The Efficacy of Limbic System Retraining and Neuroplasticity in the Management of Chronic Pain and Disease: A Systematic Review

Background: Chronic pain and disease are prevalent, affecting 51.6 million people in 2023. Therefore, due to the high complexity of chronic disease, many providers try different interventions to alleviate pain and improve their patient\u27s quality of life. The limbic system is a critical component of the brain involved in pain perception and emotional regulation. With an overactive limbic system, the perception of pain is enhanced and continues to cause discomfort for the patient. By retraining the limbic system to alter the fight or flight response, a significant reduction in pain can be achieved, which results in better emotion regulation. The primary interventions considered for limbic system retraining are neurofeedback and electrical stimulation. Purpose: This review aims to evaluate the efficacy of limbic system retraining and neuroplasticity in managing chronic pain and disease. Methods: The author conducted an extensive literature review to evaluate the evidence and conducted a thorough annotated bibliography. Inclusion criteria for this study included articles that contained the key terms, were original research, could be obtained freely, and were published later than 2019. Any articles that didn’t meet the inclusion criteria were excluded. Data was collected using these key terms: amygdala neuromodulation, amygdala and insula retraining, limbic system neuromodulation, amygdala and chronic pain, limbic system retraining, neuroplasticity, and chronic pain management. Further, the following search engines were used to obtain articles: PubMed, Google Scholar, Jane Biosematic, National Institute of Health (NIH), UpToDate, and Science Direct. Data gathered was synthesized by evaluating the study\u27s sample size and the statistical significance of the results while considering any potential bias. A limitation of the data collection was that only freely available articles through Augsburg Library sources were reviewed. Results: After a thorough literature review, evidence supports the efficacy of limbic system retraining and neuroplasticity using neurofeedback and electrical stimulation. Of the articles reviewed, 19 met inclusion criteria, with 11 supporting neuromodulation using neurofeedback and eight for electrical stimulation. Studies ranged in sample size, and of the 11 articles supporting neurofeedback for neuromodulation, all were randomized controlled studies, with three not randomized. Further, of the eight randomized controlled studies, two were double-blind studies. Additionally, of the eight papers supporting the use of electrical stimulation, all were randomized controlled, with three being double-blinded. Evidence to support limbic system retraining using neurofeedback included amygdala plus insula retraining with MBSR and using real-time fMRI and amygEFP. These articles have shown efficacy in reducing pain and overall functional impairment. For patients with post-traumatic stress disorder, a significant reduction in symptoms of 75% continued for up to 6 months. When considering articles supporting electrical stimulation, the results indicated that transcutaneous direct stimulation is effective for neuromodulation and reduced abdominal pain for inflammatory bowel disease. Additionally, 73% of participants noted reduced pain for patients who underwent electrical intramuscular stimulation. Further, transcutaneous vagus nerve stimulation also proved effective in modulating pain and reducing the number of chronic migraine attacks. Discussion: A review of the literature and studies noted a few limitations. Across multiple papers, the primary limitation was the small sample size. Additional considerations were specific to each modality. The primary limitation of articles supporting neurofeedback for neuromodulation included the time to learn neurofeedback techniques. However, other limitations had too few fMRI scans, which were noted in two studies, and there was a concern about not considering the control variable of different therapists for teaching MBSR. Additionally, electrical stimulation papers also emphasized the need for research conducted over a more extended period, varied participants, and a greater sample size. Further, for the vagus nerve articles, the primary future consideration was to evaluate the influence of the sham intervention on the overall results. In conclusion, limbic system retraining and neuroplasticity are possible and effective. However, additional research is needed to evaluate the efficacy across a larger population and consider the long-term outcomes and benefits

Alexandre Brongniart (1770-1847): Kinship, natural history, and the invention of ceramic science

In this thesis, I examine the life of Alexandre Brongniart, whose career in natural history paralleled a forty-seven-year directorship of the Sèvres Porcelain Manufactory. Critically, I show that Brongniart created a coherent science for “the arts of the Earth,” for which he established the term “la céramique.” Brongniart placed the study of the ceramic arts firmly within the context of natural history as well as that of expansive, geological time. As a case study, Brongniart’s lifetime highlights the transitions in the study of natural history that took place between the Enlightenment and the mid-nineteenth century. Brongniart was born into a family centred in artisanal and noble networks, where Enlightenment views were often admired and upheld. Shared kinships, guild ties, and social networks strengthened families and expanded financial interests, while marriages frequently established or enlarged alliances. Surrounded by prominent savants, artists, and artisans, Brongniart inherited significant advantage, but he also actively shaped his own education and career. Brongniart’s early education took place amid the chemical revolution – learning chemistry from Lavoisier himself. By his early career, Brongniart had begun the kinds of analysis and categorization that were instrumental in establishing scientific disciplines such as biology, palaeontology, geology, and mineralogy out of the study of natural history. By the end of the eighteenth century, all-encompassing, cosmological “systems” fell into disfavour, as a focus on facts, experimentation, analysis, measurement, and observation became indispensable to the practice of science. Both Brongniart, and his famous associate and friend, Georges Cuvier, sought to record observations with restricted emphasis on theory, and both considered that precise nomenclature was a key component of the practice of natural history and science. My discussion traces Brongniart’s successful and unsuccessful contributions to expanding scientific disciplines and to scientific language, including words such as Jurassic, Jovienne, Saturnienne, and, perhaps most importantly, "la céramique"

Blending scales of governance: land-use policies and practices in the small state of Luxembourg

© 2014 Regional Studies Association. Affolderbach J. and Carr C. Blending scales of governance: land-use policies and practices in the small state of Luxembourg, Regional Studies. While multilevel governance is helpful in understanding the logics behind integrated sustainable development policies, this paper argues that relational multi-scalar approaches more accurately explain actual land-use transformations in the small state of Luxembourg. These conclusions are based on surveys of planning policies and observations of land-use patterns related to housing and retail. Additionally, over 60 interviews were performed with local actors. The results reveal how actors blend scales of governance to override national directives to exert changes in land use. Blending scales is not always strategic or advantageous, but is an unavoidable process that characterizes interactions in a small state

Computers in recreation and sport management

This study was undertaken by the Department of Recreation Studies to investigate computer utilisation by sport and recreation professionals in not-for-profit sporting and recreation organisations in Western Australia, with a view to identifying the preparation needed by recreation students. One hundred and fifty (150) selected organisations from four generic groups (local government, sports adminstration organisations, recreation organisations for special populations and community recreation organisations) were surveyed. The results revealed a broad range of computer applications, predominantly for administration. The most common applications by all four groups were word processing, database management and financial management. Financial management systems were used more than any other application by professional recreation and sports personnel throughout the course of their employment. Computer skill training occurred mostly on-the-job. The main barrier to effective computer utilisation was lack of funds, and the most positive contribution of the computer was perceived to be time· efficiency. All organisations considered computer awareness and competency desirable job selection criteria, reflecting the need for students of recreation and sports administration to be computer literate as a pre-requisite for future employment

FROM GEOLOGY TO ART HISTORY: CERAMIST ALEXANDRE BRONGNIART’S OVERLOOKED CONTRIBUTION TO THE DEVELOPING SCIENCE OF ART HISTORY IN THE EARLY NINETEENTH CENTURY

Alexandre Brongniart was known for his work as an important geologist and as an administrator at the Sèvres Porcelain Manufactory, but his roles as art historian and museologist are overlooked. Brongniart created a holistic methodology taken directly from science and applied it to ceramic art of all cultures and eras. He had a uniquely modern perspective on time, world culture, and archeology. Brongniart wrote about the art of Asia and the Americas on an equal status with that of the Classical West at least fifty years before it became a mainstream idea. Brongniart integrated scientific principle and practice into the structure of the Sèvres Museum and a comprehensive set of books which includes Traité de Mineralogie avec des Applications aux Arts, Traité des Arts Ceramiques, and Description Methodique du Musée Ceramique de la Manufacture Royale de Porcelain de Sèvres. Numerous historians were influenced by Brongniart’s work, including Samuel Birch and Albert Jacquemart. Notably, the art historian Gottfried Semper refocused his ideas for Style in the Technical and Tectonic Arts after seeing the completed works of Brongniart. Although contemporary historians credit Semper with the development of a scientific approach to art history, Semper himself frequently acknowledged the importance of Brongniart’s work

Anti-racism and Occupational Therapy Education: Beyond Diversity and Inclusion

There is a pressing need to address racism within healthcare education; however, occupational therapy educators lack a compilation of discipline-specific knowledge of anti-racist actions. The objective of this study was to examine anti-racist instructional practices for educators to employ in occupational therapy education. We conducted a scoping review and systematically searched six electronic databases to identify and synthesize anti-racist educational practices within the occupational therapy literature. The 20 included articles identified that educators should: use collaborative, anti-racist teaching strategies throughout the curriculum; engage in reflexivity including how intersecting identities impact occupational engagement; decolonize curricula through including Indigenous content and non-Western practice frameworks; increase representation of Black, Indigenous, and other People of Color students and faculty; and strengthen educators’ capacity to engage in anti-racist actions. To address systemic injustices to educational inclusion and prepare students to address health care inequities, occupational educators must engage in anti-racist actions across curriculum, programs, and universities

Natural Families of Triangles II: A Locus of Symmedian Points

We group triangles into families based on three parameters: the distance between the circumcenter O and the centroid G, the circumradius, and the measure of angle Ð GOAwhere A is one vertex. We focus on the family of triangles which allows Ð GOA to vary and fixes the other two parameters. By construction, this grouping produces triangles which share the same Euler line. Perhaps unexpectedly, if we examine the family\u27s locus of a triangle center known as the symmedian point, we find that it always forms an arc of a circle centered at a specified point on the Euler line

Parents' experiences of initiation of paediatric advance care planning discussions: A qualitative study

Advance care planning enables parents to discuss their goal and wishes for the future treatment and care of their life-limited or life-threatened child. Whilst research has identified the barriers clinicians face to initiate such discussions, the views of the parents have received scant attention. This qualitative study, using reflexive thematic analysis, aimed to explore parents’ experience of the initiation of their child’s advance care planning discussions, to help provide an understanding to inform future practice. Single interviews were undertaken with 17 non-bereaved and bereaved parents. Parents reported they had engaged with future thinking but needed time before initiating this with clinicians. They identified the need for a trusted professional and time for private, thorough, non-judgemental discussion without feeling clinicians were ‘giving up’. Parents reported that advance care planning discussions were not always aligned to the dynamics of family life. They felt that health professionals were responsible for initiating advance planning conversations according to the families’ individual requirements. There was an apparent lack of standardised protocols to assist paediatric advance care planning discussion initiation. Conclusion: Initiating advance care planning is a complicated process that needs to be tailored to the specific parent and child situation. Health professionals need to appreciate that parents are key contributors to initiate engagement with advance care planning discussions but that they also require support and care, recognising this may facilitate the building of trust, identified as a key corner stone, of paediatric advance care planning initiation and engagement. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00431-021-04314-6

Natural Families of Triangles I: Parametrizing Triangle Space

We group triangles into families based on three parameters: the distance between the circumcenter O and the centroid G, the circumradius, and the measure of angle Ð GOAwhere A is one vertex. Using these parameters, we present triangle space, a subset of R3 in which every triangle is represented by exactly one point