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      Design and methods for the Ranger Resilience and Improved Performance on Phospholipid bound Omega-3's (RRIPP-3 study)

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          Abstract

          Intake of nutrients fundamental for optimal neuronal function is of increasing interest. The potential importance of omega-3 highly unsaturated fatty acids (HUFAs) for optimizing emotional states, cognitive function, and mental health has been demonstrated in observational studies and randomized controlled trials. Omega-3 (HUFAs), specifically EPA (eicosapentaenoic acid) and docosahexaenoic acid (DHA), are concentrated in neural tissues and are essential for neural function, normative neurodevelopment, neurotransmitter, and neural immune functions. Omega-3 HUFAs must be obtained from the diet, predominantly from marine sources such as fish and other seafood. HUFAs also can be found in a variety of dietary supplements (omega-3 fatty acid esters, fish oil and krill oil). As dietary supplements, omega-3 HUFAs (fatty acid esters, fish and krill oils) differ substantially in their physicochemical properties and nutrient content. Here we present the design and methods for the Ranger Resilience and Improved Performance on Phospholipid bound Omega-3's (RRIPP-3) study. RRIPP-3 was a double blind, randomized, controlled trial among individuals in the United States (US) Army Infantry Basic Officer Leaders Course (IBOLC) and following US Ranger School training (RC) at Fort Benning, GA of omega-3 HUFA on krill oil versus placebo supplementation. The RRIPP-3 study sought to determine if krill oil supplementation with omega-3 HUFAs supports aspects of cognitive functioning critical to battlefield success when measured immediately after an intense combat simulation. Sub-analyses addressed basic improvements in IBOLC performance. We also describe additional outcome measures critical for interpretation of the study results, such as diet and other dietary supplement use.

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          Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC).

          Resilience may be viewed as a measure of stress coping ability and, as such, could be an important target of treatment in anxiety, depression, and stress reactions. We describe a new rating scale to assess resilience. The Connor-Davidson Resilience scale (CD-RISC) comprises of 25 items, each rated on a 5-point scale (0-4), with higher scores reflecting greater resilience. The scale was administered to subjects in the following groups: community sample, primary care outpatients, general psychiatric outpatients, clinical trial of generalized anxiety disorder, and two clinical trials of PTSD. The reliability, validity, and factor analytic structure of the scale were evaluated, and reference scores for study samples were calculated. Sensitivity to treatment effects was examined in subjects from the PTSD clinical trials. The scale demonstrated good psychometric properties and factor analysis yielded five factors. A repeated measures ANOVA showed that an increase in CD-RISC score was associated with greater improvement during treatment. Improvement in CD-RISC score was noted in proportion to overall clinical global improvement, with greatest increase noted in subjects with the highest global improvement and deterioration in CD-RISC score in those with minimal or no global improvement. The CD-RISC has sound psychometric properties and distinguishes between those with greater and lesser resilience. The scale demonstrates that resilience is modifiable and can improve with treatment, with greater improvement corresponding to higher levels of global improvement. Copyright 2003 Wiley-Liss, Inc.
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            Comparative validation of the Block, Willett, and National Cancer Institute food frequency questionnaires : the Eating at America's Table Study.

            Researchers at the National Cancer Institute developed a new cognitively based food frequency questionnaire (FFQ), the Diet History Questionnaire (DHQ). The Eating at America's Table Study sought to validate and compare the DHQ with the Block and Willett FFQs. Of 1,640 men and women recruited to participate from a nationally representative sample in 1997, 1,301 completed four telephone 24-hour recalls, one in each season. Participants were randomized to receive either a DHQ and Block FFQ or a DHQ and Willett FFQ. With a standard measurement error model, correlations for energy between estimated truth and the DHQ, Block FFQ, and Willett FFQ, respectively, were 0.48, 0.45, and 0.18 for women and 0.49, 0.45, and 0.21 for men. For 26 nutrients, correlations and attenuation coefficients were somewhat higher for the DHQ versus the Block FFQ, and both were better than the Willett FFQ in models unadjusted for energy. Energy adjustment increased correlations and attenuation coefficients for the Willett FFQ dramatically and for the DHQ and Block FFQ instruments modestly. The DHQ performed best overall. These data show that the DHQ and the Block FFQ are better at estimating absolute intakes than is the Willett FFQ but that, after energy adjustment, all three are more comparable for purposes of assessing diet-disease risk.
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              What does the narcissistic personality inventory really measure?

              The Narcissistic Personality Inventory (NPI) is a widely used measure of narcissism. However, debates persist about its exact factor structure with researchers proposing solutions ranging from two to seven factors. The present research aimed to clarify the factor structure of the NPI and further illuminate its nomological network. Four studies provided support for a three-factor model consisting of the dimensions of Leadership/Authority, Grandiose Exhibitionism, and Entitlement/Exploitativeness. The Leadership/Authority dimension was generally linked to adaptive outcomes whereas the other two dimensions, particularly Entitlement/Exploitativeness, were generally linked to maladaptive outcomes. These results suggest that researchers interested in the psychological and behavioral outcomes associated with the NPI should examine correlates at the facet level. In light of the findings, we propose a hierarchical model for the structure of the NPI and provide researchers with a scoring scheme for this commonly used instrument.
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                Author and article information

                Contributors
                Journal
                Contemp Clin Trials Commun
                Contemp Clin Trials Commun
                Contemporary Clinical Trials Communications
                Elsevier
                2451-8654
                26 April 2019
                September 2019
                26 April 2019
                : 15
                : 100359
                Affiliations
                [a ]Nutrition Section, Division of Gastroenterology and Hepatology, Department of Medicine, and Military Division, Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, 114 Doughty Street, Ste. 630D, MSC774, Charleston, SC, 29425, USA
                [b ]Department of Neurology, College of Medicine, Medical University of South Carolina, 96 Jonathan Lucas Street, Suite 301 CSB, Charleston, SC, 29425, USA
                [c ]Acting Chief, Section on Nutritional Neurosciences, LMBB, NIAAA, NIH, 5625 Fishers Lane, Rm 3N-07, MSC 9410, Bethesda, MD, 20892, USA
                [d ]Nutrition Section, Division of Gastroenterology and Hepatology, Department of Medicine, College of Medicine, Medical University of South Carolina, 114 Doughty Street, Ste. 630D, MSC774, Charleston, SC 29425, USA
                [e ]Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Ste. 303C, Charleston, SC, 29425, USA
                [f ]Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC, 29425, USA
                [g ]Northrop Grumman Corp, 3565 Macon Rd, Columbus, GA, 31907, USA
                [h ]Maneuver Center of Excellence, Infantry Basic Officers Leader Course, Fort Benning, GA, 31905, USA
                Author notes
                []Corresponding author. Emeritus Professor, Department of Medicine, Division of Gastroenterology and Hepatology, Medical University of South Carolina, 114 Doughty Street, Suite 629, MSC 774, Charleston, SC, 29425-7740, USA. marriobp@ 123456musc.edu
                [1]

                Currently: Department of Family and Consumer Services, University of Tennessee, Knoxville, TN, 37996, USA.

                Article
                S2451-8654(19)30001-8 100359
                10.1016/j.conctc.2019.100359
                6503132
                9baf2995-43b4-4295-b8e8-06f95d42a079
                © 2019 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 20 December 2018
                : 20 March 2019
                : 5 April 2019
                Categories
                Article

                omega-3 fatty acids,cognition,krill oil,us army officers,phospholipids,resilience

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