Intention of preserving forest remnants among landowners in the Atlantic Forest: The role of the ecological context via ecosystem services

Unravelling the psychological processes determining landowners' support towards forest conservation is crucial, particularly in rural areas of the tropics, where most forest remnants are within private lands. As human–nature connections are known to shape pro‐environmental behaviours, the intention of preserving forest remnants should ultimately be determined by the ecological context people live in. Here, we investigate the pathways through which the ecological context (forest cover), via direct contact with forests and ecosystem services and disservices, influence the psychological antecedents of conservation behaviour (beliefs, attitude and intention of preserving forest remnants). We conceptualized a model based on the Reasoned Action Approach, using the ecological context and these three forest experiences as background factors, and tested the model using Piecewise Structural Equation Modelling. Data were collected through an interview‐based protocol applied to 106 landowners across 13 landscapes varying in forest cover in a consolidated rural region in the Brazilian Atlantic Forest. Our results indicate that: (a) ecosystem services are more important than disservices for shaping intention of preserving forests, particularly non‐provisioning services; (b) contact with forest has an indirect effect on intention, by positively influencing the frequency of receiving ecosystem services; (c) people living in more forested ecological contexts have more contact with forests, receive ecosystem services more frequently and, ultimately, have stronger intention of preserving forests. Hence, our study suggests a dangerous positive feedback loop between deforestation, the extinction of forest experiences and impairment of human–nature connections. Local demands across the full range of ecosystem services, the balance between services and disservices and the ecological context people live in should be considered when developing conservation initiatives in tropical rural areas

How do patient-reported outcome measures affect treatment intensification and patient satisfaction in the management of psoriatic arthritis? A cross sectional study of 503 patients

Objectives The AsseSSing Impact in pSoriatic Treatment (ASSIST) study investigated prescribing in routine PsA care and whether the patient-reported outcome—PsA Impact of Disease questionnaire (PsAID-12)—impacted treatment. This study also assessed a range of patient and clinician factors and their relationship to PsAID-12 scoring and treatment modification. Methods Patients with PsA were selected across the UK and Europe between July 2021 and March 2022. Patients completed the PsAID questionnaire and the results were shared with their physician. Patient characteristics, disease activity, current treatment methods, treatment strategies, medication changes and patient satisfaction scores were recorded. Results A total of 503 patients were recruited. Some 36.2% had changes made to treatment, and 88.8% of these had treatment escalation. Overall, the mean PsAID-12 score was higher for patients with treatment escalation; increase in PSAID-12 score is associated with increased odds of treatment escalation (odds ratio 1.58; P < 0.0001). However, most clinicians reported that PsAID-12 did not impact their decision to escalate treatment, instead supporting treatment reduction decisions. Physician’s assessment of disease activity had the most statistically significant effect on likelihood of treatment escalation (odds ratio 2.68, per 1-point score increase). Escalation was more likely in patients not treated with biologic therapies. Additional factors associated with treatment escalation included: patient characteristics, physician characteristics, disease activity and disease impact. Conclusion This study highlights multiple factors impacting treatment decision-making for individuals with PsA. PsAID-12 scoring correlates with multiple measures of disease severity and odds of treatment escalation. However, most clinicians reported that the PsAID-12 did not influence treatment escalation decisions. Psoriatic Arthritis Impact of Disease (PsAID) scoring could be used to increase confidence in treatment de-escalation

A invenção como ofício: as máquinas de preparo e benefício do café no século XIX

The article studies the Brazilian coffee-growing society from the point of view of the generation of inventions and machine innovations aimed at the preparation and processing of coffee beans in the period between 1860 and 1882. Under the protection of the 1830 Patents Law, the machinistas developed their inventions and submitted them to the National Industry Auxiliary Society (Sociedade Auxiliadora da Indústria Nacional - SAIN) for the concession of industrial privilege and later manufacture and commercialization. It is demonstrated how the coffee machinery developed by these inventors-entrepreneurs in Brazil brought to the slave-labour coffee plantation the technological update of agricultural machines existing in the industrial countries and how that has propitiated an improvement in the quality of large-scale coffee bean processing. This fact has made possible not only the consolidation of the country as the largest exporter in the international market, but has also has allowed for changes in the productive structure of the slave-labour plantations.Aborda-se a sociedade cafeeira brasileira sob o aspecto da geração de invenções e inovações de máquinas destinadas ao preparo e benefício do café no período de 1860 a 1882. Sob a proteção da Lei de Patentes de 1830, os machinistas desenvolviam seus inventos, que eram examinados pela Sociedade Auxiliadora da Indústria Nacional (SAIN) para concessão do privilégio industrial e posterior fabricação e comercialização. Demonstra-se como as máquinas de café desenvolvidas por estes inventores-empresários no Brasil trouxeram para a fazenda cafeeira escravista a atualização tecnológica de máquinas agrícolas existentes nos países industriais e propiciaram uma melhoria de qualidade do benefício em grandes quantidades de café. Tal fato tornou possível não só a consolidação do país como maior exportador no mercado internacional, mas permitiu alterações na estrutura produtiva das fazendas escravistas

How do patient-reported outcome measures affect treatment intensification and patient satisfaction in the management of psoriatic arthritis? A cross sectional study of 503 patients

Objectives The AsseSSing Impact in pSoriatic Treatment (ASSIST) study investigated prescribing in routine PsA care and whether the patient-reported outcome—PsA Impact of Disease questionnaire (PsAID-12)—impacted treatment. This study also assessed a range of patient and clinician factors and their relationship to PsAID-12 scoring and treatment modification. Methods Patients with PsA were selected across the UK and Europe between July 2021 and March 2022. Patients completed the PsAID questionnaire and the results were shared with their physician. Patient characteristics, disease activity, current treatment methods, treatment strategies, medication changes and patient satisfaction scores were recorded. Results A total of 503 patients were recruited. Some 36.2% had changes made to treatment, and 88.8% of these had treatment escalation. Overall, the mean PsAID-12 score was higher for patients with treatment escalation; increase in PSAID-12 score is associated with increased odds of treatment escalation (odds ratio 1.58; P < 0.0001). However, most clinicians reported that PsAID-12 did not impact their decision to escalate treatment, instead supporting treatment reduction decisions. Physician’s assessment of disease activity had the most statistically significant effect on likelihood of treatment escalation (odds ratio 2.68, per 1-point score increase). Escalation was more likely in patients not treated with biologic therapies. Additional factors associated with treatment escalation included: patient characteristics, physician characteristics, disease activity and disease impact. Conclusion This study highlights multiple factors impacting treatment decision-making for individuals with PsA. PsAID-12 scoring correlates with multiple measures of disease severity and odds of treatment escalation. However, most clinicians reported that the PsAID-12 did not influence treatment escalation decisions. Psoriatic Arthritis Impact of Disease (PsAID) scoring could be used to increase confidence in treatment de-escalation

An international multicentre analysis of current prescribing practices and shared decision-making in psoriatic arthritis

Objectives Shared decision-making (SDM) is advocated to improve patient outcomes in PsA. We analysed current prescribing practices and the extent of SDM in PsA across Europe. Methods The ASSIST study was a cross-sectional observational study of PsA patients ≥18 years of age attending face-to-face appointments between July 2021 and March 2022. Patient demographics, current treatment and treatment decisions were recorded. SDM was measured by the clinician’s effort to collaborate (CollaboRATE questionnaire) and patient communication confidence (PEPPI-5 tool). Results A total of 503 patients were included from 24 centres across the UK, France, Germany, Italy and Spain. Physician- and patient-reported measures of disease activity were highest in the UK. Conventional synthetic DMARDs constituted a higher percentage of current PsA treatment in the UK than continental Europe (66.4% vs 44.9%), which differed from biologic DMARDs (36.4% vs 64.4%). Implementing treatment escalation was most common in the UK. CollaboRATE and PEPPI-5 scores were high across centres. Of 31 patients with low CollaboRATE scores (<4.5), no patients with low PsAID-12 scores (<5) had treatment escalation. However, of 465 patients with CollaboRATE scores ≥4.5, 59 patients with low PsAID-12 scores received treatment escalation. Conclusions Higher rates of treatment escalation seen in the UK may be explained by higher disease activity and a younger cohort. High levels of collaboration in face-to-face PsA consultations suggests effective implementation of the SDM approach. Our data indicate that in patients with mild disease activity, only those with higher perceived collaboration underwent treatment escalation. Prospective studies should examine the impact of SDM on PsA patient outcomes