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  • The lived experience of pain-related fear in people with low back pain

    http://www.bodyinmind.org/meaning-pa...ody+in+Mind%29



    For many people low back pain (LBP) is scary. The spine is commonly perceived to be the structure linking our limbs to our trunk. It is also perceived to be the structure protecting the body’s ‘neural highway’ — the precious spinal cord. We need our spine in all our daily movements—breathing, sitting, walking and lifting. What then, when the spine is “damaged,” “injured,” “worn”? What will link our limbs to our trunk, or protect our spinal cord? How can we “escape” back pain when it is involved in all that we do?

    Despite popular belief, the spine is in fact a strong structure, and robust and serious structural causes of LBP are rare. The meanings people attribute to LBP influence how long LBP lasts and how disabling the LBP experience will be.

    The science and philosophy of the meaning of pain

    http://www.bodyinmind.org/meaning-pa...ody+in+Mind%29

    To the traditional model of pain, with its sensory-discriminative (intensity) and affective-motivational (unpleasantness) dimensions, a third dimension is suggested – “pain-related suffering”. Exploration of the meaning of this suffering has led to distinctions between suffering experienced as a “feeling that will come to an end” and suffering that is experienced as a “prolonged condition… a situation of endless affliction such as the loss of a child or a chronic pain condition… making one’s torment the basis of everlasting reality”. This latter kind of suffering – “existential suffering” is posited as a fourth and final dimension of pain.
    Update 22/08/2017
    Last edited by Jo Bowyer; 22-08-2017, 10:40 PM.
    Jo Bowyer
    Chartered Physiotherapist Registered Osteopath.
    "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

    Comment


    • Chronic unpredictable stress exacerbates surgery-induced sickness behavior and neuroinflammatory responses via glucocorticoids secretion in adult rats


      http://journals.plos.org/plosone/art...l.pone.0183077


      Abstract


      Accumulated evidence indicates that stress sensitizes neuroinflammatory responses to a subsequent peripheral immune challenge. The present study investigated whether chronic unpredictable stress (CUS) aggravated surgery-induced sickness behavior and neuroinflammatory processes via glucocorticoids secretion in the adult brain.
      Methods


      Sprague-Dawley adult male rats (12–14 weeks old) were exposed to 14-day CUS and then subjected to partial hepatectomy 24 h after the last stress session. The rats were pretreated with an antagonist of the glucocorticoids (GCs) receptor RU486 (30 mg/kg, i.p.) 1 h prior to stress exposure. The behavioral changes were evaluated with open field test and elevated plus-maze test. The hippocampal cytokines interleukin (IL)-1β and IL-6 were measured on postoperative days 1, 3 and 7. Ionized calcium binding adaptor protein (Iba)-1, microglial M2 phenotype marker Arg1, brain derived neurotrophic factor (BDNF) and CD200 were also examined at each time point.

      Results


      CUS exacerbated surgery-induced sickness behavior. Exposure to CUS alone failed to alter the levels of pro-inflammatory cytokines in the brain. However, CUS exaggerated surgery-induced pro-inflammatory cytokines expression (e.g. IL-1β and IL-6) and upregulated the levels of Iba-1 on postoperative days 1 and 3. An additional significant decreased BDNF, CD200 and a lower level of Arg1 were also observed in the stressed rats following surgical procedure. Pretreatment with RU486 blunted the potentiating effects of CUS on surgery-induced sickness behavior and neuroinflammatory responses.

      Conclusion


      Chronic unpredictable stress enhanced surgery-induced sickness behavior and neuroinflammatory responses. Stress-induced GCs played a pivotal role in enhancing surgery-induced neuroinflammatory processes by modulation of microglia functions.

      I am not keen on knee replacements, I spend too much time cleaning up after so called "failed knee replacements". The surgery has gone well, but the patient's pain is as it was before, or has worsened, despite post op physiotherapy.They have not had sufficient and timely education and they do not understand the endocrine and immune component. I often find that they can push themselves through their previous or current exercise prescription, but fail to translate this into their activities of daily living.
      Last edited by Jo Bowyer; 15-08-2017, 12:01 AM.
      Jo Bowyer
      Chartered Physiotherapist Registered Osteopath.
      "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

      Comment


      • Adult Brains Produce New Cells in Previously Undiscovered Area


        http://neurosciencenews.com/neurogen...amygdala-7304/


        Summary:
        University of Queensland researchers report they have discovered evidence of neurogenesis in the amygdala. Researchers say their findings could help develop new avenues of treatment for fear processing disorders.
        Jo Bowyer
        Chartered Physiotherapist Registered Osteopath.
        "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

        Comment


        • A paper on field theory delivers a wake-up call to academics

          http://physicstoday.scitation.org/do...0170803a/full/

          Oliver Rosten hasn’t received much feedback on the scientific merits of his new conformal algebra paper in the European Physical Journal C. But one paragraph, printed in small type before the references, has a lot of people talking. It’s the acknowledgments.

          Most study authors reserve their acknowledgments section for a laundry list of thank-yous to colleagues and reviewers. In his paper Rosten uses the section to issue a call for change. He dedicates the paper to his friend Francis Dolan, who died by suicide five years after the two started working together as postdoctoral researchers at the Dublin Institute for Advanced Studies (DIAS) in Ireland. Troubled by the toll of those years on his friend, who suffered from severe depression, Rosten writes that he is “firmly of the conviction that the psychological brutality of the post-doctoral system played a strong underlying role in Francis’ death.” He then advocates reforms to protect researchers with mental health problems. It’s a remarkably candid piece of writing for a scientific paper—so candid, in fact, that two journals refused to include it.
          It is not uncommon for severely troubled academics to present with headache and other MSK issues, some of those I have seen were persuaded to seek help, others couldn't see a way forward.
          Jo Bowyer
          Chartered Physiotherapist Registered Osteopath.
          "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

          Comment


          • More on “Behavior Priming” and Unconscious Influences

            By Neuroskeptic | August 16, 2017 10:00 am

            Last year, psychologists B. Keith Payne and colleagues breathed new life into the debate over ‘social priming’ with a paper called Replicable effects of primes on human behavior.
            It is important to get to know our patient's primes with regards to engagement with movement. Many of these will be subliminal. Movement cues can be delivered subliminally, discussion should follow.
            Jo Bowyer
            Chartered Physiotherapist Registered Osteopath.
            "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

            Comment


            • WOOP

              https://aeon.co/essays/thinking-posi...8caac-69418129

              Indulging in undirected positive flights of fancy isn’t always in our interest. Positive thinking can make us feel better in the short term, but over the long term it saps our motivation, preventing us from achieving our wishes and goals, and leaving us feeling frustrated, stymied and stuck. If we really want to move ahead in our lives, engage with the world and feel energised, we need to go beyond positive thinking and connect as well with the obstacles that stand in our way. By bringing our dreams into contact with reality, we can unleash our greatest energies and make the most progress in our lives.
              Jo Bowyer
              Chartered Physiotherapist Registered Osteopath.
              "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

              Comment


              • Teaching ‘grit’ is bad for children, and bad for democracy

                https://aeon.co/ideas/teaching-grit-...c3cd1-69418129

                According to the grit narrative, children in the United States are lazy, entitled and unprepared to compete in the global economy. Schools have contributed to the problem by neglecting socio-emotional skills. The solution, then, is for schools to impart the dispositions that enable American children to succeed in college and careers. According to this story, politicians, policymakers, corporate executives and parents agree that kids need more grit.

                The person who has arguably done more than anyone else to elevate the concept of grit in academic and popular conversations is Angela Duckworth, professor at the Positive Psychology Center at the University of Pennsylvania. In her new book, Grit: The Power of Passion and Perseverance, she explains the concept of grit and how people can cultivate it in themselves and others.

                According to Duckworth, grit is the ability to overcome any obstacle in pursuit of a long-term project: ‘To be gritty is to hold fast to an interesting and purposeful goal. To be gritty is to invest, day after week after year, in challenging practice. To be gritty is to fall down seven times and rise eight.’ Duckworth names musicians, athletes, coaches, academics and business people who succeed because of grit. Her book will be a boon for policymakers who want schools to inculcate and measure grit.
                Democracy requires active citizens who think for themselves and, often enough, challenge authority. Consider, for example, what kind of people participated in the Boston Tea Party, the Seneca Falls Convention, the March on Washington, or the present-day test-refusal movement. In each of these cases, ordinary people demand a say in how they are governed. Duckworth celebrates educational models such as Beast at West Point that weed out people who don’t obey orders. That is a disastrous model for education in a democracy. US schools ought to protect dreamers, inventors, rebels and entrepreneurs – not crush them in the name of grit.
                Jo Bowyer
                Chartered Physiotherapist Registered Osteopath.
                "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                Comment


                • From Anxious to Reckless: A Control Systems Approach Unifies Prefrontal-Limbic Regulation Across the Spectrum of Threat Detection

                  http://journal.frontiersin.org/artic...017.00018/full

                  Here we provide an integrative review of basic control circuits, and introduce techniques by which their regulation can be quantitatively measured using human neuroimaging. We illustrate the utility of the control systems approach using four human neuroimaging threat detection studies (N = 226), to which we applied circuit-wide analyses in order to identify the key mechanism underlying individual variation. In so doing, we build upon the canonical prefrontal-limbic control system to integrate circuit-wide influence from the inferior frontal gyrus (IFG). These were incorporated into a computational control systems model constrained by neuroanatomy and designed to replicate our experimental data. In this model, the IFG acts as an informational set point, gating signals between the primary prefrontal-limbic negative feedback loop and its cortical information-gathering loop. Along the cortical route, if the sensory cortex provides sufficient information to make a threat assessment, the signal passes to the ventromedial prefrontal cortex (vmPFC), whose threat-detection threshold subsequently modulates amygdala outputs. However, if signal outputs from the sensory cortex do not provide sufficient information during the first pass, the signal loops back to the sensory cortex, with each cycle providing increasingly fine-grained processing of sensory data. Simulations replicate IFG (chaotic) dynamics experimentally observed at both ends at the threat-detection spectrum. As such, they identify distinct types of IFG disconnection from the circuit, with associated clinical outcomes. If IFG thresholds are too high, the IFG and sensory cortex cycle for too long; in the meantime the coarse-grained (excitatory) pathway will dominate, biasing ambiguous stimuli as false positives. On the other hand, if cortical IFG thresholds are too low, the inhibitory pathway will suppress the amygdala without cycling back to the sensory cortex for much-needed fine-grained sensory cortical data, biasing ambiguous stimuli as false negatives. Thus, the control systems model provides a consistent mechanism for IFG regulation, capable of producing results consistent with our data for the full spectrum of threat-detection: from fearful to optimal to reckless. More generally, it illustrates how quantitative characterization of circuit dynamics can be used to unify a fundamental dimension across psychiatric affective symptoms, with implications for populations that range from anxiety disorders to addiction.
                  Jo Bowyer
                  Chartered Physiotherapist Registered Osteopath.
                  "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                  Comment


                  • “I Am I and My Bacterial Circumstances”: Linking Gut Microbiome, Neurodevelopment, and Depression

                    http://journal.frontiersin.org/artic...017.00153/full



                    Recently, there has been renewed interest in the role played by microbiome in both human health and human disease. A correct equilibrium between the human host and their microorganisms is important for an appropriate physiological function. Extensive research has shown that microbes that inhabit the gastrointestinal tract—or gut microbiota—are involved not only in both nutritive and digestive activities but also in immunological processes. Moreover, the gut microbiome influences both central nervous system and energy homeostasis. An altered gut microbiome has been associated with the pathophysiology of different diseases, including neuropsychiatric disorders. Apparently, both environmental—diet, exposition to antibiotics, and infections—and host-genetic factors have a strong influence on gut microbiome, modulating the risk for neuropsychiatric illness. Also, early life disruption of the microbiome–gut–brain (MGB) axis has been associated with an increased risk of developing depression later in life, suggesting a link between gut microbiome, neurodevelopment, and depression. This review aims to contribute to this growing area of research by exploring the role played by the gut microbiome in neurodevelopment and in the etiology of the depressive syndrome, including nutritional, immunological, and energy homeostasis approaches.

                    The title of this review is a paraphrase of the maxim from Ortega y Gasset: Yo soy yo y mi circunstancia, y si no la salvo a ella no me salvo yo (“I am I and my circumstance; and, if I do not save it, I do not save myself”) (1).
                    Jo Bowyer
                    Chartered Physiotherapist Registered Osteopath.
                    "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                    Comment


                    • Gauguin’s Stirring First-Hand Account of What Actually Happened the Night Van Gogh Cut off His Own Ear

                      https://www.brainpickings.org/2017/0...eid=9770392f91
                      Jo Bowyer
                      Chartered Physiotherapist Registered Osteopath.
                      "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                      Comment


                      • Self-esteem and subjective well-being revisited: The roles of personal, relational, and collective self-esteem


                        http://journals.plos.org/plosone/art...l.pone.0183958


                        Abstract


                        Previous studies have shown that self-esteem is an important predictor of subjective well-being. However, the majority of research has focused on self-esteem at the individual and the collective level, but has mostly ignored self-esteem at the relational level. According to social identity theory, individuals can maintain and enhance self-esteem through personal traits (personal self-esteem, PSE), relationships with significant others (relational self-esteem, RSE), and relationships with larger groups (collective self-esteem, CSE). The current research investigated whether RSE and CSE can predict subjective well-being beyond PSE among Chinese college students. With four cross-sectional studies and one longitudinal study (N = 847), we found that, when controlling for PSE, RSE was associated with greater life satisfaction, positive affect, meaning in life, happiness, and subjective vitality (Studies 1–5), but CSE was not (Studies 2–5). Implications are discussed.
                        Jo Bowyer
                        Chartered Physiotherapist Registered Osteopath.
                        "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                        Comment


                        • Longitudinal functional connectivity changes correlate with mood improvement after regular exercise in a dose-dependent fashion


                          http://onlinelibrary.wiley.com/doi/1...96c8f298a0825d


                          Abstract


                          Exercise increases wellbeing and improves mood. It is however unclear how these mood changes relate to brain function. We conducted a randomized controlled trial investigating resting-state modifications in healthy adults after an extended period of aerobic physical exercise and their relationship with mood improvements. We aimed to identify novel functional networks whose activity could provide a physiological counterpart to the mood-related benefits of exercise. Thirty-eight healthy sedentary volunteers were randomised to either the aerobic exercise group of the study or a control group. Participants in the exercise group attended aerobic sessions with a physiotherapist twice a week for 16 weeks. Resting-state modifications using magnetic resonance imaging were assessed before and after the programme and related to mood changes. An unbiased approach using graph metrics and network-based statistics was adopted. Exercise reduced mood disturbance and improved emotional wellbeing. It also induced a decrease in local efficiency in the parahippocampal lobe through strengthening of the functional connections from this structure to the supramarginal gyrus, precentral area, superior temporal gyrus and temporal pole. Changes in mood disturbance following exercise were correlated with those in connectivity between parahippocampal gyrus and superior temporal gyrus as well as with the amount of training. No changes were detected in the control group. In conclusion, connectivity from the parahippocampal gyrus to motor, sensory integration and mood regulation areas was strengthened through exercise. These functional changes might be related to the benefits of regular physical activity on mood.
                          Jo Bowyer
                          Chartered Physiotherapist Registered Osteopath.
                          "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                          Comment


                          • Pilot study shows that neurofeedback may help treatment-resistant depression

                            https://www.sciencedaily.com/release...0904093440.htm
                            Jo Bowyer
                            Chartered Physiotherapist Registered Osteopath.
                            "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                            Comment


                            • Rethinking serotonin could lead to a shift in psychiatric care

                              https://www.sciencedaily.com/release...0904093724.htm



                              For patients with depression, commonly prescribed drugs called SSRIs (Selective Serotonin Reuptake Inhibitors) can help to relieve symptoms by boosting levels of serotonin in the brain. Evidence suggests an important part of how they work is to increase activity at the serotonin 1A receptor, which reduces brain activity in important stress circuitry, thereby helping a person cope better.

                              In contrast, psychedelic compounds such as LSD and psilocybin (the psychoactive component of magic mushrooms), are thought to act primarily on the serotonin 2A receptor. Accumulating evidence suggests that psychedelics with psychotherapy can be an effective treatment for certain mental illnesses and, with a focus on the 2A receptor, the authors' paper attempts to explain why.

                              Writing in the review paper, the researchers say that while the traditional view of developing psychiatric treatments has been focused on promoting 1A activity and often blocking the 2A, the therapeutic importance of activating the 2A pathway -- the mechanism by which psychedelics have their effect -- has been largely overlooked.

                              "We may have got it wrong in the past," said Dr Robin Carhart-Harris, Head of Psychedelic Research at Imperial and lead author on the paper. "Activating serotonin 2A receptors may be a good thing, as it makes individuals very sensitive to context and to their environment. Crucially, if that is made therapeutic, then the combination can be very effective. This is how psychedelics work -- they make people sensitive to context and 'open' to change via activating the 2A receptor."

                              According to the researchers, the 1A and 2A pathways form part of a two-pronged approach which may have evolved to help us adapt to adversity. By triggering the 1A pathway, serotonin can make situations less stressful, helping us to become more resilient. However, they argue that this approach may not always be enough, and that in extreme crises, the 2A pathway may kick in to rapidly open a window of plasticity in which fundamental changes in outlook and behaviour can occur.

                              Growing evidence shows that in conditions such as treatment-resistant depression, obsessive compulsive disorder and addiction, certain brain circuitry may become 'stamped in' and resistant to change. The researchers suggest that in such cases, activating the 2A pathway -- such as through psychedelics -- could potentially offer a way to break the cycle, helping patients to change negative behaviours and thought patterns which have become entrenched.

                              By enabling the brain to enter into a more adaptive or 'plastic' state and providing patients with a suitably enriched clinical environment when they receive a drug treatment, clinicians could create a window for therapy, effectively making patients more receptive to psychotherapy.

                              According to the authors, their updated model of how serotonin acts in the brain could lead to a shift in psychiatric care, with the potential to move patients from enduring a condition using current pharmacological treatments, to actively addressing their condition by fundamentally modifying behaviours and thinking.

                              Professor David Nutt, Director of Neuropsychopharmacology in Imperial's Division of Brain Sciences, explained: "This is an exciting and novel insight into the role of serotonin and its receptors in recovery from depression that I hope may inspire more research into develop 5-HT2A receptor drugs as new treatments."

                              Dr Carhart-Harris added: "I think our model suggests that you cannot just administer a drug in isolation, at least certainly not psychedelics, and the same may also true for SSRIs. We need to pay more attention to the context in which medications are given. We have to acknowledge the evidence which shows that environment is a critical component of how our biology is expressed."

                              He added: "In psychiatry, as in science, things are rarely black and white, and part of the approach we're promoting is to have a more sophisticated model of mental healthcare that isn't just a drug or psychotherapy, it's both. I believe this is the future."

                              'Serotonin and brain function: a tale of two receptors' by Robin Carhart-Harris and David Nutt is published in the Journal of Psychopharmacology.
                              Jo Bowyer
                              Chartered Physiotherapist Registered Osteopath.
                              "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                              Comment


                              • The healing power of nature

                                https://aeon.co/essays/why-forests-a...b51d7-69418129


                                Jo Bowyer
                                Chartered Physiotherapist Registered Osteopath.
                                "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                                Comment


                                • Jo Bowyer
                                  Jo Bowyer commented
                                  Editing a comment
                                  Lawton has given an extensive list of contributory factors along with the gut and skin microbiome. Many of my patients start to feel better in themselves two to three days into any holiday including citibreaks.

                                • EG-Physio
                                  EG-Physio commented
                                  Editing a comment
                                  Maybe it's nothing to do with nature, but the change in surrounds which disrupts old patterns of neuronal firing. I reckon that's it.

                                • Jo Bowyer
                                  Jo Bowyer commented
                                  Editing a comment
                                  I think you're right, but the microbiome can have a physiological effect on the brain via the gut-brain axis.
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