Should Quantitative Measures and Management of Rheumatoid Arthritis Include More Than Control of Inflammatory Activity?

We agree strongly with Kremer et al that "metrics are essential for evaluating disease activity in patients with rheumatoid arthritis (RA)."1 Nonetheless, data reported from the Corrona and the Brigham and Women's Rheumatoid Arthritis Sequential Study (BRASS) registries for Clinical Disease Activity Index (CDAI) and Routine Assessment of Patient Index Data 3 (RAPID3) are quite similar to those reported in the initial 2008 RAPID3 report.2

Intranasal sufentanil compared with a classic protocol for acute pain management in an emergency department: A prospective sequential study

Introduction Pain is a frequent complaint in the emergency department and should be measured and treated according to the existing protocols. The intranasal route offers several advantages over the oral or intravenous routes. The aim of the study was to evaluate the efficacy and safety of intranasal sufentanil as the primary opioid for acute pain in the emergency department. Materials and methods This was a prospective open-label sequential study in patients who presented to the emergency department with severe non-visceral pain. The control group was treated according to the current standard of care including oral or intravenous opioids whereas the intervention group was treated according to a modified protocol, including intranasal sufentanil as the only opioid. Pain intensity was measured at different time points. The occurrence of side effects, the placement of intravenous lines and the need for additional analgesia were also recorded. Results Pain intensity in the two groups was not comparable at baseline (8.5; IQR 8–10 in the intervention group vs 7.9; IQR 7–9.4 in the control group; p = .026). However, the median reduction of the pain score was significantly larger in the intervention group compared to the control group after 15 minutes (2.5; IQR 1.2 – 4 vs 1.6; IQR 1–2.4; p = .005) and after 30 min (4; IQR 3–5.7 vs 3.1; IQR 2–4.4; p = .02). No significant difference in pain scores between the two groups was observed after 60 min from baseline. Conclusions Patients receiving intranasal sufentanil for severe pain achieved better pain relief at 15 min and 30 min compared to those receiving standard care. Vertigo, nausea, vomiting and diaphoresis were side effects more frequently observed in the sufentanil group. No differences in pain relief were observed after 30 and 60 min from baseline.

Exploring the Impact of an Open Access Mindfulness Course with Online Graduate Students: A Mixed Methods Explanatory Sequential Study

As enrollment in online graduate education increases, retention continues to be problematic for many colleges and universities across the United States. Non-traditional students, who represent the majority of online graduate student enrollment, have unique issues related to persistence considering they often must juggle the demands of graduate school with work and families. The competing demands can lead to increased levels of perceived stress, which can impact academic performance due to increased mind wandering and decreased attention. Mindfulness is a practice that has been shown in the literature to decrease levels of perceived stress and mind wandering, therefore, the integration of mindfulness practice could have a positive effect on student persistence in online graduate education. Therefore, an online open access mindfulness course was created at one large urban university. The purpose of this explanatory sequential study was to explore the impact of teaching mindfulness to online graduate students. Self-report levels of perceived stress and mind wandering were significantly lower after students completed Module One of an open access mindfulness course. Self-reported perceived persistence levels were found to be significantly higher after Module One with students in the first or second quarter of their program, students with little or no mindfulness experience, and students who meditated four or more times a week. Furthermore, students interviewed felt that the course provided excellent foundational information about mindfulness that could be immediately applied, and therefore should be a requirement for all incoming students.

Season ticket holder segmentation in professional sports: an application of the sports relationship marketing model

PurposeThe segmentation of customers into homogeneous groups is well researched, reflecting its importance to marketers. Specific to professional sports, published research on customer segmentation first occurred in the early 2000s, but no studies exist based on internal data from season ticket holders, an attractive and loyal customer group which is the most important customer for professional sports teams. Thus, the purpose of this research was to fill this gap in the literature through a sequential study of season ticket holders of a professional sports club.Design/methodology/approachStudy 1 employed six focus groups (n = 56) to determine the constructs, understand the issues, and sequentially inform the survey instrument for the second study. Study 2 used an online survey (n = 1,007) to collect data on factors including socio-demographics, consumption, media engagement, fan satisfaction, future intentions and sports fan motivation.FindingsThe results identified the engagement factors and selection variables which drive season ticket holder purchase and allowed for the segmentation analysis, which identified fourteen unique fan segments for a professional sports club, generalizable to other clubs.Originality/valueThe identification of 14 segments of season ticket holders based on a sequential study framed by the sports relationship marketing model is a needed contribution for practice (i.e. a specific direction on how to efficiently allocate resources when marketing to season ticket holders) and advances our conceptual knowledge by applying the model to the context of the most loyal customers in professional sports season ticket holders.

Knowledge and beliefs about the use/abuse of oral contraceptive pills among males: A mixed-method explanatory sequential study in community pharmacy settings

Background Oral contraceptive pills (OCPs) are considered one of the most important birth control methods globally. However, these pills were designed for female administration rather than males. This study was designed to investigate patterns of OCPs use and abuse among Jordanian males, according to the community pharmacists’ observations. Method A mixed-method explanatory sequential study was conducted using an online self-administered survey, followed by semi-structured in-depth interviews for registered pharmacists, assistant pharmacists and pharmacy interns. The interviews were utilized using a conceptual framework. Inductive thematic analysis and descriptive/regression analyses were completed using Nvivo and SPSS, respectively. Results A total of 158 questionnaire responses and 22 interviews were included in our analysis. Around half (48.4%) of the questionnaire responses confirmed that males could use OCPs for hair growth enhancement, muscle gain and acne treatment 12.7%, 31.7% and 4.4%, respectively. Through the interviews, the participating pharmacists highlighted that males use OCPs mostly for bodybuilding purposes, according to recommendations by their coaches at the gym. The most abused OCPs containing estrogen (Ethinyl estradiol) and progestins (Drospirenone or Levonorgestrel). Conclusion This study provided insight into unexpected uses of OCPs by males in Jordan. Community pharmacists have a crucial role in the management of OCPs use and abuse. However, restricted regulations and monitoring must be released and implemented on the community to limit such practices.

The Use/Abuse of Oral Contraceptive Pills Among Males: A Mixed-Method Explanatory Sequential Study Over Jordanian Community Pharmacists

BackgroundOral contraceptive pills (OCPs) are considered one of the most important birth control methods in the world. However, these pills were designed for female administration rather than males. This study was designed to investigate patterns of OCPs use and abuse among Jordanian males, according to the community pharmacists’ observations.MethodA mixed-method explanatory sequential study was conducted using an online self - administered survey and semi-structured in-depth interviews for community pharmacists. The interviews were utilized using a conceptual framework. Inductive thematic analysis and descriptive/regression analyses were completed using Nvivo and SPSS, respectively.ResultsA total of 158 questionnaire responses and 22 interviews were included in our analysis. Around half (48.4%) of the questionnaire responses confirmed that males could use OCPs for hair growth enhancement, muscle gain and acne treatment 12.7%, 31.7% and 4.4%, respectively. Through the interviews, the majority of the pharmacists highlighted that most of the males use OCPs for bodybuilding purposes, according to recommendations by their coaches at the gym. The most abused OCPs containing estrogen (Ethinyl estradiol) and progestins (Drospirenone or Levonorgestrel).ConclusionThis study provided insight into unexpected uses of OCPs by males in Jordan. Community pharmacists have a crucial role in the management of OCPs use and abuse, However, restricted regulations and monitoring must be released and implemented on the community to limit such practices.