Inflammatory bowel disease (IBD) including Crohn's disease (CD) and ulcerative colitis (UC) is a chronic and disabling disease with unknown etiology. There have been some controversies regarding the role of psychological factors in the course of IBD. The purpose of this paper is to review that role. First the evidence on role of stress is reviewed focusing on perceived stress and patients' beliefs about it in triggering or exacerbating the course of IBD. The possible mechanisms by which stress could be translated into IBD symptoms, including changes in motor, sensory and secretory gastrointestinal function, increase intestinal permeability, and changes in the immune system are, then reviewed. The role of patients' concerns about psychological distress and their adjustment to disease, poor coping strategies, and some personality traits that are commonly associated with these diseases are introduced. The prevalence rate, the timing of onset, and the impact of anxiety and depression on health-related quality of life are then reviewed. Finally issues about illness behavior and the necessity of integrating psychological interventions with conventional treatment protocols are explained.
The purpose of the present study was to determine the effect of metacognitive therapy (MCT) on symptoms of body dysmorphic disorder (BDD) and on symptoms of thought-fusion, by means of a wait-list controlled clinical trial. Participants were referred from dermatology and cosmetic surgery clinics in the city of Isfahan, Iran, and 20 patients were selected on the basis of DSM-IV-TR diagnostic criteria for BDD. They were randomly assigned to either the experimental or the wait-list control group. The Yale-Brown Obsessive Compulsive Scale Modified for Body Dysmorphic Disorder (BDD-YBOCS) and the Thought-Fusion Inventory (TFI) were used as the outcome measures. The experimental group received 8 weekly metacognitive intervention sessions. The control group was in the waiting-list until the end of the follow-up. Measures were taken at pre-test, post-test (after 2 months) and follow-up (after 6-months). The results of analysis of variance showed that MCT significantly reduced the symptoms of BDD and of thought-fusion, compared to the wait-list. Effects on both outcome measures were maintained at 6-months follow-up.
In recent years, biodegradable edible films have become very important in research related to food, due to their compatibility with the environment and their use in the food packaging industry. Various sources can be used in the production of biopolymers as biodegradable films that include polysaccharides, proteins and lipids. Among the various polysaccharides, starch due to its low price and its abundance in nature is of significant importance. Several factors affect the properties of starch films; such as the source which starch is obtained from, as well as the ratio of constituents of the starch. Starch films have advantages such as low thickness, flexibility and transparency though; there are some downsides to mention, such as the poor mechanical properties and water vapor permeability. Thus, using starch alone to produce the film will led to restrictions on its use. To improve the mechanical properties of starch films and also increases resistance against humidity, several methods can be used; including the starch modifying techniques such as cross linking of starch and combining starch with other natural polymers. Other methods such as the use of lipid in formulations of films to increase the resistance to moisture are possible, but lipids are susceptible to oxidation. Therefore, new approaches are based on the integration of different biopolymers in food packaging.
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