How do patients with rheumatoid arthritis perceive their self-care and self-care support? A mixed-method study.

AIM: To explore self-care and needs and preferences towards tailored self-care support of patients with rheumatoid arthritis at the outpatient clinic. DESIGN: A sequential explanatory mixed method design. METHODS: The Self-Care of Chronic Illness Inventory questionnaire, two focus groups and six semi-structured interviews were conducted between November 2021 and April 2023. Questionnaires of 107 patients were descriptively analysed. Subsequently, 11 patients and 2 healthcare professionals participated in the focus groups and 6 patients in the interviews, which were thematically analysed. RESULTS: Quantitative and qualitative data corresponded and showed that patients perform various self-care activities at an adequate level and have strategies to exert control and reduce symptoms. One key theme emerged: 'Not only being the person with rheumatoid arthritis' (RA) as patients primarily aim to get on with their lives. Nine subthemes covered self-care activities for maintaining health including staying physically active, finding the right medication and dose and adapting their diet. Patients differed in how they self-monitored their symptoms. Recognizing symptoms and finding strategies to manage symptoms included the process of body listening in which patient seek and try different strategies to find what works for them and incorporate routines. Patients experienced positive effects of a warm or cold environment. Patients felt the need for practical and emotional support from others and preferred having credible information. CONCLUSION: Patients perform adequate self-care including a diversity of self-care activities to get on with their lives and have strategies to reduce and control the symptoms and impact of RA. IMPLICATIONS: Tailoring self-care support to patients' individual needs and preferences is necessary to help patients cope with the erratic nature of the disease and maintain their quality of life. Healthcare providers need to provide practical and emotional support and use credible information to allow patients to make self-care decisions to manage their lives. REPORTING METHODS: Quantitative finding are reported according to the STROBE guidelines and qualitative finding are reported according to the COREQ guidelines. WHAT DOES THIS PAPER ADD: Patients perform various self-care activities at an adequate level and have strategies to exert control and reduce symptoms. Patients primarily aim to continue their lives and not being seen as the person with rheumatoid arthritis. Healthcare professionals need to provide practical and emotional support and use credible information to inform patients' self-care decision-making. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Perspectives and Concerns on Late Effects Regarding Sexuality among Adolescents and Young Adults Treated for Testicular Germ Cell Tumor: The PRICELESS-Study-A Qualitative Study.

This study aimed to explore perspectives and concerns regarding sexuality among adolescents and young adults (AYAs) possibly experiencing late effects after testicular germ cell tumor (TGCT) treatment. A qualitative study was performed in which semi-structured interviews were held with thirteen AYAs from a center of expertise for TGCT in the Netherlands. Data were analyzed using Braun and Clark's thematic analysis method. Seven interacting and interconnected themes were found: desire to have children, rediscovering sexuality, insecurity about sexual performance, acceptance of physical change, loss of masculinity, burden on relationship, and openness in discussing sexuality. Concerns about the desire to have children seem to play a significant role. In conclusion, TGCT patients face multiple changes (physical, emotional, relational, and sexual), followed by a difficult period of acceptance, after which a new phase of rediscovering sexuality appeared. These findings can help to make healthcare professionals aware of the underlying mechanisms and concerns about sexuality. Furthermore, insights can help to develop sexuality-themed items for a broader monitoring tool to structurally assess the late effects to support discussing sexuality.

Elucidation of the orientational order and the phase diagram of p-quinquephenyl.

The orientational order in the nematic phase of p-quinquephenyl, the pentamer of p-phenylene, has been determined by means of birefringence measurements and by wide-angle X-ray scattering (WAXS). The experimentally determined order parameters are compared with the temperature-dependent order parameter predicted by the Maier-Saupe theory. The order parameters derived from the birefringence at different temperatures in the nematic phase of p-quinquephenyl were in excellent agreement with the Maier-Saupe predictions. The values calculated from the azimuthal profiles derived from WAXS measurements were significantly lower than those determined by the birefringence measurements, especially at higher temperatures. For the birefringence measurements, alignment of the director is achieved by using polyimide alignment layers, whereas director alignment for the WAXS experiments was achieved by a magnetic field. We assign the low overall order parameters that were measured by WAXS to a lower macroscopic orientational order. In addition, upon reinvestigating the mesophase behavior of p-quinquephenyl, a monotropic smectic A phase has been observed upon cooling at 390 °C, just before the crystallization temperature is reached.

What arteries are detectable in the precarinal space on contrast-enhanced CT?

Although the precarinal space is critical in the interpretation of computed tomography (CT) of the thorax, vascular structures within the space have not been well documented. The aim of this study was to investigate vascular structures in the precarinal space that are detectable with contrast-enhanced CT scans. Contrast-enhanced CT chest scans from 90 patients aged 17-78 years (41 male, 49 female) were analyzed retrospectively. Twenty-two cadavers aged 54-93 years (13 male, 9 female) were used for gross anatomic study. We found that 9 of 90 cases of the contrast-enhanced CT scans had vessel-like structures detectable in the precarinal space, located primarily anterior to the right main bronchus. Single or double arteries were identified in the precarinal space of 19 cadavers. Thirteen of the 23 arteries observed were the right bronchial artery and 10 were the left bronchial artery. In two cadavers, a single right bronchial artery (2.5 and 4.0 mm in diameter), which could have been detected with contrast-enhanced CT, originated from the aortic arch and the root of the left subclavian artery and coursed in the precarinal space. Based on the variation in the location and size of the bronchial arteries observed in this study, we suggest that vascular structures are detectable in the precarinal space with contrast-enhanced CT, particularly anterior to the right main bronchus.