Treatment modalities of female Operation Iraqi Freedom/Operation Enduring Freedom Veterans with posttraumatic stress disorder: A systematic review of the literature

Objective. To review professional literature regarding treatment modalities of post-traumatic stress disorder (PTSD) amongst female Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) veterans, to assess the efficacy of these treatment options, and to summarize implications of the findings from this literature. Design. Systematic review of published literature. Data sources. Medline, Pubmed, Psycinfo. Review Methods. Articles selected for the literature review pertain to the treatment options of female OIF or OEF veterans who have a diagnosis of PTSD. In addition, other relevant articles, such as articles that discuss the prevalence of the problem, access to care, and similar treatment modalities for PTSD in other war settings, were selected for background information for the review. Results. The search strategy identified 1,305 potential journal articles, taken from thorough searches in Medline, Pubmed, and Psycinfo. These articles were then imported into Refworks. Following final screening, there were 18 articles included in the systematic review and 28 articles used as background information. The remaining articles were excluded following screening of abstract and/or full text of articles. Treatment modalities presented in these trials include: Exposure Therapy (average of 68% reduction in PTSD symptoms), Imagery Rehearsal Therapy (23% reduction), Body-Oriented Therapy (57% reduction), Electroconvulsive Therapy (35% reduction), Holographic Reprocessing (47% reduction), a self-defense training program (13% reduction), Cognitive Behavioral Therapy (65% reduction) and a variety of pharmacotherapies (antipsychotics at 81% reduction, sympatholytic drug at 100% reduction). Outcomes of the studies included in this systematic review were measured by using personal assessment of whether there was a reduction in symptoms of PTSD, based on the results in each study. Conclusion. Overall, all of the treatment modalities investigated in the systematic review proved to be somewhat effective in relieving the burden of symptoms of PTSD amongst female veterans of OIF/OEF. In addition to pharmacotherapy, which had the highest reduction in PTSD symptoms, both the Exposure Therapy and the Cognitive Behavioral Therapy techniques proved to have the most positive results. As all of the therapies had a positive effect on this population, to some degree, a study needs to be done in the future to compare and contrast the efficacy of each therapy intervention when applied to a standardized population.^

Correlates of post-diagnosis weight management among female breast cancer survivors: An Internet survey

Objective. Weight gain after cancer treatment is associated with breast cancer recurrence. In order to prolong cancer-free survivorship, interventions to manage post-diagnosis weight are sometimes conducted. However, little is known about what factors are associated with weight management behaviors among cancer survivors. In this study, we examined associations of demographic, clinical, and psychosocial variables with weight management behaviors in female breast cancer survivors. We also examined whether knowledge about post-diagnosis weight gain and its risk is associated with weight management behaviors. ^ Methods. 251 female breast cancer survivors completed an internet survey. They reported current performance of three weight management behaviors (general weight management, physical activity, and healthy diet). We also measured attitude, elf-efficacy, knowledge and social support regarding these behaviors along with demographic and clinical characteristics. ^ Results. Multiple regression models for the weight management behaviors explained 17% of the variance in general weight management, 45% in physical activity and 34% in healthy dieting. The models had 9–14 predictor variables which differed in each model. The variables associated with all three behaviors were social support and self-efficacy. Self-efficacy showed the strongest contribution in all models. The knowledge about weight gain and its risks was not associated with any weight management behaviors. However, women who obtained the knowledge during cancer treatment were more likely to engage in physical activity and healthy dieting. ^ Conclusions. The findings suggest that an intervention designed to increase their self-efficacy to manage weight, to be physically active, to eat healthy will effectively promote survivors to engage in these behaviors. Knowledge may motivate women to manage post-diagnosis weight about risk if information is provided during cancer treatment.^

Larval and post-larval stages of pacific oyster (Crassostrea gigas) are resistant to elevated CO2

Rising anthropogenic carbon dioxide (CO2) dissolving into coastal waters is decreasing the pH and carbonate ion concentration, thereby lowering the saturation state of calcium carbonate (CaCO3) minerals through a process named ocean acidification (OA). The unprecedented threats posed by such low pH on calcifying larvae of several edible oyster species have not yet been fully explored. Effects of low pH (7.9, 7.6, 7.4) on the early growth phase of Portuguese oyster (Crassostrea angulata) veliger larvae was examined at ambient salinity (34 ppt) and the low-salinity (27 ppt) treatment. Additionally, the combined effect of pH (8.1, 7.6), salinity (24 and 34 ppt) and temperature (24 °C and 30 °C) was examined using factorial experimental design. Surprisingly, the early growth phase from hatching to 5-day-old veliger stage showed high tolerance to pH 7.9 and pH 7.6 at both 34 ppt and 27 ppt. Larval shell area was significantly smaller at pH 7.4 only in low-salinity. In the 3-factor experiment, shell area was affected by salinity and the interaction between salinity and temperature but not by other combinations. Larvae produced the largest shell at the elevated temperature in low-salinity, regardless of pH. Thus the growth of the Portuguese oyster larvae appears to be robust to near-future pH level (> 7.6) when combined with projected elevated temperature and low-salinity in the coastal aquaculture zones of South China Sea.

Effects of elevated pCO2 on the post-settlement development of Pocillopora damicornis

Ocean acidification represents a key threat to the recruitment of scleractinian corals. Here, we investigated the effect of increased partial pressure of carbon dioxide (pCO2) on the early development of Pocillopora damicornis by rearing the recruits for 12 days at 3 pCO2 levels (446, 896 and 1681 µatm). Results showed that increased pCO2 exerted minor effects on symbiont density and maximum quantum yield (Fv/Fm), while significantly enhanced the relative electron transport through photosystem II (PSII) of Symbiodinium. Notably, calcification and biomass of recruits decreased sharply by 34% and 24% respectively in 896 µatm, and tended to remain constant as pCO2 was raised from 896 to 1681 µatm. Furthermore, recruits in 1681 ?atm, with comparable surface area as those in 896 µatm, produced fewer buds. These findings indicated that juvenile P. damicornis under high pCO2 would enhance electron transport rate and suppress asexual budding to favor skeletal and tissue growths, which are more critical for their persistence and survival in a high pCO2 environment. This work suggested the physiological plasticity of juvenile corals under short-term exposure to elevated pCO2.

Nutrition and physical activity programs for obesity treatment (PRONAF study). methodological approach of the project

Este trabajo aborda la metodología seguida para llevar a cabo el proyecto de investigación PRONAF (Clinical Trials Gov.: number NCT01116856.) Background: At present, scientific consensus exists on the multifactorial etiopatogenia of obesity. Both professionals and researchers agree that treatment must also have a multifactorial approach, including diet, physical activity, pharmacology and/or surgical treatment. These two last ones should be reserved for those cases of morbid obesities or in case of failure of the previous ones. The aim of the PRONAF study is to determine what type of exercise combined with caloric restriction is the most appropriate to be included in overweigth and obesity intervention programs, and the aim of this paper is to describe the design and the evaluation methods used to carry out the PRONAF study. Methods/design: One-hundred nineteen overweight (46 males) and 120 obese (61 males) subjects aged 18–50 years were randomly assigned to a strength training group, an endurance training group, a combined strength + endurance training group or a diet and physical activity recommendations group. The intervention period was 22 weeks (in all cases 3 times/wk of training for 22 weeks and 2 weeks for pre and post evaluation). All subjects followed a hypocaloric diet (25-30% less energy intake than the daily energy expenditure estimated by accelerometry). 29–34% of the total energy intake came from fat, 14–20% from protein, and 50–55% from carbohydrates. The mayor outcome variables assesed were, biochemical and inflamatory markers, body composition, energy balance, physical fitness, nutritional habits, genetic profile and quality of life. 180 (75.3%) subjects finished the study, with a dropout rate of 24.7%. Dropout reasons included: personal reasons 17 (28.8%), low adherence to exercise 3 (5.1%), low adherence to diet 6 (10.2%), job change 6 (10.2%), and lost interest 27 (45.8%). Discussion: Feasibility of the study has been proven, with a low dropout rate which corresponds to the estimated sample size. Transfer of knowledge is foreseen as a spin-off, in order that overweight and obese subjects can benefit from the results. The aim is to transfer it to sports centres. Effectiveness on individual health-related parameter in order to determine the most effective training programme will be analysed in forthcoming publications.

Análisis de las diferencias en el crecimiento vegetativo, en los componentes del rendimiento y en la composición de las uvas y vinos del cv. cabernet sauvignon (vitis vinifera L.), producidos por el déficit hídrico durante pre-envero y post-envero

La presente Tesis Doctoral se realizó con el fin de estimar conjuntamente la respuesta agronómica y fisiológica de la vid (Vitis vinifera L.), así como los efectos sobre la evolución de la maduración, composición y la calidad de la uva y del vino, bajo la aplicación de diferentes déficit hídricos en pre-envero y post-envero, dentro de un marco de referencia de cambio climático. La variación climática que prevén los estudios sobre el cambio climático, resulta un factor decisivo en la eficiencia del uso del agua en la vid. En zonas cálidas, las estrategias de cultivo del viñedo frente al cambio climático deben de ir dirigidas a atenuar sus efectos sobre el crecimiento y el desarrollo de la vid, haciéndose imprescindible el estudio pormenorizado del déficit hídrico como factor decisivo en la obtención de las uvas adecuadas, ya que son la clave indispensable para el éxito en la elaboración del vino, y de forma muy especial en los vinos enfocados a un sector de alta calidad. El ensayo se llevó a cabo en un viñedo comercial de Bodegas Licinia, en la Comunidad de Madrid, durante los años 2010 y 2011. La variedad estudiada fue Cabernet sauvignon / 41 B, plantada a un marco de plantación de 3 m x 1 m, con un guiado vertical de la vegetación. El dispositivo experimental fue totalmente al azar, y se establecieron 4 tratamientos experimentales con 4 grados de disponibilidad hídrica, déficit moderado continuo (T0,45-0,6), déficit severo continuo (T0-0,3), déficit severo después de envero (T0,45-0,3) y déficit severo antes de envero (T0-0,6). En cada tratamiento se distribuyeron 3 repeticiones. El año 2010 fue el más lluvioso de los años de ensayo, con 478 mm de precipitaciones anuales, lo que supuso 146 mm más que en el año 2011. Su distribución a lo largo del ciclo fue más homogénea en el año 2010, mientras que en 2011 las precipitaciones contabilizadas en el período de maduración de la uva fueron nulas. La temperatura media subió 0,9ºC en 2011, respecto a 2010 y en cuanto a la integral térmica eficaz, en 2011 se acumularon, desde el 1 de abril hasta el final de ciclo, 217 grados•día más que en 2010. El déficit hídrico en pre-envero, modificó notablemente el crecimiento vegetativo y la producción de cosecha de la parcela de ensayo, no así la fertilidad de las yemas. El tratamiento con mayor disponibilidad hídrica (T0,45-0,6) obtuvo el mayor peso de baya, y los tratamientos con menor déficit hídrico en pre-envero (T0,45-0,6 y T0,45-0,3) registraron los mayores rendimientos de cosecha, mientras que las menores tasas de cuajado correspondieron al tratamiento con un déficit severo continuo (T0-0,3). La parcela de ensayo se caracterizó por un exceso de vigor y un alto crecimiento vegetativo. El pH del mosto se vio afectado por el déficit hídrico, disminuyendo su valor en el tratamiento de déficit hídrico severo antes de envero (T0-0,6). Organolépticamente, no se percibieron diferencias significativas en los vinos elaborados en función del déficit hídrico, y respecto a su composición físico-química, solo existieron diferencias en la concentración de ácido L-Málico, con mayores concentraciones en los tratamientos sin déficit hídrico en pre-envero, T0,45-0,6 y T0,45-0,3. El déficit hídrico modificó notablemente el color del vino, aumentando los valores de las coordenadas CIELAB a* y b*, la luminosidad (L*), croma (C*) y tonalidad (H*), para los tratamientos con un déficit severo en pre-envero (T0-0,3 y T0-0,6) y disminuyendo estas en el tratamiento con mayor disponibilidad hídrica (T0,45-0,6). Del mismo modo, mediante el análisis de color por métodos tradicionales, IPT e IC de los vinos, aumentó en los tratamientos con mayor déficit hídrico en pre-envero (T0-0,3 y T0-0,6), respecto a los tratamientos de mayor disponibilidad (T0,45-0,6 y T0,45-0,3). La concentración de taninos de la baya en vendimia, no se vio afectada por el déficit hídrico, aunque sí estuvo relacionada positivamente con el tamaño de las bayas. Organolépticamente, los hollejos del año 2011 resultaron con menor frescura, acidez, afrutado, sensación herbácea e intensidad tánica, aunque con mayor astringencia respecto a 2010. Las pepitas fueron más astringentes y aromáticas pero menos crujientes, sin llegar a los niveles de madurez del año 2010. El catador relacionó los taninos con la calidad del vino, asociándolos con un mayor cuerpo, acidez, intensidad, equilibrio gustativo, amargor y menor astringencia en la fase gustativa. La concentración de taninos en los vinos se vio favorecida con el déficit hídrico en pre-envero y post-envero. Los tratamientos con mayor déficit hídrico en pre-envero, T0-0,6 y T0-0,3, obtuvieron las menores concentraciones de potasio en mostos y vinos. Las relaciones entre la concentración de potasio, ácido L-Málico y el porcentaje de color rojo puro (dA(%)) resultaron altamente significativas, de modo que las mayores tasas de potasio en el vino se asociaron a los valores más bajos de color rojo y a los mayores de ácido L-Málico. ABSTRACT The present Doctoral Thesis has been done in order to estimate the grapevine (Vitis vinifera L.) agronomic and physiologic performance or response as well as the impact in the grape and wine maturity, composition and quality evolution, with different water deficits. The variation in climate that the global warming studies for seen is a key factor for the grapevine water use efficiency. In warm areas the farming vineyards strategy to face the climatic change, should be focused on diminish the effects on the grapevine growth and development, so that the water deficit detailed analysis becomes decisive to obtain the appropriate grapes, that are the main subject for a successful wine production and especially for top quality wines. The trial was carried out in a commercial vineyard in Chinchón (Madrid), Licinia winery, during the 2010 and 2011 seasons. The grape variety studied was Cabernet Sauvignon grafted onto 41B with a vine spacing 3m x 1m trained as VSP. Experimental design consisted on 4 irrigation treatments with 3 replications totally randomized. Irrigation treatments were: moderate regulated deficit (T0,45-0,6), severe continuous deficit (T0-0,3), severe post-veraison deficit (T0,45-0,3) and severe pre veraison deficit (T0-0,6). The 2010 was rainier year than the 2011; Total annual rain in 2010 was 478 mm, which resulted in 146 mm more than in 2011. The distribution along the vine cycle was more homogeneous in the 2010, whereas precipitations in 2011 along the grape maturity period were nonexistent. The average temperature in 2011 was 0,9ºC higher than that of the 2010 and regarding to the thermal integral, in the 2011 from 1st April to the end of the growing cycle, was 217 degrees•day higher than that in 2010. Water deficit significantly modified the vegetative growth and yield but, it did not modified bud fertility. The treatment with the highest water availability (T0,45-0,6) got the highest berry size, the lowest berry set rates were found in the severe continuous deficit treatment (T0-0,3). The plot studied in this trial was characterized by both excessive vigour and vegetative growth. Water deficit modified the pH must by, reducing it in the severe water deficit during pre-veraison (T0-0,6). There were not differences in wine tasting between the water deficits treatments. Regarding to the physical-chemical composition, it only existed differences in the L-malic acid concentration, resulting higher concentrations in the water deficit pre-veraison treatments: T0,45-0,6 y T0,45-0,3. Water deficit significantly modified wine colour by, increasing the CIELAB coordinates a* and b*, the brightness (L*), croma (C*) and tonality (H*), in the lower water availability pre-veraison treatments (T0-0,3 y T0-0,6), and reducing them in the in the moderate continuous water deficit ones (T0,45-0,6). By means of traditional wine colour parameters analyses, red colour percentage, TPI, they became higher in the lower water availability pre-veraison treatments (T0-0,3 y T0-0,6), than in those with higher availability (T0,45-0,6 y T0,45-0,3). At harvest, berry tannins concentrations was not affected by the water deficit although it did in a positive way, in the berry size. Berry tasting in 2011, resulted in a lower freshness, acidity, fruity, herbaceous flavour and tannic intensity, but with higher astringency respect to the 2010 season. Seeds, in 2011, were more astringent and aromatic as in the 2010, but less crunchy, without getting to the point of maturity. The taster linked the tannins to wine quality, associating them with a higher bodiest wine, acidity, intensity, taste balance, bitterness and with a lower astringency in the tasting stage. Treatments with a higher water deficit up to veraison T0-0,6 y T0-0,3 got less musts and wines potassium concentration. The relation between L-malic acid and the full red color percentage (dA(%)), were highly related, resulting the higher potassium content the lower wine quality.