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Kennedy, United Kingdom

Jin H.,Kennedy Institute of Rheumatology | Ralston S.H.,University of Edinburgh
Methods in Molecular Biology | Year: 2012

Transcription is the process by which the rate of RNA synthesis is regulated. Here, we describe the techniques for carrying out promoter-reporter assays, electrophoretic mobility shift assays, and chromatin immunoprecipitation assays, three commonly used methods for studying gene transcription. Source

Strand V.,Stanford University | Wright G.C.,New York University | Bergman M.J.,Drexel University | Tambiah J.,UCB Pharma | Taylor P.C.,Kennedy Institute of Rheumatology
Journal of Rheumatology | Year: 2015

Objective. To identify how patients perceive the broad effect of active rheumatoid arthritis (RA) on their daily lives and indicate how RA disease management could benefit from the inclusion of individual goal-setting strategies. Methods. Two multinational surveys were completed by patients with RA. The "Good Days Fast" survey was conducted to explore the effect of disease on the daily lives and relationships of women with RA. The "Getting to Your Destination Faster" survey examined RA patients' treatment expectations and goal-setting practices. Results. Respondents from all countries agreed that RA had a substantial negative effect on many aspects of their lives (work productivity, daily routines, participation in social and leisure activities) and emotional well-being (loss of self-confidence, feelings of detachment, isolation). Daily pain was a paramount issue, and being pain- and fatigue-free was considered the main indicator of a "good day." Setting personal, social, and treatment goals, as well as monitoring disease progress to achieve these, was considered very beneficial by patients with RA, but discussion of treatment goals seldom appeared to be a part of medical appointments. Conclusion. Many patients with RA feel unable to communicate their disease burden and treatment goals, which are critically important to them, to their healthcare provider (HCP). Insights gained from these 2 surveys should help to guide patients and HCP to better focus upon mutually defined goals for continued improvement of management and achievement of optimal care in RA. The Journal of Rheumatology Copyright © 2015. All rights reserved. Source

Iqbal I.,Mundipharma International Ltd Unit 194 | Dasgupta B.,Southend Hospital NHS Trust | Taylor P.,Kennedy Institute of Rheumatology | Heron L.,Adelphi Values | Pilling C.,Adelphi Values
Journal of Medical Economics | Year: 2012

Objective: Specific symptoms of rheumatoid arthritis (RA), including joint stiffness and functional disability, are most severe in the morning. 'Morning stiffness' has a negative impact on health-related quality-of-life (HRQoL); however, how HRQoL is correlated to morning stiffness duration is unknown. The objective of this study was to obtain population-based utility values associated with different durations of morning stiffness in RA. Design and methods: The time-trade-off (TTO) approach was used to elicit utility values for four different health states (HS), which differed in morning stiffness duration. One hundred and nine members of the UK general public rated each HS in individual face-to-face interviews with trained investigators. TTO scores were converted into utility values. Visual Analog Scale (VAS) scores were obtained to validate TTO scores. Results: On a scale of 0 (death) to 1 (full health), a mean utility value of 0.45±0.29 was elicited for ~3 h of morning stiffness (anchor HS), 0.50±0.28 for 2-3h of morning stiffness (HS1), 0.61±0.25 for 1-2h of morning stiffness (HS2) and 0.78±0.20 for <1 h of morning stiffness (HS3). The difference between each HS was statistically significant (p<0.01). Mean VAS utility scores followed the same trend. Utility incrementally increased with each HS associated with a shorter duration of morning stiffness. Limitations of this research include potential bias from the TTO method due to the discounting effect of time, scale compatibility, and loss aversion. Conclusions: The UK population-based utility values show a reduction in morning stiffness duration in RA is associated with improved HRQoL. Despite the impact of morning stiffness on HRQoL, it is rarely evaluated and little is known as to how it is affected by current treatments. The results of this study can be applied in future cost-utility analyses of healthcare interventions which target an improvement in morning stiffness duration for RA patients. © 2012 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted. Source

Porter D.,Gartnavel General Hospital | Gadsby K.,Royal Derby Hospital | Thompson P.,Poole Hospital NHS Foundation Trust | White J.,Leeds Teaching Hospital NHS Trust | And 2 more authors.
Musculoskeletal Care | Year: 2011

Disease Activity Score in 28 Joints (DAS28) scoring in rheumatoid arthritis (RA) is now recommended as a basis for clinical decisions about treatment initiation and alteration. The British Society of Rheumatology suggests that most RA patients should have a DAS28 assessment at every clinic visit, to monitor disease activity and the impact of therapy. Establishing an accurate baseline assessment of DAS28, with regular re-evaluation, is considered crucial, so that progress towards a defined target of remission (or low disease activity) can be measured. The Treat-to-Target initiative, launched in March 2010, is now impacting on clinical practice throughout the UK and Europe. One of its key recommendations is that patients should be regularly monitored using validated composite measures of disease activity that include joint assessments. DAS28 is recommended as one of the most useful of these methods but, although it is becoming more widely adopted and training is ongoing, supported by materials produced by the European League Against Rheumatism (EULAR), the variability inherent in the four components of DAS28 means that standardization of practice methods is now an important issue. This short report details some of the pitfalls that can occur when applying DAS28 in clinical practice and suggests some workable solutions to enable departments to set up their own standard operating procedure. © 2011 John Wiley & Sons, Ltd. Source

Vincent T.L.,Kennedy Institute of Rheumatology | Vincent T.L.,Nuffield Orthopedic Center | Watt F.E.,Nuffield Orthopedic Center | Watt F.E.,Kennedy Institute of Rheumatology
Medicine (United Kingdom) | Year: 2014

Osteoarthritis (OA) is the most common form of joint disease, and its impact is set to grow as the prevalence of obesity rises and our elderly population increases. Many clinicians regard OA as being simply a disease of 'wear and tear', and by implication one in which disease modification is not possible. Such prejudices have led to significant academic apathy in this disease that is reflected not only in our poor understanding of disease pathogenesis, but also in the failure to classify the disease with greater precision, and to develop sensitive tools for diagnosis and prognostic assessment. The recent identification of key degradative enzymes in cartilage and the use of mouse models to study disease pathogenesis have greatly changed our outlook. The next decade is likely to see significant advances in our understanding of, and treatment for, this condition. Crown Copyright © 2014 Published by Elsevier Ltd. All rights reserved. Source

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