Non-pharmacological care for patients with generalized osteoarthritis: design of a randomized clinical trial

<p>Abstract</p> <p>Background</p> <p>Non-pharmacological treatment (NPT) is a useful treatment option in the management of hip or knee osteoarthritis. To our knowledge however, no studies have investigated the effect of NPT in patients with generalized osteoarthritis (GOA). The primary aim of this study is to compare the effectiveness of two currently existing health care programs with different intensity and mode of delivery on daily functioning in patients with GOA. The secondary objective is to compare the cost-effectiveness of both interventions.</p> <p>Methods/Design</p> <p>In this randomized, single blind, clinical trial with active controls, we aim to include 170 patients with GOA. The experimental intervention consist of six self-management group sessions provided by a multi-disciplinary team (occupational therapist, physiotherapist, dietician and specialized nurse). The active control group consists of two group sessions and four sessions by telephone, provided by a specialized nurse and physiotherapist. Both therapies last six weeks. Main study outcome is daily functioning during the first year after the treatment, assessed on the Health Assessment Questionnaire. Secondary outcomes are health related quality of life, specific complaints, fatigue, and costs. Illness cognitions, global perceived effect and self-efficacy, will also be assessed for a responder analysis. Outcome assessments are performed directly after the intervention, after 26 weeks and after 52 weeks.</p> <p>Discussion</p> <p>This article describes the design of a randomized, single blind, clinical trial with a one year follow up to compare the costs and effectiveness of two non-pharmacological interventions with different modes of delivery for patients with GOA.</p> <p>Trial registration</p> <p>Dutch Trial Register NTR2137</p

A review of the systematic biology of fossil and living bony-tongue fishes, Osteoglossomorpha (Actinopterygii: Teleostei)

The bony-tongue fishes, Osteoglossomorpha, have been the focus of a great deal of morphological, systematic, and evolutionary study, due in part to their basal position among extant teleostean fishes. This group includes the mooneyes (Hiodontidae), knifefishes (Notopteridae), the abu (Gymnarchidae), elephantfishes (Mormyridae), arawanas and pirarucu (Osteoglossidae), and the African butterfly fish (Pantodontidae). This morphologically heterogeneous group also has a long and diverse fossil record, including taxa from all continents and both freshwater and marine deposits. The phylogenetic relationships among most extant osteoglossomorph families are widely agreed upon. However, there is still much to discover about the systematic biology of these fishes, particularly with regard to the phylogenetic affinities of several fossil taxa, within Mormyridae, and the position of Pantodon. In this paper we review the state of knowledge for osteoglossomorph fishes. We first provide an overview of the diversity of Osteoglossomorpha, and then discuss studies of the phylogeny of Osteoglossomorpha from both morphological and molecular perspectives, as well as biogeographic analyses of the group. Finally, we offer our perspectives on future needs for research on the systematic biology of Osteoglossomorpha

Matter in Strong Magnetic Fields

The properties of matter are significantly modified by strong magnetic fields, $B>>2.35\times 10^9$ Gauss ($1 G =10^{-4} Tesla$), as are typically found on the surfaces of neutron stars. In such strong magnetic fields, the Coulomb force on an electron acts as a small perturbation compared to the magnetic force. The strong field condition can also be mimicked in laboratory semiconductors. Because of the strong magnetic confinement of electrons perpendicular to the field, atoms attain a much greater binding energy compared to the zero-field case, and various other bound states become possible, including molecular chains and three-dimensional condensed matter. This article reviews the electronic structure of atoms, molecules and bulk matter, as well as the thermodynamic properties of dense plasma, in strong magnetic fields, $10^9G << B < 10^{16}G$. The focus is on the basic physical pictures and approximate scaling relations, although various theoretical approaches and numerical results are also discussed. For the neutron star surface composed of light elements such as hydrogen or helium, the outermost layer constitutes a nondegenerate, partially ionized Coulomb plasma if $B<<10^{14}G$, and may be in the form of a condensed liquid if the magnetic field is stronger (and temperature $<10^6$ K). For the iron surface, the outermost layer of the neutron star can be in a gaseous or a condensed phase depending on the cohesive property of the iron condensate.Comment: 45 pages with 9 figures. Many small additions/changes. Accepted for publication in Rev. Mod. Phy

Large-scale wind disturbances promote tree diversity in a Central Amazon forest

Canopy gaps created by wind-throw events, or blowdowns, create a complex mosaic of forest patches varying in disturbance intensity and recovery in the Central Amazon. Using field and remote sensing data, we investigated the short-term (four-year) effects of large (&gt;2000 m2) blowdown gaps created during a single storm event in January 2005 near Manaus, Brazil, to study (i) how forest structure and composition vary with disturbance gradients and (ii) whether tree diversity is promoted by niche differentiation related to wind-throw events at the landscape scale. In the forest area affected by the blowdown, tree mortality ranged from 0 to 70%, and was highest on plateaus and slopes. Less impacted areas in the region affected by the blowdown had overlapping characteristics with a nearby unaffected forest in tree density (583±46 trees ha-1) (mean±99% Confidence Interval) and basal area (26.7±2.4 m2 ha-1). Highly impacted areas had tree density and basal area as low as 120 trees ha-1 and 14.9 m2 ha-1, respectively. In general, these structural measures correlated negatively with an index of tree mortality intensity derived from satellite imagery. Four years after the blowdown event, differences in size-distribution, fraction of resprouters, floristic composition and species diversity still correlated with disturbance measures such as tree mortality and gap size. Our results suggest that the gradients of wind disturbance intensity encompassed in large blowdown gaps (&gt;2000 m2) promote tree diversity. Specialists for particular disturbance intensities existed along the entire gradient. The existence of species or genera taking an intermediate position between undisturbed and gap specialists led to a peak of rarefied richness and diversity at intermediate disturbance levels. A diverse set of species differing widely in requirements and recruitment strategies forms the initial post-disturbance cohort, thus lending a high resilience towards wind disturbances at the community level. © 2014 Marra et al

The Research of Dr. Joanne Simpson: Fifty Years Investigating Hurricanes, Tropical Clouds and Cloud Systems

This AMS Meteorological Monographs is dedicated to Dr. Joanne Simpson for her many pioneering research efforts in tropical meteorology during her fifty-year career. Dr. Simpson's major areas of scientific research involved the "hot tower" hypothesis and its role in hurricanes, structure and maintenance of trade winds, air-sea interaction, and observations and the mechanism for hurricanes and waterspouts. She was also a pioneer in cloud modeling with the first one-dimensional model and had the first cumulus model on a computer. She also played a major role in planning and leading observational experiments on convective cloud systems. The launch of the Tropical Rainfall Measuring Mission (TRMM) satellite, a joint U.S.-Japan project, in November of 1997 made it possible for quantitative measurements of tropical rainfall to be obtained on a continuous basis over the entire global tropics. Dr. Simpson was the TRAM Project Scientist from 1986 until its launch in 1997. Her efforts during this crucial period ensured that the mission was both well planned scientifically and well engineered as well as within budget. In this paper, Dr. J. Simpson's nine specific accomplishments during her fifty-year career: (1) hot tower hypothesis, (2) hurricanes, (3) airflow and clouds over heated islands, (4) cloud models, (5) trade winds and their role in cumulus development, (6) air-sea interaction, (7) cloud-cloud interactions and mergers, (8) waterspouts, and (9) TRMM science, will be described and discussed