Publications by authors named "Jessica L Fairley"

4 Publications

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Person-centred care in osteoarthritis and inflammatory arthritis: a scoping review of people's needs outside of healthcare.

BMC Musculoskelet Disord 2021 Apr 9;22(1):341. Epub 2021 Apr 9.

Department of Epidemiology and Preventative Medicine, School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia.

Background: Arthritis, regardless of cause, has significant physical, social and psychological impacts on patients. We aimed to identify the non-healthcare needs perceived by patients with inflammatory arthritis (IA) and osteoarthritis (OA), and to determine if these differ.

Methods: We electronically searched MEDLINE, PsycINFO, EMBASE and CINAHL (1990-2020) systematically to identify non-healthcare-related needs of people with IA or OA. All citations were screened and quality appraised by two reviewers. Data was extracted by a single reviewer.

Results: The search identified 7853 citations, with 31 studies included (12 for OA, 20 for IA). Six areas of need emerged and these were similar in both group These were: 1) Assistance with activities of daily living especially related to a lack of independence; 2) Social connectedness: need for social participation; 3) Financial security: worry about financial security and increased costs of health-seeking behaviours; 4) Occupational needs: desire to continue work for financial and social reasons, facilitated by flexibility of workplace conditions/environment; 5) Exercise and leisure: including limitation due to pain; 6) Transportation: limitations in ability to drive and take public transport due to mobility concerns. Many areas of need were linked; e.g. loss of employment and requiring support from family was associated with a sense of "failure" and loss of identity, as social isolation.

Conclusions: This review highlights the pervasive impact of arthritis on peoples' lives, regardless of aetiology, albeit with a limited evidence base. Improved identification and targeting of non-healthcare needs of people with arthritis is likely to improve person-centred care.
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http://dx.doi.org/10.1186/s12891-021-04190-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8035722PMC
April 2021

Clinical Features of Systemic Sclerosis-Mixed Connective Tissue Disease and Systemic Sclerosis Overlap Syndromes.

Arthritis Care Res (Hoboken) 2021 May 3;73(5):732-741. Epub 2021 Apr 3.

St. Vincent's Hospital Melbourne, Melbourne, and The University of Melbourne at St Vincent's Hospital (Melbourne), Fitzroy, Victoria, Australia.

Objective: To describe the clinical characteristics and outcomes of systemic sclerosis-mixed connective tissue disease (SSc-MCTD) and SSc overlap syndrome.

Methods: We included patients from the Australian Scleroderma Cohort Study who met American College of Rheumatology/European Alliance of Associations for Rheumatology criteria for SSc. Three mutually exclusive groups were created: SSc-MCTD, SSc overlap, and SSc only. Univariate comparison of clinical features was performed by analysis of variance or chi-square test. Survival analysis was performed using Kaplan-Meier (KM) curves and Cox proportional hazards regression models.

Results: Of 1,728 patients, 97 (5.6%) had SSc-MCTD, and 126 (7.3%) had SSc overlap. Those with MCTD-SSc were more commonly Asian (18.3% versus 10.1% in SSc overlap, and 3.6% in SSc only; P < 0.0001) and younger at disease onset (38.4 years versus 46.5 or 46.8 years, P < 0.0001). Those with SSc-MCTD or SSc overlap were more likely to have limited cutaneous SSc. All 3 groups had similar frequency of interstitial lung disease (ILD), although pulmonary arterial hypertension (PAH) was less common in SSc overlap. Synovitis and myositis were more common in SSc overlap and SSc-MCTD than in SSc only. KM curves showed better survival in SSc-MCTD than SSc overlap or SSc only (P = 0.011), but this was not significant after adjustment for sex and age at disease onset. SSc-specific antibodies were survival prognostic markers, with antinuclear antibody centromere or anti-RNP conferring better survival than anti-Scl-70 or anti-RNA polymerase III (P = 0.005). Patients with SSc-MCTD and SSc overlap had lower mortality following diagnosis of ILD and PAH than patients with SSc only.

Conclusion: This study provides insights into the clinical characteristics of patients with SSc-MCTD, SSc overlap, and SSc only and shows that anti-RNP antibodies are associated with better survival than anti-Scl-70 and anti-RNA polymerase III antibodies.
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http://dx.doi.org/10.1002/acr.24167DOI Listing
May 2021

Is abnormal glucose tolerance or diabetes a risk factor for knee, hip, or hand osteoarthritis? A systematic review.

Semin Arthritis Rheum 2018 10 21;48(2):176-189. Epub 2018 Feb 21.

Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Alfred Hospital, Monash University, Melbourne Vic 3004, Australia. Electronic address:

Objective: Diabetes (DM) and osteoarthritis (OA) are two common co-existing chronic conditions. However, whether this is due to shared risk factors or may differ between joints is unclear. We performed a systematic review to determine whether abnormal glucose metabolism is a risk factor for knee, hip and hand OA, separately, independent of age and obesity.

Methods: A systematic search of Ovid Medline and EMBASE was performed from inception until October 2016 to identify studies relating glucose metabolism to osteoarthritis-related outcomes. Studies were included if they related DM and OA and the knee, hip, or hand were examined separately. In the structured synthesis, objective measures of DM and adjustment for age and obesity were also required.

Results: Of the 40 included studies, 28 examined the knee, nine the hip and 14 the hand. Five studies with a longitudinal component used objective measures of DM (blood glucose) and knee OA (radiography or joint replacement) and adjusted for age and obesity (21,299 participants). Of these, three found no association, one found a reduction in risk and one, which adjusted for the presence but not magnitude of obesity, found an increase in risk. Of the longitudinal studies examining the relationship between DM and OA that accounted for obesity, none provided evidence of an independent relationship between DM and hip (2 studies) or hand OA (1 study).

Conclusion: There is little evidence to suggest that impaired glucose metabolism is a risk factor, independent of obesity, for knee OA and no evidence that impaired glucose metabolism is an independent risk factor for hip or hand OA.
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http://dx.doi.org/10.1016/j.semarthrit.2018.02.008DOI Listing
October 2018

Magnesium status and magnesium therapy in cardiac surgery: A systematic review and meta-analysis focusing on arrhythmia prevention.

J Crit Care 2017 12 21;42:69-77. Epub 2017 Jun 21.

Department of Intensive Care, Austin Hospital, 145 Studley Rd, Heidelberg, Melbourne, VIC 3084, Australia; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Prahran, VIC 3004, Australia. Electronic address:

Purpose: To investigate magnesium as prophylaxis or treatment of postoperative arrhythmias in cardiac surgery (CS) patients. To assess impact on biochemical and patient-centered outcomes.

Materials And Methods: We searched MEDLINE, CENTRAL and EMBASE electronic databases from 1975 to October 2015 using terms related to magnesium and CS. English-Language RCTs were included involving adults undergoing CS with parenterally administered magnesium to treat or prevent arrhythmias, compared to control or standard antiarrythmics. We extracted incidence of postoperative arrhythmias, termination following magnesium administration and secondary outcomes (including mortality, length of stay, hemodynamic parameters, biochemistry).

Results: Thirty-five studies were included, with significant methodological heterogeneity. Atrial fibrillation (AF) was most commonly reported, followed by ventricular, supraventricular and overall arrhythmia frequency. Magnesium appeared to reduce AF (RR 0.69, 95% confidence interval (95%CI) 0.56-0.86, p=0.002), particularly postoperatively (RR 0.51, 95%CI 0.34-0.77, p=0.003) for longer than 24h. Maximal benefit was seen with bolus doses up to 60mmol. Magnesium appeared to reduce ventricular arrhythmias (RR=0.46, 95%CI 0.24-0.89, p=0.004), with a trend to reduced overall arrhythmias (RR=0.80, 95%CI 0.57-1.12, p=0.191). We found no mortality effect or significant increase in adverse events.

Conclusions: Magnesium administration post-CS appears to reduce AF without significant adverse events. There is limited evidence to support magnesium administration for prevention of other arrhythmias.
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http://dx.doi.org/10.1016/j.jcrc.2017.05.038DOI Listing
December 2017