Regular physical activity (PA) is increasingly promoted for people with rheumatic and musculoskeletal diseases as well as the general population. We evaluated if the public health recommendations for PA are applicable for people with inflammatory arthritis (iA; Rheumatoid Arthritis and Spondyloarthritis) and osteoarthritis (hip/knee OA) in order to develop evidence-based recommendations for advice and guidance on PA in clinical practice. The EULAR standardised operating procedures for the development of recommendations were followed. A task force (TF) (including rheumatologists, other medical specialists and physicians, health professionals, patient-representatives, methodologists) from 16 countries met twice. In the first TF meeting, 13 research questions to support a systematic literature review (SLR) were identified and defined. In the second meeting, the SLR evidence was presented and discussed before the recommendations, research agenda and education agenda were formulated. The TF developed and agreed on four overarching principles and 10 recommendations for PA in people with iA and OA. The mean level of agreement between the TF members ranged between 9.8 and 8.8. Given the evidence for its effectiveness, feasibility and safety, PA is advocated as integral part of standard care throughout the course of these diseases. Finally, the TF agreed on related research and education agendas. Evidence and expert opinion inform these recommendations to provide guidance in the development, conduct and evaluation of PA-interventions and promotion in people with iA and OA. It is advised that these recommendations should be implemented considering individual needs and national health systems.

Objectives This study sought to determine the impact of health literacy and acculturation on oral health status of Somali refugees in Massachusetts. Methods Survey of 439 adult Somalis who arrived in the U.S. < 10 years ago. Subjects had an oral examination with decayed, missing, and filled teeth (DMFT) counts. STOFHLA was used to measure health literacy. Generalized linear multivariable regression models were used to assess the association between English literacy (STOFHLA) and the oral health parameters. Results Participants had means of 1.4 decayed, 2.8 missing, and 1.3 filled teeth. Among subjects in the U.S. 0-4 years, subjects with low STOFHLA scores had lower mean DMFT (Mean Rate Ratio=0.78, p=0.016) compared with subjects with higher STOFHLA scores; however, among subjects in the U.S. 5-10 years, those with low STOFHLA scores had higher mean DMFT (Mean Rate Ratio=1.37, p=0.012) compared with subjects with higher STOFHLA scores. No significant association between STOFHLA and decayed teeth was detected. Participants with low STOFHLA scores had marginally lower risk of periodontal disease compared to those with high scores (OR=0.22, p=0.047) Conclusions Overall Somali oral health status is good. Oral health of Somalis with low health literacy worsens over time in the U.S. It is possible that beneficial factors linked to low literacy for newly arrived Somali refugees diminish and may be countered by less access to preventive care and less utilization of beneficial oral hygiene practices.

Background This study investigated the impact of English health literacy and spoken proficiency and acculturation on preventive dental care use among Somali refugees in Massachusetts. Methods 439 adult Somalis in the U.S. ≤ 10 years ago were interviewed. English functional health literacy, dental word recognition, and spoken proficiency were measured using STOFHLA, REALD, and BEST Plus. Logistic regression tested associations of language measures with preventive dental care use. Results Without controlling for acculturation, participants with higher health literacy were 2.0 times more likely to have had preventive care (p=0.02). Subjects with higher word recognition were 1.8 times as likely to have had preventive care (p=0.04). Controlling for acculturation, these were no longer significant, and spoken proficiency was not associated with increased preventive care use. Discussion English health literacy and spoken proficiency were not associated with preventive dental care. Other factors, like acculturation, were more predictive of care use than language skills.

These considerations represent the first international consensus on the conduct of interventional studies following acute knee joint trauma.

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