Objective To evaluate key factors for Presenteeism and Activity impairment in multinational patients with Behçet’s syndrome (BS) and recurrent aphthous stomatitis (RAS). Methods In this cross-sectional study, 364 BS patients from Jordan, Brazil, the United Kingdom and Turkey and 143 RAS patients from the United Kingdom and Turkey were included. Work Productivity Activity Impairment (WPAI) scale was used for Presenteeism and Activity impairment. Mediation analyses were performed to evaluate both direct and indirect causal effects. Results Presenteeism score was higher in active patients with genital ulcers and eye involvement as well as patients with comorbidities and current smokers than the others in BS (p< 0.05). In RAS, Presenteeism score was elevated by oral ulcer activity in the direct path (p= 0.0073) and long disease duration as a mediator in the indirect path (p= 0.0191). Patients with active joint involvement had poor scores in Absenteeism, Presenteeism, Overall impairment and Activity impairment compared with those of inactive patients (p < 0.05). Using mediation analysis, the Activity impairment score was directly mediated by joint activity (p = 0.0001) and indirectly mediated through oral ulcer-related pain in BS (p = 0.0309). Conclusion In BS, Presenteeism was associated with disease activity, presence of comorbidities and being a current smoker, whereas in RAS, Presenteeism was associated with oral ulcer activity and increased length of the disease. Moreover, Activity impairment was adversely affected by joint activity and oral ulcer related pain in BS. Patients need to be empowered by using appropriate treatment strategies in their working environment and daily life.

This article was migrated. The article was marked as recommended. Introduction: On March 18, 2020, in face of COVID-19 pandemic and the suspension of in-person activities by the Board of the Paulista School of Medicine (EPM), students on clinical rotations (5th and 6th grades) organized themselves to support the local community and the Hospital São Paulo complex. Method: The construction of the Volunteering-EPM was, despite fast, progressive, following as required by the Hospital São Paulo-Escola Paulista de Medicina complex. Results: After one week, Volunteering-EPM added more than 100 students and the unconditional support of professors. The quantifiable results enable an adequate supply of resources to the hospital complex. However, the biggest impact was the moment of solidarity promoted by the initiative. Discussion: Volunteering enabled unique experiences for those involved, enhancing students and professor's skill sets otherwise not developed in medical school. Emphasizing the humanitarian view of medicine improved employee and community health access and welfare. Conclusion: The speed with which actions were implemented and their impact on the community shows the ability for transformation of the volunteers. The immediate demands have been solved. In medium and long term, the project continues to respond to the new demands of the hospital.

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