Predictors of outcome after 6 and 12 months following anthroposophic therapy for adult outpatients with chronic disease: a secondary analysis from a prospective observational study

<p>Abstract</p> <p>Background</p> <p>Anthroposophic medicine is a physician-provided complementary therapy system involving counselling, artistic and physical therapies, and special medications. The purpose of this analysis was to identify predictors of symptom improvement in patients receiving anthroposophic treatment for chronic diseases.</p> <p>Methods</p> <p>913 adult outpatients from Germany participated in a prospective cohort study. Patients were starting anthroposophic treatment for mental (30.4% of patients, n = 278/913), musculoskeletal (20.2%), neurological (7.6%), genitourinary (7.4%) or respiratory disorders (7.2%) or other chronic indications. Stepwise multiple linear regression analysis was performed with the improvement of Symptom Score (patients' assessment, 0: not present, 10: worst possible) after 6 and 12 months as dependent variables. 61 independent variables pertaining to socio-demographics, life style, disease status, co-morbidity, health status (SF-36), depression, and therapy factors were analysed.</p> <p>Results</p> <p>Compared to baseline, Symptom Score improved by average 2.53 points (95% confidence interval 2.39-2.68, p < 0.001) after six months and by 2.49 points (2.32-2.65, p < 0.001) after 12 months. The strongest predictor for improvement after six months was baseline Symptom Score, which alone accounted for 25% of the variance (total model 32%). Improvement after six months was also positively predicted by better physical function, better general health, shorter disease duration, higher education level, a diagnosis of respiratory disorders, and by a higher therapy goal documented by the physician at baseline; and negatively predicted by the number of physiotherapy sessions in the pre-study year and by a diagnosis of genitourinary disorders. Seven of these nine variables (not the two diagnoses) also predicted improvement after 12 months. When repeating the 0-6 month analysis on two random subsamples of the original sample, three variables (baseline Symptom Score, physical function, general health) remained significant predictors in both analyses, and three further variables (education level, respiratory disorders, therapy goal) were significant in one analysis.</p> <p>Conclusion</p> <p>In adult outpatients receiving anthroposophic treatment for chronic diseases, symptom improvement after 6 and 12 months was predicted by baseline symptoms, health status, disease duration, education, and therapy goal. Other variables were not associated with the outcome. This secondary predictor analysis of data from a pre-post study does not allow for causal conclusions; the results are hypothesis generating and need verification in subsequent studies.</p

Dietary beauvericin and enniatin B exposure cause different adverse health effects in farmed Atlantic salmon

The extensive use of plant ingredients in novel aquafeeds have introduced mycotoxins to the farming of seafood. The emerging enniatin B (ENNB) and beauvericin (BEA) mycotoxins have been found in the novel aquafeeds and farmed fish. Little is known about the potential toxicity of ENNs and BEA in farmed fish and their feed-to-organ transfer. Atlantic salmon (Salmo salar) presmolt (75.3 +/- 8.10 g) were fed four graded levels of spiked chemical pure ENNB or BEA feeds for three months, in triplicate tanks. Organismal adverse health end-point assessment included intestinal function (protein digestibility), disturbed hematology (red blood cell formation), bone formation (spinal deformity), overall energy use (feed utilization), and lipid oxidative status (vitamin E). Both dietary BEA and ENNB had a low ( liver > brain > muscle), with a higher transfer for ENNB compared to BEA. BEA caused a growth reduction combined with a decreased protein digestion and feed conversion rate-ENNB caused a stunted growth, unrelated to feed utilization capacity. In addition, ENNB caused anemia while BEA gave an oxidative stress response. Lower bench-mark dose regression assessment showed that high background levels of ENNB in commercial salmon feed could pose a risk for animal health, but not in the case of BEA.Grant 281032 HAVBRUK2;info:eu-repo/semantics/publishedVersio

Eurythmy therapy in chronic disease: a four-year prospective cohort study

<p>Abstract</p> <p>Background</p> <p>Many patients with chronic diseases use complementary therapies, often provided by their physicians. In Germany, several physician-provided complementary therapies have been reimbursed by health insurance companies as part of health benefit programs. In most of these therapies, the patient has a predominantly passive role. In eurythmy therapy, however, patients actively exercise specific movements with the hands, the feet or the whole body. The purpose of this study was to describe clinical outcomes in patients practising eurythmy therapy exercises for chronic diseases.</p> <p>Methods</p> <p>In conjunction with a health benefit program, 419 outpatients from 94 medical practices in Germany, referred to 118 eurythmy therapists, participated in a prospective cohort study. Main outcomes were disease severity (Disease and Symptom Scores, physicians' and patients' assessment on numerical rating scales 0–10) and quality of life (adults: SF-36, children aged 8–16: KINDL, children 1–7: KITA). Disease Score was documented after 0, 6 and 12 months, other outcomes after 0, 3, 6, 12, 18, 24, and (SF-36 and Symptom Score) 48 months.</p> <p>Results</p> <p>Most common indications were mental disorders (31.7% of patients; primarily depression, fatigue, and childhood emotional disorder) and musculoskeletal diseases (23.4%). Median disease duration at baseline was 3.0 years (interquartile range 1.0–8.5). Median number of eurythmy therapy sessions was 12 (interquartile range 10–19), median therapy duration was 119 days (84–188).</p> <p>All outcomes improved significantly between baseline and all subsequent follow-ups (exceptions: KITA Psychosoma in first three months and KINDL). Improvements from baseline to 12 months were: Disease Score from mean (standard deviation) 6.65 (1.81) to 3.19 (2.27) (p < 0.001), Symptom Score from 5.95 (1.75) to 3.49 (2.12) (p < 0.001), SF-36 Physical Component Summary from 43.13 (10.25) to 47.10 (9.78) (p < 0.001), SF-36 Mental Component Summary from 38.31 (11.67) to 45.01 (11.76) (p < 0.001), KITA Psychosoma from 69.53 (15.45) to 77.21 (13.60) (p = 0.001), and KITA Daily Life from 59.23 (21.78) to 68.14 (18.52) (p = 0.001). All these improvements were maintained until the last follow-up. Improvements were similar in patients not using diagnosis-related adjunctive therapies within the first six study months.</p> <p>Adverse reactions to eurythmy therapy occurred in 3.1% (13/419) of patients. No patient stopped eurythmy therapy due to adverse reactions.</p> <p>Conclusion</p> <p>Patients practising eurythmy therapy exercises had long-term improvement of chronic disease symptoms and quality of life. Although the pre-post design of the present study does not allow for conclusions about comparative effectiveness, study findings suggest that eurythmy therapy can be useful for patients motivated for this therapy.</p

Acceptability, feasibility, drug safety, and effectiveness of a pilot mass drug administration with a single round of sulfadoxine-pyrimethamine plus primaquine and indoor residual spraying in communities with malaria transmission in Haiti, 2018

For a malaria elimination strategy, Haiti's National Malaria Control Program piloted a mass drug administration (MDA) with indoor residual spraying (IRS) in 12 high-transmission areas across five communes after implementing community case management and strengthened surveillance. The MDA distributed sulfadoxine-pyrimethamine and single low-dose primaquine to eligible residents during house visits. The IRS campaign applied pirimiphos-methyl insecticide on walls of eligible houses. Pre- and post-campaign cross-sectional surveys were conducted to assess acceptability, feasibility, drug safety, and effectiveness of the combined interventions. Stated acceptability for MDA before the campaign was 99.2%; MDA coverage estimated at 10 weeks post-campaign was 89.6%. Similarly, stated acceptability of IRS at baseline was 99.9%; however, household IRS coverage was 48.9% because of the high number of ineligible houses. Effectiveness measured by Plasmodium falciparum prevalence at baseline and 10 weeks post-campaign were similar: 1.31% versus 1.43%, respectively. Prevalence of serological markers were similar at 10 weeks post-campaign compared with baseline, and increased at 6 months. No severe adverse events associated with the MDA were identified in the pilot; there were severe adverse events in a separate, subsequent campaign. Both MDA and IRS are acceptable and feasible interventions in Haiti. Although a significant impact of a single round of MDA/IRS on malaria transmission was not found using a standard pre- and post-intervention comparison, it is possible there was blunting of the peak transmission. Seasonal malaria transmission patterns, suboptimal IRS coverage, and low baseline parasitemia may have limited the effectiveness or the ability to measure effectiveness

Vitamin C Enhances Vitamin E Status and Reduces Oxidative Stress Indicators in Sea Bass Larvae Fed High DHA Microdiets

Docosahexaenoic acid (DHA) is an essential fatty acid necessary for many biochemical, cellular and physiological functions in fish. However, high dietary levels of DHA increase free radical injury in sea bass (Dicentrarchus labrax) larvae muscle, even when vitamin E (&alpha;-tocopherol, &alpha;-TOH) is increased. Therefore, the inclusion of other nutrients with complementary antioxidant functions, such as vitamin C (ascorbic acid, vitC), could further contribute to prevent these lesions. The objective of the present study was to determine the effect of vitC inclusion (3,600 mg/kg) in high DHA (5 % DW) and &alpha;-TOH (3,000 mg/kg) microdiets (diets 5/3,000 and 5/3,000 + vitC) in comparison to a control diet (1 % DHA DW and 1,500 mg/kg of &alpha;-TOH; diet 1/1,500) on sea bass larvae growth, survival, whole body biochemical composition and thiobarbituric acid reactive substances (TBARS) content, muscle morphology, skeletal deformities and antioxidant enzymes, insulin-like growth factors (IGFs) and myosin expression (MyHC). Larvae fed diet 1/1,500 showed the best performance in terms of total length, incidence of muscular lesions and ossification degree. IGFs gene expression was elevated in 5/3,000 diet larvae, suggesting an increased muscle mitogenesis that was confirmed by the increase in the mRNA copies of MyHC. vitC effectively controlled oxidative damages in muscle, increased &alpha;-TOH larval contents and reduced TBARS content and the occurrence of skull deformities. The results of the present study showed the antioxidant synergism between vitamins E and C when high contents of DHA are included in sea bass larvae diets

Mycobacterium leprae diversity and population dynamics in medieval Europe from novel ancient genomes

Hansen’s disease (leprosy), widespread in medieval Europe, is today mainly prevalent in tropical and subtropical regions with around 200,000 new cases reported annually. Despite its long history and appearance in historical records, its origins and past dissemination patterns are still widely unknown. Applying ancient DNA approaches to its major causative agent, Mycobacterium leprae, can significantly improve our understanding of the disease’s complex history. Previous studies have identified a high genetic continuity of the pathogen over the last 1500 years and the existence of at least four M. leprae lineages in some parts of Europe since the Early Medieval period

The genome and transcriptome of Japanese flounder provide insights into flatfish asymmetry

Flatfish have the most extreme asymmetric body morphology of vertebrates. During metamorphosis, one eye migrates to the contralateral side of the skull, and this migration is accompanied by extensive craniofacial transformations and simultaneous development of lopsided body pigmentation(1-5). The evolution of this developmental and physiological innovation remains enigmatic. Comparative genomics of two flatfish and transcriptomic analyses during metamorphosis point to a role for thyroid hormone and retinoic acid signaling, as well as phototransduction pathways. We demonstrate that retinoic acid is critical in establishing asymmetric pigmentation and, via cross-talk with thyroid hormones, in modulating eye migration. The unexpected expression of the visual opsins from the phototransduction pathway in the skin translates illumination differences and generates retinoic acid gradients that underlie the generation of asymmetry. Identifying the genetic underpinning of this unique developmental process answers long-standing questions about the evolutionary origin of asymmetry, but it also provides insight into the mechanisms that control body shape in vertebrates.National Natural Science Foundation of China [31130057, 31461163005, 31530078, 31472269, 31472262, 31472273]; State 863 High Technology R&D Project of China [2012AA092203, 2012AA10A408, 2012AA10A403-2]; Education and Research of Guangdong Province [2013B090800017]; Taishan Scholar Climb Project Fund of Shandong of China; Taishan Scholar Project Fund of Shandong of China for Young Scientists; Shanghai Universities First-class Disciplines Project of Fisheries; Program for Professor of Special Appointment (Eastern Scholar) at the Shanghai Institutions of Higher Learning; Shanghai Municipal Science, Special Project on the Integration of Industryinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/publishedVersio

On the Variability of the Length Weight Relationship for Atlantic Bluefin Tuna, Thunnus thynnus (L.)

Following extensive review, a model of the Atlantic bluefin tuna (ABFT), Thunnus thynnus (L.), length–weight relationship for the eastern Atlantic and Mediterranean (RW = 0.0000188 SFL3.01247; Ec 1) is presented on the basis of samples of ABFT spawners, with an average value of index K = 2.03 ± 0.15SD, collected by the Atlantic traps of Portugal and Spain in the Strait of Gibraltar (1963; 1996–1998; 2000–2012), and a set of samples of juvenile fishes from ICCAT–GBYP (n = 707). The resulting model (Ec 1), together with the model used for the eastern stock assessment (RW = 0.000019607 SFL3.0092; Ec 2) and a recently adopted by ICCAT Standing Committee on Research and Statistics (SCRS) (RW = 0.0000315551 SFL2.898454; EAST) are analyzed in using a bi-variant sample [SFL (cm), RW (kg)] of 474 pairs of data with the aim of validating them and establishing which model(s) best fit the reality represented by the sample and, therefore, will have the greatest descriptive and predictive power. The result of the analysis indicates that the model EAST clearly underestimates the weight of spawning ABFT and that model Ec 2 overestimates it slightly, being model Ec 1 that best explains the data of the sample. The result of the classical statistical analysis is confirmed by means of the quantile regression technique, selecting the quantiles 5, 25, 50, 75, and 95%. Other fisheries and biological indicators also conclude that the model EAST gradually underestimates the weight of ABFT spawners (of 2–3 m) by 9–12.5 %, and does not meet the criterion that for RW = 725 kg (Wmax), SFL = 319.93 ± 11.3 cm (Lmax).Cort, JL.; Estruch Fuster, VD.; Neves Dos Santos, M.; Di Natale, A.; Abid, N.; De La Serna, JM. (2015). On the Variability of the Length Weight Relationship for Atlantic Bluefin Tuna, Thunnus thynnus (L.). Reviews in Fisheries Science & Aquaculture. 23(1):23-38. doi:10.1080/23308249.2015.1008625S2338231Aguado-Giménez, F., & García-García, B. (2005). Changes in some morphometric relationships in Atlantic bluefin tuna (Thunnus thynnus thynnus Linnaeus, 1758) as a result of fattening process. Aquaculture, 249(1-4), 303-309. doi:10.1016/j.aquaculture.2005.04.064Block, B. A., Teo, S. L. H., Walli, A., Boustany, A., Stokesbury, M. J. W., Farwell, C. J., … Williams, T. D. (2005). Electronic tagging and population structure of Atlantic bluefin tuna. Nature, 434(7037), 1121-1127. doi:10.1038/nature03463Chapman, E. W., Jørgensen, C., & Lutcavage, M. E. (2011). Atlantic bluefin tuna (Thunnus thynnus): a state-dependent energy allocation model for growth, maturation, and reproductive investment. Canadian Journal of Fisheries and Aquatic Sciences, 68(11), 1934-1951. doi:10.1139/f2011-109Cort, J. L., Arregui, I., Estruch, V. D., & Deguara, S. (2014). Validation of the Growth Equation Applicable to the Eastern Atlantic Bluefin Tuna,Thunnus thynnus(L.), UsingLmax, Tag-Recapture, and First Dorsal Spine Analysis. Reviews in Fisheries Science & Aquaculture, 22(3), 239-255. doi:10.1080/23308249.2014.931173Cort, J. L., Deguara, S., Galaz, T., Mèlich, B., Artetxe, I., Arregi, I., … Idrissi, M. (2013). Determination ofLmaxfor Atlantic Bluefin Tuna,Thunnus thynnus(L.), from Meta-Analysis of Published and Available Biometric Data. Reviews in Fisheries Science, 21(2), 181-212. doi:10.1080/10641262.2013.793284Fraser, K.Possessed. World Record Holder for Bluefin Tuna. Kingstown, Nova Scotia: T & S Office Essentials and printing, 243 pp. (2008).Fromentin, J.-M., & Powers, J. E. (2005). Atlantic bluefin tuna: population dynamics, ecology, fisheries and management. Fish and Fisheries, 6(4), 281-306. doi:10.1111/j.1467-2979.2005.00197.xHattour, A.Contribution a l’étude des Scombridés de Tunisie. Université de Tunis. Faculté des Sciences, 168 pp. (1979).Karakulak, S., Oray, I., Corriero, A., Deflorio, M., Santamaria, N., Desantis, S., & De Metrio, G. (2004). Evidence of a spawning area for the bluefin tuna (Thunnus thynnus L.) in the eastern Mediterranean. Journal of Applied Ichthyology, 20(4), 318-320. doi:10.1111/j.1439-0426.2004.00561.xKoenker, R., & Bassett, G. (1978). Regression Quantiles. Econometrica, 46(1), 33. doi:10.2307/1913643Koenker, R. (2005). Quantile Regression. doi:10.1017/cbo9780511754098Milatou, N., & Megalofonou, P. (2014). Age structure and growth of bluefin tuna (Thunnus thynnus, L.) in the capture-based aquaculture in the Mediterranean Sea. Aquaculture, 424-425, 35-44. doi:10.1016/j.aquaculture.2013.12.037Perçin, F., & Akyol, O. (2009). Lengthâ weight and lengthâ length relationships of the bluefin tuna,Thunnus thynnusL., in the Turkish part of the eastern Mediterranean Sea. Journal of Applied Ichthyology, 25(6), 782-784. doi:10.1111/j.1439-0426.2009.01288.xPercin, F., & Akyol, O. (2010). Some Morphometric Relationships in Fattened Bluefin Tuna, Thunnus thynnus L., from the Turkish Aegean Sea. Journal of Animal and Veterinary Advances, 9(11), 1684-1688. doi:10.3923/javaa.2010.1684.1688Rooker, J. R., Alvarado Bremer, J. R., Block, B. A., Dewar, H., de Metrio, G., Corriero, A., … Secor, D. H. (2007). Life History and Stock Structure of Atlantic Bluefin Tuna (Thunnus thynnus). Reviews in Fisheries Science, 15(4), 265-310. doi:10.1080/10641260701484135Sinovcic, G., Franicevic, M., Zorica, B., & Cikes-Kec, V. (2004). Length-weight and length-length relationships for 10 pelagic fish species from the Adriatic Sea (Croatia). Journal of Applied Ichthyology, 20(2), 156-158. doi:10.1046/j.1439-0426.2003.00519.xTičina, V., Grubišić, L., Šegvić Bubić, T., & Katavić, I. (2011). Biometric characteristics of small Atlantic bluefin tuna (Thunnus thynnus, Linnaeus, 1758) of Mediterranean Sea origin. Journal of Applied Ichthyology, 27(4), 971-976. doi:10.1111/j.1439-0426.2011.01752.

Teacher Wellbeing: The Importance of Teacher–Student Relationships

Many studies have examined the importance of teacher-student relationships for the development of children. Much less is known, however, about how these relationships impact the professional and personal lives of teachers. This review considers the importance of teacher-student relationships for the wellbeing of teachers guided by the Transactional Model of Stress and Coping of Lazarus (1991). Based on theories on interpersonal relationships, it is postulated that teachers have a basic need for relatedness with the students in their class that originates from the close proximity between teacher and student. It is discussed that teachers internalize experiences with students in representational models of relationships that guide emotional responses in daily interactions with students, and changes teacher wellbeing in the long run. In addition, the notion of mental representations of relationships at different levels of generalization could offer a window to understand how individual teacher-student relationships may affect the professional and personal self-esteem of teachers. Lastly, it is argued that the influence of student misbehavior on teacher stress may be more fully understood from a relationship perspective. The review shows that few studies have directly tested these propositions and offers suggestions for future research