (RA) in Denmark using various data sources for serostatus definition. Method: This nationwide population-based cohort study was based on data from Danish healthcare and clinical quality registries between 2000 and 2018. Information on anti-cyclic citrullinated peptide and immunoglobulin M rheumatoid factor was obtained, and definitions of seropositivity according to the number of applied data sources were prespecified. Annual age- and sex-standardized IRs were calculated as the number of incident seropositive and seronegative cases, divided by the number of person-years (PY) in the general population in that given year. Results: An increasing temporal trend in IR of seropositive RA and a decreasing trend in seronegative RA were observed. The IRs were higher for seropositive RA than for seronegative RA from 2009 onwards, with a widening of the IR gap between 2009 and 2016 regardless of the definition of seropositivity. When combining laboratory- and physician-reported autoantibody information and ICD-10 codes, the IR of seropositive RA in 2018 was approximately twice that of seronegative RA, at 19.0 and 9.0 per 100 000 PY, respectively. The level of antibody testing increased significantly during the study period. Conclusions: The IR of seropositive RA increased over time, whereas the IR of seronegative RA decreased. Temporal IR changes may be caused by a real change in the RA serology subtypes, an increase in autoantibody testing and availability, changes in registration practice over time, or a combination of these factors. [ABSTRACT FROM AUTHOR]

Background: Chronic pain is the hallmark symptom of joint diseases. This study examined the differences in quantitative sensory testing between patients with psoriatic arthritis (PsA), hand osteoarthritis (hand‐OA) and a pain‐free control group and differences between patients with and without concomitant fibromyalgia (cFM). Methods: All patients and pain‐free controls were assessed using pressure pain thresholds (PPT), temporal summation of pain (TSP), conditioned pain modulation (CPM) and clinical pain intensities. Psychological distress was assessed with the Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale, and Pittsburgh Sleep Quality Index. Disability was assessed with the Health Assessment Questionnaire and pain quality with the painDETECT questionnaire. cFM was identified using the revised 2016 American College of Rheumatology diagnostic criteria. Results: Patients with hand‐OA (n = 75) or PsA (n = 58) had statistically significant lower PPTs and CPM, greater TSP, and higher scores of psychological distress (p < 0.05) than controls (n = 20). Patients with cFM (58%) had higher scores of depression (p = 0.001), anxiety (p = 0.004), catastrophizing (p = 0.012), disability (p < 0.001), higher painDETECT score (p = 0.001), TSP (p = 0.027), and reduced sleep quality (p = 0.021) when compared to patients without cFM. Conclusion: Patients with hand‐OA and PsA exhibited signs of pain sensitization and a higher degree of psychological distress and disability than pain‐free individuals. Patients with cFM had greater TSP, painDETECT score, disability, catastrophizing, and reduced sleep quality, than patients without, indicating greater degree of pain sensitization, psychological burden, and disability. Statement of Significance: This paper shows that a significant proportion of patients with hand osteoarthritis and psoriatic arthritis with moderate pain intensity have significantly increased signs of pain sensitization and markers of psychological distress. A large proportion of these patients fulfil the criteria for concomitant fibromyalgia and these patients show even greater propensity towards pain sensitization and psychological distress. [ABSTRACT FROM AUTHOR]

Obesity and psoriatic arthritis (PsA) have a complicated relationship. While weight alone does not cause PsA, it is suspected to cause worse symptoms. Neutrophil gelatinase-associated lipocalin (NGAL) is secreted through various cell types. Our objective was to assess the changes and trajectories in serum NGAL and clinical outcomes in patients with PsA during 12 months of anti-inflammatory treatment. This exploratory prospective cohort study enrolled PsA patients initiating conventional synthetic or biological disease-modifying anti-rheumatic drugs (csDMARDs/bDMARDs). Clinical, biomarker, and patient-reported outcome measures were retrieved at baseline, and 4 and 12 months. Control groups at baseline were psoriasis (PsO) patients and apparently healthy controls. The serum NGAL concentration was quantified by a high-performance singleplex immunoassay. In total, 117 PsA patients started a csDMARD or bDMARD, and were compared indirectly at baseline with a cross-sectional sample of 20 PsO patients and 20 healthy controls. The trajectory in NGAL related to anti-inflammatory treatment for all included PsA patients showed an overall change of −11% from baseline to 12 months. Trajectories in NGAL for patients with PsA, divided into treatment groups, showed no clear trend in clinically significant decrease or increase following anti-inflammatory treatment. NGAL concentrations in the PsA group at baseline corresponded to the levels in the control groups. No correlation was found between changes in NGAL and changes in PsA outcomes. Based on these results, serum NGAL does not add any value as a biomarker in patients with peripheral PsA, either for disease activity or for monitoring. [ABSTRACT FROM AUTHOR]

The collision regulations include several qualitative terms without providing guidance as to how these terms could be understood in quantitative terms. These terms must therefore be interpreted by navigators, which poses a problem for autonomous ships. Extend the knowledge of how navigators interpret the collision regulations, with a specific focus on how they interpret the rule covering the requirement to proceed at a safe speed. Qualitative study based on interviews of a convenience sample of eight Norwegian navigators. Data was analysed with systematic text condensation. Navigators characterise safe speed as a speed in which they have control. Navigators do not look at different factors mentioned in the collision regulations in isolation, but within the context of the situation. Determining the safe speed of a vessel is more complicated than made out in the literature. As autonomous ships will have to cooperate with conventional vessels, their programming must include the knowledge of how the collision regulations are interpreted by human navigators. [ABSTRACT FROM AUTHOR]

To investigate the incidence and prevalence of rheumatoid arthritis (RA) in the adult Danish population. In this nationwide register-based cohort study, patients with incident RA between 1998 and the end of 2018 were identified using Danish administrative registries. The age- and sex-standardized incidence rate (IR), incidence proportion (IP), lifetime risk (LR), and point prevalence (PP) of RA were calculated. RA was defined as a first-time RA diagnosis registered in the Danish National Patient Registry combined with a redeemed prescription of a conventional synthetic disease-modifying anti-rheumatic drug in the following year. In addition, three different case definitions of RA were explored. The overall age- and sex-standardized IR of RA from 1998 to 2018 was 35.5 [95% confidence interval (CI) 35.1–35.9] per 100 000 person-years while the IP was 35.2 (95% CI 34.8–35.5) per 100 000 individuals. The IR was two-fold higher for women than for men. The LR of RA ranged from 2.3% to 3.4% for women and from 1.1% to 1.5% for men, depending on the RA case definition used. The overall PP of RA was 0.6% (95% CI 0.5–0.6%) in 2018: 0.8% (95% CI 0.7–0.8%) for women and 0.3% (95% CI 0.3–0.4%) for men. The prevalence increased about 1.5-fold from 2000 to 2018. The IR and PP were approximately two-fold higher for women than for men. The prevalence of RA in Denmark increased significantly from 2000 to 2018. The RA case definition had more impact on the results than the choice of denominator. [ABSTRACT FROM AUTHOR]

Throughout a person's life, characteristics such as creativity, adaptability and perseverance are needed. Research has shown that these characteristics can be cultivated through a combination of high self-efficacy and intrinsic motivation. Self-efficacy, or the belief one has about one's own ability, has a direct influence on how motivated one is to participate in a specific task or activity. An interrelationship therefore exists between the two, and can be influenced by an overall mindset regarding ability or intellect. Teachers often use rewards in the classroom to motivate learners to reach high performance standards; however, heavy debates about the influence of rewards on learners' self-efficacy and motivation are ongoing among academics. These debates are often due to different views or points of departure concerning motivation, such as the behaviouristic and cognitive approaches. The behaviouristic approach to motivation focuses mainly on three components, namely a driving force, learned motives, and incentives to "push" someone into participating in a task or activity. As opposed to the behaviouristic approach, the cognitive approach focuses on cognition, a personal, social, and cultural incentive that "pulls" a person towards participating in a given task or activity. According to the cognitive approach, motivation depends largely on the task or activity, on how interesting it is or what its perceived value is, on a person's abilities (or perceived abilities), and on the reason for success or failure in similar activities in the past. Past experiences are of crucial importance when people judge their own abilities (selfefficacy). Other criteria used to evaluate one's own abilities include social comparisons, verbal feedback, and physiological reactions. Research has shown that learners in special-needs schools often have low self-efficacy beliefs about their academic ability due to repeated experiences of failure. A study to investigate the role of rewards on these learners' self-efficacy was therefore imperative. Teachers could use the findings to inform their decisions on how to use rewards in the classroom. Deci and Ryan's (1985) self-determination theory (SDT) was used as theoretical framework for this study. This theory strives to develop learners' self-efficacy beliefs through fulfilling three basic human needs for optimal functioning, constructive social development, and personal wellbeing. These needs are identified as 1) the need to feel capable, 2) the need to be in control (autonomy) and 3) the need for relatedness. As far as rewards are concerned, the self-determination theory covers issues such as how rewards can be used as informative feedback for learners, scaffolding them into becoming more effective in a task or activity. The theory further distinguishes between autonomous and controlled motivation providing opportunities for extrinsic motivation to become intrinsic motivation through integration. Five participants were purposefully selected from a special-needs school in the northern suburbs of Cape Town where they took part in a collective case study design that investigated their experiences of rewards and self-efficacy. It was found that learners value and experience different types of academic rewards on an individual basis and that the classroom teacher should therefore carefully select and award rewards. The types of rewards vary from abstract rewards like verbal praise to concrete rewards such as stickers or sweets. The awarding of rewards should furthermore focus on the learning process, and not on product or outcome, in order to increase learners' self-efficacy. The process of rewarding the learning process can be visualised as a staircase where each step is a learner's individual learning goal, with the overarching learning outcome (or product) at the top. As the learner climbs each step, he or she is in fact reaching a learning outcome. Rewarding for process and outcomes thus becomes integrated and the process becomes the product. This study's findings contribute to the increasing repository of literature on the use of academic rewards, focusing on how, and not if, rewards should be used. [ABSTRACT FROM AUTHOR]