scholarly journals Effects of compassion training on brain responses to suffering others

2019 ◽  
Author(s):  
Yoni K. Ashar ◽  
Jessica R. Andrews-Hanna ◽  
Joan Halifax ◽  
Sona Dimidjian ◽  
Tor D. Wager
Keyword(s):  
Orbitofrontal Cortex ◽  
Smartphone Application ◽  
Post Intervention ◽  
Placebo Condition ◽  
Demand Characteristics ◽  
Compassion Meditation ◽  
Brain Responses ◽  
Author Note ◽  
Additional Support ◽  
Research Assistants

AbstractWhat are the active ingredients and brain mechanisms of compassion training? To address these questions, we conducted a three-armed randomized trial (N = 57) of compassion meditation (CM). We compared a four-week CM program delivered by smartphone application to i) a placebo condition, in which participants inhaled sham oxytocin, which they were told would enhance compassion, and ii) a familiarity control condition, designed to control for increased familiarity with suffering others. Functional MRI was collected while participants listened to narratives describing suffering others at pre- and post-intervention. CM increased brain responses to suffering others in the medial orbitofrontal cortex (mOFC) relative to both the placebo and familiarity control conditions, and in the nucleus accumbens relative to the familiarity control condition. Results support the specific efficacy of CM beyond effects of expectancy, demand characteristics, and increased familiarity with suffering others, and implicate affective and motivational pathways as brain mechanisms of CM.Author NoteFunded by the John Templeton Foundation’s Positive Neuroscience project (PIs Wager and Dimidjian), with additional support from NIH R01 R01DA035484 (PI Wager). Gratitude to research assistants Jenifer Mutari, Robin Kay, Scott Meyers, Nicholas Peterson, and Brandin Williams for help with data collection.

scholarly journals Promotion of Early and Exclusive Breastfeeding in Neonatal Care Units in Rural Rwanda: a Quasi-experimental Study

2020 ◽  
Author(s):  
Saidath Gato ◽  
Francois Biziyaremye ◽  
Catherine M. Kirk ◽  
Chiquita Palha De Sousa ◽  
Alain Mukuralinda ◽  
...  
Keyword(s):  
Experimental Study ◽  
Exclusive Breastfeeding ◽  
Child Survival ◽  
Neonatal Care ◽  
Post Intervention ◽  
Factors Associated ◽  
Before And After ◽  
Quasi Experimental ◽  
Evidenced Based ◽  
Additional Support

Abstract Background: Early initiation of breastfeeding after birth and ongoing exclusive breastfeeding for the first 6 months improves child survival, nutrition and health outcomes. However, only 42% of newborns worldwide are breastfed within the first hour of life. Small and sick newborns are at greater risk of not receiving breastmilk and often require additional support for feeding. This study compares breastfeeding practices in Rwandan neonatal care units (NCUs) before and after the implementation of a package of interventions aimed to improve breastfeeding, aligned with the Baby Friendly Hospital Initiative for small and sick newborns.Methods: A pre-post quasi experimental study was conducted at two District hospital NCUs in rural Rwanda from October 2017–December 2017 (pre-intervention) and September 2018–March 2019 (post-intervention). Only newborns admitted before their second day of life (DOL) were included. Data was extracted from patient charts for clinical and demographic characteristics, feeding throughout admission, and patient outcomes. Bivariate analyses were conducted using Fisher’s exact and Wilcoxon rank sum tests. Logistic regression was used to evaluate factors associated with exclusive breastfeeding at discharge following a backwards stepwise procedure.Results: Pre-intervention, 255 newborns were admitted in the NCUs and 793 were admitted in the post-intervention period. The percentage of infants who were exclusively breastfed on their day of birth, or day-of-life zero (DOL0) increased from 5.4% to 35.9% (p<0.001). For newborns discharged alive, the proportion exclusively breastfeeding increased from 69.6% to 87.0% (p<0.001). The mortality rate for all admitted newborns decreased from 16.1% to 10.5% (p<0.019). Factors associated with greater odds of exclusive breastfeeding at discharge included post-intervention time point (Odds Ratio (OR): 4.91, 95% Confidence Interval (CI) 1.99-12.11, p<0.001), and admission for infection (OR 2.99, 95%CI 1.13-7.93, p=0.027). Home deliveries (OR 0.15, 95%CI 0.05-0.47, p=0.001), preterm delivery (OR 0.36, 95%CI 0.15-0.87, p=0.0260 and delayed first breastmilk feed (OR=0.04 for DOL3 vs. DOL0, 95%CI 0.01, 0.35, p=0.004) reduced odds of exclusive breastfeeding at discharge. Conclusion: Expansion and adoption of evidenced-based guidelines, using innovative approaches, aimed at the unique needs of small and sick newborns should be expanded and adapted in similar settings to improve outcomes for these infants.

scholarly journals 0695 Sleepwell24, A Smartphone Application To Promote PAP Therapy Adherence: Feasibility And Acceptability

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A265-A265
Author(s):  
M E Petrov ◽  
K Hasanaj ◽  
C M Hoffmann ◽  
D R Epstein ◽  
L Krahn ◽  
...  
Keyword(s):  
Real Time ◽  
Smartphone Application ◽  
Sleep Medicine ◽  
Retention Rates ◽  
Activity Levels ◽  
Post Intervention ◽  
Personal Technology ◽  
Lost To Follow Up ◽  
First Time

Abstract Introduction We aimed to test the feasibility and acceptability of SleepWell24, a multicomponent, smartphone-delivered intervention to increase positive airway pressure (PAP) adherence among newly diagnosed OSA patients. Methods SleepWell24 targets PAP adherence along with other health behaviors through education, trouble-shooting, goal-setting, and near real-time biofeedback of PAP machine use, and sleep and physical activity levels (via Fitbit integration), and other chronic disease self-management components. Patients with a first-time diagnosis of OSA (AHI≥5) and prescribed PAP therapy were enrolled from the Centers for Sleep Medicine at Mayo Clinic in Rochester, MN and Phoenix, AZ. Patients were randomized to SleepWell24 or usual care (UC) and assessed for PAP use over 60 consecutive nights. UC patients received a Fitbit monitor to control for non-specific intervention effects related to the introduction of a new personal technology. Feasibility was assessed with recruitment and retention rates and acceptability was assessed post-intervention with the validated, 8-item Treatment Evaluation Questionnaire (TEQ; range:0-4). ANCOVA models, adjusting for age, sex, and AHI severity, compared intervention arms on acceptability ratings. Results OSA patients were consented and randomized (N=111). Before the intervention began 4 participants withdrew, 12 were lost to follow-up, and 5 could not start the trial due to durable medical equipment (DME) vendor barriers. Ninety OSA patients (n=41 SleepWell24, n=49 UC; age M±SD=57.2±12.2; 44.4% female, 61.1% AHI≥15) started the intervention, with 2 participants withdrawing, 1 becoming deceased (unrelated to treatment) and 7 with missing PAP data due to DME vendor barriers. There was no significant between-groups differences on post-treatment acceptability (SleepWell24 M±SD=2.7±1.1 vs. UC M±SD=3.1±0.9, F[1,73]=2.3, p=0.11), and 77% of SleepWell24 participants found the app to be moderately to totally acceptable. Conclusion Overall, SleepWell24 was found to be feasible for delivery in two large clinical sleep medicine centers, and patients found the app to be acceptable. A number of challenges in trial delivery were encountered that have implications for scaled-up efficacy testing: (a) partnerships with DME vendors for near real-time PAP data integration; (b) alignment with clinical practice (i.e., referral, medical record integration); and (c) patient engagement. Support National Institute of Nursing Research / National Institutes of Health: R21NR016046

Altered reward processing in the orbitofrontal cortex and hippocampus in healthy first-degree relatives of patients with depression

2013 ◽  
Vol 44 (6) ◽  
pp. 1183-1195 ◽  
Author(s):  
J. Macoveanu ◽  
U. Knorr ◽  
A. Skimminge ◽  
M. G. Søndergaard ◽  
A. Jørgensen ◽  
...  
Keyword(s):  
Orbitofrontal Cortex ◽  
Reward Processing ◽  
Negative Outcomes ◽  
Neural Responses ◽  
First Degree Relatives ◽  
Brain Responses ◽  
Left Hippocampus ◽  
Risk Choice ◽  
Double Blinded ◽  
Depressive Patients

BackgroundHealthy first-degree relatives of patients with major depression (rMD+) show brain structure and functional response anomalies and have elevated risk for developing depression, a disorder linked to abnormal serotonergic neurotransmission and reward processing.MethodIn a two-step functional magnetic resonance imaging (fMRI) investigation, we first evaluated whether positive and negative monetary outcomes were differentially processed by rMD+ individuals compared to healthy first-degree relatives of control probands (rMD−). Second, in a double-blinded placebo-controlled randomized trial we investigated whether a 4-week intervention with the selective serotonergic reuptake inhibitor (SSRI) escitalopram had a normalizing effect on behavior and brain responses of the rMD+ individuals.ResultsNegative outcomes increased the probability of risk-averse choices in the subsequent trial in rMD+ but not in rMD− individuals. The orbitofrontal cortex (OFC) displayed a stronger neural response when subjects missed a large reward after a low-risk choice in the rMD+ group compared to the rMD− group. The enhanced orbitofrontal response to negative outcomes was reversed following escitalopram intervention compared to placebo. Conversely, for positive outcomes, the left hippocampus showed attenuated response to high wins in the rMD+ compared to the rMD− group. The SSRI intervention reinforced the hippocampal response to large wins. A subsequent structural analysis revealed that the abnormal neural responses were not accounted for by changes in gray matter density in rMD+ individuals.ConclusionsOur study in first-degree relatives of depressive patients showed abnormal brain responses to aversive and rewarding outcomes in regions known to be dysfunctional in depression. We further confirmed the reversal of these aberrant activations with SSRI intervention.

scholarly journals Teaching scripts via smartphone app facilitate resident-led teaching of medical students

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nicholas R. Zessis ◽  
Amanda R. Dube ◽  
Arhanti Sadanand ◽  
Jordan J. Cole ◽  
Christine M. Hrach ◽  
...  
Keyword(s):  
Medical Students ◽  
Controlled Trial ◽  
Smartphone Application ◽  
Teaching Performance ◽  
Pediatric Resident ◽  
Post Intervention ◽  
Pediatric Residents ◽  
Resident Teaching ◽  
Novel Approach ◽  
Barriers To Teaching

Abstract Background Previous studies have suggested that resident physicians are the most meaningful teachers during the clinical clerkships of third-year medical students (MS3s). Unfortunately, residents often feel unprepared for this crucial role. The pediatrics clerkship at our institution identified a paucity in the frequency of resident-led teaching with MS3s. Lack of confidence, suboptimal teaching space, and insufficient time were cited as the most significant barriers. To enhance resident-led teaching of MS3s, we created teaching scripts of general pediatrics topics accessible via a smartphone application (app). Methods Prior to the implementation of the app, MS3s and pediatric residents were surveyed on clerkship teaching practices. From May 2017 through July 2018, pediatric residents working with MS3s were introduced to the app, with both groups queried on resident teaching habits afterward. We compared pre-intervention and post-intervention data of time spent teaching, teaching frequency, and a ranking of pediatric resident teaching performance compared to residents of other MS3 core clerkships. Results 44 out of 90 residents (49%) responded to a pre-intervention survey on baseline teaching habits. 49 out of 61 residents (80%) completed our post-intervention survey. Pre-intervention, 75% (33/44) of residents reported spending less than 5 min per teaching session on average. Post-intervention, 67% (33/49) reported spending more than 5 min (p < 0.01). 25% (11/44) of residents reported teaching at least once per day pre-intervention, versus 55% (27/49, p = 0.12) post-intervention. Post-intervention data demonstrated a statistically significant correlation between app use and increased frequency of teaching (p < 0.01). The MS3 average ranking of pediatric resident teaching increased from 2.4 to 3.4 out of 6 (p < 0.05) after this intervention. Conclusions Residency programs looking to reform resident-led teaching, particularly of residents early in their training, should consider our novel approach. In addition to addressing barriers to teaching and creating a platform for near-peer teaching, it is adaptable to any specialty or learner level. Future direction includes developing objective measures for teaching performance and content proficiency to better assess our intervention as an educational curriculum, as well as further investigation of the intervention as a controlled trial.

scholarly journals Restoration of Hypoglycemia Awareness Alters Brain Activity in Type 1 Diabetes

2020 ◽  
Author(s):  
Munachiso Nwokolo ◽  
Stephanie A. Amiel ◽  
Owen O’Daly ◽  
Ian A. Macdonald ◽  
Fernando O. Zelaya ◽  
...  
Keyword(s):  
Decision Making ◽  
Blood Flow ◽  
Type 1 Diabetes ◽  
Anterior Cingulate ◽  
Partial Recovery ◽  
Post Intervention ◽  
Pump Therapy ◽  
Brain Responses ◽  
The Impact

Objective <p>Impaired awareness of hypoglycemia (IAH) in type 1 diabetes (T1D) is a major risk factor for severe hypoglycemia (SH), and is associated with atypical responses to hypoglycemia in brain regions involved in arousal, decision-making and memory. Whether restoration of hypoglycemia awareness alters these responses is unknown. We sought to investigate the impact of awareness restoration on brain responses to hypoglycemia.</p> <p> </p> <p>Research Design and Methods</p> <p>Twelve T1D IAH adults underwent pseudo-continuous arterial spin labelling functional MRI during a hypoglycemic clamp (5mmol/L-2.6mmol/L), before and after a hypoglycemia avoidance program of structured education (Dose Adjustment for Normal Eating, DAFNE), specialist support and sensor-augmented pump therapy (Medtronic Minimed™ 640G). Hypoglycemic cerebral blood flow (CBF) responses were compared pre- and post-intervention using predefined region of interest analysis of the thalamus, anterior cingulate cortex (ACC), orbitofrontal cortex (OFC) and hippocampus.</p> <p> </p> <p>Results</p> <p>Post-intervention, Gold and Clarke scores fell (6.0±1.0 to 4.0±1.6, p=0.0002; 5.7±1.7 to 3.4±1.8, p=0.0008), SH rates reduced (1.5±2 to 0.3±0.5 episodes per year, p=0.03), hypoglycemic symptom scores increased (18.8±6.3 to 27.3±12.7, p=0.02), epinephrine responses did not change (p=0.2). Post-intervention, hypoglycemia induced greater increases in ACC CBF (p=0.01, peak voxel coordinates [6,40,-2]), while thalamic and OFC activity did not change.</p> <p> </p> <p>Conclusions</p> <p>Increased blood flow is seen within brain pathways involved in internal self-awareness and decision-making (ACC) after restoration of hypoglycemia awareness, suggesting partial recovery of brain responses lost in IAH. Resistance of frontothalamic networks, involved in arousal and emotion processing, may explain why not all IAH individuals achieve awareness restoration with education and technology alone. </p>

scholarly journals Maladaptive avoidance learning in the orbitofrontal cortex in adolescents with major depression

2021 ◽  
Author(s):  
David Willinger ◽  
Iliana Irini Karipidis ◽  
Selina Neuer ◽  
Sophie Emery ◽  
Carolina Rauch ◽  
...  
Keyword(s):  
Orbitofrontal Cortex ◽  
Effective Connectivity ◽  
Gain Control ◽  
Imaging Study ◽  
Prediction Errors ◽  
Monetary Incentives ◽  
Brain Responses ◽  
Posterior Insula ◽  
Monetary Incentive Delay ◽  
Reinforcement Model

Background: Understanding the mechanisms in the brain's incentive network that give rise to symptoms of major depressive disorder (MDD) during adolescence provides new perspectives to address MDD in early stages of development. This functional magnetic resonance imaging study determines whether instrumental vigor and brain responses to appetitive and aversive monetary incentives are altered in adolescent MDD and associated with symptom severity. Methods: Adolescents with moderate to severe MDD (n=30, age=16.1 [1.4]), and healthy controls (n=33, age=16.2 [1.9]) matched for age, sex, and IQ performed a monetary incentive delay task. During outcome presentation, prediction error signals were used to study the response and coupling of the incentive network during learning of cue-outcome associations. A computational reinforcement model was used to assess adaptation of response vigor. Brain responses and effective connectivity to model-derived prediction errors were assessed and related to depression severity and anhedonia levels. Results: Participants with MDD behaved according to a more simplistic learning model and exhibited slower learning. Effective connectivity analysis of fMRI data revealed that impaired loss error processing in the orbitofrontal cortex was associated with aberrant gain-control. Anhedonia scores correlated with loss-related error signals in the posterior insula and habenula. Conclusions: Adolescent MDD is selectively related to impaired processing of error signals during loss, but not reward, in the orbitofrontal cortex. Aberrant evaluation of loss outcomes might reflect an early mechanism of how negative bias and helplessness manifest in the brain. This approach sheds light on pathomechanisms in MDD and may improve early diagnosis and treatment selection.

scholarly journals Enhanced deviant responses in patterned relative to random sound sequences

2017 ◽  
Author(s):  
Rosy Southwell ◽  
Maria Chait
Keyword(s):  
Human Brain ◽  
Orbitofrontal Cortex ◽  
Sensory Input ◽  
Automatic Processing ◽  
Specific Pattern ◽  
Visual Task ◽  
Brain Responses ◽  
Temporal Pole ◽  
Incoming Information ◽  
Preceding Context

AbstractHow are brain responses to deviant events affected by the statistics of the preceding context? We recorded electroencephalography (EEG) brain responses to frequency deviants in matched, regularly-patterned (REG) versus random (RAND) tone-pip sequences. Listeners were naïve and distracted by an incidental visual task. Stimuli were very rapid so as to limit conscious reasoning about the sequence order and tap automatic processing of regularity.Deviants within REG sequences evoked a substantially larger response (by 71%) than matched deviants in RAND sequences from 80 ms after deviant onset. This effect was underpinned by distinct sources in right temporal pole and orbitofrontal cortex in addition to the standard bilateral temporal and right pre-frontal network for generic frequency deviance-detection. These findings demonstrate that the human brain rapidly acquires a detailed representation of regularities within the sensory input and evaluates incoming information according to the context established by the specific pattern.

scholarly journals Mindful Age and Technology: a Qualitative Analysis of a Tablet/Smartphone App Intervention Designed for Older Adults

2020 ◽  
Author(s):  
Francesco Vailati Riboni ◽  
Isabel Sadowski ◽  
Benedetta Comazzi ◽  
Francesco Pagnini
Keyword(s):  
Older Adults ◽  
Qualitative Analysis ◽  
Technology Acceptance ◽  
Interpersonal Relationships ◽  
Well Being ◽  
Smartphone Application ◽  
Smartphone App ◽  
Control Group ◽  
Structured Interviews ◽  
Post Intervention

Abstract The global population is aging while modern healthcare systems are responding with limited success to the growing care demands of the senior population. Capitalizing on recent technological advancements, new ways to improve older adults’ quality of life have recently been implemented. The current study investigated, from a qualitative point of view, the utility of a mindfulness-based smartphone application for older adults. A description of the older adults’ experience with the smartphone application designed to enhance well-being and mindfulness will be presented. Participants’general beliefs about the benefits of technology for personal well-being will also be discussed. 68 older adults were recruited from different education centers for seniors. Participants were randomly assigned to two groups: a) a treatment group, which received the smartphone application intervention (n = 34), or b) a waitlist control group (n = 34). The experimental intervention included the utilization of a smartphone app designed specifically for improving older adult well-being and mindfulness levels. Participants completed semi-structured interviews evaluating participants’ treatment experience and technology-acceptance at recruitment (T0, baseline) and post-intervention (T1, post-intervention). Through thematic analysis, four themes were identified from verbatim responses of both interviews: Utility of technology for health, Impressions of technology, Mindful-benefits of smartphone application usage, and Smartphone application usage as a means to improve interpersonal relationships. Participants showed a positive experience of the app intervention. Qualitative analysis underlined the main Mindfulness-benefits reported by participants and the potentially crucial role of “Langerian” mindfulness in the relationship between older adults and health technology.

scholarly journals Rise and Recharge: Exploring Employee Perceptions of and Contextual Factors Influencing an Individual-Level E-Health Smartphone Intervention to Reduce Office Workers’ Sedentary Time at Work

2021 ◽  
Vol 18 (18) ◽  
pp. 9627
Author(s):  
Abigail S. Morris ◽  
Kelly A. Mackintosh ◽  
Neville Owen ◽  
Paddy C. Dempsey ◽  
David W. Dunstan ◽  
...  
Keyword(s):  
Large Scale ◽  
Sedentary Time ◽  
Contextual Factors ◽  
Smartphone Application ◽  
Health Intervention ◽  
Office Workers ◽  
Post Intervention ◽  
Intervention Delivery ◽  
Individual Level ◽  
Factors Influencing

This feasibility study explored the contextual factors influencing office workers’ adherence to an e-health intervention targeting total and prolonged sedentary time over 12 weeks. A three-arm quasi-randomized intervention included prompts at 30 or 60 min intervals delivered via a smartphone application, and a no-prompt comparison arm. Fifty-six office workers completed baseline (64% female) and 44 completed the 12 week follow-up (80% retention). Ecological momentary assessments (EMA) captured contextual data, with 82.8 ± 24.9 EMA prompt questionnaires completed weekly. Two focus groups with n = 8 Prompt 30 and 60 participants were conducted one-month post-intervention to address intervention acceptability and feasibility. Contextual findings indicate that when working on a sedentary task (i.e., reading or screen-based work) and located at an individual workstation, hourly prompts may be more acceptable and feasible for promoting a reduction in total and prolonged sedentary time compared to 30 min prompts. Interpersonal support also appears important for promoting subtle shifts in sedentary working practices. This novel study gives a real-time insight into the factors influencing adherence to e-health prompts. Findings identified unique, pragmatic considerations for delivering a workplace e-health intervention, indicating that further research is warranted to optimize the method of intervention delivery prior to evaluation of a large-scale intervention.

scholarly journals Effectiveness of Smartphone Application “Nutriatlet” in Increasing Energy Intake of Martial Arts Athletes

2018 ◽  
Vol 13 (3) ◽  
pp. 389-395
Author(s):  
Irwan Budiono ◽  
Tandiyo Rahayu ◽  
Soegiyanto KS ◽  
Lukman Fauzi
Keyword(s):  
Energy Consumption ◽  
Energy Intake ◽  
Martial Arts ◽  
Energy Requirement ◽  
Smartphone Application ◽  
Bivariate Analysis ◽  
Control Group ◽  
P Value ◽  
Post Intervention ◽  
Control Group Design

One of the pillars in achieving good sport achievement is athlete’s nutritional status. Preliminary study on martial arts athletes in Student Sport Education and Training Central Office (BPPLOP) of Central Java Province showed that 8% of athletes had malnutrition. Survey of athlete’s consumption showed that average of energy consumption was only 74% from the number of energy requirement. The aim of this study was to test the effectiveness of smartphone application model “Nutriatlet” to increase energy intake of athletes. This study was conducted in 2017 using pre and posttest with control group design. We recruited 30 athletes with 15 athletes in each treatment and control group. Bivariate analysis was performed using cox proportional-hazard test. The output of statistical analysis were p value, median post-intervention duration, and hazard ratio (HR). The analysis was performed using STATA 12.1. The result showed that the athletes which performed dietary planning using Nutriatlet had 4 times higher possibilities to achieve an increase in energy consumption level ≥10% per time unit compared to athletes who did not do it. 

Sign in / Sign up

Export Citation Format

Share Document