ABSTRACT
Standard treatment for IBS focuses on the management or alleviation of the predominant gastrointestinal presenting symptoms, such as diarrhea or constipation, often using pharmacological therapy. For many patients, this approach is unsatisfactory, and patients frequently seek the advice of complementary and alternative medicine (CAM) practitioners in order to explore other treatment options. CAM practices include a broad range of modalities, and mind-body interventions hold particular promise as treatment modalities for IBS because psychological factors could have an important role in IBS symptomatology and quality of life. Psychological stressors are postulated to result in gastrointestinal symptoms through alteration of intestinal function mediated by the autonomic nervous system, hypothalamic-pituitary-adrenal axis and immune system. Hypnotherapy has the strongest supportive evidence as a beneficial mind-body intervention for IBS. Clinical studies of hypnotherapy have uniformly shown improvement of gastrointestinal symptoms, anxiety, depression and quality of life in patients with IBS. Mindfulness meditation remains unstudied for IBS, but is theoretically attractive as a stress-reduction technique. There is a suggestion that relaxation therapy or multimodal therapy (a combination of relaxation therapy, education and psychotherapy) is beneficial for IBS. The most generally accepted psychological mind-body intervention is cognitive behavioral therapy, and clinical trials support the beneficial effects of cognitive behavioral therapy in patients with IBS.
Subject(s)
Complementary Therapies , Irritable Bowel Syndrome/psychology , Irritable Bowel Syndrome/therapy , Adult , HumansABSTRACT
The advent of the Global War on Terrorism (GWOT) underscored the need to improve the U.S. disaster response paradigm. Existing systems involve numerous agencies spread across disparate functional and geographic jurisdictions. The current architecture remains vulnerable to sophisticated terrorist strikes. To address these vulnerabilities, we must continuously adapt and improve our Homeland Security architecture. Virtual Reality (VR) technologies will help model those changes and integrate technologies. This paper provides a broad overview of the strategic threats, together with a detailed examination of how specific VR technologies could be used to ensure successful disaster responses.
Subject(s)
Security Measures , Terrorism , User-Computer Interface , Disaster Planning , Program Development , United StatesABSTRACT
We have developed a method employing a scanning electron microscope (SEM) and energy dispersive X-ray spectroscopy for examining uncoated ice specimens. By permitting the ice to sublimate in the SEM at temperatures between -115 degrees and -60 degrees C, enough ions are produced to prevent specimen charging. The absence of a conductive coating permits both the acquisition of uncompromised X-ray spectra, and a dynamic view of impurities as the ice sublimates. The method has enabled us to examine the microstructure and impurities in ice in ways not possible through standard melt chemistry measurements or even through using a SEM to study coated samples. Soluble impurities appeared either as white spots in grain interiors, grain boundaries, and triple junctions, or as filaments in grain boundaries. Inclusions of insoluble impurities have also been observed in natural ice. Thus, we have been able to compare the microstructural location and concentration of impurities in ice from different terrestrial locations. Even when ion chromatography of the melt from two core sections reveals similar levels of impurities, the morphology and location of the impurity aggregates can be quite different. Analysis of impurity type and location can provide clues to the depositional environment and history of the ice.