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Before putting the food into the food dehydrator, always slice them into one-fourth inch pieces or sections. This will allow the optimal exposure of the surface to the heat and airflow of the dehydrator.

As much as possible, evenly distribute the slices of food across the dehydrator sheets. This will also facilitate the process of drying, making it very extensive and effective.

It is advisable to sporadically inspect the drying condition of the food. The items which are located near the fan of the food dehydrator will dry out faster than the other foods. This can be remedied by alternately repositioning the trays after a couple of hours.

Make sure to carefully dry out food and give them time to cool down at room temperature prior to placing them inside a container which has an airtight seal. Even if the moisture level of food removed from the dehydrator is at a low level, they can still secrete some amount of water. The moisture will be kept out of the airtight container if the food is given a cool down period right after it goes through dehydration and prior to placing them inside the airtight container.

Sporadically clean the dehydrator using tepid water particularly near the base of the dehydrator where small pieces of food may have collected.

Try out a variety of food items, recipes and the different methods of preparing food.

Never attempt to fast-track the drying process of the food by increasing the temperature of the dehydrator above the suggested temperature level that the food is supposed to be exposed to. If this is done, hardening will occur or a partial dehydration will occur and the food will have a hard surface with the inside still moist which will spoil the food items too early.

Dry out food items of the same kind together. Dry out vegetables together with other vegetables and fruits with other fruits. Do not dry out asparagus or onions together with bananas and other kinds of fruit.

Always label the containers of the dried food with the date when they were dehydrated. You will be able to monitor the age of the food items and its shelf life with this.

Do not use a microwave oven to dry out food. The best way to dehydrate is with a food dehydrator. There are many types of dehydrators available in the market for home usage. Here you can read further about choosing a food dehydrator to use at home.

Ashley writes about food dehydrating at All Food Dehydrators. You can check out her website to learn more about food dehydrating at home, read food dehydrator reviews, guides and recipes.

Pharmacotherapy of Combat-stress-related Post Traumatic Stress Disorder

ANNALS Winter 2007 www.americanpsychotherapy.com

This 1-credit continuing education opportunity is co-sponsored by the American College of Forensic Examiners International (ACFEI) and the American Psychotherapy Association. ACFEI maintains responsibility for all continuing education accreditations. This article is approved by the following for 1 continuing education credit:

APA provides this continuing education credit for Diplomates.

The American College of Forensic Examiners International is approved by the American Psychological Association to sponsor continuing education for psychologists. ACFEI maintains responsibility for this program and its content.

The American College of Forensic Examiners International is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME). The American College of Forensic Examiners International designates this educational activity for a maximum of 1 hour AMA PRA Category 1 Credits™.. Physicians should only claim credit commensurate with the extent of their participation in the activity.

By Harpriya A. (Sonya) Bhagar, MBBS and Alan D. Schmetzer, MD, Fellow of the American Psychotherapy Association, and Master Therapist

A number of veterans from Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) are returning home with signs of combat-stress-related Post Traumatic Stress Disorder (PTSD). In a recent study, 16.6% of the soldiers met the screening criteria for PTSD. On average, they showed a significant increase in sick visits, missed workdays, severity of somatic symptoms, and poorer overall health (Hoge et al., 2007). In another study, the youngest age group, 18–24 years, was at greater risk compared with veterans 40 years of age or above. Diagnosis was made early (median of 13 days), and most of them were detected in primary care clinics (Seal et al., 2007).

Upon return from the war zone, veterans frequently report intrusive thoughts, flashbacks, increased vigilance, avoidance of social situations, hyperarousal, and nightmares. Treatment involves integration of mental health, primary care, physical medicine, attention to substance abuse, and vocational services. The mental health portion involves an initial screening of the combat veteran for PTSD and other mental illnesses, followed by a full assessment. Both pharmacotherapy and psychotherapy (individual, couple, and group) are offered for treatment.

From a pharmacological perspective, several studies have found the traditional anti-depressants effective in PTSD. Selective serotonin reuptake inhibitors (SSRIs), like sertraline (Zoloft®), paroxetine (Paxil®), and fluoxetine (Prozac®), have been studied extensively for PTSD, and sertraline and paroxetine have been approved by the Food and Drug Administration for PTSD. SSRIs have been found to be effective both in short-term trials and long-term maintenance treatment for relapse prevention (Asnis et al., 2004). However, earlier studies have focused mainly on PTSD secondary to interpersonal trauma in a civilian setting. In a multicenter study, venlafaxine extended release (Effexor XR®), a serotonin norepinephrine reuptake inhibitor, was found to improve both the re-experiencing and the avoidance symptoms of PTSD, but not hyperarousal. The drug was effective and well tolerated in both short-term and continuation treatment of PTSD (Davidson et al., 2006). In a small study, mirtazapine (Remeron) was found to be effective in both short-term and continuation treatment of combat-stress-related PTSD without any serious side effects (Kim et al., 2005). In addition, sedation from mirtazapine can even prove beneficial in improving sleep in PTSD. In a randomized trial comparing phenelzine (a monoamine oxidase inhibitor) and imipramine (a tricyclic antidepressant), both significantly reduced combat stress related PTSD symptoms (Kosten et al., 1991). Benzodiazepines are used in PTSD for panic attacks or anxiety states. They provide temporary relief but run the risk of tolerance and addiction.

Veterans with PTSD find it hard both to fall asleep and to maintain sleep due to hyperarousal and vivid nightmares related to combat. Significant others often report that patients scream in their sleep and may even wake up soaked in sweat. Prasozin and clonidine both decrease the central nervous system’s noradrenergic activity. They have been found to be effective in decreasing hyperarousal symptoms and improving sleep (Boehnlein, 2007). Other drugs used for sleep are the benzodiazepine class of drugs, like temazepam, and non-benzodiazepines, like zolpidem (Ambien™) and ezopiclone (Lunesta™). However, caution must be taken regarding the habit-forming potential of these drugs (Bhagar and Schmetzer, 2006).

The presence of psychotic symptoms in PTSD can further complicate the clinical picture. In one study, 20% of the 91 males with combat-stress-related PTSD were found to be suffering from hallucinations and delusions, and hyperarousal was positively associated with the occurrence of psychotic symptoms (Kastelan, 2007). In a small study, augmentation of SSRI with olanzapine (Zyprexa), an atypical antipsychotic, was effective in treating SSRI-resistant combat-related PTSD symptoms, especially sleep (Stein, 2002). In another study, monotherapy with typical or atypical antipsychotics, reduced both PTSD and psychotic symptoms, and antipsychotics seemed to offer another approach to treat the psychotic subtype of combat–related PTSD resistant to previous antidepressant therapy (Pivac, 2006).

Overall, PTSD pharmacotherapy involves several drugs based on our experience with PTSD in general, but well-designed studies are needed to establish treatment guidelines specifically for combat-stress-related PTSD.

References

Asnis, G. M., Kohn, S. R., Henderson, M., & Brown, N. L. (2004). SSRIs versus non-SSRIs in post traumatic stress disorder: an update with recommendations. Drugs, 64(4), 383–404.

Bhagar, H. A., & Schmetzer, A. D. (2006). The newest medicines for sleep. Annals of American Psychotherapy Association, 9(2), 25–26.

Boehnlein, J. K., & Kinzie, J. D. (2007). Pharmacologic reduction of CNS noradrenergic activity in PTSD: The case for clonidine and prazosin. Journal of Psychiatric Practice, 13(2), 72–78.

Davidson, J., Baldwin D., Stein, D.J., Kuper, E., Benattia, I., Ahmed, S., et al. (2006). Treatment of post traumatic stress disorder with venlafaxine extended release: a 6-month randomized controlled trial. Archives of General Psychiatry, 63(10), 1158–1165.

Hoge, C. W., Terhakopian, A., Castro, C. A., Messer, S. C., & Engel, C. C. (2007). Association of post traumatic stress disorder with somatic symptoms, health care visits, and absenteeism among Iraq war veterans. American Journal of Psychiatry,164(1), 150–153.

Kastelan, A., Franciskovi,? T., Moro, L., Roncevic-Grzeta, I., Grkovic, J., Jurcan, V., et al. (2007). Psychotic symptoms in combat-related post traumatic stress disorder. Military Medicine, 172(3), 273–277.

Kim, W., Pae, C. U., Chae, J. H., Jun, T. Y., & Bahk, W. M. (2005). The effectiveness of mirtazapine in the treatment of post-traumatic stress disorder: A 24-week continuation therapy. Psychiatry and Clinical Neurosciences, 59(6), 743–747.

Kosten, T. R., Frank, J. B., Dan, E., McDougle, C. J., & Gille, E. L., Jr. (1991). Pharmacotherapy for posttraumatic stress disorder using phenelzine or imipramine. Journal of Nervous and Mental Disease, 179(6), 366–370.

Martényi, F. (2005). [Three paradigms in the treatment of posttraumatic stress disorder]. Neuropsychopharmacol Hung, 7(1), 11–21.

Pivac, N., & Kozari?-Kovaci,? D. (2006). Pharmacotherapy of treatment-resistant combat-related posttraumatic stress disorder with psychotic features. Croatian Medical Journal, 47(3), 440–451.

Seal, K. H., Bertenthal, D., Miner, C. R., Sen, S., & Marmar, C. (2007). Bringing the war back home: mental health disorders among 103,788 US veterans returning from Iraq and Afghanistan seen at Department of Veterans Affairs facilities. Archives of Internal Medicine, 167(5), 476–482.

(800) 205-9165 Winter 2007 ANNALS

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About the Author

The American Psychotherapy Association's goal is to improve the public perception of psychotherapy. In recent years, the psychotherapeutic process has been devalued by insurance companies, the court system, and other professional membership associations. The APA promotes the field of psychotherapy and those professionals who are committed to the practice. APA encourages individual professional growth and works to elevate professional standards for practicing psychotherapy.

Does any one no the measurement of a ddg shotter seat pole hole, also the seal steerer tube measurement?

i need the measuremeents of the seat post hole so i can get a new clamp and seat pole for my bike, also what is the measurement for the steerer tube were the forks go up were the seal is.

you can measure the seat post clamp size with a ruler, or take the old clamp to a bike shop and get them to match the size.

steerer tube measurements on nearly all non road bikes these days is 1 1/8. the length varies depending on the hight of the headtube and how many spacers you need

Lively Danny helps Portugal seal victory
Portugal winger Danny made the most of every opportunity to help his team secure victory over Mozambique in their final friendly before the World Cup.

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