Influence of an outpatient multidisciplinary pain management program on the health-related quality of life and the physical fitness of chronic pain patients

BACKGROUND: Approximately 10 to 20 percent of the population is suffering from chronic pain. Since this represents a major contribution to the costs of the health care system, more efficient measures and interventions to treat these patients are sought. RESULTS: The development of general health and physical activity of patients with chronic pain was assessed in an interdisciplinary outpatient pain management program (IOPP). 36 patients with an average age of 48 years were included in the IOPP. Subjective assessment of well-being was performed at five time points (baseline, post intervention and 3, 6, and 12 months thereafter) by using standardized questionnaires. The study focused on the quality of life survey Medical Outcomes Study Short Form-36, which is a validated instrument with established reliability and sensitivity. In addition, the patients participated in physical assessment testing strength, power, endurance, and mobility. Prior to therapy a substantial impairment was found on different levels. Marked improvements in the psychological parameters were obtained by the end of the program. No success was achieved with regard to the physical assessments. CONCLUSION: Although many different studies have evaluated similar programs, only few of them have attained positive results such as improvements of general quality of life or of physical strength. Often no difference from the control group could be detected only some months after the intervention. In the present study no significant persistent improvement of well-being occurred. Possible reasons are either wrong instruments, wrong selection of patients or wrong interventions

S-D logic-informed customer engagement: Integrative framework, revised fundamental propositions, and application to CRM

Advance online in 2016</p

Biosignatures present in a hydrothermal massive sulfide from the Mid-Atlantic Ridge

Mid-ocean spreading and accompanying hydrothermal activities result in huge areas with exposure of minerals rich in reduced chemicals – basaltic and peridotitic rocks as well as metal sulfide precipitates – to the oxygenated seawater. Oxidation of Fe and S present in these rocks provides an extensive long-term source of energy to lithotrophs. Investigation of lipid biomarkers and their carbon isotope ratios from a massive iron sulfide of an inactive sulfide mound or inactive chimney sampled at the western flank of the Turtle-Pits hydrothermal field (Mid-Atlantic Ridge, 5°S) revealed a unique lipid distribution. The bacterial fauna appears to be dominated by chemolithotrophs with a distinct lipid composition mainly comprising of iso-branched fatty acids and nonisoprenoidal dialkyl glycerol diethers partially including the very rare macrocyclic cores with 30–35 carbon atoms (including 13,16-dimethyloctacosane and 5,13,16-trimethyloctacosane). The Bacteria are accompanied by most likely hydrogen/CO2-dependent methanogenic Archaea (e.g. Methanococcus) as well as other Archaea with a different life style (e.g. Ferroplasma). Alike some of the bacterial lipids the archaeal lipids predominantly consist of macrocyclic diethers including one C40 and one C41 isoprenoid. Structural homologues of the latter are so far only reported from a methanogenic archaeum and a Pleistocene sulfur deposit. Compound-specific analyses of the stable isotope ratios revealed δ13C values for the majority of bacterial and archaeal lipid components of about 0‰ (vs. VPDB), indicative for chemolithoautotrophically fixed carbon which is, for distinct pathways, accompanied by only negligible fractionations. However, the presence of methanogenic Archaea is indicated by 13C-depleted isoprenoidal lipids (δ13C ~ –50‰) characteristic for certain CO2-reducing methanogens synthesizing lipids via acetyl CoA

Reliability and variability of sleep and activity as biomarkers of ageing in Drosophila

There are currently no reliable biomarkers of ageing. A biomarker should indicate biological age, that is, the amount of an animal's total lifespan it has lived and, therefore, the amount of time it has remaining. Some potential biomarkers cannot be validated as their measurement involves harm or death of the animal, such that its ultimate lifespan cannot be determined. A non-destructive biomarker would allow us to test molecular markers potentially involved directly in the ageing process, to monitor the effectiveness of therapeutic interventions to delay ageing, and provide a useful measure of general health of the organism. In the model organism Drosophila, various behavioural phenotypes change directionally with age, but we do not know whether they predict lifespan. Here we measure activity and sleep parameters in 64 wild type male flies from two recently wild-caught populations over the course of their natural lives, and determine whether such measures may predict biological age and ultimate lifespan. Indices of sleep fragmentation and circadian rhythm were the best predictors of lifespan, though population differences were evident. However, when used to predict a biological age of 50 % lifespan elapsed our best behavioural measure was slightly less accurate and less precise compared with using chronological age as predictor