Mindfulness and Acceptance in the Neonatal Intensive Care Unit: A Trauma-informed Approach

Preterm labor or other medical conditions resulting in Neonatal Intensive Care Unit (NICU) admission has an immense potential to be a traumatic event for both parents and their babies. Birth trauma in the context of the NICU may lead to a heightened stress response, decreasing one’s ability to cope with those stressors. This experience may have long-lasting effects for both parents and infants, necessitating a better understanding of interventions that can be offered during NICU admission and beyond to address trauma responses from both a physical and psychological perspective. The positive effects of mindfulness and acceptance-based interventions have the potential to help alleviate stress and anxiety and improve safety, connectedness, and bonding with lasting effects beyond the NICU. This research project aims to discuss the stressors of preterm birth or other medical conditions resulting in NICU admission and to explore mindfulness and acceptance interventions that have been studied in the NICU. This project also hopes to address the opportunity to further fill the gaps within the research of mindfulness and acceptance interventions in the context of the NICU, especially from a trauma-informed perspective. Implications of this project are relevant for both medical and mental health providers treating NICU parents and infants

Project Management Through Experiential Learning

Classroom-based projects are insufficient, in of themselves, when preparing students for positions in the digital media field today. David Kolb and Roger Fry argue that effective learning entails the possession of four different abilities: concrete experience, reflective observation, abstract conceptualization and active experimentation.2 Encouraging students to participate in community-based projects outside the classroom can help build the necessary skill sets in learning how to work in a real-world environment. Community-based learning teaches the student on three distinct levels: intellectually, socially, and emotionally including feelings, values, and meanings. Digital Media students should involve themselves in community projects to exercise their skills and broaden their experience. Working on community-based projects allows them to build their portfolio while affording the opportunity to start working under the constraints of actual projects with timelines and budgets. Students learn what an individual’s time is worth, what mistakes can cost, and how to deal with a client. Students also learn how to manage a real world project with deadlines. This paper describes our approach in having students come together to enhance their digital media skills by contributing in the development of a community-based animation festival. This paper also addresses how students learned to plan and manage a festival event while working with a community-based organization

Encouraging Student Participation In Social Entrepreneurship Opportunities

Social entrepreneurs utilize the traits of commercial entrepreneurs; organizational abilities, opportunity identification, combining resources in novel ways, willingness to accept and manage risk and explosive growth or returns, to create enterprises that return high social value. As educators, we see opportunities where entrepreneurial skills can be applied to education, not-for-profit organizations, government offices and programs and philanthropic concerns and create service learning opportunities for students beyond the boundaries of the university. Many of us involved in higher education are frustrated with students who do not attend class, turn in assignments late or exhibit a lack of effort in classes where they pay tuition and receive a grade. It is a challenge, therefore, to gain the involvement of students in social entrepreneurship efforts where the reward (grade, pay or recognition) is not immediate or minimal and the trade-off (time management for their schedule) may be more fun or financially rewarding. This paper discusses the evolution for the process of enlisting student involvement in two distinct social entrepreneurship programs at our university. The first program involves linking university skill sets in the arts, digital media, technology and project management to the planning, implementation and evaluation of a regional arts and music festival held in the city where our university operates. Students involved in this social entrepreneurial venture work with community volunteers, city government officials and local business owners for a period of nine to ten months. In the first two years of sponsoring this program the strategy has evolved from enlisting the help of a student technology club (Edge Club, Digital Media) to working with a small volunteer student team (3 to 4 students). In each case, the organization or student team that worked on the project received no academic credit for the work involved beyond enhancement of their resume. Initial enthusiasm was high but tended to decline as the time horizon for finishing the project extended beyond the current semester and other activities or demands competed for the students’ participation. The second program also utilizes a student organization (Students In Free Enterprise, SIFE) to work on social entrepreneurship projects. In SIFE we have found that the students prefer projects that entail an afternoon of preparation for a short presentation, or service within a 3-4 day period. In that this group is involved in a “competition” with SIFE teams from other institutions at the end of the year, it is important that they seek projects that will differentiate themselves. The short-term projects that they prefer do little to accomplish this differentiation. The projects that truly differentiate are those that require a high degree of preparation for an event that culminates at the end of the semester, or even the following year. To that end, all students of this select team are required to create a long-term project that they will spearhead throughout the year. This leads to an escalation of commitment due to their “ownership” of that project. They are also required to assist another team member on their long-term project. Their efforts on these projects tend to be greater in that they realize that the other members will be assisting them on their project and they want to receive a conscientious effort from their teammates. This synergistic performance enhances both the number and quality of the projects. Using this method, we typically create 5 to 6 viable projects each year. Most teams that we compete with tend to have one major project per year. Using this system our university team has completed an average of 10 projects per year for presentation, of which 2 to 3 have been major projects

Maternal attitudes, adjustment, health behaviors, and social support among mothers of infants in the neonatal intensive care unit

Introduction: A growing body of research suggests that an infants’ admission to a neonatal intensive care unit (NICU) is associated with adverse maternal mental health outcomes. Maternal attitudes, adjustment to motherhood, social support, and health behaviors may be important modifiable factors that could improve quality of life and well-being among NICU mothers. The current study examined the relationships among maternal attitudes, adjustment to motherhood, health behaviors, social support, and psychological functioning in NICU mothers. Methods: One hundred twenty-seven women were recruited from NICUs at three hospitals in the Philadelphia area and completed self-report measures while in the NICU. Descriptive analyses were conducted on the main variables, and a series of bivariate correlations and linear regression analyses were used to evaluate the primary study aims. Results: Descriptive statistics indicated that NICU mothers had diverse attitudes towards motherhood, specifically regarding body image, somatic symptoms, romantic relationships, sex, and their baby. In general, they perceived high levels of social support, which varied based upon psychological and reproductive characteristics. Statistically significant findings revealed that maternal attitudes, adjustment, and perceived social support variables were negatively correlated with anxiety, stress, and depressive symptoms. Discussion: This study demonstrates that certain maternal variables are related to psychological functioning among NICU mothers, such as maternal attitudes, adjustment, and social support. Determining how to bolster these variables as a protective mechanism for mothers during the stressful NICU experience is an important future direction. This study suggests that developing and implementing unique programs and interventions that target these variables in the NICU setting may benefit mothers, families, and infants

Linking Art to Science: Digital Media as a Technology Translation Tool

Technology translation can be achieved through the blending of the sciences and arts in the form of digital imagery. Digital animation and video can be utilized to portray molecular events where the mechanism of action is known but the process occurs at a sub-microscopic level. There needs to be a strong collaboration between scientific advisors and digital artists when creating the animation such that the artistic interpretation of the molecular event conforms to the known and accepted confines of science. The finished animation may be used for information, education or persuasion as entrepreneurial biotechnical companies attempt to find markets, customers and investors interested in their inventions. Educational institutions with programs in the sciences, arts, digital media and medicine need to promote the interaction of students from these disciplines through cross-functional teams and courses. Solutions to problems developed by these teams tend to be broader and more comprehensive than more homogeneous teams

Linking the University with the Community: An Experiential Learning Project to Promote Arts Entrepreneurship

Teaching students entrepreneurial skills and the utility of cross-disciplinary teams is difficult if only classroom exercises are employed. In this program, university students worked together with commercial artists and business-persons residing in our declining downtown region to assist in the organization, planning and management of an established regional arts festival and to launch a new feature of the festival based on digital animation. Through experiential learning, students gained an appreciation for “real-life” budgets, deadlines, responsibilities and an appreciation of working on cross-disciplinary teams while the community observed first-hand the benefits of students trained in digital media, entrepreneurship and project management

PET brain imaging in HIV-associated neurocognitive disorders (HAND) in the era of combination antiretroviral therapy

Effective combination antiretroviral therapy (cART) has lead to a significant reduction in the prevalence and incidence of central nervous system (CNS) HIV-associated brain disease, particularly CNS opportunistic infections and HIV encephalitis. Despite this, cognitive deficits in people living with HIV, also known as HIV-associated neurocognitive disorders (HAND) have become more prevalent in recent years. The pathogenesis of HAND is likely to be multifactorial, however recent evidence suggests that brain microglial activation is the most likely pathogenic mechanism. Recent developments in positron emission tomography (PET) brain neuroimaging using novel brain radioligands targeting a variety of physiological changes in the brains of HIV-positive individuals have improved our understanding of the mechanisms associated with the development of HAND. This review will highlight recent PET brain neuroimaging studies in the cART era, focusing on physiological and neurochemical changes associated with HAND in people living with HIV

Alterations in Cerebral Glucose Metabolism Measured by FDG PET in Subjects Performing a Meditation Practice Based on Clitoral Stimulation

Background: The relationship between sexuality, or the libido, and spirituality or religion has long been debated in psychiatry. Recent studies have explored the neurophysiology of both sexual experiences and spiritual practices such as meditation or prayer. In the present study, we report changes in cerebral glucose metabolism in a unique meditation practice augmented by clitoral stimulation called, Orgasmic Meditation, in which a spiritual state is described to be attained by both male and female participants engaged in the practice as a pair. Methods: Male (N=20) and female (N=20) subjects had an intravenous catheter connected to a bag of normal saline inserted prior to the practice. During the practice, men stimulated their partner’s clitoris for exactly 15 minutes (he received no sexual stimulation). Midway through the practice, researchers injected 18F-fluorodeoxyglucose so the scan would reflect cerebral metabolism during the practice. Positron emission tomography (PET) imaging was performed approximately 30 minutes later. Results: In the female participants, the meditation state showed significant decreases in the left inferior frontal, inferior parietal, insula, middle temporal, and orbitofrontal regions as well as in the right angular gyrus, anterior cingulate and parahippocampus compared to a neutral state (p\u3c0.01). Male subjects had significant decreases in the left middle frontal, paracentral, precentral, and postcentral regions as well as the right middle frontal and paracentral regions during meditation (p\u3c0.01). Men also had significantly increased metabolism in the cerebellum and right postcentral and superior temporal regions (p\u3c0.01). Conclusions: These findings represent a distinct pattern of brain activity, for both men and women, that is a hybrid between that of other meditation practices and sexual stimulation. Such findings have potential psychotherapeutic implications and may deepen our understanding of the relationship between spiritual and sexual experience

Alterations in Functional Connectivity Measured by Functional Magnetic Resonance Imaging and the Relationship With Heart Rate Variability in Subjects After Performing Orgasmic Meditation: An Exploratory Study

Background: We measured changes in resting brain functional connectivity, with blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI), associated with a creative meditation practice that is augmented by clitoral stimulation and is designed to not only achieve a spiritual experience but to help individuals manage their most intimate personal relationships. Briefly, the meditative state is attained by both the male and female participants while the male stimulates the woman\u27s clitoris. The goal of this practice, called orgasmic meditation (OM), according to the practitioners is not sexual, but to use the focus on clitoral stimulation to facilitate a meditative state of connectedness and calm alertness between the two participants. Methods: fMRI was acquired on 20 pairs of subjects shortly following one of two states that were randomized in their order - during the OM practice or during a neutral condition. The practice is performed while the female is lying down on pillows with the clitoris exposed. During the practice, the male performs digital stimulation of the clitoris for 15 min. Resting BOLD image acquisition was performed at completion of the practice to assess changes in functional connectivity associated with the performance of the practice. Results: The results demonstrated significant changes (p \u3c 0.05) in functional connectivity associated with the OM compared to the neutral condition. For the entire group there was altered connectivity following the OM practice involving the left superior temporal lobe, the frontal lobe, anterior cingulate, and insula. In female subjects, there was altered connectivity involving the cerebellum, thalamus, inferior frontal lobe posterior parietal lobe, angular gyrus, amygdala and middle temporal gyrus, and prefrontal cortex. In males, functional connectivity changes involved the supramarginal gyrus, cerebellum, and orbitofrontal gyrus, cerebellum, parahippocampus, inferior temporal gyrus, and anterior cingulate. Conclusion: Overall, these findings suggest a complex pattern of functional connectivity changes occurring in both members of the couple pair that result from this unique meditation practice. The changes represent a hybrid of functional connectivity findings with some similarities to meditation based practices and some with sexual stimulation and orgasm. This study has broader implications for understanding the dynamic relationship between sexuality and spirituality

Identification of Chronic Mild Traumatic Brain Injury Using Resting State Functional MRI and Machine Learning Techniques

Mild traumatic brain injury (mTBI) is a major public health concern that can result in a broad spectrum of short-term and long-term symptoms. Recently, machine learning (ML) algorithms have been used in neuroscience research for diagnostics and prognostic assessment of brain disorders. The present study aimed to develop an automatic classifier to distinguish patients suffering from chronic mTBI from healthy controls (HCs) utilizing multilevel metrics of resting-state functional magnetic resonance imaging (rs-fMRI). Sixty mTBI patients and forty HCs were enrolled and allocated to training and testing datasets with a ratio of 80:20. Several rs-fMRI metrics including fractional amplitude of low-frequency fluctuation (fALFF), regional homogeneity (ReHo), degree centrality (DC), voxel-mirrored homotopic connectivity (VMHC), functional connectivity strength (FCS), and seed-based FC were generated from two main analytical categories: local measures and network measures. Statistical two-sample t-test was employed comparing between mTBI and HCs groups. Then, for each rs-fMRI metric the features were selected extracting the mean values from the clusters showing significant differences. Finally, the support vector machine (SVM) models based on separate and multilevel metrics were built and the performance of the classifiers were assessed using five-fold cross-validation and via the area under the receiver operating characteristic curve (AUC). Feature importance was estimated using Shapley additive explanation (SHAP) values. Among local measures, the range of AUC was 86.67-100% and the optimal SVM model was obtained based on combined multilevel rs-fMRI metrics and DC as a separate model with AUC of 100%. Among network measures, the range of AUC was 80.42-93.33% and the optimal SVM model was obtained based on the combined multilevel seed-based FC metrics. The SHAP analysis revealed the DC value in the left postcentral and seed-based FC value between the motor ventral network and right superior temporal as the most important local and network features with the greatest contribution to the classification models. Our findings demonstrated that different rs-fMRI metrics can provide complementary information for classifying patients suffering from chronic mTBI. Moreover, we showed that ML approach is a promising tool for detecting patients with mTBI and might serve as potential imaging biomarker to identify patients at individual level. Clinical trial registration: [clinicaltrials.gov], identifier [NCT03241732]