Classifying the health of Connecticut streams using benthic macroinvertebrates with implications for water management.

Bioassessments have formed the foundation of many water quality monitoring programs throughout the United States. Like many state water quality programs, Connecticut has developed a relational database containing information about species richness, species composition, relative abundance, and feeding relationships among macroinvertebrates present in stream and river systems. Geographic Information Systems can provide estimates of landscape condition and watershed characteristics and when combined with measurements of stream biology, provide a useful visual display of information that is useful in a management context. The objective of our study was to estimate the stream health for all wadeable stream kilometers in Connecticut using a combination of macroinvertebrate metrics and landscape variables. We developed and evaluated models using an information theoretic approach to predict stream health as measured by macroinvertebrate multimetric index (MMI) and identified the best fitting model as a three variable model, including percent impervious land cover, a wetlands metric, and catchment slope that best fit the MMI scores (adj-R (2) = 0.56, SE = 11.73). We then provide examples of how modeling can augment existing programs to support water management policies under the Federal Clean Water Act such as stream assessments and anti-degradation.

Childhood traumatic stress and obesity in women: the intervening effects of PTSD and MDD.

In this study, symptoms of posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) were modeled as intervening variables in the relationship between childhood traumatic stress and weight outcomes in civilian women in the United States. Of the 148 participants, 72 had current PTSD, 64 had current MDD, and 32 had neither disorder. In separate single indirect effect models, there were significant indirect effects of both PTSD and depressive symptoms on body mass index and waist-hip ratio. When models included both PTSD and depressive symptoms, an indirect effect of PTSD symptoms was evident in the relationship between childhood traumatic stress and waist-hip ratio. Posttraumatic stress disorder may play a particularly important role in the development of central adiposity.

Preliminary findings from a clinical demonstration project for veterans returning from Iraq or Afghanistan.

Military veterans are at high risk for nicotine dependence. This clinical demonstration project used invitational letters, referral to the National Cancer Institute's Smoking Quitline, and local Veteran Affairs prescriptions for tobacco cessation to evaluate whether this low-cost method would potentially reduce smoking in separated veterans who served in Afghanistan and Iraq. Three cohorts (500 each) of recently separated veterans from Afghanistan and Iraq were contacted by survey letters. Interested veterans received follow-up telephone calls using standardized scripts. They were referred to the National Cancer Institute's Smoking Quitline (1-877-44U-QUIT) and offered local Veteran Affairs pharmacologic treatment for smoking cessation. Forty-three percent of respondents who were smokers were interested in the clinical program; of these, 77% participated. At 2 months follow-up, 38% of participants self-reported maintained smoking abstinence. Results suggested that the intervention was feasible and assisted the small number of veterans who participated.

A placebo-controlled trial of bupropion SR in the treatment of chronic posttraumatic stress disorder.

OBJECTIVE: Although selective serotonin reuptake inhibitors have been the most empirically studied pharmacotherapy for posttraumatic stress disorder (PTSD), a need remains for the investigation of additional pharmacological agents in the treatment of PTSD. The present study examined the use of bupropion sustained release (SR) as compared with placebo for symptom reduction in patients with PTSD: approximately half who were already prescribed an selective serotonin reuptake inhibitor and half who were not. METHOD: Thirty patients (mean age, 50 years) with civilian- or military-related PTSD enrolled in an 8-week evaluation of bupropion SR versus placebo assigned in a 2:1 ratio in addition to their usual pharmacological care. Statistical tests included analyzing both study completers and using an intent-to-treat analysis, as well as post hoc examination of responders versus nonresponders. RESULTS: Although no between-group differences were detected, both groups reported a reduction in PTSD symptoms. In a hypothesis-generating post hoc analysis of responders versus nonresponders in the bupropion SR condition (defined as a Clinician Global Improvement score of at least minimally improved), it seemed that younger patients not currently on another antidepressant were more likely to benefit from bupropion. CONCLUSIONS: Bupropion SR in the treatment of PTSD had no significant effect in the current sample. Factors contributing to the absence of an effect need further study. Our analysis points to the inclusion of age and concomitant antidepressant treatment as important variables in any future larger-scale study.

Posttraumatic stress disorder in women: assessment and treatment in primary care.

The focus of this article is to provide primary care clinicians with a better understanding of women who have undergone sexual trauma and have related post-traumatic stress disorder. Victimization has adverse physical and mental health effects and affects a woman's clinical presentation, her coping skills, and the primary care intervention strategies needed to treat her. The article reviews issues of victimization and related PTSD among women, including the prevalence and sequel of victimization, and provides a theoretical framework for primary care intervention, treatment, and referral.