644 research outputs found
Interoception, Contemplative Practice, and Health
AcceptedArticleCopyright: © 2015 Farb, Daubenmier, Price, Gard, Kerr, Dunn, KLein, Paulus and Mehling.This Document is Protected by copyright and was first published by Frontiers. All rights reserved. it is reproduced with permission.Interoception can be broadly defined as the sense of signals originating within the body. As such, interoception is critical for our sense of embodiment, motivation and well-being. And yet, despite its importance, interoception remains poorly understood within modern science. This paper reviews interdisciplinary perspectives on interoception, with the goal of presenting a unified perspective from diverse fields such as neuroscience, clinical practice, and contemplative studies. It is hoped that this integrative effort will advance our understanding of how interoception determines well-being, and identify the central challenges to such understanding. To this end, we introduce an expanded taxonomy of interoceptive processes, arguing that many of these processes can be understood through an emerging predictive coding model for mind-body integration. The model, which describes the tension between expected and felt body sensation, parallels contemplative theories, and implicates interoception in a variety of affective and psychosomatic disorders. We conclude that maladaptive construal of bodily sensations may lie at the heart of many contemporary maladies, and that contemplative practices may attenuate these interpretative biases, restoring a personâs sense of presence and agency in the world
Fundamental Flaws of Hormesis for Public Health Decisions
Hormesis (defined operationally as low-dose stimulation, high-dose inhibition) is often used to promote the notion that while high-level exposures to toxic chemicals could be detrimental to human health, low-level exposures would be beneficial. Some proponents claim hormesis is an adaptive, generalizable phenomenon and argue that the default assumption for risk assessments should be that toxic chemicals induce stimulatory (i.e., âbeneficialâ) effects at low exposures. In many cases, nonmonotonic doseâresponse curves are called hormetic responses even in the absence of any mechanistic characterization of that response. Use of the term âhormesis,â with its associated descriptors, distracts from the broader and more important questions regarding the frequency and interpretation of nonmonotonic dose responses in biological systems. A better understanding of the biological basis and consequences of nonmonotonic doseâresponse curves is warranted for evaluating human health risks. The assumption that hormesis is generally adaptive is an oversimplification of complex biological processes. Even if certain low-dose effects were sometimes considered beneficial, this should not influence regulatory decisions to allow increased environmental exposures to toxic and carcinogenic agents, given factors such as interindividual differences in susceptibility and multiplicity in exposures. In this commentary we evaluate the hormesis hypothesis and potential adverse consequences of incorporating low-dose beneficial effects into public health decisions
Multidimensional sexual perfectionism and female sexual function: A longitudinal investigation
Research on multidimensional sexual perfectionism differentiates four forms of sexual perfectionism: self-oriented, partner-oriented, partner-prescribed, and socially prescribed. Self-oriented sexual perfectionism reflects perfectionistic standards people apply to themselves as sexual partners; partner-oriented sexual perfectionism reflects perfectionistic standards people apply to their sexual partner; partner-prescribed sexual perfectionism reflects peopleâs beliefs that their sexual partner imposes perfectionistic standards on them; and socially prescribed sexual perfectionism reflects peopleâs beliefs that society imposes such standards on them. Previous studies found partner-prescribed and socially prescribed sexual perfectionism to be maladaptive forms of sexual perfectionism associated with a negative sexual self-concept and problematic sexual behaviors, but only examined cross-sectional relationships. The present article presents the first longitudinal study examining whether multidimensional sexual perfectionism predicts changes in sexual self-concept and sexual function over time. A total of 366 women aged 17-69 years completed measures of multidimensional sexual perfectionism, sexual esteem, sexual anxiety, sexual problem self-blame, and female sexual function (cross-sectional data). Three to six months later, 164 of the women completed the same measures again (longitudinal data). Across analyses, partner-prescribed sexual perfectionism emerged as the most maladaptive form of sexual perfectionism. In the cross-sectional data, partner-prescribed sexual perfectionism showed positive relationships with sexual anxiety, sexual problem self-blame, and intercourse pain and negative relationships with sexual esteem, desire, arousal, lubrication, and orgasmic function. In the longitudinal data, partner-prescribed sexual perfectionism predicted increases in sexual anxiety and decreases in sexual esteem, arousal, and lubrication over time. The findings suggest that partner-prescribed sexual perfectionism contributes to womenâs negative sexual self-concept and female sexual dysfunction
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Effect of implementation of the MORE <sup>OB</sup> program on adverse maternal and neonatal birth outcomes in Ontario, Canada: A retrospective cohort study
In 2002, the MORE OB (Managing Obstetrical Risk Efficiently) obstetrical patient safety program was phased-in across hospitals in Ontario, Canada. The purpose of our study was to evaluate the effect of the MORE OB program on rates of adverse maternal and neonatal outcomes. Methods: A retrospective cohort study, using province-wide administrative hospitalization data. We included maternal and neonatal records between fiscal years 2002-2003 and 2013-2014, for deliveries taking place at the 67 Ontario hospitals where the MORE OB program was implemented between 2002 and 2012. After accounting for institutional mergers and excluding very small hospitals, 55 hospitals (1,447,073 deliveries) were included. Multivariable logistic and linear mixed effects regression analysis were used, accounting for secular trends, within hospital correlation and over time correlation, and adjusting for a maternal comorbidity index, hospital annual birth volume, and level of care. The main outcome measure was a composite individual-level indicator of incidence of any adverse events, and a hospital-level score, called the Weighted Adverse Outcome Score (WAOS) capturing both maternal and neonatal adverse outcomes. Results: Across the 12 years of follow up, there were 98,789 adverse maternal and neonatal outcomes, a rate of 6.83 per 100 deliveries (6.66 per 100 occurring before, 6.91 per 100 during, and 6.84 per 100 after program implementation). The multivariable analysis found no statistically significant decrease in adverse events associated with program implementation (OR for adverse events after versus before =1.11 (95% CI: 1.06 to 1.17, change in mean WAOS score after minus before =0.15 (- 0.36 to 0.67)). Conclusions: We did not find a reduction in the incidence of maternal and neonatal adverse outcomes associated with the MORE OB program, and small yet statistically significant increases in some adverse events were observed
People with higher interoceptive sensitivity are more altruistic, but improving interoception does not increase altruism
People consistently show preferences and behaviors that benefit others at a cost to themselves, a phenomenon termed altruism. We investigated if perception of oneâs body signals â interoception - may be underlying such behaviors. We tested if participantsâ sensitivity to their own heartbeat predicted their decision on a choice between self-interest and altruism, and if improving this sensitivity through training would make participants more altruistic. Across these two experiments, interoceptive sensitivity predicted altruism measured through monetary generosity. Improving interoceptive sensitivity did, however, not lead to more altruistic behaviour. We conclude that there is a unique link between interoception and altruistic behaviour, likely established over an individualâs history of altruistic acts, and the body responses they elicit. The findings suggest that humans might literally âlisten to their heartâ to guide their altruistic behavior
Variance component estimation uncertainty for unbalanced data: Application to a continent-wide vertical datum
Variance component estimation (VCE) is used to update the stochastic model in least-squares adjustments, but the uncertainty associated with the VCE-derived weights is rarely considered. Unbalanced data is where there is an unequal number of observations in each heterogeneous dataset comprising the variance component groups. As a case study using highly unbalanced data, we redefine a continent-wide vertical datum from a combined least-squares adjustment using iterative VCE and its uncertainties to update weights for each data set. These are: (1) a continent-wide levelling network, (2) a model of the oceanâs mean dynamic topography and mean sea level observations, and (3) GPS-derived ellipsoidal heights minus a gravimetric quasigeoid model. VCE uncertainty differs for each observation group in the highly unbalanced data, being dependent on the number of observations in each group. It also changes within each group after each VCE iteration, depending on the magnitude of change for each observation groupâs variances. It is recommended that VCE uncertainty is computed for VCE updates to the weight matrix for unbalanced data so that the quality of the updates for each group can be properly assessed. This is particularly important if some groups contain relatively small numbers of observations. VCE uncertainty can also be used as a threshold for ceasing iterations, as it is shownâfor this data set at leastâthat it is not necessary to continue time-consuming iterations to fully converge to unity
Antidepressant-Warfarin Interaction and Associated Gastrointestinal Bleeding Risk in a Case-Control Study
Bleeding is the most common and worrisome adverse effect of warfarin therapy. One of the factors that might increase bleeding risk is initiation of interacting drugs that potentiate warfarin. We sought to evaluate whether initiation of an antidepressant increases the risk of hospitalization for gastrointestinal bleeding in warfarin users.Medicaid claims data (1999-2005) were used to perform an observational case-control study nested within person-time exposed to warfarin in those â„18 years. In total, 430,455 warfarin users contributed 407,370 person-years of warfarin use. The incidence rate of hospitalization for GI bleeding among warfarin users was 4.48 per 100 person-years (95% CI, 4.42-4.55). Each gastrointestinal bleeding cases was matched to 50 controls based on index date and state. Warfarin users had an increased odds ratio of gastrointestinal bleeding upon initiation of citalopram (ORâ=â1.73 [95% CI, 1.25-2.38]), fluoxetine (ORâ=â1.63 [95% CI, 1.11-2.38]), paroxetine (ORâ=â1.64 [95% CI, 1.27-2.12]), amitriptyline (ORâ=â1.47 [95% CI, 1.02-2.11]). Also mirtazapine, which is not believed to interact with warfarin, increased the risk of GI bleeding (ORâ=â1.75 [95% CI, 1.30-2.35]).Warfarin users who initiated citalopram, fluoxetine, paroxetine, amitriptyline, or mirtazapine had an increased risk of hospitalization for gastrointestinal bleeding. However, the elevated risk with mirtazapine suggests that a drug-drug interaction may not have been responsible for all of the observed increased risk
Pneumonia in adults - Quality standard QS110
IntroductionThis quality standard covers adults (18 years and older) with a suspected or confirmed diagnosis of community acquired pneumonia. For more information see the pneumonia topic overview.Why this quality standard is neededPneumonia is an infection of the lung tissue. When a person has pneumonia the air sacs in their lungs become filled with microorganisms, fluid and inflammatory cells and their lungs are not able to work properly. Diagnosis of pneumonia is based on symptoms and signs of an acute lower respiratory tract infection, and can be confirmed by a chest X-ray showing new shadowing that is not due to any other cause (such as pulmonary oedema or infarction). The NICE guideline on pneumonia classifies pneumonia depending on the source of the infection as community acquired or hospital-acquired, which need different management strategies. Every year between 0.5% and 1% of adults in the UK will have community-acquired pneumonia. It is diagnosed in 5â12% of adults who present to GPs with symptoms of lower respiratory tract infection, and 22â42% of these are admitted to hospital, where the mortality rate is between 5% and 14%. Between 1.2% and 10% of adults admitted to hospital with community acquired pneumonia are managed in an intensive care unit, and for these patients the risk of dying is over 30%. More than half of pneumonia-related deaths occur in people older than 84 years.At any time, 1.5% of hospital patients in England have a hospital-acquired respiratory infection, more than half of which are hospital-acquired pneumonia and are not associated with intubation. Hospital-acquired pneumonia is estimated to increase a hospital stay by about 8 days and has a reported mortality rate ranging from 30â70%. There are variations in clinical management and outcomes across the UK
Changes in oxygen partial pressure of brain tissue in an animal model of obstructive apnea
Background: Cognitive impairment is one of the main consequences of obstructive sleep apnea (OSA) and is
usually attributed in part to the oxidative stress caused by intermittent hypoxia in cerebral tissues. The presence of
oxygen-reactive species in the brain tissue should be produced by the deoxygenation-reoxygenation cycles which
occur at tissue level during recurrent apneic events. However, how changes in arterial blood oxygen saturation
(SpO2) during repetitive apneas translate into oxygen partial pressure (PtO2) in brain tissue has not been studied.
The objective of this study was to assess whether brain tissue is partially protected from intermittently occurring
interruption of O2 supply during recurrent swings in arterial SpO2 in an animal model of OSA.
Methods: Twenty-four male Sprague-Dawley rats (300-350 g) were used. Sixteen rats were anesthetized and noninvasively
subjected to recurrent obstructive apneas: 60 apneas/h, 15 s each, for 1 h. A control group of 8 rats was
instrumented but not subjected to obstructive apneas. PtO2 in the cerebral cortex was measured using a fastresponse
oxygen microelectrode. SpO2 was measured by pulse oximetry. The time dependence of arterial SpO2
and brain tissue PtO2 was carried out by Friedman repeated measures ANOVA.
Results: Arterial SpO2 showed a stable periodic pattern (no significant changes in maximum [95.5 ± 0.5%; m ± SE]
and minimum values [83.9 ± 1.3%]). By contrast, brain tissue PtO2 exhibited a different pattern from that of arterial
SpO2. The minimum cerebral cortex PtO2 computed during the first apnea (29.6 ± 2.4 mmHg) was significantly
lower than baseline PtO2 (39.7 ± 2.9 mmHg; p = 0.011). In contrast to SpO2, the minimum and maximum values of
PtO2 gradually increased (p < 0.001) over the course of the 60 min studied. After 60 min, the maximum (51.9 ± 3.9
mmHg) and minimum (43.7 ± 3.8 mmHg) values of PtO2 were significantly greater relative to baseline and the first
apnea dip, respectively.
Conclusions: These data suggest that the cerebral cortex is partially protected from intermittently occurring
interruption of O2 supply induced by obstructive apneas mimicking OSA
Embodiment and body awareness in meditators
[EN] Mindfulness practice consists of focusing attention in an intentional way on the experience of the present moment, including bodily sensations, thoughts or feelings, and the environment, with an attitude of acceptance and without judging. The body and, especially, body awareness are key elements in mindfulness. Embodiment or the feeling of being located within one's physical body is a related concept, and it is composed of the sense of ownership, location, and agency of the body. The rubber hand illusion (RHI) is an experimental paradigm that has been used to understand the mechanisms of embodiment, and evidence shows that body awareness modulates this illusion. To our knowledge, no studies have analyzed embodiment processes in meditators. The aim of this study is to use the RHI to analyze the mechanisms of embodiment and its relationship with body awareness and mindfulness in meditators and non-meditators. The sample was composed of long-term meditators (n = 15) and non-meditators (n = 15). Objective and self-report measures for embodiment with the RHI and self-report questionnaires of body awareness and mindfulness were administered. One-way ANOVA revealed significant differences between groups in sense of agency in the rubber hand. Meditators experienced less sense of agency in the rubber hand than non-meditators. Pearson's correlations showed that this lower sense of agency in the rubber hand was associated with higher body awareness and mindfulness. Results highlight the role of body awareness and mindfulness in embodiment mechanisms. This study has clinical implications, especially in psychopathological disorders that can be influenced by disturbances in these processes.The authors would like to acknowledge the "BODYTA" project (Spanish Ministry of Economy and Competitiveness, PSI2014-51928-R), "PROMOSAM" (Spanish Ministry of Economy and Competitiveness, PSI2014-56303-REDT), and "Excellence Research Program PROMETEO II" (Generalitat Valenciana, Conselleria de Educacion, Cultura y Deporte, PROMETEOII/2013/003). CIBERobn is an initiate of the ISCIII. PROMOSAM Excellence in Research Program (PSI2014-56303-REDT), MINECO, Spain.Cebolla, A.; Miragall, M.; Palomo, P.; Llorens RodrĂguez, R.; Soler, J.; Demarzo, M.; GarcĂa Campayo, J.... (2016). Embodiment and body awareness in meditators. Mindfulness. 7(6):1297-1305. https://doi.org/10.1007/s12671-016-0569-xS1297130576Aguado, J., Luciano, J. V., Cebolla, A., Serrano-Blanco, A., Soler, J., & GarcĂa-Campayo, J. (2015). 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