An Overview of Blood Flow Restriction Physiology and Clinical Considerations.

ABSTRACT: The utilization of blood flow restriction has garnished considerable attention due to its widespread application and benefits that include strength enhancement, muscle hypertrophy, and increased level of function for specific populations. Blood flow restriction induces a hypoxic environment within a muscle group, initiating a metabolic cascade that stimulates muscle protein synthesis, altered gene regulation of muscle satellite cells, and increased muscle fiber recruitment, ultimately resulting in improved strength and endurance. When using blood flow restriction, consideration of the individual patient, occlusion pressure, cuff width, and cuff size are paramount. Blood flow restriction has been proven to be a consistently safe and effective tool for augmenting rehabilitative regimens for the upper and lower extremity.

The Assessment and Measurement of Wellness in the Clinical Medical Setting: A Systematic Review.

We conducted a systematic review of the published literature relating to the assessment and measurement of wellness in order to answer the following questions: 1) What is the working definition of wellness? 2) What wellness assessment instruments have been evaluated or applied in medical settings? 3) How valid, reliable, and accessible are these wellness assessment tools? The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed for this systematic review. Studies published from1990 to 2016 on wellness assessment were identified through Medline and PsycINFO using the following keywords: "assessment" OR "evaluation" OR "measurement" AND "wellness" OR "wellbeing." Two authors independently conducted a focused analysis then reached a consensus on 23 studies that met the specific selection criteria. This review revealed that there is a lack of uniform definition of wellness. The studies utilizing wellness assessment tools demonstrate strongest reliability values for the following instruments: Wellness Evaluation of Lifestyle, Five-factor Wellness Evaluation of Lifestyle, Perceived Wellness Survey, the Optimal Living Profile, and the Body-Mind-Spirit Wellness Behavior and Characteristic Inventory. However, there is insufficient evidence to support the clinical utility of a single particular wellness instrument. Properly defining wellness might help drive the development and validation of more precise assessment and measurement methods. This could reinforce interventions that promote wellness.

Effect of Tree-to-Shrub Type Conversion in Lower Montane Forests of the Sierra Nevada (USA) on Streamflow.

Higher global temperatures and increased levels of disturbance are contributing to greater tree mortality in many forest ecosystems. These same drivers can also limit forest regeneration, leading to vegetation type conversion. For the Sierra Nevada of California, little is known about how type conversion may affect streamflow, a critical source of water supply for urban, agriculture and environmental purposes. In this paper, we examined the effects of tree-to-shrub type conversion, in combination with climate change, on streamflow in two lower montane forest watersheds in the Sierra Nevada. A spatially distributed ecohydrologic model was used to simulate changes in streamflow, evaporation, and transpiration following type conversion, with an explicit focus on the role of vegetation size and aspect. Model results indicated that streamflow may show negligible change or small decreases following type conversion when the difference between tree and shrub leaf areas is small, partly due to the higher stomatal conductivity and the deep rooting depth of shrubs. In contrast, streamflow may increase when post-conversion shrubs have a small leaf area relative to trees. Model estimates also suggested that vegetation change could have a greater impact on streamflow magnitude than the direct hydrologic impacts of increased temperatures. Temperature increases, however, may have a greater impact on streamflow timing. Tree-to-shrub type conversion increased streamflow only marginally during dry years (annual precipitation < 800 mm), with most streamflow change observed during wetter years. These modeling results underscore the importance of accounting for changes in vegetation communities to accurately characterize future hydrologic regimes for the Sierra Nevada.

Emotional dampening in persons with elevated blood pressure: affect dysregulation and risk for hypertension.

BACKGROUND: Persons with higher blood pressure have emotional dampening in some contexts. This may reflect interactive changes in central nervous system control of affect and autonomic function in the early stages of hypertension development. PURPOSE: The purpose of this study is to determine the independence of cardiovascular emotional dampening from alexithymia to better understand the role of affect dysregulation in blood pressure elevations. METHODS: Ninety-six normotensives were assessed for resting systolic and diastolic (DBP) blood pressure, recognition of emotions in faces and sentences using the Perception of Affect Task (PAT), alexithymia, anxiety, and defensiveness. RESULTS: Resting DBP significantly predicted PAT emotion recognition accuracy in men after adjustment for age, self-reported affect, and alexithymia. CONCLUSIONS: Cardiovascular emotional dampening is independent of alexithymia and affect in men. Dampened emotion recognition could potentially influence interpersonal communication and psychosocial distress, thereby further contributing to BP dysregulation and increased cardiovascular risk.