A pragmatic randomised controlled trial of hydrotherapy and land exercises on overall well being and quality of life in rheumatoid arthritis

Background \ud Hydrotherapy is highly valued by people with rheumatoid arthritis yet few studies have compared the benefits of exercises in heated water against exercises on land. In particular, data on quality of life is rarely reported. This is especially important because patients treated with hydrotherapy often report an enhanced sense of well-being. We report a randomised controlled trial in which we compared the effects of hydrotherapy with exercises on land on overall response to treatment, physical function and quality of life in patients with rheumatoid arthritis. \ud \ud Methods \ud One hundred and fifteen patients with RA were randomised to receive a weekly 30-minute session of hydrotherapy or similar exercises on land for 6 weeks. Our primary outcome was a self-rated global impression of change – a measure of treatment effect on a 7-point scale ranging from 1(very much worse) to 7 (very much better) assessed immediately on completion of treatment. Secondary outcomes including EuroQol health related quality of life, EuroQol health status valuation, HAQ, 10 metre walk time and pain scores were collected at baseline, after treatment and 3 months later. Binary outcomes were analysed by Fisher's exact test and continuous variables by Wilcoxon or Mann-Whitney tests. \ud \ud Results \ud Baseline characteristics of the two groups were comparable. Significantly more patients treated with hydrotherapy (40/46, 87%) were much better or very much better than the patients treated with land exercise (19/40, 47.5%), p < 0.001 Fisher's exact test. Eleven patients allocated land exercise failed to complete treatment compared with 4 patients allocated hydrotherapy (p = 0.09). Sensitivity analyses confirmed an advantage for hydrotherapy if we assumed non-completers would all not have responded (response rates 70% versus 38%; p < 0.001) or if we assumed that non-completers would have had the same response as completers (response rates 82% versus 55% p = 0.002). Ten metre walk time improved after treatment in both cases (median pre-treatment time for both groups combined 10.9 seconds, post-treatment 9.1 s, and 3 months later 9.6 s). There was however no difference between treatment groups. Similarly there were no significant differences between groups in terms of changes to HAQ, EQ-5D utility score, EQ VAS and pain VAS. \ud \ud Conclusion \ud Patients with RA treated with hydrotherapy are more likely to report feeling much better or very much better than those treated with land exercises immediately on completion of the treatment programme. This perceived benefit was not reflected by differences between groups in 10-metre walk times, functional scores, quality of life measures and pain scores

Cell surface properties of Pseudomonas stutzeri in the process of diesel oil biodegradation

Pseudomonas stutzeri, isolated from crude oil-contaminated soil, was used to degrade diesel oil. Of three surfactants, 120 mg rhamnolipids 1−1 significantly increased degradation of diesel oil giving 88% loss after 14 days compared to 54% loss without the surfactant. The system with rhamnolipids was characterised by relatively high particle homogeneity. However, the addition of saponins to diesel oil caused the cells to aggregate (the polydispersity index: 0.542) and the biodegradation of diesel oil was only 46%. The cell yield was 0.22 g l−1

Wellness through a comprehensive Yogic breathing program – A controlled pilot trial

<p>Abstract</p> <p>Background</p> <p>Increasing rates of psychosocial disturbances give rise to increased risks and vulnerability for a wide variety of stress-related chronic pain and other illnesses. Relaxation exercises aim at reducing stress and thereby help prevent these unwanted outcomes. One of the widely used relaxation practices is yoga and yogic breathing exercises. One specific form of these exercises is Sudarshan Kriya and related practices (SK&P) which are understood to have favourable effects on the mind-body system. The goal of this pilot study was to design a protocol that can investigate whether SK&P can lead to increased feeling of wellness in healthy volunteers.</p> <p>Methods</p> <p>Participants were recruited in a small university city in Sweden and were instructed in a 6-day intensive program of SK&P which they practiced daily for six weeks. The control group was instructed to relax in an armchair each day during the same period. Subjects included a total of 103 adults, 55 in the intervention (SK&P) group and 48 in the control group. Various instruments were administered before and after the intervention. Hospital Anxiety Depression Scale measured the degree of anxiety and depression, Life Orientation Test measured dispositional optimism, Stress and Energy Test measured individual's energy and stress experiences. Experienced Deviation from Normal State measured the experience of altered state of consciousness.</p> <p>Results</p> <p>There were no safety issues. Compliance was high (only 1 dropout in the SK&P group, and 5 in the control group). Outcome measures appeared to be appropriate for assessing the differences between the groups. Subjective reports generally correlated with the findings from the instruments. The data suggest that participants in the SK&P group, but not the control group, lowered their degree of anxiety, depression and stress, and also increased their degree of optimism (ANOVA; p < 0.001). The participants in the yoga group experienced the practices as a positive event that induced beneficial effects.</p> <p>Conclusion</p> <p>These data indicate that the experimental protocol that is developed here is safe, compliance level is good, and a full scale trial is feasible. The data obtained suggest that adult participants may improve their wellness by learning and applying a program based on yoga and yogic breathing exercises; this can be conclusively assessed in a large-scale trial.</p> <p>Trial Registration</p> <p>Australian Clinical Trial Registry ACTRN012607000175471.</p

Plant removals in perennial grassland : vegetation dynamics, decomposers, soil biodiversity, and ecosystem properties.

The consequences of permanent loss of species or species groups from plant communities are poorly understood, although there is increasing evidence that individual species effects are important in modifying ecosystem properties. We conducted a field experiment in a New Zealand perennial grassland ecosystem, creating artificial vegetation gaps and imposing manipulation treatments on the reestablishing vegetation. Treatments consisted of continual removal of different subsets or “functional groups” of the flora. We monitored vegetation and soil biotic and chemical properties over a 3-yr period. Plant competitive effects were clear: removal of the C3 grass Lolium perenne L. enhanced vegetative cover, biomass, and species richness of both the C4 grass and dicotyledonous weed functional groups and had either positive or negative effects on the legume Trifolium repens L., depending on season. Treatments significantly affected total plant cover and biomass; in particular, C4 grass removal reduced total plant biomass in summer, because no other species had appropriate phenology. Removal of C3 grasses reduced total root biomass and drastically enhanced overall shoot-to-root biomass ratios. Aboveground net primary productivity (NPP) was not strongly affected by any treatment, indicating strong compensatory effects between different functional components of the flora. Removing all plants often negatively affected three further trophic levels of the decomposer functional food web: microflora, microbe-feeding nematodes, and predaceous nematodes. However, as long as plants were present, we did not find strong effects of removal treatments, NPP, or plant biomass on these trophic groupings, which instead were most closely related to spatial variation in soil chemical properties across all trophic levels, soil N in particular. Larger decomposer organisms, i.e., Collembola and earthworms, were unresponsive to any factor other than removal of all plants, which reduced their populations. We also considered five functional components of the soil biota at finer taxonomic levels: three decomposer components (microflora, microbe-feeding nematodes, predaceous nematodes) and two herbivore groups (nematodes and arthropods). Taxa within these five groups responded to removal treatments, indicating that plant community composition has multitrophic effects at higher levels of taxonomic resolution. The principal ordination axes summarizing community-level data for different trophic groups in the soil food web were related to each other in several instances, but the plant ordination axes were only significantly related to those of the soil microfloral community. There were time lag effects, with ordination axes of soil-associated herbivorous arthropods and microbial-feeding nematodes being related to ordination axes representing plant community structure at earlier measurement dates. Taxonomic diversity of some soil organism groups was linked to plant removals or to plant diversity. For herbivorous arthropods, removal of C4 grasses enhanced diversity; there were negative correlations between plant and arthropod diversity, presumably because of negative influences of C4 species in the most diverse treatments. There was evidence of lag relationships between diversity of plants and that of the three decomposer groups, indicating multitrophic effects of altering plant diversity. Relatively small effects of plant removal on the decomposer food web were also apparent in soil processes regulated by this food web. Decomposition rates of substrates added to soils showed no relationship with treatment, and rates of CO2 evolution from the soil were only adversely affected when all plants were removed. Few plant functional-group effects on soil nutrient dynamics were identified. Although some treatments affected temporal variability (and thus stability) of soil biotic properties (particularly CO2 release) throughout the experiment, there was no evidence of destabilizing effects of plant removals. Our data provide evidence that permanent exclusion of plant species from the species pool can have important consequences for overall vegetation composition in addition to the direct effects of vegetation removal, and various potential effects on both the above- and belowground subsystems. The nature of many of these effects is driven by which plant species are lost from the system, which depends on the various attributes or traits of these species