Posted on Arthritis

People with arthritis are 20% less likely to be at work. Is this true for you?

Sandra Purdy


Sandra Purdy, lives with ankylosing spondylitis, a type of arthritis in which the spine and other body areas become inflamed. CREDIT Sandra Purdy

The typical person living with arthritis in the UK is 20% less likely to be in work than their equivalent without the condition, new research shows.

And the most striking finding was that non-university-educated women aged 60-plus are at least 37% less likely to be in work if they have arthritis compared to matched individuals without the condition.

The study, published today by the University of Leeds, matched a group of 18,000 people with arthritis to another group of 18,000 who were the most similar to the first group regarding various characteristics but had not been diagnosed with arthritis. These characteristics included age, gender, level of education, ethnicity and where they lived.

The research shows significant differences in how arthritis affects people’s working lives, depending on their age, level of education and gender.

The team is now suggesting that workplaces provide more support for people living with the condition, so they can keep working as long as they wish.

Principal Investigator Dr Adam Martin, Associate Professor in Health Economics at the University of Leeds’ School of Medicine, said:

“We already know that arthritis is more common amongst women and people from lower socio-economic backgrounds. Our new findings show that substantial inequalities also exist in terms of how the work outcomes of these groups are affected by arthritis.

 “Government and employers should consider how interventions in workplaces could better support people living with arthritis and improve their health and employment prospects, whilst also potentially tackling inequalities and address the need to support people in their 50s and 60s to stay in work for longer if they want to.

“Given the increasing prevalence of arthritis and the trend towards older retirement ages, this need for better support represents a substantial and growing challenge for society.”

Deborah Alsina MBE, Chief Executive of Versus Arthritis, said:
“This is a vital and important study and reinforces what we have heard from people with arthritis about how the condition robs them of their health, independence, and careers.

“We know work matters to people with arthritis, benefitting health and wellbeing as well as their finances, yet this evidence demonstrates how arthritis is truly an unfair and unequal condition.

“We as a country need to tackle these health inequalities. Arthritis should no longer disproportionately and unfairly impact women and those less well served in our society, potentially driving millions into disability and unemployment.”

Patient experience

Sandra Purdy, 61, from Churwell in Leeds, had to retrain due to chronic pain caused by ankylosing spondylitis, a type of arthritis in which the spine and other body areas become inflamed.

She said: “I had problems with pain since my late teens and was misdiagnosed several times.

“When I was younger, I had manual jobs, but the pain meant I often couldn’t work. There’s a stigma in saying you have back pain at work, so I tried to hide it, but it got more difficult as the pain worsened.

“Eventually, I started looking for an office job which I thought would be more manageable. I got a job in a bank but sitting down all day was worse. Due to morning stiffness, I needed to get up at 4.30 am to be ready for 7.30 am. I needed crutches and sticks to walk at the start of the day. I wouldn’t need them by the end of the day, so I’d worry that people thought I was making it up. But during a bad flare-up, the pain would last all day, and I couldn’t move.

“When I was 45, I developed iritis, a painful eye condition which causes swelling and irritation in the iris. I was referred to a rheumatologist and had an MRI scan, and they diagnosed me with ankylosing spondylitis.

“I took part in a trial for a drug called infliximab, which was liquid gold. It changed my life – but at the end of the trial, I had a severe flare-up. Because of this, I was moved onto a drug called adalimumab, which I still take now. However, it lowers my immune system, so I pick up many bugs.

“I found a new job with a more understanding employer, where I could move about during the day. I now have a management role so I’m less customer-facing and can work from home.

“I hear a lot of people at my hospital patient participation group talking about how they have been treated and their employers aren’t great.

“I have always worried about losing my job, especially at first. I left school with no qualifications, so I had to sit exams in English and maths to get work in an office. I’ve had to adapt, but not everyone can do this.

“Patients need better access to diagnostics, and more joined-up thinking between employers and the health service.”

Research findings

The Nuffield Foundation-funded research used two decades of data about people aged 18-80. The team compared 18,000 people with arthritis to 18,000 people without the condition to better understand how it affects people’s lives.

The study showed that as people with arthritis reach middle age, their likelihood of being in work diminishes at a faster rate than those who do not have the condition. Many of these will have taken early retirement. This effect is more pronounced for people without a university-level education, possibly as symptoms may be easier to manage in professional jobs than in manual roles.

And once both men and women reach 60, their chances of being in work when living with arthritis are markedly more reduced compared to people without the condition.

The chart below shows the percentage reduction in the likelihood of being in work for each group compared to their counterparts without arthritis.

Age:30405060
Men with a degree6.3%2.0%2.0%14.1%
Men without a degree12.6%5.3%5.3%25.0%
Women with a degree12.8%5.3%5.3%25.4%
Women without a degree24.3%14.0%12.6%37.2%

People with a history of working in routine (such as lorry drivers or bar staff) and intermediate (such as paramedics or bank staff) occupational groups were also much less likely to work if they had arthritis. However, this was not the case for people in professional work (such as lawyers or architects). For them, arthritis did not seem to affect the likelihood of being in work, although some people with arthritis in this group did work fewer hours and had lower earnings if they had arthritis. This was especially true for working women aged over 40.

Among people living with arthritis, those with a history of working at small private companies were also generally less likely to be in work than people with arthritis who had worked in larger companies or the public sector. The team’s discussions with people living with arthritis indicated that this might be due to smaller firms having fewer resources available or less scope for them to adjust work patterns or take on alternative roles.

Dr Martin said: “In light of this research, people with arthritis told us that potential interventions could involve making appropriate adjustments to the working environment, tackling workplace discrimination and supporting changes in people’s roles.

“Existing evidence suggests that providing personalised case management by an occupational health practitioner could help to encourage constructive dialogue between employees, healthcare practitioners and employers.

“Our study indicates that such support could be especially cost-effective if designed for and targeted for the people we identified who are most at risk of poor work outcomes.”

Notes to Editors
The 18,000 people aged 18-80 in the data who said they had been diagnosed with arthritis were collected between 2001 and 2019. This group was compared with 18,000 selected people from the same datasets who were similar in terms of age, gender, ethnicity, education level and where they live but who had not been diagnosed with the condition.

Using statistical models, comparisons were made between the two groups based on the likelihood that each individual had a job, what their earnings were and their weekly working hours. The team then looked at differences in age, gender, degree status, occupation (professional, administrative, technical or routine) and employer characteristics (size of the organisation; public or private sector).

The team expected that some people with arthritis might experience poorer work outcomes than those without the condition, such as job loss or slower career progression. Their study set out to determine how significant the differences in work outcomes were and if particular age groups or genders doing specific jobs were especially at risk.

Posted on Autism

This research project focuses on promoting dual-language development for autistic children in bilingual families


A University of Massachusetts Amherst researcher has been awarded a National Institutes of Health (NIH) grant to study bilingualism in children with autism whose household speaks a language other than English.

“This is a group that often is excluded from existing research or intervention studies,” says Megan Gross, assistant professor of communication disorders in the School of Public Health and Health Sciences. “And I think there’s still a lot of misinformation that can get out there to bilingual families about what language to speak at home with their child.”

The five-year, $755,000 career development grant will enable Gross to be mentored by a multidisciplinary team of experienced researchers from the fields of psychology, communication disorders and public health as she recruits 60 families in western Massachusetts for her sequential mixed-methods project, combining both quantitative and qualitative measures. 

“I’ve worked clinically with autistic children, but I have not done research in the area of autism, so I think this career development award will be really beneficial for gaining training in how to conduct research with this population responsibly,” Gross says.

Until relatively recently, bilingual families who have a child with autism were often encouraged by professionals to stick to one language in the home.

“I think they’re still getting advice that if language is hard for their child, two languages will be even harder, so they should just speak English,” Gross says. “And that has a lot of negative potential ramifications for the child’s positive development in terms of identity, their ability to communicate and interact with family members who may not speak English and so on. So, for a condition like autism, where communication is one of the areas that can be a source of challenge, adding to that by creating a language barrier between the child and their family member can be really problematic.”

Recent studies have shown that bilingual exposure is not detrimental to the development of children on the autism spectrum, Gross points out. “We need to move beyond that to understanding how we promote bilingual development in autistic children,” she says.

Gross will examine the type of bilingual environment to which children with autism , ages 4-6, are exposed, as well as the different factors that relate to their ability to speak or understand both Spanish and English. She will also consider the children’s social communication and social-cognitive skills, such as cognitive flexibility, as well as their ability to understand and communicate in two languages.

To make it possible to include children who do not speak, Gross will use innovative eye-tracking technology to analyze their ability to comprehend bilingual spoken language. A camera at the bottom of a laptop computer will track the child’s eye movement as a word or phrase in English and Spanish is played out loud.

“By following their eye movements over time, we can tell whether they’ve understood the word or phrase that they heard because they should look at the corresponding picture,” Gross says. “This is a group I’m especially interested in including in my study. Even if they are not speaking, we need a way to measure what they are understanding when people are speaking to them in Spanish and English. And what skills might they have that they aren’t able to show us through their spoken language?”

Gross will spend the first year of her research in training and preparing materials, and will start recruiting families in 2024. Ultimately, she will interpret the quantitative findings within the context of in-depth qualitative interviews, focusing on family perspectives and challenges. The long-term goal is to collaborate with families and support services to develop community-based programs that promote bilingual children’s linguistic and social-cognitive development across the autism spectrum.

“It’s been a great interest of mine to contribute to the evidence base at the intersection between dual-language learning and autism,” Gross says.

This piece uses both identity-first (autistic person) and person-first language (person with autism) out of respect for differing preferences expressed among autistic adults, family members and community advisory board members for this project.

Posted on Diabetes

Lower Blood Sugar at Home Easily for FREE

Lower Blood Sugar at Home Easily for FREE - YouTube


In this episode, we discuss a simple and effective way to improve glucose metabolism for free from the comfort of your own home. This ground-breaking study looked at how people who are mainly sedentary can increase the utilization and clearance of glucose from the bloodstream more efficiently. The study from the University of Houston demonstrated how the human soleus muscle could increase local oxidative metabolism to high levels for hours without fatigue, significantly improving glucose metabolism. This is a simple but effective way to improve your metabolism while sitting that almost anyone can do for free at almost any time.

Posted on Diabetes

Testing a immunological drug as a new treatment for early type 1 diabetes

Ólafsdóttir & Lind


PhD student Arndís Ólafsdóttir and Professor Marcus Lind, Sahlgrenska Academy at the University of Gothenburg. CREDIT Photo by Elin Lindström/University of Gothenburg

A large clinical study is beginning on an approved drug for treating psoriasis. The drug will be tested on patients recently diagnosed with type 1 diabetes. The theory is that the drug could preserve the patient’s remaining insulin production.

Many hospitals throughout Sweden are participating in this large project, which the Swedish Research Council funds within clinical treatment research. The project is headed by Marcus Lind, a professor of diabetology at the University of Gothenburg and chief physician responsible for clinical diabetes research at Sahlgrenska University Hospital and NU-hospital Group.

Lind notes that the study could mean a big change in how type 1 diabetes is treated: “Of the mechanisms now being investigated for immunological treatment of type 1 diabetes, I have the greatest confidence in this one, but I am well aware of how difficult success will be.”

An immunological disease

Type 1 diabetes is one of the most common chronic diseases in children, but the disease can also develop in adults. In the disease, the body’s immune response destroys beta cells in the pancreas, so the body can no longer produce insulin. People with type 1 diabetes need to take insulin injections or use an insulin pump to strictly track their blood sugar levels for the rest of their lives, which requires much effort.

The beta cells die slowly, so everyone with newly developed type 1 diabetes continues to produce insulin during the first years of the disease.

“They benefit greatly from the remaining insulin their body produces. If they could maintain this production, treating type 1 diabetes would be much easier. So far, we have not had a good treatment for preventing beta cell death. Still, we have reason to believe that a medication currently approved for individuals with psoriasis could have a protective effect for individuals with type 1 diabetes,” says Marcus Lind.

Tests show the two stages of the disease

Based on immunological patterns in the blood, currently, researchers can determine with a high probability who will develop type 1 diabetes (stage 1 of type 1 diabetes) within a few years. About a year before the onset of the disease, they can then see disturbances in the blood sugar pattern with stress tests, even if the criteria for diabetes are not met (stage 2 of the disease). When clinical onset occurs, it is classified as stage 3.

“If we succeed in identifying the immunological mechanism central to the destruction of beta cells, we will also be able to screen children and adults in the future and treat them even before the onset of the disease. The disease will then be prevented from breaking out or counteracted so that it does not begin until much later in life.”

Psoriasis and type 1 diabetes

The drug to be tested affects the immune response in the body by inhibiting the protein interleukin-17, which seems to be an essential signalling molecule in the process that destroys beta cells. For the last few years, the drug has been used as a treatment for psoriasis, where a specific type of white blood cells, known as TRM cells, plays a key role in developing the disease, just as these cells seem to do in type 1 diabetes. Among other things, these cells act through IL-17, which the current treatment affects.

“Research on type 1 diabetes and IL-17 has been ongoing for almost 20 years. Animal experiments have shown that this signalling pathway stimulates the development of type 1 diabetes. Other studies have shown that this signalling pathway is usually overactivated in people with type 1 diabetes. It will be particularly interesting to evaluate for the first time whether the treatment can protect insulin-producing cells in the pancreas, in light of recent research on TRM cells in newly diagnosed type 1 diabetes, just as in psoriasis.”

Recruitment of individuals with type 1 diabetes for a comprehensive multicenter study has begun. The study will include adults, between the ages 18 and 35, who have been diagnosed with type 1 diabetes in the last three months. A blood test has shown an ongoing immunological process affecting the beta cells. A total of 127 individuals will be included, with half being randomly assigned to receive IL-17 inhibitors and half receiving a placebo in the control group.

Towards precision medicine

In parallel with the Swedish study from the University of Gothenburg, several other studies are underway elsewhere in the world. They are also seeking ways to treat the immunological cause behind type 1 diabetes and not just the symptoms, which until now has been the only treatment option.

As with many other diseases, researchers of type 1 diabetes are now on the verge of precision medicine. Efforts to map different subgroups within type 1 diabetes have just begun to study, for example, a certain gene variation that causes a certain type of islet cell antibodies to first appear.

“It is likely that treatment with IL-17 inhibitors may be more effective for certain subgroups. If the results from our study are encouraging, over time, we can investigate certain immunological patterns or cell types in the blood that can be used to identify patient groups that respond best to the treatment.”