Dietary supplement use among military personnel: international patterns and motivations for use.

Dietary supplements, products that contain one or more dietary ingredients, or their components, typically in a concentrated form, are often consumed for purported health and performance benefits. The frequency, forms and motivations for dietary supplement use may differ between civilian and military populations. The objective of this manuscript is to review patterns and trends in dietary supplement use in military personnel from the USA, France, the UK and Slovenia. Main findings indicate that dietary supplement use may be higher in military personnel as compared with civilian populations. Factors motivating dietary supplement use in military personnel include physical and cognitive performance, recovery, and the maintenance of body weight and composition, whereas civilian populations tend to be motivated by health and wellness. Commonly used dietary supplements in military populations, such as proteins and amino acids, may be associated with performance, body weight management and body composition. The relationship between dietary supplement use and the frequency and severity of adverse events, along with the potential benefits of dietary supplements, has not been carefully assessed in military populations and should be the focus of future studies.

Dual Sounding Rocket and C/NOFS Satellite Observations of DC Electric Fields and Plasma Density in the Equatorial E- and F-Region Ionosphere at Sunset.

E × B plasma drifts and plasma number density were measured on two NASA rockets launched simultaneously at sunset from Kwajalein Atoll with apogees of 182 and 331 km, with similar, coincident measurements gathered on the Communications/Navigation Outage Forecasting System (C/NOFS) satellite at 390 km. The combined measurements portray a highly dynamic ionosphere in a narrow range of local time and altitude, providing evidence of vortex-like motions. Although the vertical plasma drift was upwards, its magnitude was not constant, increasing between ∼150 and 250 km altitude where the plasma density was reduced. The zonal plasma drifts displayed a shear with altitude, changing from eastward to westward flow below 270 km, coincident with the larger upward drifts and consistent with the maintenance of the vortex flow. The plasma density on the western flank was highly structured compared to the eastern flank, despite the fact that the western region corresponded to slightly earlier local times. These observations illustrate that the low latitude ionosphere at sunset must be considered as an ensemble of interconnected flows encompassing an evolving "theater," as opposed to a background that simply unfolds linearly with respect to local time. The observations also underscore how satellites at high altitudes do not capture the highly dynamic ionosphere and thermosphere at the lower altitudes which are critical for understanding the electrodynamics system. Such motions set the stage for large scale plasma instabilities to form later in the evening, as observed by radars at Kwajalein and subsequent passes of the C/NOFS satellite.

Putative biotic drivers of plant phenology: With special reference to pathogens and deciduousness.

Plant phenology is not only manifested in the seasonal timing of vegetative and reproductive processes but also has ontogenetic aspects. The adaptive basis of seasonal phenology has been considered mainly in terms of climatic drivers. However, some biotic factors as likely evolutionary influences on plants' phenology appear to have been under-researched. Several specific cases of putative biotic factors driving plant phenology are outlined, involving both herbivores and pathogens. These illustrate the diversity of likely interactions rather than any systematic coverage or review. Emphasis is on woody perennials, in which phenology is often most multifaceted and complicated by the ontogenetic aspect. The complete seasonal leaf fall that characterizes deciduous plants may be a very important defense against some pathogens. Whether biotic influences drive acquisition or long-term persistence of deciduousness is considered. In one case, of leaf rusts in poplars, countervailing influences of the rusts and climate suggest persistence. Often, however, biotic and environmental influences likely reinforce each other. The timing and duration of shoot flushing may in at least some cases contribute to defenses against herbivores, largely through brief periods of "predator satiation" when plant tissues have highest food value. Wide re-examination of plant phenology, accommodating the roles of biotic factors and their interplays with environments as additional adaptive drivers, is advocated toward developing and applying hypotheses that are observationally or experimentally testable.

Daytime Dynamo Electrodynamics With Spiral Currents Driven by Strong Winds Revealed by Vapor Trails and Sounding Rocket Probes.

We investigate the forces and atmosphere-ionosphere coupling that create atmospheric dynamo currents using two rockets launched nearly simultaneously on 4 July 2013 from Wallops Island (USA), during daytime Sq conditions with ΔH of -30 nT. One rocket released a vapor trail observed from an airplane which showed peak velocities of >160 m/s near 108 km and turbulence coincident with strong unstable shear. Electric and magnetic fields and plasma density were measured on a second rocket. The current density peaked near 110 km exhibiting a spiral pattern with altitude that mirrored that of the winds, suggesting the dynamo is driven by tidal forcing. Such stratified currents are obscured in integrated ground measurements. Large electric fields produced a current opposite to that driven by the wind, believed created to minimize the current divergence. Using the observations, we solve the dynamo equation versus altitude, providing a new perspective on the complex nature of the atmospheric dynamo.

Goodbye to S2- in aqueous solution.

New Raman spectra of Na2S dissolved in hyper-concentrated NaOH(aq) and CsOH(aq) cast serious doubt on the widely-assumed existence of S2-(aq). To avoid conceptual and practical problems with sulfide equilibria in numerous applications, S2-(aq) should be expunged from the chemical literature. Thermodynamic databases involving sulfide minerals also need careful revision.

Cognitive behavioral therapy as an adjunct treatment for Pakistani men with ED.

The goal of this study was to determine potential positive effects of cognitive behavioral therapy (CBT) on Pakistani men with ED who were undergoing treatment with a PDE-5 inhibitor. We used a pre-post research design comparing men with and without adjunctive CBT. Men in the two groups were compared to determine whether CBT improved sexual function, as measured by the International Index of Erectile Function (IIEF). A total of 60 individuals diagnosed with ED completed the study. Participants were systematically assigned to one of two groups, the CBT group or the control group. The sample was drawn from outpatients referred through several hospitals in Islamabad. All men showed improvement in sexual functioning over the course of the study, though post treatment, men in the CBT group showed greater improvement on IIEF subscales of erectile functioning, orgasmic function, intercourse satisfaction and overall satisfaction than those in the control group. CBT can be considered an effective and supportive means for achieving better sexual outcomes for Pakistani men taking PDE-5 inhibitors for erectile problems.

The fixed-bias Langmuir probe on the Communication/Navigation Outage Forecast System satellite: calibration and validation.

A fixed-bias spherical Langmuir probe is included as part of the Vector Electric Field Instrument (VEFI) suite on the Communication/Navigation Outage Forecast System (C/NOFS) satellite. C/NOFS gathers data in the equatorial ionosphere between 400 and 860 km, where the primary constituent ions are H(+) and O(+). The ion current collected by the probe surface per unit plasma density is found to be a strong function of ion composition. The calibration of the collected current to an absolute density is discussed, and the performance of the spherical probe is compared to other in situ instruments on board the C/NOFS satellite. The application of the calibration is discussed with respect to future fixed-bias probes; in particular, it is demonstrated that some density fluctuations will be suppressed in the collected current if the plasma composition rapidly changes along with density. This is illustrated in the observation of plasma density enhancements on C/NOFS.

Genital and heart rate response to erotic stimulation in men with and without premature ejaculation.

This study compared genital and penile response patterns in men with and without premature ejaculation (PE) so as to identify the potential anomalous psychosomatic relationships among men with PE. Genital and heart rate response profiles of 25 men with PE were compared with those of 13 age-matched sexually functional counterparts during visual sexual stimulation presented in combination with vibrotactile penile stimulation. Although no differences were found between men with PE and controls on maximum penile circumference change, overall penile response was significantly lower in the PE group and PE men who ejaculated during the session exhibited shorter latencies to maximum circumference change. Furthermore, significant differences were found between groups in patterns of heart rate. These findings indicate differences in physiological responses between men with PE and sexually functional counterparts during erectile tumescence and progression toward ejaculation. Such differences might be explained by 'premature' sympathetic activation during the sexual response cycle in men with PE, thereby diminishing parasympathetically controlled penile response and triggering sympathetically mediated seminal emission prematurely.

The acoustic properties, centered on 20 MHZ, of an IEC agar-based tissue-mimicking material and its temperature, frequency and age dependence.

The purpose of this study was to characterize the ultrasonic properties of agar-based tissue-mimicking materials (TMMs) at ultrasound frequencies centered around 20 MHz. The TMM acoustic properties measured are the amplitude attenuation coefficient alpha (dB cm(-1)MHz(-1)), the speed of sound (ms(-1)) and the backscattered power spectral density (distribution of power per unit frequency normalized to the total received power) characteristics of spectral slope (dB MHz(-1)), y-axis intercept (dB) and reflected power (dB). The acoustic properties are measured over a temperature range of 22 to 37 degrees C. An intercomparison of results between two independent ultrasound measurement laboratories is also presented. A longitudinal study of the acoustic properties over a period of two years is also detailed, and the effect of water immersion on the acoustic properties of TMM is measured. In addition, the physical parameters of mass density rho (kg m(-3)) and specific heat capacity C (J kg(-1) K(-1)) are included. The measurement techniques used were based on the substitution technique using both broadband and narrowband pulses centered on 20 MHz. Both the attenuation coefficient and speed of sound (both group and phase) showed good agreement with the expected values of 0.5 dB cm(-1) MHz(-1) and 1540 ms(-1), respectively, with average values over the three-year period of 0.49 dBcm(-1)MHz1 (SD +/- 0.05) and 1540.9 ms(-1) (SD +/- 8.7). These results also showed agreement between the two independent measurement laboratories. Speed of sound and attenuation coefficient were shown to change with temperature with rates of + 2.1 m s(-1) degrees C(-1) and -0.005 dB cm(-1) MHz(-1) degrees C(-1), respectively. Attenuation changed linearly with frequency at the high frequency range of 17 to 23 MHz, and speed of sound was found to be independent of frequency in this range. The spectral slope of relative backscattered power for the material increased with frequency at typically 1.5 dB MHz(-1). This compared favorably with theoretical spectral slope values, calculated for a variety of scatterer sizes, albeit at a lower frequency range. It is also noticed that, on extrapolation back to lower frequencies, the backscatter is comparable with that measured at 7 MHz. Overall, this non-commercial agar-based TMM is shown to perform as expected at the higher frequency range of 17 to 23 MHz and is seen to retain its acoustic properties of attenuation and speed of sound over a three-year period.

Pharmaceutical companies could serve their own interests by supporting research on the efficacy of psychotherapy on premature ejaculation.

For many men, the treatment of sexual dysfunctions such as premature ejaculation may well be most effective when pharmacotherapy is combined with psychotherapy. Yet the essential elements of psychotherapy that might best be combined with pharmacological-based therapy are currently unknown. Support for evidence-based studies that identify key components of psychotherapy that might improve positive long-term outcomes, including patient satisfaction, are needed. Pharmaceutical companies having a vested interest in achieving both treatment adherence and improved patient outcomes could benefit from such information.

The aetiology of premature ejaculation and the mind-body problem: implications for practice.

Recent attempts to find effective pharmacological treatments for premature ejaculation (PE) have spurred significant interest in the causes of, consequences of, and existing therapies for this common male sexual dysfunction. The recurring tendency in science and medicine, however, to dichotomise causes of such problems into either biological or psychological is not only counterproductive, it is misguided. Ejaculatory response should be viewed as a system of integrated and inseparable hardwired and softwired central and peripheral responses, some being readily modifiable, others not. Such a view argues that treatment of PE aimed at multiple levels of functioning will be self-enhancing and ultimately more effective in producing positive therapeutic outcomes than strategies relying solely on either psychological or biological approaches.

Putting public health evidence into practice: increasing the prevalence of working smoke alarms in disadvantaged inner city housing.

STUDY OBJECTIVES: The UK government recommends that local authorities install battery operated smoke alarms to prevent fire related injury. However, a randomised controlled trial of smoke alarm installation in local authority housing found a low level of working alarms at follow up. Qualitative work, which accompanied the trial explored barriers and levers to the use of this public health intervention. DESIGN: Semi-structured group and individual interviews were conducted with a sample of the adult participants in a randomised controlled trial of free smoke alarm installation. Group interviews and "draw and write" exercises were conducted with children at a local primary school. PARTICIPANTS: A sample of trial participants and primary school children in the trial neighbourhood. SETTING: An inner city housing estate in central London. MAIN RESULTS: The main barrier to smoke alarm use was the distress caused by false alarms. Although trial participants considered themselves to be at high risk for fires and would recommend smoke alarms to others, respondents' reports on the distress caused by false alarms suggest that people balance immediate and longer term risks to their health and wellbeing when they disable alarms. CONCLUSIONS: This study identified some of the reasons for the low level of functioning smoke alarms, and problems experienced with alarms. The results have implications for the implementation of this public health intervention. The effectiveness of smoke alarm installation could be improved if alarm manufacturers and those responsible for implementation programmes considered ways of tackling the issues raised in this study.

Predicting responsiveness to the treatment of rapid ejaculation with 25 mg clomipramine as needed.

Clomipramine (25 mg) taken as needed increases ejaculatory latency in men with rapid ejaculation (RE), although only about half the men treated respond to this regimen. It would therefore be clinically advantageous to know the patient's potential responsiveness to an 'as needed' regimen prior to treatment. The present study attempted to identify a priori factors that might enable prediction of patients' response or nonresponse to 'as needed' clomipramine. Variables relevant to rapid ejaculation were examined in 23 men with RE, 12 of whom had responded to clomipramine. Logistic regression indicated that three factors assessed prior to treatment--initial ejaculation latency, overall sexual satisfaction, and ejaculation frequency each week--significantly improved the prediction of responsiveness to this treatment regimen. Specifically, RE men with initial ejaculatory latencies over 60 s, self-reported sexual satisfaction of 5 or higher (on a seven-point scale), and ejaculation frequency of twice or more weekly were more likely to benefit from 25 mg 'as needed' clomipramine. As such, men meeting these criteria might be considered for this treatment regimen. Those not matching these characteristics might better be considered for 20 or 30 mg clomipramine given on a daily basis.

Sexual response in men with inhibited or retarded ejaculation.

Inhibited ejaculation (IE) is a poorly understood male sexual dysfunction having both somatic and psychological etiologies. This study investigated sexual response in 25 IE men with no probable somatic cause. Using a standard psychophysiological assessment procedure, these men were compared with sexually functional and other dysfunctional groups on two measures of sexual response: erectile response and self-reported sexual arousal. Within the sample of IE men, sexual response was investigated as a function of both diagnostic classification and relationship factors. Differences occurred between IE men and the other groups on erectile response and self-reported sexual arousal during psychosexual stimulation in the lab, with IE men reporting lowest levels of sexual arousal. Within the IE group, diagnostic classifications and relationship variables were also related to self-reported sexual arousal. These findings suggest that inhibited arousal may be fairly common among IE men having no apparent somatic etiology, and further that several specific relationship factors may provide potential strategies for enhancing arousal in these men.

Randomised controlled trial of site specific advice on school travel patterns.

AIMS: To evaluate the effect of site specific advice from a school travel coordinator on school travel patterns. METHODS: Cluster randomised controlled trial of children attending 21 primary schools in the London boroughs of Camden and Islington. A post-intervention survey measured the proportion of children walking, cycling, or using public transport for travel to school, and the proportion of parents/carers very or quite worried about traffic and abduction. The proportion of schools that developed and implemented travel plans was assessed. RESULTS: One year post-intervention, nine of 11 intervention schools and none of 10 control schools had travel plans. Proportions of children walking, cycling, or using public transport on the school journey were similar in intervention and control schools. The proportion of parents who were very or quite worried about traffic danger was similar in the intervention (85%) and control groups (87%). However, after adjusting for baseline and other potential confounding factors we could not exclude the possibility of a modest reduction in parental concern about traffic danger as a result of the intervention. CONCLUSIONS: Having a school travel coordinator increased the production of school travel plans but there was no evidence that this changed travel patterns or reduced parental fears. Given the uncertainty about effectiveness, the policy of providing school travel coordinators should only be implemented within the context of a randomised controlled trial.

Potential public health importance of the oven ready chip.

BACKGROUND: Chip pan fires are responsible for 25% of fire related injury in the UK, despite government strategies to encourage safer frying. To establish the feasibility of promoting oven ready chips (fries), the residents in a materially deprived ward of London were surveyed. Sample frame: 1073 of 2145 households participating in a randomised controlled trial. RESULTS: Approximately half of those surveyed deep fry, mostly chips, fish, and meat. Ownership of ovens and microwaves was high (99% and 80% respectively). Reasons for deep frying included taste (50%), speed (32%), and tradition (25%). CONCLUSIONS: Improving the quality of oven baked alternatives may encourage consumers to change to safer and healthier cooking methods, with potentially important repercussions for public health.

Job-based health insurance in 2001: inflation hits double digits, managed care retreats.

Drawing on the results of a national survey of 1,907 firms with three or more workers, this paper reports on several facets of job-based health insurance, including the cost to employers and workers; plan offerings and enrollments; patient cost sharing and benefits; eligibility, coverage, and take-up rates; and results from questions about employers' knowledge of market trends and health policy initiatives. Premiums increased 11 percent from spring 2000 to spring 2001, and the percentage of Americans in health maintenance organizations (HMOs) fell six percentage points to its lowest level since 1993, while preferred provider organization (PPO) enrollment rose to 48 percent. Despite premium increases, the percentage of firms offering coverage remained statistically unchanged, and a relatively strong labor market has continued to shield workers from the higher cost of coverage.