Search

The evolution of social media has transformed the way people communicate, share experiences and search for information before and after a trip. These platforms can bring countless benefits to businesses but implementing them effectively brings countless challenges. In the hotel industry, the use of social media as a digital marketing strategy has become fundamental to promote brands and services, as well as to create a closer relationship with the customer. It then becomes essential to understand how hotels can use these platforms effectively. Moreover, defining communication strategies, especially in periods of global crisis, with customers and public that include social networks are fundamental and a great challenge. In this sense, in this paper a case study of a hotel in a period including the global pandemic crisis of COVID-19 was conducted where good practices for social media management in hospitality are proposed, supported by the literature review and the practical learning provided in the fieldwork. These good practices also take into consideration the application of successful social media strategies in a hotel during times of crisis.

Developing a course curricula is a complex and difficult task since it must reflect the fundamental technical competencies and skills, but also the soft skills that students must develop to practice a specific profession. In this sense, Higher Education Institutions have been struggling to find strategies and incorporate methodologies into their course curricula that will promote the balanced development of these technical and transversal competencies and skills. Therefore, this paper describes an exploratory study on how the competencies and skills dynamic is featured in the description of the learning outcomes of a 3-year Bachelor in Hospitality Management degree in Portugal. It analysed the forty learning outcomes of the different subjects of the degree and framed in the Reference Framework by The Council of the European Union. Moreover, it also analysed the application of the taxonomy of Bloom in describing the learning outcomes. The preliminary results show that there are some explicit learning outcomes outlined in the reference framework of the European Union but they still lack those related to soft skills development. Furthermore, the application of the taxonomy of Bloom is adequate and fully present in the learning outcomes. These results highlight the need of reviewing the description of the learning outcomes, mainly its alignment with the content and teaching and assessment methodologies adopted by the different subjects.

The aim of this work was to study the stability and morphological properties of polystyrene latex containing kaolinite as a filler during the process of synthesis of nanocomposites viaemulsion polymerization. Nanocomposites with 1, 3, and 5 wt% of kaolinite were prepared. Latexes with 1 to 3 wt% of kaolinite were stable during the polymerization reaction. Hydrodynamic diameters of 93.68 and 82.11 nm were found for latexes with 1 and 3 wt% of kaolinite, respectively. The quantities of 1 to 3 wt% of kaolinite added during the reaction did not influence the reaction conversion curves or the number of particles. X-ray diffraction (XRD) and unconventional techniques of scanning electron microscopy (SEM) and high-resolution transmission electron microscopy (HRTEM) showed the presence of exfoliated and intercalated structures of the kaolinite.

Funding Information: The authors thank the Coordination for the Improvement of Higher Education Personnel (CAPES) and the National Council for Scientific and Technological Development (CNPq) for their financial support. This study was supported by the CAPES — number 88887.505029/2020–00 . Cecilia Gomes Barbosa receives a scholarship funded by CAPES — number 88887.643352/2021–00 . Publisher Copyright: © 2023 Elsevier B.V. The compound 3a,10b-dihydro-1H-cyclopenta[b]naphtho[2,3-d]furan-5,10-dione (IVS320) is a naphthoquinone with antifungal and antichagasic potential, which however has low aqueous solubility. To increase bioavailability, inclusion complexes with β-cyclodextrin (βCD) and methyl-β-cyclodextrin (MβCD) were prepared by physical mixture (PM), kneading (KN) and rotary evaporation (RE), and their in vitro anti-SARS-CoV-2 and antichagasic potential was assessed. The formation of inclusion complexes led to a change in the physicochemical characteristics compared to IVS320 alone as well as a decrease in crystallinity degree that reached 74.44% for the IVS320-MβCD one prepared by RE. The IVS320 and IVS320-MβCD/RE system exhibited anti-SARS-CoV-2 activity, showing half maximal effective concentrations (EC50) of 0.47 and 1.22 μg/mL, respectively. Molecular docking simulation suggested IVS320 ability to interact with the SARS-CoV-2 viral protein. Finally, the highest antichagasic activity, expressed as percentage of Tripanosoma cruzi growth inhibition, was observed with IVS320-βCD/KN (70%) and IVS320-MβCD/PM (72%), while IVS320 alone exhibited only approximately 48% inhibition at the highest concentration (100 μg/mL). publishersversion published

Direct restorations in composite resin require superficial rugosity appropriate to guarantee a surface free of biofilm buildup, which interferes with the durability of the restoration, its properties and the aesthetic aspect. Thus, it is relevant to know the behaviour of the finishing and polishing systems. The in vitro study aimed to compare the polishing efficiency of three different polishing systems in promoting the surface smoothness of a nanocomposite resin. Sixty specimens of the nanocomposite resin Filtek Z350 XT (3M) were made, randomly divided into three groups (n=20), according to the tested polishing systems: Enhance (Dentsply), DFL Polishers, and Sof-Lex Spiral (3M). The surface rugosity of the samples was measured by means of the rugosimeter equipment. The data were analysed through statistical tests: ANOVA two-way and post-hoc Tukey. The results indicated Sof-Lex (3M) polishing discs as the ones with the lowest average surface rugosity (0.13µm), presenting statistically significant results (p

BACKGROUND: Currently there is no consensus on which are the characteristics of rehabilitation approaches (bottom-up or top-down) most effective in the rehabilitation of ADLs in people with Neglet Syndrome (NS). AIM: To characterize the approaches (bottom-up or top-down) with more impact on ADLs in adults and elderly with NS. METHODS: This systematic review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) recommendation. A bibliographic search was carried out in PubMed, Web of Science, PEDro and Cochrane databases. Experimental studies were considered in which at least one technique of the bottom-up and top-down approaches was used. The Joanna Briggs Institute Critical Appraisal Checklist for RCTs tool was used to assess the methodological quality of the studies. The following combination of keywords was used: Negligence Syndrome OR Unilateral Syndrome OR Negligence (...) AND Activities OF Daily OR Daily Life (...) AND Treatment OR Intervention OR Technique (...). RESULTS: 16 studies were included, which 9 include techniques from the bottom-up approach, 6 include techniques from the top-down approach and 1 article includes two techniques, each belonging to each approach. The techniques of the bottom-up approach that increased independence in the ADLs were Visuomotor Feedback Training, Smooth Pursuit Eye Movement Training and the combination of Eye Patching with Constraint-induced Therapy. In the top-down approach, the techniques with the same results were Visual Scanning, Mental Practice, Continuous Theta Burst Stimulation and Transcranial Direct Current Stimulation. CONCLUSION: Both bottom-up and top-down approaches increase independence in ADLs. Each approach contains techniques with a significant positive impact on ADLs such as Visuomotor Feedback Training and Continuous Theta Burst Stimulation. The present work also allowed a critical analysis to the classification of the approaches in bottom-up and top-down, since they are not different to the category of rehabilitation mechanisms.

Chronic obstructive pulmonary disease (COPD) can lead to increased dependence on the informal caregiver and, consequently, to distress associated with caregiving burden. In the general population, higher levels of physical activity (PA) are related to lower distress levels; however, this relationship has been scarcely studied in COPD. This study aimed to explore the relationship between distress and PA in informal caregivers of patients with COPD, and the influence of caregivers’ (age, sex) and patients’ (age, sex, lung function) characteristics and caregiving duration on this relationship. A cross-sectional study was conducted with 50 caregivers (62.7 ± 9.8 years, 88% female; 78% caring for a spouse/partner; 38% caring >40 h/week; patients’ FEV1=45.2 ± 21.3% predicted). Data collection comprised questions related to the caregiving context, distress related to caregiving burden assessed with the Informal Caregiver Burden Assessment Questionnaire (QASCI; total score, 7 subscales), and self-reported PA with the Habitual Physical Activity Questionnaire (HPAQ). Spearman’s correlation coefficient and linear regressions were used. Significant, negative and moderate correlations were found between the QASCI (28.5 ± 19.8) and the HPAQ (5.2 ± 1.3) (ρ=-0.46; p = 0.01); and between the HPAQ and some QASCI subscales (emotional burden ρ=-0.47; implications for personal life ρ=-0.52; financial burden ρ=-0.44; perception of efficacy and control mechanisms ρ=-0.42; p

This work evaluates an epoxy composite reinforced with curauá fibres and/or organophilic clay. Epoxy polymers reinforced with nano-clays are also assessed. Composites are manufactured by cold pressing using fibres in pristine and treated conditions. Three levels of the factors NaOH solution (2.5, 5 and 10%) and immersion time (2, 4 and 10 hours) are investigated. Nano-clays are incorporated at the levels of 2.5, 5 and 10 wt.%. The morphology and crystallinity of the treated fibres are evaluated by scanning electron microscopy and X-ray diffraction, respectively. Tensile, three-point bending and impact tests are performed to characterise the composites. Tensile strength, flexural strength and impact resistance are increased by 24%, 44% and 47%, respectively, when compared to untreated fibre composites. The highest tensile and flexural strengths are achieved by hybrid composites containing 5 wt.% of nano-clay and 20 wt.% of curauá fibres treated with 5% NaOH for 4 hours. In contrast, the highest tensile modulus is achieved when hybrid composites are made from untreated fibres and 10 wt.% of nanoparticles. The highest impact resistance is obtained by curauá composites, without particles, composed of fibres treated with 5% NaOH for 4 hours. The inclusion of nano-clay leads to reduced impact resistance values.

Composite resins are used in Dentistry to perform direct aesthetic restorations, and are a material whose properties can be influenced by the diet of the individual, especially in the face of the action of beverages with acid pH, such as energy drinks. The aim of this in vitro study was to evaluate the effect of two energy beverages on the chemical composition of a nanoparticulate composite resin, at two-time intervals. Filtek Z350XT (3M/ESPE) composite resin was used to produce thirty-six specimens (discs) of 6.0mm x 1.5mm dimensions. The specimens were initially immersed in distilled water for 24h at 37ºC and then randomly divided into two groups (n=18); according to the immersion time: 1 month (T1) and 3 months (T2); and in three subgroups (n=6) referring to immersion solutions: distilled water (control) and two energy beverages (RedBull and Monster). The inorganic composition of the specimens was measured by a spectrometry. The data were submitted to two-way ANOVA and Tukey tests. The main inorganic elements of this restorative material were respectively: zirconium (Zr), silicon (Si) and calcium (Ca), which reduced its percentage after immersion time. RedBull was the most active solution, promoting losses of the mineral Si after 1 month of immersion, of Zr, after 3 months, and of Ca after 1 month and after 3 months. Monster influenced losses only in Si, after 1 month. Distilled water did not induce significant losses. Thus, the two energy beverages reduced the inorganic percentage of the nanoparticulate composite resin evaluated in this research.

O objetivo deste estudo é analisar e descrever os principais conceitos e contextos no que tange a inserção do cateter venoso central, e como objetivos secundários, apontar as principais complicações e indicações para o procedimento. Tornando-se essa técnica mais segura e prezando o prognóstico dos pacientes. Objetivando expor produções científicas e reconstruir conceitos e linhas de pensamentos, articulando saberes de diversos trabalhos conceituados, na tentativa de trilhar caminhos na direção alvo de novas concepções e redes de pensamento. O presente estudo trata-se de uma revisão narrativa, na pesquisa sobre o acesso venoso central e a introdução do cateter venoso central. Foi realizada uma pesquisa de artigos nas bases de dados Medical Literature Analysis and Retrievel System Online (MEDLINE), Scientific Electronic Library Online (SciELO) e PubMed, com os seguintes Descritores em Ciências da Saúde (DeCS): Acesso Venoso; Cateter Venoso Central; Cirurgia; Segurança do Paciente. Selecionando artigos entre os períodos de 2005 a 2022, nos idiomas Inglês, Português e Espanhol, para ampliar o nível de relevância e a qualidade da revisão, além do baseamento técnico-científico advindo de obras literárias conceituadas pela história. Resume-se em um cateter intravascular com final próximo as extremidades cardíacas ou grandes vasos, aorta, artéria pulmonar, veias cavas inferior e superior, jugulares internas, femorais, braquicefálicas e, especialmente em neonatais, artéria e veia umbilical. Quando trata-se de indicações médicas, a prática do procedimento é variada, como: instabilidade hemodinâmica por falha na primeira tentativa de acesso, nutrição parenteral, medicação osmótica, necessidade de infusão contínua de medicamentos.

Passiflora nitida Kunth, an Amazonian Passiflora species, is little studied, although the specie’s high biological potential. Herein the plant’s pharmacognostic characterization, extract production, antioxidant potential evaluation, and application of this extract in cosmetic products is reported. The physical chemical parameters analyzed were particle size by sieve analysis, loss through drying, extractive yield, total ash content, laser granulometry, specific surface area and pore diameter (SBET), differential scanning calorimetry, thermogravimetry (TG), and wave dispersive X-Ray fluorescence (WDXRF). Total phenol/flavonoid content, LC-MS/MS analysis, DPPH and ABTS antioxidant radical assays, cytotoxicity, melanin, and tyrosinase inhibition in melanocytes test provided evidence to determine the content of the major constituent. P. nitida dry extract provided a fine powder with mesopores determined by SBET, with the TG curve showing five stages of mass loss. The antioxidant potential ranged between 23.5-31.5 mg∙mL-1 and tyrosinase inhibition between 400-654 μg∙mL-1. The species presented an antimelanogenic effect and an inhibitory activity of cellular tyrosinase (26.6%) at 25 µg/mL. The LC-MS/MS analysis of the spray-dried extract displayed the main and minor phenolic compounds constituting this sample. The results indicate that P. nitida extract has promising features for the development of cosmetic formulations.

O fígado é um órgão indispensável para a manutenção da homeostase do nosso corpo, sendo responsável por funções importantes como a eliminação de toxinas. Apresenta uma capacidade considerável de regeneração, porém, quando essas agressões não cessam, a regeneração ocorre de forma incorreta, surgindo cicatrizes e nódulos. Diante da importância epidemiológica do EH, este artigo visa discutir os mecanismos fisiopatológicos da doença. Este estudo trata-se de uma revisão narrativa com o propósito de discutir e descrever sobre a EH e sua fisiopatologia, como também, demonstrar como esta síndrome afeta a vida pessoal dos indivíduos acometidos. Foi utilizado o banco de dados: SciElo (Scientific Eletronic Library Online) e PubMed (US National Library of Medicine), com dados científicos de 2 de janeiro de 2023, sem restrição de idioma e sem restrição ao ano de publicação. Vários estudos mostram que o maior sistema neuroinibitório, GABA, está aumentado na EH. Ademais, uma importante consideração pela amônia diante da síndrome deve ser exposta; os receptores que ficam localizados na periferia da mitocôndria, pela presença da amônia, assim como de ligandinas, provocando a ativação da produção de neuroesteroides nos astrócitos. De qualquer maneira, todas as pesquisas afirmaram que quanto mais tardiamente é feito o diagnóstico, mais grave serão as consequências sistêmicas da patologia. Além disso, é de fundamental importância que os centros médicos responsáveis por oferecer o apoio hospitalar aos pacientes acometidos pela EH estejam preparados.

Purpose: Anemia is highly prevalent in patients with advanced cancer and adversely affects quality of life. There is limited data on the frequency, clinical utility and effectiveness of red blood cell transfusions (RBC), and no randomized controlled trials or clinical practice guidelines are available. The aim of this study was to evaluate clinician practices on RBC transfusion in an oncologic palliative care service (PCS) and its impact in patients’ symptoms, adverse events and overall survival.Methods: Retrospective analyses of all advanced cancer patients who received RBC transfusions admitted, during a 3-year period. Pre-blood counts, reason for transfusion, subjective benefit and objective outcomes were listed.Results: We identified 179 patients with a mean age of 67 years. A total of 435 RBC units, during 301 transfusion episodes were recorded. Asthenia/fatigue was the most frequent symptom (68%). The mean pretransfusion hemoglobin (Hb) was 6.85 g/dL and 48% patients had an Hb above 7 g/dL. Symptomatic benefit was achieved in 36% of patients. Adverse events were reported in 4%, with a 30-day survival rate of 57%. A statistically significant association between ECOG performance status (ECOG-PS) and symptomatic benefit was found (p=0.005). Hemoglobin level pre-transfusion, ECOG-PS and symptomatic benefit with transfusions were significantly associated with survival.Conclusion: This study suggests that advanced cancer patients with a higher level of functioning may have a bigger benefit from RBC transfusion. Post-transfusion symptomatic benefit, and pre-transfusion ECOG-PS and hemoglobin levels seem to be independent predictors of survival. Further studies are needed to develop validated measures of objective functional changes to evaluate the clinical impact of transfusions and to identify patients most likely to benefit from it.

We report the case of a 40-year old woman followed at our Rheumatology department for a 14-year history of a relatively well controlled Sjögren's syndrome who developed, for the first time in life, lesions suggestive of subacute cutaneous lupus erythematosus, nine weeks after taking oral terbinafine prescribed for onychomycosis. She denied additional symptoms, namely systemics, and no other clinical finding besides cutaneous lesions were detected. No laboratory findings were in favour of a flare of her connective tissue disease. Here we explore the possibility of terbinafine-induced subacute cutaneous lupus erythematosus in the context of previous autoimmunity. This clinical case highlights the importance of avoiding the prescription of terbinafine in this kind of patients.

© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/)., Motivation can be broadly defined as what moves people to act. Low motivation is a frequently reported factor for the reduced physical activity (PA) levels observed in patients with chronic obstructive pulmonary disease (COPD). This study assessed patients' motives to be physically active, according to three pulmonary rehabilitation (PR) participation groups (Never PR, Previous PR and Current PR) and explored whether these motives were related to the PA levels and clinical characteristics. The motives to be physically active were assessed with the Exercise Motivation Inventory-2 (EMI-2, 14 motivational factors, five dimensions) and PA with accelerometry (PA groups: 0.05) but having less symptoms and ≥two comorbidities were associated with higher scores in psychological/health and body-related motives, respectively (p < 0.05). The findings may encourage health professionals to actively explore with patients their motives to be physically active to individualise PA promotion., This work was funded by FEDER, through COMPETE2020—Programa Operacional Competitividade e Internacionalização and by Portuguese national funds provided by Fundação para a Ciência e Tecnologia (FCT) (OnTRACK projects—POCI-01-0145-FEDER-028446 and UIDB/05704/2020).

Skills are understood as key issues in the labour market and conceptualised as individual attributes needed to perform competent work. The distinction between hard and soft skills is one of the most used theoretical conceptualization – hard skills being understood as technical skills, required of professionals, and soft skills being seen as personal traits which are not specifically related to the function. One hundred years after the publication of Mann's A Study of Engineering Education (1918), and as employers expect a new level of readiness from new hires, the focus is on bridging the soft skills gap. However, most of the literature delves into mismatched expectations of both industry and educators, and little documentation can be found regarding the skills that future employees believe their employers will require.

A key factor for the adoption of an active lifestyle is self-determined motivation; however, it is often overlooked in COPD. Understanding the motives underlying patients’ decision to be (or not) physically active will provide insight into future interventions. This study assessed the motives for patients with COPD to engage in physical activity (PA) and their association with PA behaviour. A cross-sectional study was conducted in stable patients with COPD. Motivation was assessed with the Exercise Motivation Inventory-2 (EMI-2; score 0[Not at all true for me]–5[Very true for me]; 5 dimensions) and PA with accelerometry [ActiGraph-GT3X+, 7 days; moderate to vigorous PA (MVPA), steps/day]. Spearman’s correlations (ρ) were used to assess their relationship. 60 participants were enrolled (67.2±7.7 years; 76.7% men; FEV1 49.5±19.7pp). Patients’ motives to be physically active were mostly Health, Fitness and Psychological. Correlations with PA were weak and non-significant (p>0.05) (Table 1). Patients with COPD value Health, Fitness and Psychological motives to be physically active, although these are not related to their PA behaviour. Findings highlight the complex nature of PA and the need to further explore factors influencing PA and motivation in this population. info:eu-repo/semantics/publishedVersion

Fatigue is highly prevalent in COPD and may be associated with reduced physical activity (PA) and poor outcomes. This study explored the relationship between fatigue, objectively measured PA and health-related factors in people with COPD. Fatigue was assessed with the Checklist of Individual Strength (CIS20) and CIS20-Subjective Fatigue (CIS20-SF) and PA with Actigraph GT3X monitors (moderate-to-vigorous PA, MVPA; total PA; steps/day). Dyspnoea (modified Medical Research Council, mMRC), exercise tolerance (6-min walk distance, 6MWD), lung function (spirometry) and GOLD AD were collected. Spearman (ρ) and Pearson (r) correlations and multiple regressions were performed. Variables entered the model if correlation≥0.2. 54 patients participated (68±7 years; 82% men) and 69% reported fatigue (CIS20-SF≥27). Fatigue was significantly correlated with MVPA, steps/day, mMRC, 6MWD, GOLD AD and FEV pp (Table 1). In regression models for CIS20 (p=.001; r =.61) and CIS20-SF (p=.003; r =.56), dyspnoea was the only significant variable. Table 1. Descriptives and correlations between fatigue, PA and health-related factors. Descriptives CIS20 CIS20-SF 1 2 2 d THANK YOU FOR ACCEPTING COOKIES You can now hide this message or find out more about cookies. Hide More info

Higher education in health study programs is particularly focused on the development of technical skills, despite there being a consensus on the importance of training students regarding socioemotional and life skills. The aim of this study was to characterize and explore correlations between socioemotional skills and decision-making styles in undergraduate health students. Undergraduate students (18–25 years old) were recruited at a School of Health Sciences in Portugal. Participants were characterized in terms of sociodemographic data, socioemotional skills (Study on Social and Emotional Skills questionnaire) and decisionmaking styles (Melbourne Decision Making questionnaire). Descriptive statistics and correlations between questionnaires´ subscales were calculated. Students presented higher scores in tolerance (34.8±3.4), cooperation (34.7±2.4), empathy (31.1±3.2), vigilance (16.0±1.9), and procrastination (9.9±2.1). Assertiveness presented negative correlations with buck-passing (rho=-0.43, p

N/a

Objectives: To assess the discontinuation of first-line biological treatment and to evaluate the reasons and predictors thereof in patients with rheumatoid arthritis (RA) from daily clinical practice. Methods: RA patients registered in the Rheumatic Diseases Portuguese Register (Reuma.pt) starting treatment with biologic DMARDs (bDMARDs) were included in this prospective observational study. The main outcome was the time to discontinuation (in years) due to any cause. Discontinuation was defined as a 90-day discontinuation of treatment or the occurrence of any switch to another bDMARD during follow-up. Baseline and time-varying sociodemographic and clinical characteristics were tested as possible predictors of discontinuation using multivariable Cox models. Results: Of the 1,851 RA patients included in the study, 871 (47%) discontinued their first bDMARD. The median overall persistence of the first bDMARD was 5.5 years and the leading cause of discontinuation was inefficacy [N=476 (55%)], followed by adverse events [N=262 (30%)], other causes [N=69, (8%)] and unknown causes [N=64 (7%)]. Patients with a higher HAQ score (more disability) at baseline were more likely to discontinue their first bDMARD [hazard ratio (HR):1.39 (95% CI: 1.17-1.64)], as were patients with a higher number of comorbidities [HR: 1.17 (1.05-1.29)] and patients starting treatment from 2007 onwards [HR:1.89 (1.5-2.38)]. On the contrary, receiving TNFi bDMARD [HR:0.74 (0.57-0.94)] as opposed to non-TNFi was associated with less discontinuation. Expectedly, the higher the DAS28 during follow-up the higher the likelihood to discontinue bDMARD [HR:1.08 (1.06-1.1)]. No other time-varying predictor was found. Conclusion: In the Portuguese RA population, maintenance of first-line bDMARD was shown to be relatively high. Inefficacy was the leading cause of discontinuation. Features found to predict drug discontinuation (e.g. baseline disability) may contribute to inform clinician’s decisions in clinical practice.

Objective.To assess differences in initial treatment and treatment response in male and female patients with rheumatoid arthritis (RA) in daily clinical practice.Methods.The proportion of patients with RA starting different antirheumatic treatments (disease-modifying antirheumatic drugs; DMARD) and the response to treatment were compared in the international, observational METEOR register. All visits from start of the first DMARD until the first DMARD switch or the end of followup were selected. The effect of sex on time to switch from first to second treatment was calculated using Cox regression. Linear mixed model analyses were performed to assess whether men and women responded differently to treatments, as measured by Disease Activity Score (DAS) or Health Assessment Questionnaire.Results.Women (n = 4393) more often started treatment with hydroxychloroquine, as monotherapy or in combination with methotrexate (MTX) or a glucocorticoid, and men (n = 1142) more often started treatment with MTX and/or sulfasalazine. Time to switch DMARD was shorter for women than for men. Women had a statistically significantly higher DAS over time than men (DAS improvement per year β −0.69, 95% CI −0.75 to −0.62 for men and −0.58, 95% CI −0.62 to −0.55 for women). Subanalyses per DMARD group showed for the conventional synthetic DMARD combination therapy a slightly greater decrease in DAS over time in men (−0.89, 95% CI −1.07 to −0.71) compared to women (−0.59, 95% CI −0.67 to −0.51), but these difference between the sexes were clinically negligible.Conclusion.This worldwide observational study suggests that in daily practice, men and women with RA are prescribed different initial treatments, but there were no differences in response to treatment between the sexes.