13 research outputs found

    EULAR recommendations for the non-pharmacological management of systemic lupus erythematosus and systemic sclerosis

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    Objective To develop evidence-based recommendations for the non-pharmacological management of systemic lupus erythematosus (SLE) and systemic sclerosis (SSc). Methods A task force comprising 7 rheumatologists, 15 other healthcare professionals and 3 patients was established. Following a systematic literature review performed to inform the recommendations, statements were formulated, discussed during online meetings and graded based on risk of bias assessment, level of evidence (LoE) and strength of recommendation (SoR; scale AD , A comprising consistent LoE 1 studies, D comprising LoE 4 or inconsistent studies), following the European Alliance of Associations for Rheumatology standard operating procedure. Level of agreement (LoA; scale 0-10, 0 denoting complete disagreement, 10 denoting complete agreement) was determined for each statement through online voting. Results Four overarching principles and 12 recommendations were developed. These concerned common and disease-specific aspects of non-pharmacological management. SoR ranged from A to D. The mean LoA with the overarching principles and recommendations ranged from 8.4 to 9.7. Briefly, non-pharmacological management of SLE and SSc should be tailored, person-centred and participatory. It is not intended to preclude but rather complement pharmacotherapy. Patients should be offered education and support for physical exercise, smoking cessation and avoidance of cold exposure. Photoprotection and psychosocial interventions are important for SLE patients, while mouth and hand exercises are important in SSc. Conclusions The recommendations will guide healthcare professionals and patients towards a holistic and personalised management of SLE and SSc. Research and educational agendas were developed to address needs towards a higher evidence level, enhancement of clinician-patient communication and improved outcomes

    EULAR recommendations for the non-pharmacological management of systemic lupus erythematosus and systemic sclerosis

    Get PDF
    Objective To develop evidence-based recommendations for the non-pharmacological management of systemic lupus erythematosus (SLE) and systemic sclerosis (SSc). Methods A task force comprising 7 rheumatologists, 15 other healthcare professionals and 3 patients was established. Following a systematic literature review performed to inform the recommendations, statements were formulated, discussed during online meetings and graded based on risk of bias assessment, level of evidence (LoE) and strength of recommendation (SoR; scale A–D, A comprising consistent LoE 1 studies, D comprising LoE 4 or inconsistent studies), following the European Alliance of Associations for Rheumatology standard operating procedure. Level of agreement (LoA; scale 0–10, 0 denoting complete disagreement, 10 denoting complete agreement) was determined for each statement through online voting. Results Four overarching principles and 12 recommendations were developed. These concerned common and disease-specific aspects of non-pharmacological management. SoR ranged from A to D. The mean LoA with the overarching principles and recommendations ranged from 8.4 to 9.7. Briefly, non-pharmacological management of SLE and SSc should be tailored, person-centred and participatory. It is not intended to preclude but rather complement pharmacotherapy. Patients should be offered education and support for physical exercise, smoking cessation and avoidance of cold exposure. Photoprotection and psychosocial interventions are important for SLE patients, while mouth and hand exercises are important in SSc. Conclusions The recommendations will guide healthcare professionals and patients towards a holistic and personalised management of SLE and SSc. Research and educational agendas were developed to address needs towards a higher evidence level, enhancement of clinician–patient communication and improved outcomes

    Mild-to-Moderate Kidney Dysfunction and Cardiovascular Disease: Observational and Mendelian Randomization Analyses

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    BACKGROUND: End-stage renal disease is associated with a high risk of cardiovascular events. It is unknown, however, whether mild-to-moderate kidney dysfunction is causally related to coronary heart disease (CHD) and stroke. METHODS: Observational analyses were conducted using individual-level data from 4 population data sources (Emerging Risk Factors Collaboration, EPIC-CVD [European Prospective Investigation into Cancer and Nutrition-Cardiovascular Disease Study], Million Veteran Program, and UK Biobank), comprising 648 135 participants with no history of cardiovascular disease or diabetes at baseline, yielding 42 858 and 15 693 incident CHD and stroke events, respectively, during 6.8 million personyears of follow-up. Using a genetic risk score of 218 variants for estimated glomerular filtration rate (eGFR), we conducted Mendelian randomization analyses involving 413 718 participants (25917 CHD and 8622 strokes) in EPIC-CVD, Million Veteran Program, and UK Biobank. RESULTS: There were U-shaped observational associations of creatinine-based eGFR with CHD and stroke, with higher risk in participants with eG FR values 105 mL.min(-1).1.73 m(-2), compared with those with eG FR between 60 and 105 mL.min(-1).1.73 m(-2). Mendelian randomization analyses for CHD showed an association among participants with eGFR 105 mL.min(-1).1.73 m(-2). Results were not materially different after adjustment for factors associated with the eGFR genetic risk score, such as lipoprotein(a), triglycerides, hemoglobin Alc, and blood pressure. Mendelian randomization results for stroke were nonsignificant but broadly similar to those for CHD. CONCLUSIONS: In people without manifest cardiovascular disease or diabetes, mild-to-moderate kidney dysfunction is causally related to risk of CHD, highlighting the potential value of preventive approaches that preserve and modulate kidney function

    ATTITYDER TILL AMNING BLAND SJUKVÅRDSPERSONAL INOM BARNSJUKVÅRDEN

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    Barn under två år utgör en stor patientgrupp inom barnsjukvården. När ett barn blir sjukt och behöver ligga på sjukhus kan det påverka etablering och fortsatt amning. Sjukvårdspersonal som arbetar med små barn bör ha en positiv attityd till amning och kunskaper i amning för att kunna stötta och främja den samt bedriva en familjefokuserad omvårdnad. Forskning har visat att det föreligger positiva attityder till amning bland sjukvårdspersonal men att det råder brist på amningsutbildning och amningskunskaper. Syftet med denna studie var att undersöka vad sjukvårdspersonal inom barnsjukvården hade för attityder till amning. Arbetet utfördes som en tvärsnittsstudie med en beskrivande kvantitativ design. En webbenkät skickades ut till 628 barnsjuksköterskor, sjuksköterskor, undersköterskor och barnsköterskor inom barnsjukvården i södra Sverige. Det var 116 respondenter som besvarade webbenkäten. Resultatet indikerar att det föreligger en positiv attityd till amning bland respondenterna. Det framkom även att det är få som har utbildning i amning och att majoriteten önskar erhålla utbildning i amning. Således behövs amningsutbildning för att sjukvårdspersonal ska ge amningsråd som är evidensbaserade. Ytterligare forskning, med större undersökningsgrupper, behövs för att få djupare inblick i sjukvårdspersonals attityder till och kunskaper om amning inom barnsjukvården.When a child becomes ill and in need of hospital care it could affect the initiation and continuation of breastfeeding. Health care professionals who work with young children should have a positive attitude towards and knowledge about breastfeeding in order to be able to support and promote it and practice family-centred care. Previous studies have shown that health care professionals have positive attitudes towards breastfeeding but there is a lack of knowledge and education regarding breastfeeding. The purpose of this study was to examine health care professional’s attitudes towards breastfeeding. The study was conducted as a cross-sectional study with a descriptive quantitative design. A web-based survey was sent out to 628 health care professionals working in paediatric units in southern Sweden. The web-based survey was answered by 116 respondents. The result indicates that there are positive attitudes towards breastfeeding among the respondents. It also emerged that few respondents had breastfeeding education and that the majority wished to receive breastfeeding education. More education in breastfeeding is needed so that health care professionals can give evidence based breastfeeding advice. Further studies, with more participants, are needed on this subject to achieve a deeper understanding about health care professionals´ attitudes and knowledge about breastfeeding in paediatric hospital settings

    Nature de l'interférence et niveau de mémorisation. Analyse expérimentale chez le hamster doré

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    Summary The effectof two types of interference — introduced for a certain temporal interval between the elements of the learning paradigm — on both acquisition and retention of a discrimination task — was studied in golden hamsters. During the intertrial intervals (ITIs) the animals remained either in the startbox of the experimental apparatus, a three path divergent maze, or were transferred to a novel environment. The results show that the decrement observed in the performance is related to an association between the type of stimulus-situation during the ITIs and the particular phase of the learning process in which the ITIs are introduced.Résumé Nous avons étudié chez le hamster doré l'influence de deux sources d'interférence — appliquées pendant un intervalle temporel introduit entre les éléments du paradigme expérimental — sur l'acquisition et le maintien d'un apprentissage discriminatif (apprentissage d'élimination). Au cours des intervalles (ITIs) les animaux ont été soit maintenus bloqués dans la boîte de départ du dispositif, soit transférés dans un nouvel environnement. Nos résultats montrent que les déficits observés au niveau des perfor- mances dépendent de l'association d'une catégorie particulière de stimulus interférents à une phase particulière — acquisition ou surapprentissage — du processus étudié.Ammassari-Teule M., Welin Anne-Charlotte. Nature de l'interférence et niveau de mémorisation. Analyse expérimentale chez le hamster doré. In: L'année psychologique. 1978 vol. 78, n°2. pp. 319-330

    EULAR recommendations for the non-pharmacological management of systemic lupus erythematosus and systemic sclerosis

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    OBJECTIVE: To develop evidence-based recommendations for the non-pharmacological management of systemic lupus erythematosus (SLE) and systemic sclerosis (SSc). METHODS: A task force comprising 7 rheumatologists, 15 other healthcare professionals and 3 patients was established. Following a systematic literature review performed to inform the recommendations, statements were formulated, discussed during online meetings and graded based on risk of bias assessment, level of evidence (LoE) and strength of recommendation (SoR; scale A-D, A comprising consistent LoE 1 studies, D comprising LoE 4 or inconsistent studies), following the European Alliance of Associations for Rheumatology standard operating procedure. Level of agreement (LoA; scale 0-10, 0 denoting complete disagreement, 10 denoting complete agreement) was determined for each statement through online voting. RESULTS: Four overarching principles and 12 recommendations were developed. These concerned common and disease-specific aspects of non-pharmacological management. SoR ranged from A to D. The mean LoA with the overarching principles and recommendations ranged from 8.4 to 9.7. Briefly, non-pharmacological management of SLE and SSc should be tailored, person-centred and participatory. It is not intended to preclude but rather complement pharmacotherapy. Patients should be offered education and support for physical exercise, smoking cessation and avoidance of cold exposure. Photoprotection and psychosocial interventions are important for SLE patients, while mouth and hand exercises are important in SSc. CONCLUSIONS: The recommendations will guide healthcare professionals and patients towards a holistic and personalised management of SLE and SSc. Research and educational agendas were developed to address needs towards a higher evidence level, enhancement of clinician-patient communication and improved outcomes
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