Group-based intervention program in inflammatory bowel disease patients: effects on quality of life.

BACKGROUND: Inflammatory bowel diseases (IBD) such as ulcerative colitis (UC) and Crohn's disease (CD) have great impact on patients' health-related quality of life (HRQOL). The aim of this study was to develop an integrated medical and psychological/ psychosocial group-based intervention program for IBD patients and to evaluate if such a program could influence the patients' HRQOL and coping abilities. METHODS: IBD patients in remission or with low disease activity were randomized to intervention or control groups. The intervention comprised nine weekly sessions, alternating lectures, and group therapy sessions. The Inflammatory Bowel Disease Questionnaire (IBDQ) and the Sense of Coherence scale (SOC) were used to measure HRQOL and coping ability at 0, 6, and 12 months. The intervention was evaluated by a visual analog scale (VAS) and written comments by a content analysis. RESULTS: In all, 24 patients were included in the intervention group and 20 in the control group. The mean IBDQ score showed no statistically significant differences before (173.9) or after the intervention at month 6 (175.7) or at month 12 (171.8), or when comparing intervention and controls at month 12. Similarly, there were no statistically significant differences in mean SOC before or after intervention or when comparing groups. The VAS and the content analysis showed that the intervention was well appreciated by the patients. CONCLUSIONS: The group-based intervention program was feasible and highly appreciated. There were no statistically significant differences in average IBDQ or SOC over time or in comparison with controls, although a significant increase was seen in patients with short disease duration.

The Making of the Andrea Wave and other Rogues.

Unexpectedly large ocean waves or 'rogues' are sometimes claimed to be the cause of damage to ships at sea and to offshore structures. While wind-driven wave models are capable of predicting the average characteristics of waves, the maximum height of rogues that may occur is yet unknown. Rogues form in the open ocean through the addition of elemental wave trains or groups and, infrequently, with many elements coming together in phase, producing rogues. Here we perform directional analyses on one of the steepest rogues ever recorded: the Andrea wave. We find that the Andrea wave was close to the breaking-limited height. Analysis of the 72 twenty minute records on the day of the Andrea wave yields encounter return periods of about 21 days for maximally steep waves, while less steep rogues occur about twice daily. An explicit formula is given for the encounter probability, based on the target area. This work answers the critical questions regarding rogues in the design and operation of ships and offshore structures: how high can rogues be and how frequently they occur.