A 5 item version of the Compliance Questionnaire for Rheumatology (CQR5) successfully identifies low adherence to DMARDs

© 2013 Hughes et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly citedTaking DMARDs as prescribed is an essential part of self-management for patients with Rheumatoid Arthritis. To date, the Compliance Questionnaire for Rheumatology (CQR) is the only self-report adherence measure created specifically for and validated in rheumatic diseases. However, the factor structure of the CQR has not been reported and it can be considered lengthy at 19 items. The aim of this study was to test the factor structure of the CQR and reduce the number of items whilst retaining robust explanation of non-adherence to DMARDs. Such a reduction would increase the clinical utility of the scale, to identify patients with sub-optimal adherence to DMARDs in the clinic as well as for research purposes.Peer reviewe

Job satisfaction and career prospects of Oral Health Therapists in Aotearoa/New Zealand: A research update and call for further research in light of the COVID-19 pandemic

Peer Reviewe

Nucleoside diphosphate kinase A as a controller of AMP-kinase in airway epithelia

This review integrates recent understanding of a novel role for NDPK-A in two related directions: Firstly, its role in an airway epithelial cell when bound to the luminal (apical) membrane and secondly in the cytosol of many different cells (epithelial and non-epithelial) where an isoform-specific interaction occurs with a regulatory partner, AMPKα1. Thus NDPK-A is present in both a membrane and cytosolic environment but in the apical membrane, its roles are not understood in detail; preliminary data suggest that it co-localises with the cystic fibrosis protein (CFTR). In cytosol, we find that NDPK-A is coupled to the catalytic alpha1 isoform of the AMP-activated protein kinase (AMPKα subunit), which is part of a heterotrimeric protein complex that responds to cellular energy status by switching off ATP-consuming pathways and switching on ATP-generating pathways when ATP is limiting. We find that ATP is located within this complex and ‘fed’ from NDPK to AMPK without ever ‘seeing’ bulk solution. Importantly, the reverse can also happen such that AMPK activity can be made to decline when NDPK-A ‘steals’ ATP from AMPK. Thus we propose a novel paradigm in NDPK-A function by suggesting that AMP-kinase can be regulated by NDPK-A, independently of AMP

Women’s experiences of wearing therapeutic footwear in three European countries

Background: Therapeutic footwear is recommended for those people with severe foot problems associated with rheumatoid arthritis (RA). However, it is known that many do not wear them. Although previous European studies have recommended service and footwear design improvements, it is not known if services have improved or if this footwear meets the personal needs of people with RA. As an earlier study found that this footwear has more impact on women than males, this study explores women’s experiences of the process of being provided with it and wearing it. No previous work has compared women’s experiences of this footwear in different countries, therefore this study aimed to explore the potential differences between the UK, the Netherlands and Spain. Method: Women with RA and experience of wearing therapeutic footwear were purposively recruited. Ten women with RA were interviewed in each of the three countries. An interpretive phenomenological approach (IPA) was adopted during data collection and analysis. Conversational style interviews were used to collect the data. Results: Six themes were identified: feet being visibly different because of RA; the referring practitioners’ approach to the patient; the dispensing practitioners’ approach to the patient; the footwear being visible as different to others; footwear influencing social participation; and the women’s wishes for improved footwear services. Despite their nationality, these women revealed that therapeutic footwear invokes emotions of sadness, shame and anger and that it is often the final and symbolic marker of the effects of RA on self perception and their changed lives. This results in severe restriction of important activities, particularly those involving social participation. However, where a patient focussed approach was used, particularly by the practitioners in Spain and the Netherlands, the acceptance of this footwear was much more evident and there was less wastage as a result of the footwear being prescribed and then not worn. In the UK, the women were more likely to passively accept the footwear with the only choice being to reject it once it had been provided. All the women were vocal about what would improve their experiences and this centred on the consultation with both the referring practitioner and the practitioner that provides the footwear. Conclusion: This unique study, carried out in three countries has revealed emotive and personal accounts of what it is like to have an item of clothing replaced with an ‘intervention’. The participant’s experience of their consultations with practitioners has revealed the tension between the practitioners’ requirements and the women’s ‘social’ needs. Practitioners need greater understanding of the social and emotional consequences of using therapeutic footwear as an intervention

Understanding the drivers of extensive plant damage in boreal and Arctic ecosystems: Insights from field surveys in the aftermath of damage.

The exact cause of population dieback in nature is often challenging to identify retrospectively. Plant research in northern regions has in recent decades been largely focussed on the opposite trend, namely increasing populations and higher productivity. However, a recent unexpected decline in remotely-sensed estimates of terrestrial Arctic primary productivity suggests that warmer northern lands do not necessarily result in higher productivity. As large-scale plant dieback may become more frequent at high northern latitudes with increasing frequency of extreme events, understanding the drivers of plant dieback is especially urgent. Here, we report on recent extensive damage to dominant, short, perennial heath and tundra plant populations in boreal and Arctic Norway, and assess the potential drivers of this damage. In the High-Arctic archipelago of Svalbard, we recorded that 8-50% of Cassiope tetragona and Dryas octopetala shoots were dead, and that the ratios of dead shoots increased from 2014 to 2015. In boreal Norway, 38-63% of Calluna vulgaris shoots were dead, while Vaccinium myrtillus had damage to 91% of shoots in forested sites, but was healthy in non-forested sites. Analyses of numerous sources of environmental information clearly point towards a winter climate-related reason for damage to three of these four species. In Svalbard, the winters of 2011/12 and 2014/15 were documented to be unusually severe, i.e. insulation from ambient temperature fluctuation by snow was largely absent, and ground-ice enforced additional stress. In boreal Norway, the 2013/14 winter had a long period with very little snow combined with extremely low precipitation rates, something which resulted in frost drought of uncovered Calluna plants. However, extensive outbreaks of a leaf-defoliating geometrid moth were identified as the driver of Vaccinium mortality. These results suggest that weather and biotic extreme events potentially have strong impacts on the vegetation state of northern lands

‘Is it worth potentially dealing with someone who won't get it?’: LGBTQA+ university students’ perspectives on mental health care

LGBTQA+ university students have unique mental health needs and high rates of mental distress compared to their cisgender heterosexual peers; however, it is likely that many LGBTQA+ individuals remain untreated or receive inappropriate or insensitive care. The aim of this study was to explore the experiences and preferences in mental health care of LGBTQA+ university students in Aotearoa New Zealand. Twenty-eight young adults participated across 12 focus groups or interviews in which they were asked about their experiences and preferences. We used thematic analysis to identify patterns of meaning in the data. Researchers developed three themes of I can do this on my own, but others should seek help; you have to be lucky to access mental health care; and ‘therapists just need to be a bit more like up with the programme’. The results of this study mirror those found in more general studies of LGBTQA+ mental healthcare experiences, however, also adds to considerations for university campus healthcare services. The findings of this study should be considered by all mental health providers working with LGBTQA+ young adult university students

‘We’ll be okay together’: navigating challenges as queer university students in Aotearoa New Zealand

Queer university students face multiple stressors which can contribute to mental health difficulties, including minority stressors unique to their queer identities. However, there is little literature exploring stressors faced by queer individuals in university settings. The aim of this study was to qualitatively explore the current challenges and strengths faced by queer university students in Aotearoa New Zealand, in order to contextualise their mental health experiences. Twenty-eight queer students participated across 12 focus groups or interviews. Two queer researchers thematically analysed the data. Three themes were interpreted from the data: ‘That’s not feminine enough’: the impact of societal ideologies on queer students; ‘There’s one rainbow person in the room’: Tokenism, social isolation, and then finding community; and ‘You know what it’s like to not be heard’: The transformation of challenges into strengths. The findings illustrate how queer university students make meaning of their challenges, and the strengths they develop to mitigate these. Educational institutions are highlighted as important sites of systemic change, to reduce minority stressors in students’ lives