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- Mangnus, L., et al.
(author)
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Bone mineral density loss in clinically suspect arthralgia is associated with subclinical inflammation and progression to clinical arthritis
- 2017
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In: Scandinavian Journal of Rheumatology. - : TAYLOR & FRANCIS LTD. - 0300-9742 .- 1502-7732. ; 46:5, s. 364-368
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Journal article (peer-reviewed)abstract
- Objective: Peripheral bone mineral density (BMD) may be decreased in early rheumatoid arthritis (RA) but it is unknown whether BMD loss emerges before arthritis is clinically apparent. We aimed to study whether BMD loss occurs in patients with clinically suspect arthralgia (CSA), and whether it is associated with progression to clinical arthritis and magnetic resonance imaging (MRI)-detected subclinical inflammation.Method: Patients with CSA had arthralgia for amp;lt;1year and were at risk of progressing to RA according to their rheumatologists. At baseline, a 1.5T MRI was performed of unilateral metacarpophalangeal, wrist, and metatarsophalangeal joints, and scored on synovitis, bone marrow oedema, and tenosynovitis;. summing these features yielded the total MRI inflammation score. Digital X-ray radiogrammetry (DXR) was used to estimate BMD on two sequential conventional hand radiographs (mean interval between radiographs 4.4months). The change in BMD was studied; BMD loss was defined as a decrease of 2.5mg/cm(2)/month. Patients were followed for arthritis development for a median of 18.4months.Results: In CSA patients (n=108), change in BMD was negatively associated with age (=-0.03, p=0.007). BMD loss in CSA patients was associated with arthritis development [adjusted for age hazard ratio (HR)=6.1, 95% confidence interval (CI) 1.7 to 21.4] and was most frequently estimated in the months before clinical arthritis development. The total MRI inflammation scores were associated with the change in BMD (adjusted for age =-0.05, p=0.047). The total MRI inflammation score and BMD loss were both independently associated with arthritis development (HR=1.1, 95% CI 1.1 to 1.2, and HR=4.6, 95% CI 1.2 to 17.2, respectively).Conclusion: In CSA patients, severe BMD loss is associated with MRI-detectable subclinical inflammation and with progression to clinical arthritis.
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- Vervoort, Joost M., et al.
(author)
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9 Dimensions for evaluating how art and creative practice stimulate societal transformations
- 2024
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In: Ecology and Society. - : Resilience Alliance. - 1708-3087. ; 29:1
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Journal article (peer-reviewed)abstract
- There is an urgent need to engage with deep leverage points in sustainability transformations-fundamental myths, paradigms, and systems of meaning making-to open new collective horizons for action. Art and creative practice are uniquely suited to help facilitate change in these deeper transformational leverage points. However, understandings of how creative practices contribute to sustainability transformations are lacking in practice and fragmented across theory and research. This lack of understanding shapes how creative practices are evaluated and therefore funded and supported, limiting their potential for transformative impact. This paper presents the 9 Dimensions tool, created to support reflective and evaluative dialogues about links between creative practice and sustainability transformations. It was developed in a transdisciplinary process between the potential users of this tool: researchers, creative practitioners, policy makers, and funders. It also brings disciplinary perspectives on societal change from evaluation theory, sociology, anthropology, psychology, and more in connection with each other and with sustainability transformations, opening new possibilities for research. The framework consists of three categories of change, and nine dimensions: changing meanings (embodying, learning, and imagining); changing connections (caring, organizing, and inspiring); and changing power (co-creating, empowering, and subverting). We describe how the 9 Dimensions tool was developed, and describe each dimension and the structure of the tool. We report on an application of the 9 Dimensions tool to 20 creative practice projects across the European project Creative Practices for Transformational Futures (CreaTures). We discuss user reflections on the potential and challenges of the tool, and discuss insights gained from the analysis of the 20 projects. Finally, we discuss how the 9 Dimensions can effectively act as a transdisciplinary research agenda bringing creative practice further in contact with transformation research.
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