Performance anxiety in actors: symptoms, explanations and an Indian approach to treatment

There are numerous examples of renowned performers across the arts (actors and musicians) and in sports, which become news items in the media due to their performance anxiety (also called stage fright in English, or Lampenfieber in German). Given the number of celebrity actors suffering from stage fright, the number of those actors who do not make the news headlines in relation to their stage fright but nevertheless suffer from it must be even higher. In t his essay we provide an up to date account of the symptoms of stage fright, possible explanations for it and a range of known approaches to treatment. This is followed by an original approach to treating stage fright, based on Indian performance techniques, using details of a study undertaken in 2005.This multi-author journal article provides an in-depth analysis into the nature and treatment available for performance anxiety. The article offers examples of numerous artists and singers, including Sir Laurence Olivier, who had experienced stage fright for the duration of his performances of the title role in Ibsen’s The Master Builder (1965). The article run a clear analysis of the symptoms of stage fright and explain the nature of this psychophysical anxiety using clinical evidences and therapeutic methods. The key focus of the article is to compare and contrast two therapeutic methods for deducing stage anxiety: NLP, a well-established method, and SIT, which is an emerging method developed by Sreenath Nair using South Indian Bodily traditions. The article is based on a project carried out by Emerita Elizabeth Valentine and Daniel Meyer-Dinkgräfe in 2005, funded by the British Academy and the University of Wales Aberystwyth. The project compared two distinct methods of reducing stage fright in stage actors (Valentine et.al. 2006), one of them based on Indian approaches (South Indian Techniques, SIT) and the other Neuro Linguistic Programming (NLP). The SIT approach makes use of a range of psychophysical approaches deriving from the martial and performance traditions of Kerala. The study concludes that although many of the results were not statistically significant, ten of the eleven main effects were in the predicted direction, i.e. a greater effect for SIT than NLP. This multi-author journal article provides an in-depth analysis into the nature and treatment available for performance anxiety. The article offers examples of numerous artists and singers, including Sir Laurence Olivier, who had experienced stage fright for the duration of his performances of the title role in Ibsen’s The Master Builder (1965). The article run a clear analysis of the symptoms of stage fright and explain the nature of this psychophysical anxiety using clinical evidences and therapeutic methods. The key focus of the article is to compare and contrast two therapeutic methods for deducing stage anxiety: NLP, a well-established method, and SIT, which is an emerging method developed by Sreenath Nair using South Indian Bodily traditions. The article is based on a project carried out by Emerita Elizabeth Valentine and Daniel Meyer-Dinkgräfe in 2005, funded by the British Academy and the University of Wales Aberystwyth. The project compared two distinct methods of reducing stage fright in stage actors (Valentine et.al. 2006), one of them based on Indian approaches (South Indian Techniques, SIT) and the other Neuro Linguistic Programming (NLP). The SIT approach makes use of a range of psychophysical approaches deriving from the martial and performance traditions of Kerala. The study concludes that although many of the results were not statistically significant, ten of the eleven main effects were in the predicted direction, i.e. a greater effect for SIT than NLP. The study is a practice-based research demonstrating a highly relevant contribution to a therapeutic practice reducing stage fright. The research combines science and humanities indicating direct and wider impact

Influencing Student Beliefs about Poverty and Health through Interprofessional Community-Based Educational Experiences

Background: Pre-licensure students from medicine, physical therapy, kinesiology, nursing, and social work participated in a population health project at the University of Saskatchewan. We assessed the effect of this interactive, interprofessional, community-based educational experience on students’ attitudes and beliefs about poverty and health.Methods and Findings: Participants (N = 119) completed two measures at the beginning and end of the five-week project: the 37-item Attitudes toward Poverty Scale (APS) and the 8-item Beliefs about the Relationship between Poverty and Health (BRPH). APS scores showed a modest significant increase toward more positive attitudes over time (F(1, 110) = 7.97, p < .01). On the BRPH, participants agreed significantly less at Week 5 with two behavioral explanations (F(1, 114) = 5.07, p < .05; F(1, 114) = 11.00, p < .01) and one structural explanation (F(1, 112) = 11.09, p < .01) about relationships between poverty and health. There was some evidence that face-to-face interactions with community members had more impact than a simulation exercise. Students gave positive evaluations of the interprofessional format of the project. Attrition effects may limit the interpretation of these results.Conclusions: Results demonstrate that brief interprofessional community-based learning experiences can positively influence students’ attitudes and beliefs about the relationship between poverty and health

Novel and Emerging Therapies for Inflammatory Bowel Disease.

Inflammatory bowel diseases (IBD) such as ulcerative colitis and Crohn\u27s disease are chronic, relapsing and remitting disorders of intestinal inflammation with potential systemic manifestations. Despite the availability of current biologics, such as anti-tumor necrosis factor (anti-TNF), anti-integrins, anti-interleukins and small molecules such as tofacitinib, the rates of primary and secondary treatment failure remain high in IBD. This highlights the importance of continued development of new therapeutic targets and modifications of existing ones to improve the treatment response rates and to also improve the safety profile and tolerability of these medications. In this review we will discuss novel treatment target agents including selective janus kinase (JAK) inhibitors, anti-interleukin (IL) (IL-12/IL-23), leukocyte trafficking/migrating inhibitors (such as sphingosine-1-phosphate receptor modulator) and other small molecules currently in development

Reduction of hexavalent chromium by fasted and fed human gastric fluid. I. Chemical reduction and mitigation of mutagenicity

Abstract Evaluation of the reducing capacity of human gastric fluid from healthy individuals, under fasted and fed conditions, is critical for assessing the cancer hazard posed by ingested hexavalent chromium [Cr(VI)] and for developing quantitative physiologically-based pharmacokinetic models used in risk assessment. In the present study, the patterns of Cr(VI) reduction were evaluated in 16 paired pre- and post-meal gastric fluid samples collected from 8 healthy volunteers. Human gastric fluid was effective both in reducing Cr(VI), as measured by using the s-diphenylcarbazide colorimetric method, and in attenuating mutagenicity in the Ames test. The mean (± SE) Cr(VI)-reducing ability of post-meal samples (20.4 ± 2.6 μg Cr(VI)/mL gastric fluid) was significantly higher than that of pre-meal samples (10.2 ± 2.3 μg Cr(VI)/mL gastric fluid). When using the mutagenicity assay, the decrease of mutagenicity produced by pre-meal and post-meal samples corresponded to reduction of 13.3 ± 1.9 and 25.6 ± 2.8 μg Cr(VI)/mL gastric fluid, respectively. These data are comparable to parallel results conducted by using speciated isotope dilution mass spectrometry. Cr(VI) reduction was rapid, with > 70% of total reduction occurring within 1 min and 98% of reduction is achieved within 30 min with post-meal gastric fluid at pH 2.0. pH dependence was observed with decreasing Cr(VI) reducing capacity at higher pH. Attenuation of the mutagenic response is consistent with the lack of DNA damage observed in the gastrointestinal tract of rodents following administration of ≤ 180 ppm Cr(VI) for up to 90 days in drinking water. Quantifying Cr(VI) reduction kinetics in the human gastrointestinal tract is necessary for assessing the potential hazards posed by Cr(VI) in drinking water

High-Throughput Screening Data Interpretation in the Context of In Vivo Transcriptomic Responses to Oral Cr(VI) Exposure

The toxicity of hexavalent chromium [Cr(VI)] in drinking water has been studied extensively, and available in vivo and in vitro studies provide a robust dataset for application of advanced toxicological tools to inform the mode of action (MOA). This study aimed to contribute to the understanding of Cr(VI) MOA by evaluating high-throughput screening (HTS) data and other in vitro data relevant to Cr(VI), and comparing these findings to robust in vivo data, including transcriptomic profiles in target tissues. Evaluation of Tox21 HTS data for Cr(VI) identified 11 active assay endpoints relevant to the Ten Key Characteristics of Carcinogens (TKCCs) that have been proposed by other investigators. Four of these endpoints were related to TP53 (tumor protein 53) activation mapping to genotoxicity (KCC#2), and four were related to cell death/proliferation (KCC#10). HTS results were consistent with other in vitro data from the Comparative Toxicogenomics Database. In vitro responses were compared to in vivo transcriptomic responses in the most sensitive target tissue, the duodenum, of mice exposed to ≤ 180 ppm Cr(VI) for 7 and 90 days. Pathways that were altered both in vitro and in vivo included those relevant to cell death/proliferation. In contrast, pathways relevant to p53/DNA damage were identified in vitro but not in vivo. Benchmark dose modeling and phenotypic anchoring of in vivo transcriptomic responses strengthened the finding that Cr(VI) causes cell stress/injury followed by proliferation in the mouse duodenum at high doses. These findings contribute to the body of evidence supporting a non-mutagenic MOA for Cr(VI)-induced intestinal cancer

Surgical site infections after emergency hernia repair:substudy from the Management of Acutely Symptomatic Hernia (MASH) study

Introduction: Acutely symptomatic abdominal wall and groin hernias (ASH) are a common acute surgical presentation. There are limited data to guide decisions related to surgical repair technique and use of antibiotics, which can be driven by increased risk of surgical site infection (SSI) in this group. This study aims to report rates of SSI following ASH repair and explore the use of patient-reported outcome measure reporting in this setting.Methods: An 18-week, UK-based, multicentre prospective cohort study (NCT04197271) recruited adults with ASH. This study reports operatively managed patients. Data on patient characteristics, inpatient management, quality of life, complications, and wound healing (Bluebelle score) were collected. Descriptive analyses were performed to estimate event rates of SSI and regression analysis explored the relationship between Bluebelle scores and SSI. The 30 and 90-day follow-up visits assessed complications and quality of life.Results: The MASH study recruited 273 patients, of whom 218 were eligible for this study, 87.2 per cent who underwent open repair. Mesh was used in 123 patients (50.8 per cent). Pre- and postoperative antibiotics were given in 163 (67.4 per cent) and 28 (11.5 per cent) patients respectively. There were 26 reported SSIs (11.9 per cent). Increased BMI, incisional, femoral, and umbilical hernia were associated with higher rates of SSI (P = 0.006). In 238 patients, there was a difference in healthy utility values at 90 days between patients with and without SSI (P = 0.025). Also, when analysing 191 patients with Bluebelle scores, those who developed an SSI had higher Bluebelle values (P < 0.001).Conclusion: SSI is frequent in repair of acutely symptomatic hernia and correlates with BMI and site of hernia

Reduction of hexavalent chromium by fasted and fed human gastric fluid. II. Ex vivo gastric reduction modeling

AbstractTo extend previous models of hexavalent chromium [Cr(VI)] reduction by gastric fluid (GF), ex vivo experiments were conducted to address data gaps and limitations identified with respect to (1) GF dilution in the model; (2) reduction of Cr(VI) in fed human GF samples; (3) the number of Cr(VI) reduction pools present in human GF under fed, fasted, and proton pump inhibitor (PPI)-use conditions; and (4) an appropriate form for the pH-dependence of Cr(VI) reduction rate constants. Rates and capacities of Cr(VI) reduction were characterized in gastric contents from fed and fasted volunteers, and from fasted pre-operative patients treated with PPIs. Reduction capacities were first estimated over a 4-h reduction period. Once reduction capacity was established, a dual-spike approach was used in speciated isotope dilution mass spectrometry analyses to characterize the concentration-dependence of the 2nd order reduction rate constants. These data, when combined with previously collected data, were well described by a three-pool model (pool 1 = fast reaction with low capacity; pool 2 = slow reaction with higher capacity; pool 3 = very slow reaction with higher capacity) using pH-dependent rate constants characterized by a piecewise, log-linear relationship. These data indicate that human gastric samples, like those collected from rats and mice, contain multiple pools of reducing agents, and low concentrations of Cr(VI) (<0.7 mg/L) are reduced more rapidly than high concentrations. The data and revised modeling results herein provide improved characterization of Cr(VI) gastric reduction kinetics, critical for Cr(VI) pharmacokinetic modeling and human health risk assessment

Comparison of the Effects of Hexavalent Chromium in the Alimentary Canal of F344 Rats and B6C3F1 Mice Following Exposure in Drinking Water: Implications for Carcinogenic Modes of Action

Exposure to high concentrations of hexavalent chromium (Cr[VI]) in drinking water is reported to induce oral mucosa tumors in F344 rats and intestinal tumors in B6C3F1 mice. To investigate the modes of action underlying these tumors, 90-day drinking water studies (with interim necropsy at day 8) were conducted with concentrations of 0.1–182 mg/l Cr(VI), administered as 0.3–520 mg/l sodium dichromate dihydrate. Blood and tissue samples were analyzed for chromium content, oxidative stress, iron levels, and gross and microscopic lesions. Results for the F344 rats are described herein and compared with results from B6C3F1 mice published previously. After 90 days of exposure, total chromium concentrations in the rat and mouse oral mucosae were comparable, yet significant dose-dependent decreases in the reduced-to-oxidized glutathione ratio (GSH/GSSG) were observed only in rats. In the duodenum, changes in GSH/GSSG were only observed in mice. Levels of 8-hydroxydeoxyguanosine were not increased in the oral or duodenal mucosae of either species. Glutathione levels were increased in the duodenum but decreased in the jejunum of both species, indicating potential differential responses in the intestinal segments. Histiocytic infiltration was observed in the duodenum of both species, yet duodenal cytokines were repressed in mice but increased in rats. Serum and bone marrow iron levels were more decreased in rats than mice. Collectively, these data suggest that Cr(VI)-induced carcinogenesis in the rodent alimentary canal involves oxidative stress; however, differences in histopathology, cytokines, and iron status suggest potential contributions from other factors as well

Ulcerative colitis-risk loci on chromosomes 1p36 and 12q15 found by genome-wide association study.

Ulcerative colitis is a chronic inflammatory disease of the colon that presents as diarrhea and gastrointestinal bleeding. We performed a genome-wide association study using DNA samples from 1,052 individuals with ulcerative colitis and preexisting data from 2,571 controls, all of European ancestry. In an analysis that controlled for gender and population structure, ulcerative colitis loci attaining genome-wide significance and subsequent replication in two independent populations were identified on chromosomes 1p36 (rs6426833, combined P = 5.1 x 10(-13), combined odds ratio OR = 0.73) and 12q15 (rs1558744, combined P = 2.5 x 10(-12), combined OR = 1.35). In addition, combined genome-wide significant evidence for association was found in a region spanning BTNL2 to HLA-DQB1 on chromosome 6p21 (rs2395185, combined P = 1.0 x 10(-16), combined OR = 0.66) and at the IL23R locus on chromosome 1p31 (rs11209026, combined P = 1.3 x 10(-8), combined OR = 0.56; rs10889677, combined P = 1.3 x 10(-8), combined OR = 1.29)