Effects of needs-based patient education on self-efficacy and health outcomes in people with rheumatoid arthritis: A multicentre, single blind, randomised controlled trial

Objectives The Educational Needs Assessment Tool (ENAT) is a self-completed questionnaire, which allows patients with arthritis to prioritise their educational needs. The aim of this study was to evaluate the effects of needs-based patient education on self-efficacy, health outcomes and patient knowledge in people with rheumatoid arthritis (RA). Methods Patients with RA were enrolled into this multicentre, single-blind, parallel-group, pragmatic randomised controlled trial. Patients were randomised to either the intervention group (IG) where patients completed ENAT, responses of which were used by the clinical nurse specialist to guide patient education; or control group (CG) in which they received patient education without the use of ENAT. Patients were seen at weeks 0, 16 and 32. The primary outcome was selfefficacy (Arthritis Self Efficacy Scale (ASES)-Pain and ASES-Other symptoms). Secondary outcomes were health status (short form of Arthritis Impact Measurement Scale 2, AIMS2-SF) and patient knowledge questionnaire-RA. We investigated between-group differences using analysis of covariance, adjusting for baseline variables. Results A total of 132 patients were recruited (IG=70 and CG=62). Their mean (SD) age was 54 (12.3) years, 56 (13.3) years and disease duration 5.2 (4.9) years, 6.7 (8.9) years for IG and CG, respectively. There were significant between-group differences, in favour of IG at week 32 in the primary outcomes, ASES-Pain, mean difference (95% CI) -4.36 (1.17 to 7.55), t=-2.72, p=0.008 and ASES-Other symptoms, mean difference (95% CI) -5.84 (2.07 to 9.62), t=-3.07, p=0.003. In secondary outcomes, the between-group differences favoured IG in AIMS2-SF Symptoms and AIMS2-SF Affect. There were no between-group differences in other secondary outcomes. Conclusions The results suggest that needs-based education helps improve patients' self-efficacy and some aspects of health status

Teams between Neo-Taylorism and Anti-Taylorism

The concept of teamworking is the product of two distinct developments. One: a neo- Tayloristic form of organization of work, of which Toyota has shown that it can be very profitable, was packaged and reframed to make it acceptable to the Western public. Two: anti-Tayloristic ways of organizing work, inspired by ideals of organizational democracy, were relabeled to make these acceptable to profit-oriented managers. Drawing on empirical research in Scandinavia, Germany, The Netherlands and the UK, as well as on published case studies of Japanese companies, the paper develops a neo-Tayloristic and an anti-Tayloristic model of teamworking. Key concerns in the teamworking literature are intensification of work and the use of shop floor autonomy as a cosmetic or manipulative device. Indeed, all the features of neo-Tayloristic teamworking are geared towards the intensification of work. However, one of the intensification mechanisms, the removal of Tayloristic rigidities in the division of labor, applies to anti-Tayloristic teamworking as well. This poses a dilemma for employee representatives. In terms of autonomy, on the other hand, the difference between neo-Tayloristic and anti-Tayloristic teamworking is real. In anti-Tayloristic teamworking, there is no supervisor inside the team. The function of spokesperson rotates. All team members can participate in decision-making. Standardization is not relentlessly pursued; management accepts some measure of worker control. There is a tendency to alleviate technical discipline, e.g. to find alternatives for the assembly line. Buffers are used. Remuneration is based on proven skill level; there are no group bonuses. In contrast, in neo-Tayloristic teamworking, a permanent supervisor is present in the team as team leader. At most, only the team leader can participate in decision-making. Standardization is relentlessly pursued. Management prerogatives are nearly unlimited. Job designers treat technical discipline, e.g. short-cycled work on the assembly line, as unproblematic. There are no buffers. A substantial part of wages consists of individual bonuses based on assessments by supervisors on how deeply workers cooperate in the system. Group bonuses are also given. The instability and vulnerability of anti-Tayloristic teamworking imply that it can only develop and flourish when managers and employee representatives put determined effort into it. The opportunity structure for this contains both economic and political elements. In mass production, the economic success of Toyota, through skillful mediation by management gurus, makes the opportunity structure for anti-Tayloristic teamworking relatively unfavorable

Early prognostic factors for disability in multiple sclerosis, a European multicenter study

The effects of initial clinical variables on short-term prognosis are analyzed in a cross-sectional study of 574 multiple sclerosis patients from 7 centers in 5 European countries. Patients with a primary progressive course had a 2.3 higher mean disability score (EDSS) than the primary remittent group after a mean duration of disease of 6.6 years. High age at onset was associated with a primary progressive course, and was also related to increased risk of a rapid shift to a secondary progressive course. Among the remittent patients without a secondary progressive course a high age at onset was significantly correlated to a higher disability score. In the whole remittent group the presence of pyramidal and cerebellar symptoms at onset predicted both a high disability score and a rapid shift to a secondary progression, while the effect was reverse for sensory and visual symptoms. No difference between the sexes was found

Feeling Something without Knowing Why: Measuring Emotions toward Archetypal Content

Abstract. To enhance communication among users through technology, we propose a framework that communicates ‘pure experience. ’ This framework can be achieved by providing emotionally charged communication. To initiate this undertaking, we propose to explore materials for communicating human emotions. Research on emotion mainly focuses on emotions that are relevant to utilitarian concerns. Besides the commonly-known emotions like joy and fear, there are non-utilitarian emotions, such as aesthetic emotions, which are essential to our daily lives. Based on Jung’s theory of collective unconsciousness, we consider archetypal content as a new category of affective stimuli of non-utilitarian emotions. We collected pictures and sounds of the archetype of the self, and conducted an experiment with existing affective stimuli of utilitarian emotions. The results showed that archetypal content i