The Planetary Nebula Luminosity Function at the Dawn of Gaia

The [O III] 5007 Planetary Nebula Luminosity Function (PNLF) is an excellent extragalactic standard candle. In theory, the PNLF method should not work at all, since the luminosities of the brightest planetary nebulae (PNe) should be highly sensitive to the age of their host stellar population. Yet the method appears robust, as it consistently produces < 10% distances to galaxies of all Hubble types, from the earliest ellipticals to the latest-type spirals and irregulars. It is therefore uniquely suited for cross-checking the results of other techniques and finding small offsets between the Population I and Population II distance ladders. We review the calibration of the method and show that the zero points provided by Cepheids and the Tip of the Red Giant Branch are in excellent agreement. We then compare the results of the PNLF with those from Surface Brightness Fluctuation measurements, and show that, although both techniques agree in a relative sense, the latter method yields distances that are ~15% larger than those from the PNLF. We trace this discrepancy back to the calibration galaxies and argue that, due to a small systematic error associated with internal reddening, the true distance scale likely falls between the extremes of the two methods. We also demonstrate how PNLF measurements in the early-type galaxies that have hosted Type Ia supernovae can help calibrate the SN Ia maximum magnitude-rate of decline relation. Finally, we discuss how the results from space missions such as Kepler and Gaia can help our understanding of the PNLF phenomenon and improve our knowledge of the physics of local planetary nebulae.Comment: 12 pages, invited review at the conference "The Fundamental Cosmic Distance Scale: State of the Art and Gaia Perspective", to appear in Astrophysics and Space Scienc

The effects of exercise on cardiovascular disease risk factors and cardiovascular physiology in rheumatoid arthritis

© 2019, Springer-Verlag GmbH Germany, part of Springer Nature. Cardiovascular disease (CVD) morbidity and mortality is highly prevalent in patients with rheumatoid arthritis (RA) with debilitating effects for the individual as well as significant healthcare impact. Current evidence demonstrates that engaging in aerobic and resistance exercise (i.e. structured physical activity) can significantly improve patient-reported and clinical index-assessed outcomes in RA. In addition to this, engagement in exercise programmes improves, in a dose-dependent manner, the risk of developing CVD as well as CVD symptoms and outcomes. The present narrative review uses evidence from systematic reviews and meta-analyses as well as controlled trials, to synthesize the current state-of-the-art on the potential effects of aerobic and resistance exercise on CVD risk factors as well as on cardiac and vascular function and structure in people with RA. Where there is a lack of evidence in RA to explain potential mechanisms, relevant studies from the general population are also discussed and linked to RA.Published versio

The methodological quality is insufficient in clinical practice guidelines in the context of COVID-19 : systematic review

Objectives The number of published clinical practice guidelines related to COVID-19 has rapidly increased. This study explored if basic methodological standards of guideline development have been met in the published clinical practice guidelines related to COVID-19. Study Design and Setting Rapid systematic review from February 1 until April 27, 2020 using MEDLINE [PubMed], CINAHL [Ebsco], Trip and manual search, including all types of healthcare workers providing any kind of healthcare to any patient population in any setting. Results There were 1342 titles screened and 188 guidelines included. The highest average AGREE II domain score was 89% for scope and purpose, the lowest for rigor of development (25%). Only eight guidelines (4%) were based on a systematic literature search and a structured consensus process by representative experts (classified as the highest methodological quality). The majority (156; 83%) was solely built on an informal expert consensus. A process for regular updates was described in 27 guidelines (14%). Patients were included in the development of only one guideline. Conclusion Despite clear scope, most publications fell short of basic methodological standards of guideline development. Clinicians should use guidelines that include up-to-date information, were informed by stakeholder involvement, and employed rigorous methodologies

Educational readiness among health professionals in rheumatology: low awareness of EULAR offerings and unfamiliarity with the course content as major barriers: results of a EULAR-funded European survey

Background: Ongoing education of health professionals in rheumatology (HPR) is critical for high-quality care. An essential factor is education readiness and a high quality of educational offerings. We explored which factors contributed to education readiness and investigated currently offered postgraduate education, including the European Alliance of Associations for Rheumatology (EULAR) offerings. Methods and participants: We developed an online questionnaire, translated it into 24 languages and distributed it in 30 European countries. We used natural language processing and the Latent Dirichlet Allocation to analyse the qualitative experiences of the participants as well as descriptive statistics and multiple logistic regression to determine factors influencing postgraduate educational readiness. Reporting followed the Checklist for Reporting Results of Internet E-Surveys guideline. Results: The questionnaire was accessed 3589 times, and 667 complete responses from 34 European countries were recorded. The highest educational needs were 'professional development', 'prevention and lifestyle intervention'. Older age, more working experience in rheumatology and higher education levels were positively associated with higher postgraduate educational readiness. While more than half of the HPR were familiar with EULAR as an association and the respondents reported an increased interest in the content of the educational offerings, the courses and the annual congress were poorly attended due to a lack of awareness, comparatively high costs and language barriers. Conclusions: To promote the uptake of EULAR educational offerings, attention is needed to increase awareness among national organisations, offer accessible participation costs, and address language barriers.Orthopaedics, Trauma Surgery and Rehabilitatio

Exercise and inflammation

Based on current knowledge deriving from studies in animals and humans (the general population and patients with non-communicable diseases), there is biological plausibility that exercise may have anti-inflammatory effects. This may be particularly important for patients with chronic inflammatory rheumatic and musculoskeletal diseases (RMDs). The present review discusses the current state-of-the-art on exercise and inflammation, explores how exercise can moderate inflammation-dependent RMD outcomes and the most prevalent systemic manifestations and addresses the relationship between the dosage (particularly the intensity) of exercise and inflammation. We conclude that present data support potential beneficial effects of exercise on inflammation, however, the evidence specifically in RMDs is limited and inconclusive. More targeted research is required to elucidate the effects of exercise on inflammation in the context of RMDs. © 202

Development of the role and scope of an academic mentorship network for health professionals working with people with rheumatological and musculoskeletal conditions across Europe

The workshop provided an open forum to debate and discuss the aspirations for a mentorship scheme within eular hps, and the possible scope and remit. Some practical examples on how this could be realized were presented and offer routes to the next stages of developing a eular hp mentorship network. What is evident is that expectations of academic mentorship relating to time, scope and support available need to be defined clearly at the outset. Potential mentees need to drive the mentorship relationship, with the responsibility for active learning remaining with the mentee. However, for any mentorship programme to work and have the input of mentors, clear definitions about what mentors can provide must also be clearly articulated and agreed, to ensure that expectations are realistic and sustainable. Conclusion academic mentorship for eular hps working in rmd settings has been identified as an area for development across europe. Sharing and supporting academic expertise and good practice between professions and between countries has been agreed as a positive step to helping support the academic development of all hp groups across europe who are working with people with rmd conditions. Acknowledgements the authors would like to thank fiona cramp, university of west england, for contributing material and professor tony redmond and dr yeliz prior for group facilitation during the eular 2015 mentorship workshop. References cho, cs, ramanan, ra, feldman, md ( 2011). Defining the ideal qualities of mentorship: a qualitative analysis of the characteristics of outstanding mentors. American journal of medicine 124: 453– 8. Crossref pubmed web of science®google scholarmaastricht university find full text connor, mp, pokora, jb ( 2007). Coaching and mentoring at work: developing effective practice. Maidenhead: open university press (mcgraw hill education). Google scholarmaastricht university find full text detsky, as, baerlocher, mo, detsky, md ( 2007). Academic mentoring – how to give it and how to get it. Jama 297: 2134– 6. Crossref cas pubmed web of science®google scholarmaastricht university find full text frank-bertoncelj, m, hatemi, g, ospelt, c, ramiro, s, machado, p, mandl, p, gossec, l, buch, mh ( 2014). Mentoring of young professionals in the field of rheumatology in europe: results from an emerging eular network (emeunet) survey. Clinical and experimental rheumatology 32: 935– 41. Pubmed web of science®google scholarmaastricht university find full text garvey, r, stokes, p, megginson, d ( 2009). Coaching and mentoring: theory and practice. London: sage. Google scholarmaastricht university find full text megginson, d, clutterbuck, d ( 1995). Mentoring in action. London: kogan page. Google scholarmaastricht university find full text parsloe, e ( 1992). Coaching, mentoring and assessing – a practical guide to developing competence. London: kogan page. Google scholarmaastricht university find full text parsloe, e, leedham, m ( 2009). Coaching and mentoring: practical conversations to improve learning. London: kogan page. Google scholarmaastricht university find full text straus, se, graham, id, taylor, m, lockyer, j ( 2008). Development of a mentorship strategy: a knowledge translation case study. Journal of continuing education in the health professions 28: 117– 22. Wiley online library pubmed web of science®google scholarmaastricht university find full text

The AUSCAN subscales, AIMS-2 hand/finger subscale, and FIOHA were not unidimensional scales

Objectives: Evaluate the internal construct validity of the Australian/Canadian (AUSCAN) index for hand osteoarthritis (HOA) and identify the physical. function instrument with best performance. Study Design and Setting: AUSCAN, AIMS-2 (Arthritis Impact Measurement Scale 2), and Functional Index of HOA (FIHOA) were self-completed by 209 HOA patients (mean [standard deviation] age 61.6 [5.7] years) at baseline and 128 at follow-up. Rasch analysis was performed. Results: AUSCAN pain, physical function, and stiffness subscales comprised three constructs. AUSCAN scale performance was improved after removal of "Pain at rest" from the pain scale and division of physical function into two scales of high precision and grip strength tasks. AIMS-2 hand/finger subscale and FIHOA were improved after removal of one and two items, respectively and collapse of two AIMS-2 response categories. AUSCAN physical function scale showed better targeting to the sample and higher person reliability compared with FIHOA and especially AIMS-2 because of less "severe" items concerning grip strength tasks as opposed to precision tasks. Conclusion: The AUSCAN subscales, AIMS-2 hand/finger scale, and FIHOA were not unidimensional. However, deletion of misfitting items improved scale performance. The revised AUSCAN physical function and FIHOA scales are preferable for measurement of grip strength and precision tasks, respectively. (C) 2011 Elsevier Inc. All rights reserved

Facilitators to implement standards of care for rheumatoid arthritis and osteoarthritis: the EUMUSC.NET project

Background Rheumatoid arthritis (RA) and osteoarthritis (OA) are important musculoskeletal diseases that the EUMUSC.NET project developed Standards of Care (SOC) for. Objective The purpose was to explore factors to enable successful implementation of the SOC for RA and OA. Methods A combined set of methods was used; a literature search, a European survey among patients, clinicians and policymakers; and focus groups. Results Potential facilitators were identified during a literature search. The online survey captured 282 responses from clinicians, patients and policymakers from 35 European countries, and focus groups from 5 countries contributed with knowledge about possible additional facilitators and strategies. Both the survey and the focus groups endorsed all 11 facilitators. The most important facilitators for implementing the SOC were motivation, agreement, knowledge and personal attitude. The focus groups underlined the lack of access to recommended care in some countries, that multidisciplinary teams should be strengthened and that some healthcare reimbursement systems need change to implement recommended clinical practice. Conclusion Eleven facilitators key for the implementation of the SOC for RA and OA were endorsed by patients and clinicians from 35 European countries. This knowledge may contribute to improved care for patients with RA and OA in Europe