Cortisol and hypothalamic–pituitary–gonadal axis hormones in follicular-phase women with fibromyalgia and chronic fatigue syndrome and effect of depressive symptoms on these hormones

We investigated abnormalities of the hypothalamic–pituitary–gonadal axis and cortisol concentrations in women with fibromyalgia and chronic fatigue syndrome (CFS) who were in the follicular phase of their menstrual cycle, and whether their scores for depressive symptoms were related to levels of these hormones. A total of 176 subjects participated – 46 healthy volunteers, 68 patients with fibromyalgia, and 62 patients with CFS. We examined concentrations of follicle-stimulating hormone, luteinizing hormone (LH), estradiol, progesterone, prolactin, and cortisol. Depressive symptoms were assessed using the Beck Depression Inventory (BDI). Cortisol levels were significantly lower in patients with fibromyalgia or CFS than in healthy controls (P < 0.05); there were no significant differences in other hormone levels between the three groups. Fibromyalgia patients with high BDI scores had significantly lower cortisol levels than controls (P < 0.05), and so did CFS patients, regardless of their BDI scores (P < 0.05). Among patients without depressive symptoms, cortisol levels were lower in CFS than in fibromyalgia (P < 0.05). Our study suggests that in spite of low morning cortisol concentrations, the only abnormalities in hypothalamic–pituitary–gonadal axis hormones among follicular-phase women with fibromyalgia or CFS are those of LH levels in fibromyalgia patients with a low BDI score. Depression may lower cortisol and LH levels, or, alternatively, low morning cortisol may be a biological factor that contributes to depressive symptoms in fibromyalgia. These parameters therefore must be taken into account in future investigations

Socioeconomic Response to Water Quality: a First Experience in Science and Policy Integration for the Izmit Bay Coastal System

Deterioration of the Izmit Bay ecosystem, mainly caused by heavy industrialization and urbanization, has significantly impaired its beneficial use and resulted in the surrounding coastal zone losing its attractiveness for the inhabitants. An integrated coastal zone management approach has become an important requirement of future development plans to protect this fragile bay ecosystem. One of the main indicators of deterioration of the Izmit Bay coastal system is the decreasing water quality resulting from increased nutrient loads from the surrounding land.The consensus during the initial stakeholder meeting confirmed the widespread awareness of this phenomenon and "improvement of water quality in Izmit Bay" was determined as the main policy issue at stake. Public perception of and satisfaction with water quality were measured by a willingness to pay (WTP) survey. The WTP for improved water quality was analyzed using the contingent valuation method. According to the questionnaire survey, 55% of the participants are willing to pay to increase the water quality. Impact of water quality on real-estate values was evaluated by hedonic pricing method, which is suitable for estimating direct and indirect use values of water resources. These results were used in a simulation model to assess coupled ecosystem, social, and economic system functioning of the Izmit Bay in response to various scenarios, and thus, to permit the necessary actions to be taken proactively. Two scenario simulations, for which domestic and runoff nitrogen loads are reduced independently, showed that hypothetical domestic wastewater treatment resulted in an improvement in simulated water transparency. The results suggest that domestic wastewater treatment should be a first priority for local administrations

Socioeconomic Response to Water Quality: a First Experience in Science and Policy Integration for the Izmit Bay Coastal System

Deterioration of the Izmit Bay ecosystem, mainly caused by heavy industrialization and urbanization, has significantly impaired its beneficial use and resulted in the surrounding coastal zone losing its attractiveness for the inhabitants. An integrated coastal zone management approach has become an important requirement of future development plans to protect this fragile bay ecosystem. One of the main indicators of deterioration of the Izmit Bay coastal system is the decreasing water quality resulting from increased nutrient loads from the surrounding land. The consensus during the initial stakeholder meeting confirmed the widespread awareness of this phenomenon and "improvement of water quality in Izmit Bay" was determined as the main policy issue at stake. Public perception of and satisfaction with water quality were measured by a willingness to pay (WTP) survey. The WTP for improved water quality was analyzed using the contingent valuation method. According to the questionnaire survey, 55% of the participants are willing to pay to increase the water quality. Impact of water quality on real-estate values was evaluated by hedonic pricing method, which is suitable for estimating direct and indirect use values of water resources. These results were used in a simulation model to assess coupled ecosystem, social, and economic system functioning of the Izmit Bay in response to various scenarios, and thus, to permit the necessary actions to be taken proactively. Two scenario simulations, for which domestic and runoff nitrogen loads are reduced independently, showed that hypothetical domestic wastewater treatment resulted in an improvement in simulated water transparency. The results suggest that domestic wastewater treatment should be a first priority for local administrations