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Uppsatsens syfte är att undersöka hur relationen mellan människa och djur framställs i den samtida realistiska litteraturen för att diskutera motsägelsefulla etiska aspekter av djursynen i den industrialiserade delen av världen. Genom att i analysen av romanen Vi är alla helt utom oss av Karen Joy Fowler utgå från djurstudier är ambitionen att synliggöra och ifrågasätta rådande normer kring djursyn. Fowler illustrerar hur en nära relation till ett annat djur kan skapa medkänsla för andra levande varelser, påverka livsval och förändra sättet vi agerar på. Genom att minska distanseringen arterna emellan och leva med andra djur kan människan få en mer empatisk djursyn och förlegade idéer om att utnyttja djur kan ifrågasättas. Fowlers roman visar att olikheterna mellan arter snarare handlar om uppträdande än om beteckning, vilket öppnar för en diskussion kring multiarter. Det framgår också att språket saknar förmågan att spegla verklighetens rikedom och komplexitet när det rör sig om identitet. The purpose of the thesis is to examine how the relation between human and animal is depicted in the contemporary realistic literature and to discuss contradictory ethical aspects of the Western view of animals. Using Animal Studies, the analysis of the novel We Are All Completely Beside Ourselves by Karen Joy Fowler questions the prevailing norms around the view of animals in our society. Fowler’s novel illustrates how a close relationship with another animal can create compassion for other living beings, influence the choices we make and may change the way we act. By reducing the distance between species, humans can develop a stronger understanding for animals and start to question norms and outdated ideas about exploiting animals. Fowler’s novel shows that the differences between species concerns behavior rather than designation, which opens up for a discussion about multi-species. It is clear that language lacks the ability to reflect the richness and complexity of reality when it comes to identity.

PURPOSE: To assess the long-term outcome of uveitis in juvenile idiopathic arthritis (JIA).DESIGN: Population-based, multicenter, prospective JIA cohort, with a cross-sectional assessment of JIA-associated uveitis (JIA-U) 18 years after the onset of JIA.PARTICIPANTS: A total of 434 patients with JIA, of whom 96 had uveitis, from defined geographic areas of Denmark, Finland, Norway, and Sweden.METHODS: Patients with onset of JIA between January 1997 and June 2000 were prospectively followed for 18 years. Pediatric rheumatologists and ophthalmologists collected clinical and laboratory data.MAIN OUTCOME MEASURES: Cumulative incidence of uveitis and clinical characteristics, JIA and uveitis disease activity, ocular complications, visual outcome, and risk factors associated with the development of uveitis-related complications.RESULTS: Uveitis developed in 96 (22.1%) of 434 patients with JIA. In 12 patients (2.8%), uveitis was diagnosed between 8 and 18 years of follow-up. Systemic immunosuppressive medication was more common among patients with uveitis (47/96 [49.0%]) compared with patients without uveitis (78/338 [23.1%]). Active uveitis was present in 19 of 78 patients (24.4%) at the 18-year visit. Ocular complications occurred in 31 of 80 patients (38.8%). Short duration between the onset of JIA and the diagnosis of uveitis was a risk factor for developing ocular complications (odds ratio [OR], 1.4; 95% confidence interval [CI], 1.1-1.8). Patients with a diagnosis of uveitis before the onset of JIA all developed cataract and had an OR for development of glaucoma of 31.5 (95% CI, 3.6-274). Presence of antinuclear antibodies (ANAs) was also a risk factor for developing 1 or more ocular complications (OR, 3.0; 95% CI, 1.2-7.7). Decreased visual acuity (VA) CONCLUSIONS: Our results suggest that uveitis screening should start immediately when the diagnosis of JIA is suspected or confirmed and be continued for more than 8 years after the diagnosis of JIA. Timely systemic immunosuppressive treatment in patients with a high risk of developing ocular complications must be considered early in the disease course to gain rapid control of ocular inflammation.

Juvenile idiopathic arthritis, JIA, is used as an umbrella term covering a heterogeneous group of chronic arthritis forms in children, many of which have important differences compared to adult arthritis, while others possibly represent similar diseases among children and adults. Classification aims to give a better understanding of the pathogenesis, patterns, disease trajectories and treatment responses. For the juvenile psoriatic arthritis, JPsA, the classification criteria are currently being debated. The distribution of affected joints in JIA differs greatly and it is unknown why some joints appear to be more affected than others. The temporomandibular joint (TMJ) can be affected early in the course of the disease and often the symptoms are mild and without obvious swelling. This thesis has its origin in the Nordic Study Group of Paediatric Rheumatology and the population-based prospective study of 510 children with newly diagnosed JIA included between 1997 and 1999. Totally 440 children were included in the eight-year follow-up, and in the TMJ study 265 patients were examined and underwent cone-beam computed tomography, CBCT, 17 years after onset. After eight years a considerable proportion of the children with definite psoriasis were classified as undifferentiated JIA based on the exclusion criteria in the ILAR classification. Our data also presents the heterogenicity of JPsA and the development over time of clinical variables supporting a psoriatic diathesis, as well as the overlap between JPsA and enthesitis-related arthritis in a group of patients. We found that extensive symptoms and dysfunctions of the TMJ are seen in JIA 17 years after disease onset, even in patients registered with inactive disease or remission. Individuals with substantial condylar damage on CBCT were found in all JIA categories. The deeper understanding of a chronic disease over time is crucial for research initiatives to improve care as well as for clinical decisions and planning of the health care. Our findings suggest a need for a more appropriate classification of JPsA and also that aspects of TMJ involvement should be included in the general health assessment in JIA.

Purpose - To assess the long-term outcome of uveitis in juvenile idiopathic arthritis (JIA). Design - Population-based, multicenter, prospective JIA cohort, with a cross-sectional assessment of JIA-associated uveitis (JIA-U) 18 years after the onset of JIA. Participants - A total of 434 patients with JIA, of whom 96 had uveitis, from defined geographic areas of Denmark, Finland, Norway, and Sweden. Methods - Patients with onset of JIA between January 1997 and June 2000 were prospectively followed for 18 years. Pediatric rheumatologists and ophthalmologists collected clinical and laboratory data. Main Outcome Measures - Cumulative incidence of uveitis and clinical characteristics, JIA and uveitis disease activity, ocular complications, visual outcome, and risk factors associated with the development of uveitis-related complications. Results - Uveitis developed in 96 (22.1%) of 434 patients with JIA. In 12 patients (2.8%), uveitis was diagnosed between 8 and 18 years of follow-up. Systemic immunosuppressive medication was more common among patients with uveitis (47/96 [49.0%]) compared with patients without uveitis (78/338 [23.1%]). Active uveitis was present in 19 of 78 patients (24.4%) at the 18-year visit. Ocular complications occurred in 31 of 80 patients (38.8%). Short duration between the onset of JIA and the diagnosis of uveitis was a risk factor for developing ocular complications (odds ratio [OR], 1.4; 95% confidence interval [CI], 1.1–1.8). Patients with a diagnosis of uveitis before the onset of JIA all developed cataract and had an OR for development of glaucoma of 31.5 (95% CI, 3.6–274). Presence of antinuclear antibodies (ANAs) was also a risk factor for developing 1 or more ocular complications (OR, 3.0; 95% CI, 1.2–7.7). Decreased visual acuity (VA) Conclusions - Our results suggest that uveitis screening should start immediately when the diagnosis of JIA is suspected or confirmed and be continued for more than 8 years after the diagnosis of JIA. Timely systemic immunosuppressive treatment in patients with a high risk of developing ocular complications must be considered early in the disease course to gain rapid control of ocular inflammation.

This is the peer reviewed version of the following article: Glerup, M., Rypdal, V., Arnstad, E. D., Ekelund, M., Peltoniemi, S., Aalto, K., ...Herlin, T. (2019). Long‐term outcomes in juvenile idiopathic arthritis: 18 years of follow‐up in the population‐based Nordic Juvenile Idiopathic Arthritis (JIA) cohort. Arthritis Care and Research, ?(?), ?. , which has been published in final form at https://doi.org/10.1002/acr.23853 . This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. Objectives - This study assessed the long‐term course, remission rate and disease burden in juvenile idiopathic arthritis (JIA) 18 years after disease onset in a population‐based setting from the early biologic era. Methods - A total of 510 consecutive cases of JIA with disease onset between 1997 and 2000 from defined geographic regions in Denmark, Norway, Sweden and Finland were prospectively included in this 18‐year cohort study. At the follow‐up visit, patient‐reported, demographic and clinical data were collected. Results - The study included 434 (85%) of the 510 eligible JIA participants. The mean age ± SD was 24.0 ± 4.4 years. The median juvenile arthritis disease activity (JADAS71) score was 1.5 (IQR 0‐5), with the ERA category of JIA having the highest median score, 4.5 (IQR 1.5–8.5) (P=0.003). In this cohort, 46% still had active disease, and 66 (15%) were treated with synthetic disease‐modifying anti‐rheumatic drugs and 84 (19%) with biologics. Inactive disease indicated by JADAS71 Conclusions - A high prevalence of the JIA cohort did not achieve CR despite new treatment options during the study period. The ERA category showed the worst outcomes and, in general, there is still a high burden of disease in adulthood for JIA.

Additional file 2: Table S2. Clinical characteristics of participants in the Nordic JIA cohort at the 17-year follow-up visit. y* = mean in years ± SD, ANA = antinuclear antibodies, HLA-B27 = human leucocyte antigen B27, CRP = C-Reactive Protein, ESR = Erythrocyte Sedimentation Rate, IQR = 1st-3rd interquartile range, JADAS71 = juvenile arthritis disease activity score of 71 joints, sJIA = systemic JIA, Oligo persist = oligo persistent JIA, Oligo ext. = oligo extended JIA, Poly RF- = polyarticular rheumatoid factor negative JIA, Poly RF+ = polyarticular rheumatoid factor positive JIA, ERA = enthesitis-related arthritis, Undiff = undifferentiated JIA. (DOCX 17 kb)

An increased access to information and knowledge through the development of information- and communication technology, Internet and social media has led to changes in perceptions of what the public library is and what role it has in contemporary society. In addition, the use of smartphones has contributed to an easy and economic way to market an institution and to build relationships with users through visual communication. In the context of adapting both to the influences of a global market and stated cultural policies on a national, regional and municipal level, the public library aims to serve a target group that includes all citizens. The question at issue states: How does the public libraries in Jönköping use Instagram to market their activity and in what way is different library roles expressed through the images? During 2016 – 2017, 302 images were posted on Instagram by the municipality of Jönköping. These images where studied using content analysis. The four spaces model, as explained by Jochumsen, Hvenegaard Rasmussen and Skot- Hansen (2012), was used to analyze the result. The result shows that the public libraries use Instagram to legitimize the librarys existence towards users and decision-makers, to build relationships with users and to market activities, for instance. he majority of the studied images could be related to the inspiration space.

OBJECTIVE: The present study was undertaken to assess the long-term course, remission rate, and disease burden in juvenile idiopathic arthritis (JIA) 18 years after disease onset in a population-based setting from the early biologic era.METHODS: A total of 510 consecutive cases of JIA with disease onset between 1997 and 2000 from defined geographic regions in Denmark, Norway, Sweden, and Finland were prospectively included in this 18-year cohort study. At the follow-up visit, patient-reported demographic and clinical data were collected.RESULTS: The study included 434 (85%) of the 510 eligible JIA participants. The mean ± SD age was 24.0 ± 4.4 years. The median juvenile arthritis disease activity score in 71 joints (JADAS-71) was 1.5 (interquartile range [IQR] 0-5), with the enthesitis-related arthritis (ERA) category of JIA having the highest median score (4.5 [IQR 1.5-8.5], P = 0.003). In this cohort, 46% of patients still had active disease, and 66 (15%) were treated with synthetic disease-modifying antirheumatic drugs and 84 (19%) with biologics. Inactive disease indicated by a JADAS-71 score of CONCLUSION: A substantial proportion of the JIA cohort did not achieve CR despite new treatment options during the study period. The ERA category showed the worst outcomes, and in general there is still a high burden of disease in adulthood for JIA.

To study self-reported pain early in the disease course of juvenile idiopathic arthritis (JIA) as a predictor of long-term disease outcomes.Consecutive cases of JIA with disease onset from 1997 to 2000 from defined geographical areas of Norway, Sweden, Finland, and Denmark were prospectively enrolled in this population-based cohort study. Self-reported, disease-related pain was measured on a 10-cm visual analog scale (VAS pain). Inclusion criteria were a baseline visit with a pain score 6 months after disease onset, followed by an 8-year study visit. Remission was defined according to Wallace et al (2004) preliminary criteria. Functional disability was measured by the Childhood Health Assessment Questionnaire and the Child Health Questionnaire Parent Form if the child was age18 years and by the Health Assessment Questionnaire if age ≥18 years. Damage was scored using the Juvenile Arthritis Damage Index.The final study cohort consisted of 243 participants, and 120 participants (49%) had oligoarticular onset. At baseline, 76% reported a VAS pain score0 compared to 57% reporting at 8 years. Half of those who reported baseline pain also reported pain at 8 years but at a lower intensity. Compared to no pain, higher pain intensity at baseline predicted more pain at 8 years, more functional disability, more damage, and less remission without medication. Baseline pain predicted more use of disease-modifying antirheumatic drugs/biologics during the disease course. Participants with oligoarticular JIA reporting pain at baseline were more likely to develop extended oligoarticular JIA or other JIA categories with an unfavorable prognosis.Early self-reported, disease-related pain among children and adolescents with JIA is common and seems to predict persistent pain and unfavorable long-term disease outcomes.

Table S5. Baseline clinical characteristics as predictors of joint damage (JADI-A) in univariate logistic regression. (PDF 161 kb)

Table S2. Medications given before the baseline study visit. (PDF 108 kb)

This is the peer reviewed version of the following article: Arnstad, E.D., Rypdal, V., Peltoniemi, S., Herlin, T., Berntson. L., Fasth, A., ..., Rygg, M.. Early self-reported pain in juvenile idiopathic arthritis (JIA) is related to long-term outcomes. Results from the Nordic JIA cohort study. Arthritis care & research, which has been published in final form at https://doi.org/10.1002/acr.23715. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. Objective: To study self‐reported pain early in the disease course of juvenile idiopathic arthritis (JIA) as predictor of long‐term disease outcomes. Methods: Consecutive cases of JIA with disease onset 1997‐2000 from defined geographical areas of Norway, Sweden, Finland and Denmark were prospectively enrolled in this population‐based cohort study. Self‐reported, disease‐related pain was measured on a 10 cm visual analogue scale (VAS pain). Inclusion criteria were a baseline visit with pain score six months after disease onset, followed by an eight‐year study visit. Remission was defined according to Wallace preliminary criteria. Functional disability was measured by Childhood Health Assessment Questionnaire (CHAQ) and Child Health Questionnaire (CHQ‐PF50) if age Results: The final study cohort consisted of 243 participants, and 120 (49%) had oligoarticular onset. At baseline 76% reported VAS pain >0 compared to 57% at eight‐year. Half of those who reported baseline pain also reported pain at eight‐year, but at a lower intensity. Compared to no pain, higher pain intensity at baseline predicted more pain at eight‐year, more functional disability, more damage and less remission off medication. Baseline pain predicted more use of DMARDs/biologics during the disease course. Participants with oligoarticular JIA reporting pain at baseline were more likely to develop extended oligoarticular or other unfavorable JIA categories. Conclusion: Early self‐reported, disease‐related pain among children and adolescents with JIA is common and seems to predict persistent pain and unfavorable long‐term disease outcomes.

Figure S1. Receiver operating characteristic (ROC) curves for the four unfavorable clinical outcomes in the validation sets, but for models constructed without using blood samples as predictors. The colored lines are the mean ROC curves for the 100 different realizations of the partitioning of the cohort into training sets and validation sets (thin gray curves). (a) Not in remission. (b) Childhood Health Assessment Questionnaire (CHAQ) >0. (c) Physical Summary Score (PhS)â 0. (PDF 435 kb)

Figure S2. Receiver operating characteristic (ROC) curves for a test in the Nordic JIA cohort of the prediction model for severe disease course by Guzman et al. The area under the curve (AUC) values were 0.69 for non-achievement of remission off medication, 0.68 for Childhood Health Assessment Questionnaire (CHAQ) >0, 0.69 for Physical Summary Score (PhS) 0. (PDF 287 kb)

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Table S3. Baseline clinical characteristics as predictors of functional disability (CHAQ) in univariate logistic regression. (PDF 125 kb)

Background: To study the impact of psoriasis and features associated with psoriasis on classification and outcome in a population-based follow-up cohort of children with juvenile idiopathic arthritis (JIA). Methods: In all, 440 children with JIA were followed for a median of 8 years in a prospective Nordic population-based cohort study. Data for remission was available for 427 of these children. The presence of psoriasis, psoriasis-like rash, dactylitis, nail pitting, enthesitis, tenosynovitis and heredity was assessed in relation to ILAR classification and remission. Results: Clinical findings associated with psoriasis developed consecutively during the 8-year period. Six of 14 children with psoriasis were not classified as juvenile psoriatic arthritis according to the ILAR criteria at 8 year follow-up. Dactylitis was more common in children with early onset of JIA. After 8 years we found a cumulative median number of eleven arthritic joints in children with psoriasis or psoriasis- like rash compared with six in the rest of the cohort (p = 0.02). Also, the chance for not being in remission after 8 years increased significantly in patients with psoriasis, psoriasis-like rash or at least two of: 1) first-degree heredity for psoriasis or psoriatic arthritis, 2) dactylitis or 3) nail pitting, compared with the rest of the group (OR 3.32, p = 0.010). Conclusions: Our results indicate a more severe disease over time in psoriasis- associated JIA, as features of psoriasis develop during the disease course. This group is a major challenge to encompass in a future JIA classification in order to facilitate early tailored treatment.

Den svenska fysikern Eva von Bahr-Bergius (1874-1962) konverterade till katolska kyrkan 1930. Vid den tiden fanns en stark misstro mot det katolska i Sverige, och katolikerna var fortfarande kringskurna av begränsande lagar. Ändå valde hon – i likhet med flera andra – att skriva och publicera berättelsen om sin konversion i de två skrifterna Min väg tillbaka till kristendomen (1933), och Efterskrift till Min väg tillbaka till kristendomen (1934). Berättelsen fokuserar på att ge rationella förklaringar till konversionen, istället för att helt enkelt lägga ansvaret på Gud. Denna uppsats vill försöka förstå dels varför hon valde att offentliggöra sin katolicism, dels vad rationaliseringarna handlar om. Genom en jämförelse mellan de båda texterna konstateras att publiceringen fungerar som en befriande komma-ut-process. Genom att sätta berättelsen i en samtida religiös kontext, kan rationaliseringarna förstås som ett svar mot omgivningens förväntningar på rationalitet, och gör så den tillsynes obegripliga konversionen möjlig att genomföra. Detta då själva orsaken till konversionen – den icke-rationella längtan efter Gud – inte kan godtas som en acceptabel förklaring i samtiden.

Objective To assess concordance among criteria for inactive disease (ID) and low disease activity (LDA) in juvenile idiopathic arthritis (JIA) and to seek factors driving discordance. Methods The frequency of fulfillment of existing criteria was evaluated in information on 10,186 patients extracted from 3 cross-sectional data sets. Patients were divided up according to the functional phenotypes of oligoarthritis and polyarthritis. Concordance between criteria was examined using weighted Venn diagrams. The role of each individual component in explaining discordance between criteria was assessed by calculating the absolute number and percentage of instances in which the component was responsible for discrepancy between definitions. Results Criteria for ID were met by 28.6–41.1% of patients with oligoarthritis and by 24.0–33.4% of patients with polyarthritis. Criteria for LDA were met by 44.8–62.4% of patients with oligoarthritis and by 44.6–50.4% of patients with polyarthritis. There was a 57.9–62.3% overlap between criteria for ID and a 67.9–85% overlap between criteria for LDA. Parent and physician global assessments and acute-phase reactants were responsible for the majority of instances of discordance among criteria for ID (8.7–15.5%, 10.0–12.3%, and 10.8–17.3%, respectively). Conclusion We found fair concordance between criteria for ID and LDA in JIA, with the main drivers of discordance for ID being physician and parent global assessments and acute-phase reactants. This observation highlights the need for further studies aimed to evaluate the impact of subjective physician and parent perception of disease remission and of laboratory measures of inflammatory activity on the definition of ID.

Made available in DSpace on 2019-10-05T16:54:20Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-04-01 IRCCS Istituto Giannina Gaslini Background To our knowledge, the characteristics and burden of childhood arthritis have never been studied on a worldwide basis. We aimed to investigate, with a cross-sectional study, the prevalence of disease categories, treatment methods, and disease status in patients from across different geographical areas and from countries with diverse wealth status. Methods In this multinational, cross-sectional, observational cohort study, we asked international paediatric rheumatologists from specialised centres to enrol children with a diagnosis of juvenile idiopathic arthritis, according to International League of Associations for Rheumatology criteria, who were seen consecutively for a period of 6 months. Each patient underwent retrospective and cross-sectional assessments, including measures of disease activity and damage and questionnaires on the wellbeing and quality of life of the children. We qualitatively compared the collected data across eight geographical areas, and we explored an association between disease activity and damage and a country's gross domestic product (GDP) with a multiple logistic regression analysis. Findings Between April 4, 2011, and Nov 21, 2016, 9081 patients were enrolled at 130 centres in 49 countries, grouped into eight geographical areas. Systemic arthritis (125 [33.0%] of 379 patients) and enthesitis-related arthritis (113 [29.8%] of 379) were more common in southeast Asia, whereas oligoarthritis was more prevalent in southern Europe (1360 [56.7%] of 2400) and rheumatoid factor-negative polyarthritis was more frequent in North America (165 [31.5%] of 523) than in the other areas. Prevalence of uveitis was highest in northern Europe (161 [19.1%] of 845 patients) and southern Europe (450 [18.8%] of 2400) and lowest in Latin America (54 [6.4%] of 849), Africa and Middle East (71 [5.9%] of 1209), and southeast Asia (19 [5.0%] of 379). Median age at disease onset was lower in southern Europe (3.5 years, IQR 1.9-7.3) than in other regions. Biological, disease-modifying antirheumatic drugs were prescribed more frequently in northern Europe and North America than in other geographical settings. Patients living in countries with lower GDP had greater disease activity and damage than those living in wealthier countries. Damage was associated with referral delay. Interpretation Our study documents a variability in prevalence of disease phenotypes and disparities in therapeutic choices and outcomes across geographical areas and wealth status of countries. The greater disease burden in lowerresource settings highlights the need for public health efforts aimed at improving equity in access to effective treatments and care for juvenile idiopathic arthritis. Copyright (C) 2019 Elsevier Ltd. All rights reserved. Univ Genoa, Ist Giannina Gaslini, IRCCS, Clin Paediat & Rheumatol, Genoa, Italy Univ Genoa, Ist Giannina Gaslini, IRCCS, Epidemiol & Biostat Serv, Genoa, Italy Univ Genoa, Ist Giannina Gaslini, IRCCS, Sci Directory, Genoa, Italy Univ Genoa, PRINTO, IRCCS, Ist Giannina Gaslini, Genoa, Italy Univ Genoa, Dept Neurosci Rehabil Ophthalmol Genet & Maternal, Genoa, Italy Wilhelmina Childrens Hosp, Dept Pediat Immunol & Rheumatol, Utrecht, Netherlands Sanjay Gandhi Postgrad Inst Med Sci, Lucknow, Uttar Pradesh, India Univ Hosp 12 Octubre, Dept Pediat Rheumatol, Madrid, Spain Alfaisal Univ, Dept Pediat Rheumatol, King Faisal Specialist Hosp, Riyadh, Saudi Arabia Alfaisal Univ, Res Ctr, Riyadh, Saudi Arabia Western Univ Childrens Hosp, Hlth Sci Ctr, London, ON, Canada Oslo Univ Hosp, Dept Rheumatol, Oslo, Norway Oslo Univ Hosp, Med Fac, Oslo, Norway Univ Oslo, Oslo, Norway Oslo Univ Hosp, Norwegian Natl Advisory Unit Rheumat Dis Children, Oslo, Norway Univ Hosp Munster, Dept Pediat Rheumatol & Immunol, Munster, Germany Hosp Sor Maria Ludovica, Rheumatol Serv, La Plata, Buenos Aires, Argentina Bucharest Emergency Hosp, Cluj Napoca, Romania Childrens Emergency Hosp, Cluj Napoca, Romania Cincinnati Childrens Hosp Med Ctr, Div Rheumatol, Cincinnati, OH 45229 USA Alberta Childrens Prov Gen Hosp, Div Pediat Rheumatol, Dept Pediat, Calgary, AB, Canada Sofiamed, Pediat Dept, Sofia, Bulgaria Rigshosp, Juliane Marie Ctr, Paediat Rheumatol Unit, Copenhagen, Denmark Natl Inst Rheumatism & Physiotherapy, Clin Immunol Adult & Paediat Rheumatol Dept, Budapest, Hungary Univ Latvia, Pediat Dept, Riga, Latvia Univ Latvia, Univ Childrens Hosp, Riga, Latvia Univ Estadual Paulista, Botucatu Fac Med, Botucatu, SP, Brazil Shariati Hosp, Rheumatol Res Ctr, Dept Pediat & Rheumatol, Tehran, Iran Inst Rheumatol Belgrade, Div Pediat Rheumatol, Belgrade, Serbia Thessaloniki Univ, Dept Pediat 1, Hippokrat Gen Hosp, Sch Med, Thessaloniki, Greece Univ Estadual Paulista, Botucatu Fac Med, Botucatu, SP, Brazil