The relationship between psychological distress and multiple tender points across the adult lifespan

Multiple tender points are common in the population and, in studies of mid-life adults, are strongly associated with high levels of psychological distress. Whether this relationship occurs in older adults is unclear. This cross-sectional study investigated whether high levels of psychological distress would be associated with a high tender point count and whether the relationship would be moderated by age. Three thousand three hundred and seventy-nine individuals were mailed a questionnaire which included the Hospital Anxiety and Depression (HAD) scale, the Pain Catastrophising Scale (PCS), the Brief Illness Perception Questionnaire (Brief IPQ), and the Pittsburgh Sleep Quality Index (PSQI). A random sample of approximately 10% of subjects who returned the questionnaire undertook a physical assessment, including a manual tender point count assessment.A total of 2385 (71%) subjects completed the questionnaire, of whom 798 (33%) were invited to take part in the physical assessment and 290 (12%) participated. Of the 290 participants the median age was 64 years (range 34-97) and 63% were female. The median HAD score was 9 (IQR 5-14) and the median number of tender points was 3 (range 0-7).Increasing HAD score was positively and significantly associated with tender point count, but this relationship was not moderated by age. In a final multivariable model, sex, HAD score and PSQI score were independent predictors of multiple tender points.Psychological distress was associated with multiple tender points independent of age. Psychological distress and trouble sleeping were important, potentially modifiable factors associated with the outcome

Evidence-Based Professional Development of Science Teachers in Two Countries

The focus of this collaborative research project of King?s College London, and the Weizmann Institute, Israel. project is on investigating the ways in which teachers can demonstrate accomplished teaching in a specific domain of science and on the teacher learning that is generated through continuing professional development programs (CPD) that lead towards such practice. The interest lies in what processes and inputs are required to help secondary school science teachers develop expertise in a specific aspect of science teaching. `It focuses on the design of the CPD programmes and examines the importance of an evidence-based approach through portfolioconstruction in which professional dialogue pathes the way for teacher learning. The set of papers highlight the need to set professional challenge while tailoring CPD to teachers? needs to create the environment in which teachers can advance and transform their practice. The cross-culture perspective added to the richness of the development and enabled the researchers to examine which aspects were fundamental to the design by considering similarities and differences between the domains

Collaboration between academics and teachers : a complex relationship

Collaboration between academics and teachers has become increasingly prevalent over recent years. Whether its aim is joint research or continuing professional development for teachers, collaboration seems to offer a realistic opportunity for reducing the perceived gap between theory and practice. However, collaboration is not merely academics and teachers working together on a common project. It is complex in nature and involves a range of requirements that must be satisfied in order to maximise the potential of the relationship. In this paper we will theorise on the nature of academics and teachers working together and suggest that a working relationship between academic researchers and teachers can be one of three models: client–supplier, a coercive relationship or a collaborative relationship. We identify and unpack specific factors that underpin collaboration and suggest a number of concrete actions to establish collaboration between academics and teachers. We draw heavily from existing literature and our own reflections on two collaborative projects with which we have recently been involved. We use data from these projects to provide a number of anecdotes from the teachers who participated to support our own reflections. Finally, we suggest that further research should investigate the different ways attempts to collaborate fail, to build a more complete sense of the problems and potential of this special relationship. Keywords: collaboration; continuing professional development; action research; science teacher

Bringing installation art to reconnaissance to share values and generate action

The English education system has recently seen something of a revival of enthusiasm for the use of research both to develop educational practices and to gather evidence about their effectiveness. These initiatives often present action research as a model of individual problem-solving, which, we argue, communicates a limited conception of action research. In this paper we propose an alternative to this ‘problem-solving’ conception of action research that acknowledges the complex, messy nature of action research through the use of arts installations. Specifically, we present the reconnaissance phase of a project which brought together a partnership comprising a water heritage museum, university staff, teachers and artists. A pedagogical adaptation of contemporary installation art theory and practice fostered the exploration of individual and collective understandings of water, and also established a shared approach to curriculum development and ownership of the project among all participants. We propose that this creative practice enhanced and changed the process of reconnaissance; it allowed the group to establish and share commitments to the value of water conservation and generated a wide range of options for our action research

'New to me': changing patient understanding of psoriasis and identifying mechanisms of change. The Pso Well® patient materials mixed-methods feasibility study

BACKGROUND: Psoriasis is an inflammatory long-term condition involving comorbidities, unhealthy lifestyle and significant life impact. Patients' understanding of psoriasis is limited and support lacking. The Common-Sense Model of Self-Regulation of Health and Illness emphasizes the role of illness and treatment beliefs on coping and self-management. New 'Pso Well® ' patient materials informed by the model, addressed psoriasis as a long-term condition, medication management and lifestyle behaviours. OBJECTIVES: To investigate whether Pso Well® materials (i) broaden understanding of psoriasis without increasing anxiety; (ii) are acceptable; and (iii) comprise features that appear to effect change. METHODS: The Revised Illness Perceptions Questionnaire (IPQ-R modified) and the Hospital Anxiety and Depression Scale (HADS) were administered in patients before and after intervention. Numerical rating scales assessed perceptions of change in understanding and anxiety resulting from engagement with the materials. Qualitative interviews explored acceptability and perceived 'active ingredients'. RESULTS: Fifty-five patients completed pre- and postintervention questionnaires (56% female; median age 59 years). Postintervention, a large effect size was indicated in two IPQ-R domains - illness coherence [t(55) = -3·48, P = 0·001 (two-tailed), η2  = 0·19] and personal control [t(55) = -2·98, P = 0·004 (two-tailed), η2  = 0·14] - and a medium effect in one, treatment control [t(55) = -2·08, P = 0·042 (two-tailed), η2  = 0·08]. HADS scores did not change. For numerical rating scales, 80% of participants reported increased understanding of psoriasis and none reported increased anxiety. Interviews with 19 patients indicated the materials were acceptable and usable. Factors reported to broaden understanding and promote engagement with self-management included linking of related disease aspects, personally relevant content and high-quality design. CONCLUSIONS: High-quality, theory-based psoriasis materials are acceptable to patients and can improve understanding and sense of control without increasing anxiety

Impact of inadequate adherence on response to subcutaneously administered anti-tumour necrosis factor drugs: results from the Biologics in Rheumatoid Arthritis Genetics and Genomics Study Syndicate cohort

Objective. Non-adherence to DMARDs is common, but little is known about adherence to biologic therapies and its relationship to treatment response. The purpose of this study was to investigate the association between self-reported non-adherence to s.c. anti-TNF therapy and response in individuals with RA. Methods. Participants about to start s.c. anti-TNF therapy were recruited to a large UK multicentre prospective observational cohort study. Demographic information and disease characteristics were assessed at baseline. Self-reported non-adherence, defined as whether the previous due dose of biologic therapy was reported as not taken on the day agreed with the health care professional, was recorded at 3 and 6 months following the start of therapy. The 28-joint DAS (DAS28) was recorded at baseline and following 3 and 6 months of therapy. Multivariate linear regression was used to examine these relationships. Results. Three hundred and ninety-two patients with a median disease duration of 7 years [interquartile range (IQR) 3–15] were recruited. Adherence data were available in 286 patients. Of these, 27% reported non-adherence to biologic therapy according to the defined criteria at least once within the first 6-month period. In multivariate linear regression analysis, older age, lower baseline DAS28 and ever non-adherence at either 3 or 6 months from baseline were significantly associated with a poorer DAS28 response at 6 months to anti-TNF therapy. Conclusion. Patients with RA who reported not taking their biologic on the day agreed with their health care professional showed poorer clinical outcomes than their counterparts, emphasizing the need to investigate causes of non-adherence to biologics

Astrocytic Ion Dynamics: Implications for Potassium Buffering and Liquid Flow

We review modeling of astrocyte ion dynamics with a specific focus on the implications of so-called spatial potassium buffering, where excess potassium in the extracellular space (ECS) is transported away to prevent pathological neural spiking. The recently introduced Kirchoff-Nernst-Planck (KNP) scheme for modeling ion dynamics in astrocytes (and brain tissue in general) is outlined and used to study such spatial buffering. We next describe how the ion dynamics of astrocytes may regulate microscopic liquid flow by osmotic effects and how such microscopic flow can be linked to whole-brain macroscopic flow. We thus include the key elements in a putative multiscale theory with astrocytes linking neural activity on a microscopic scale to macroscopic fluid flow.Comment: 27 pages, 7 figure

Using evidence-informed logic models to bridge methods in educational evaluation

Designs combining different types of data are increasingly used in educational evaluation, to provide both evidence of impact and an explanation of the processes by which impacts are created. Logic models are visual representations of how an intervention leads via a set of steps from resources and inputs to outputs and then sets of outcomes. Their use has become widespread to underpin evaluations; and they have become of more interest in education as they have been promoted by policy makers and funders including the Education Endowment Foundation (EEF) in England. This paper addresses the question: how can logic models be used to frame and implement educational evaluations using combinations of methods? To do so, the paper draws on theory-based evaluation literature to identify a set of issues to be considered: the role of implementation logic; causal mechanisms; the context of interventions; and the importance of considering and addressing issues around complexity. Using detailed examples from two study designs for EEF evaluations, the paper presents an evidence-informed logic model approach to deal with these issues. The paper concludes by reflecting on the practical and theoretical implications of this approach, laying out a set of key issues to address in future evaluations for which a design framed by an evidence-informed logic model may be appropriate