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  • Bech, B, et al. (författare)
  • 2018 update of the EULAR recommendations for the role of the nurse in the management of chronic inflammatory arthritis
  • 2020
  • Ingår i: Annals of the rheumatic diseases. - : BMJ. - 1468-2060 .- 0003-4967. ; 79:1, s. 61-68
  • Tidskriftsartikel (refereegranskat)abstract
    • To update the European League Against Rheumatism (EULAR) recommendations for the role of the nurse in the management of chronic inflammatory arthritis (CIA) using the most up to date evidence. The EULAR standardised operating procedures were followed. A task force of rheumatologists, health professionals and patients, representing 17 European countries updated the recommendations, based on a systematic literature review and expert consensus. Higher level of evidence and new insights into nursing care for patients with CIA were added to the recommendation. Level of agreement was obtained by email voting. The search identified 2609 records, of which 51 (41 papers, 10 abstracts), mostly on rheumatoid arthritis, were included. Based on consensus, the task force formulated three overarching principles and eight recommendations. One recommendation remained unchanged, six were reworded, two were merged and one was reformulated as an overarching principle. Two additional overarching principles were formulated. The overarching principles emphasise the nurse’s role as part of a healthcare team, describe the importance of providing evidence-based care and endorse shared decision-making in the nursing consultation with the patient. The recommendations cover the contribution of rheumatology nursing in needs-based patient education, satisfaction with care, timely access to care, disease management, efficiency of care, psychosocial support and the promotion of self-management. The level of agreement among task force members was high (mean 9.7, range 9.6-10.0). The updated recommendations encompass three overarching principles and eight evidence-based and expert opinion-based recommendations for the role of the nurse in the management of CIA.
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  • Dures, E., et al. (författare)
  • 2023 EULAR recommendations for the management of fatigue in people with inflammatory rheumatic and musculoskeletal diseases
  • 2023
  • Ingår i: Annals of the Rheumatic Diseases. - 0003-4967 .- 1468-2060.
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives Fatigue is prevalent in people with inflammatory rheumatic and musculoskeletal diseases (I-RMDs) and recognised as one of the most challenging symptoms to manage. The existence of multiple factors associated with driving and maintaining fatigue, and the evidence about what improves fatigue has led to a multifaceted approach to its management. However, there are no recommendations for fatigue management in people with I-RMDs. This lack of guidance is challenging for those living with fatigue and health professionals delivering clinical care. Therefore, our aim was to develop EULAR recommendations for the management of fatigue in people with I-RMDs.Methods A multidisciplinary taskforce comprising 26 members from 14 European countries was convened, and two systematic reviews were conducted. The taskforce developed the recommendations based on the systematic review of evidence supplemented with taskforce members' experience of fatigue in I-RMDs.Results Four overarching principles (OAPs) and four recommendations were developed. OAPs include health professionals' awareness that fatigue encompasses multiple biological, psychological and social factors which should inform clinical care. Fatigue should be monitored and assessed, and people with I-RMDs should be offered management options. Recommendations include offering tailored physical activity and/or tailored psychoeducational interventions and/or, if clinically indicated, immunomodulatory treatment initiation or change. Patient-centred fatigue management should consider the individual's needs and preferences, their clinical disease activity, comorbidities and other psychosocial and contextual factors through shared decision-making.Conclusions These 2023 EULAR recommendations provide consensus and up-to-date guidance on fatigue management in people with I-RMDs.
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  • Ungstrup, E., et al. (författare)
  • Rocket-borne particle, field, and plasma observations in the cleft region
  • 1975
  • Ingår i: Geophysical Research Letters. - 0094-8276 .- 1944-8007. ; 2:7, s. 345-348
  • Tidskriftsartikel (refereegranskat)abstract
    • First results of comprehensive observations of magnetic and electric fields, and ambient and suprathermal plasmas above the dayside auroral oval with rocket-borne instrumentation which penetrated the cleft region are reported. Measurements were also obtained equatorward and poleward of the cleft. Convection velocities as inferred from electric field measurements were generally toward noon equatorward of the cleft and were antisunward over the polar cap. Our observations of electron temperatures, electric fields and low-frequency electrostatic noise provide strong evidence of a plasma instability (Farley-Buneman) in the E-layer, which is associated with the appearance of the ‘slant E condition’ identified in ground-acquired ionograms. The positions of these measurements relative to that of the cleft were firmly established via the determination of the plasma environment with an electrostatic analyzer.
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  • Agca, R., et al. (författare)
  • EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update
  • 2017
  • Ingår i: Ann Rheum Dis. - : BMJ. - 0003-4967 .- 1468-2060. ; 76:1, s. 17-28
  • Tidskriftsartikel (refereegranskat)abstract
    • Patients with rheumatoid arthritis (RA) and other inflammatory joint disorders (IJD) have increased cardiovascular disease (CVD) risk compared with the general population. In 2009, the European League Against Rheumatism (EULAR) taskforce recommended screening, identification of CVD risk factors and CVD risk management largely based on expert opinion. In view of substantial new evidence, an update was conducted with the aim of producing CVD risk management recommendations for patients with IJD that now incorporates an increasing evidence base. A multidisciplinary steering committee (representing 13 European countries) comprised 26 members including patient representatives, rheumatologists, cardiologists, internists, epidemiologists, a health professional and fellows. Systematic literature searches were performed and evidence was categorised according to standard guidelines. The evidence was discussed and summarised by the experts in the course of a consensus finding and voting process. Three overarching principles were defined. First, there is a higher risk for CVD in patients with RA, and this may also apply to ankylosing spondylitis and psoriatic arthritis. Second, the rheumatologist is responsible for CVD risk management in patients with IJD. Third, the use of non-steroidal anti-inflammatory drugs and corticosteroids should be in accordance with treatment-specific recommendations from EULAR and Assessment of Spondyloarthritis International Society. Ten recommendations were defined, of which one is new and six were changed compared with the 2009 recommendations. Each designated an appropriate evidence support level. The present update extends on the evidence that CVD risk in the whole spectrum of IJD is increased. This underscores the need for CVD risk management in these patients. These recommendations are defined to provide assistance in CVD risk management in IJD, based on expert opinion and scientific evidence.
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  • Blomberg, Lars G., et al. (författare)
  • EMMA - the electric and magnetic monitor of the aurora on Astrid-2
  • 2004
  • Ingår i: Annales Geophysicae. - : Copernicus GmbH. - 0992-7689 .- 1432-0576. ; 22:1, s. 115-123
  • Tidskriftsartikel (refereegranskat)abstract
    • The Astrid-2 mission has dual primary objectives. First, it is an orbiting instrument platform for studying auroral electrodynamics. Second, it is a technology demonstration of the feasibility of using micro-satellites for innovative space plasma physics research. The EMMA instrument, which we discuss in the present paper, is designed to provide simultaneous sampling of two electric and three magnetic field components up to about 1 kHz. The spin plane components of the electric field are measured by two pairs of opposing probes extended by wire booms with a separation distance of 6.7 m. The probes have titanium nitride (TiN) surfaces. which has proved to be a material with excellent properties for providing good electrical contact between probe and plasma. The wire booms are of a new design in which the booms in the stowed position are wound around the exterior of the spacecraft body. The boom system was flown for the first time on this mission and worked flawlessly. The magnetic field is measured by a tri-axial fluxgate sensor located at the tip of a rigid. hinged boom extended along the spacecraft spin axis and facing away from the Sun. The new advanced-design fluxgate magnetometer uses digital signal processors for detection and feedback, thereby reducing the analogue circuitry to a minimum. The instrument characteristics as well as a brief review of the science accomplished and planned are presented.
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  • Danielides, M. A., et al. (författare)
  • Measurement of Auroral characteristics by Auroral Turbulence II sounding rocket
  • 1999
  • Ingår i: Geophysica. - 0367-4231 .- 2324-0741. ; 35:1-2, s. 33-44
  • Tidskriftsartikel (refereegranskat)abstract
    • The Auroral Turbulence II sounding rocket was launched into a moderately active night-side aurora from the Poker Flat Research Range, Alaska, US. This unique three payload rocket experiment contained both electric and magnetic field, and particle instruments, which provided three point measurements over a wide range of scales. The payloads passed through several auroral arcs providing details of the auroral fine structure and the three point measurements allowed the distinction of spatial and temporal variations. The rocket data are compared with optical observations with special emphasis on a large quiet arc traversed in the middle of the flight. The observed features and field-aligned current densities are found to agree with earlier studies.
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  • Ivchenko, Nickolay, et al. (författare)
  • Quasiperiodic oscillations observed at the edge of an auroral arc by Auroral Turbulence 2
  • 1999
  • Ingår i: Geophysical Research Letters. - 0094-8276 .- 1944-8007. ; 26:22, s. 3365-3368
  • Tidskriftsartikel (refereegranskat)abstract
    • The Auroral Turbulence II (AT2) sounding rocket carried three payloads into the auroral ionosphere where they crossed several are structures. At the border of an auroral are a quasiperiodic structure was observed by the magnetic and electric field instruments as well as by the particle detectors. The variations were temporal oscillations, but existed only in a narrow (approximate to 7 km) region transverse to the are, with a correlation length along the are of at least several km. The relation between the electric and magnetic field amplitude indicates the Alfvenic nature of the variations. Field aligned electron precipitation is correlated to the field variations. The narrow band nature of the oscillations and frequency around 0.6 Hz is consistent with waves confined in the ionospheric Alfven resonator.
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  • Lynch, A., et al. (författare)
  • Multiple-point electron measurements in a nightside auroral arc : Auroral Turbulence II particle observations
  • 1999
  • Ingår i: Geophysical Research Letters. - 0094-8276 .- 1944-8007. ; 26:22, s. 3361-3364
  • Tidskriftsartikel (refereegranskat)abstract
    • We report here three-point measurements of bursty, velocity-dispersed, field-aligned electron precipitation at the poleward edge of a northward-moving, post-breakup, nightside auroral arc. The three-point measurement allows detection of the proper motion of the inverted-V arc, which is shown to be 550 m/sec northward. The velocity dispersion patterns are fitted to find the source altitude of the precipitation bursts as a function of distance from the poleward edge of the are. These source points are interpreted to trace out the low-altitude boundary of the inverted-V potential drop, which is seen to rise both in time, and in the northward direction. The precipitation bursts under the inverted-V are seen to have an are-aligned velocity which varies with time, and which is consistent with the measured E x B local drift speed.
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  • Ritschl, Valentin, et al. (författare)
  • 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
  • 2023
  • Ingår i: RMD Open. - : BMJ PUBLISHING GROUP. - 2056-5933. ; 9:2
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundOngoing 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 participantsWe 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.ResultsThe 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.ConclusionsTo promote the uptake of EULAR educational offerings, attention is needed to increase awareness among national organisations, offer accessible participation costs, and address language barriers.
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  • Sperl, L, et al. (författare)
  • EDUCATIONAL NEEDS AMONG HEALTH PROFESSIONALS IN RHEUMATOLOGY: LOW AWARENESS OF EULAR OFFERINGS AND UNFAMILIARITY WITH COURSE CONTENT AS A MAJOR BARRIER - A EULAR FUNDED EUROPEAN SURVEY
  • 2022
  • Ingår i: ANNALS OF THE RHEUMATIC DISEASES. - : BMJ. - 0003-4967 .- 1468-2060. ; 81, s. 139-140
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Health professionals in rheumatology (HPRs) should participate in post-graduate or continuous education to update and advance their knowledge and skills. This can improve patient outcomes and increase quality of care.1 EULAR aims to become a leading provider of postgraduate education for HPRs.ObjectivesThe aims of this study were to evaluate the current motivations for participating in postgraduate education of HPRs, identify barriers and facilitators for participation in postgraduate education, and evaluate participation in the current educational offerings of EULAR for HPRs across Europe.MethodsAn online survey was developed and distributed in collaboration with the EULAR Standing Committee of Education and Training (ESCET) and the Paediatric Rheumatology European Society (PReS). The questionnaire was translated by national HPR representatives in 24 languages to cover the 25 national member organisations. Barriers were assessed using 5-point Likert scales, higher scores representing higher barriers. Quantitative data were analysed using descriptive statistics. In addition, we ran the Latent Dirichlet Allocation (LDA) on the answers to the open questions. LDA is an unsupervised probabilistic topic modelling technique that extracts the meanings of a pre-defined number of topics. Design of the survey and reporting of results were done according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES).ResultsThe online questionnaire was accessed 3,589 times but only 667 complete responses were recorded. HPRs from 34 European countries responded to the survey; 80% of whom were women. The highest-ranked educational need was prevention, including lifestyle interventions and professional development. Although EULAR was well known among HPRs, only 32.1% of HPRs in adult care and 18.6% of HPRs in paediatric care have ever heard of the EULAR School of Rheumatology (Table 1 A).Table 1.A: Feedback on EULAR. Data are presented separately for HPRs in adult and paediatric care; except for the filter questions, no mandatory questions were included in the survey. To clarify the number of responses per question, the number of valid answers for each question was reported.VariablesHPRs in adult careHPRs in paediatric careHave you ever heard of the EULAR School of Rheumatology?61443  I am not sure, n(%)62 (10.1%)7 (16.3%)  No, n(%)355 (57.8%)28 (65.1%)  Yes, n(%)197 (32.1%)8 (18.6%)Are you aware of courses offered by the EULAR School of Rheumatology? (sub question)1978  I am not sure, n(%)30 (15.2%)2 (25.0%)  No, n(%)63 (32.0%)5 (62.5%)  Yes, n(%)104 (52.8%)1 (12.5%)Have you ever attended one of the EULAR School of Rheumatology courses? (sub question)1031  I am not sure, n(%)1 (1.0%)0  No, n(%)47 (45.6%)0  Yes, n(%)55 (53.4%)1 (100%)Have you ever participated in a EULAR annual congress meeting?61843  I am not sure, n(%)11 (1.8%)0  No, n(%)457 (73.9%)39 (90.7%)  Yes, n(%)150 (24.3%)4 (9.3%)The main barriers to participation in EULAR’s educational offerings were identified by HPRs in adult care and in paediatric care (respectively) as: the unfamiliarity with the course content (3.48 [±1.50]; 3.92 [±1.46]), the associated costs (3.44 [±1.35]; 3.69 [±1.28]) and English language (2.59 [±1.50]; 2.80 [±1.34]).ConclusionEULAR is well-known by HPRs in Europe, however, awareness of educational offerings is low and barriers to participation are numerous. To become the leading provider of postgraduate training by 2023, EULAR could use a “franchise” model that can be tailored to local conditions. This could be achieved by strengthening national organizations by actively involving them in the development of training programs and disseminating these programs and offerings through their networks.References[1]World Health Organization. Health workforce: Education and training: World Health Organization; 2019 [Available from: https://www.who.int/hrh/education/en/ accessed November, 2019 2019.Disclosure of InterestsLisa Sperl: None declared, Tanja Stamm Speakers bureau: AbbVie, Novartis, Roche, Sanofi, and Takeda, Consultant of: AbbVie and Sanofi Genzyme, Grant/research support from: AbbVie and Roche, Margaret Renn Andrews: None declared, Mathilda Bjork: None declared, Carina Boström: None declared, Jeannette Cappon: None declared, Jenny de la Torre-Aboki: None declared, Annette de Thurah: None declared, Andrea Domjan: None declared, Razvan Dragoi Speakers bureau: Received speaker fees last year from: Pfizer, Elly Lilly, Sandoz, Abbvie, Secom, EwoPharma, Fernando Estevez-Lopez: None declared, Ricardo J. O. Ferreira: None declared, George E. Fragoulis: None declared, Jolanta Grygielska: None declared, Katti Korve: None declared, Marja Leena Kukkurainen: None declared, Christel Madelaine-Bonjour: None declared, Andrea Marques: None declared, Jorit Meesters: None declared, Rikke Helene Moe: None declared, Ellen Moholt: None declared, Erika Mosor: None declared, Claudia Naimer-Stach: None declared, Mwidimi Ndosi: None declared, Polina Pchelnikova: None declared, Jette Primdahl: None declared, Polina Putrik: None declared, Anne-Kathrin Rausch Osthoff: None declared, Hana Smucrova: None declared, Sinisa Stefanac: None declared, Marco Testa: None declared, Leti van Bodegom-Vos: None declared, Wilfred Peter: None declared, Heidi A. Zangi: None declared, Olena Zimba: None declared, T.P.M. Vliet Vlieland: None declared, Valentin Ritschl: None declared
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