Relaxation Techniques

Relax Your Mind

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Relaxation

Exposure-based treatment may sometimes be accompanied by additional elements. In systematic desensitization, relaxation is added to the exposure to the anxiety-eliciting situation. Relaxation is not essential for successful exposure however. Relaxation exercises focus on the physiological component of anxiety and tension. The patient learns, first in the therapist's office and later at home, to relax various muscle groups progressively. It is essential that the patient first learns to recognize tension in the different muscle groups. Accordingly, he can apply the relaxation effectively when the early signs of tension manifest themselves. In behaviour therapy, relaxation exercises are applied much more widely than merely as a component of systematic desensitization. Relaxation training has been an important component of various treatments, most notably in the treatment of generalized anxiety disorder. Relaxation training can also be useful in treating tension headaches and disturbed...

Anaesthetic Emergencies

After loss of consciousness, suxamethonium is administered. Maximal relaxation occurs after the fasciculations have ceased and this is when the trachea should be intub-ated. The cuff is sealed and then cricoid pressure is released. Ventilation proceeds as usual. The entire procedure should take between 30 and 90 s with adequate preoxygenation this should not produce serious hypoxaemia.

The Length Tension Relationship

It has been convenient to classify muscle contractions as either isotonic or isometric. If both ends of the muscle are firmly fixed the length cannot change and the contraction is termed isometric only tension can be developed. The curves in Fig. 6 were generated in isometric muscles by varying the muscle length between beats and measuring tensions during contraction and relaxation. However, if the muscle contracts against a finite load then it will shorten whenever its ability to develop force exceeds the load against which it is contracting. If the load remains constant throughout the contraction (as often occurs in the laboratory) the contraction is termed isotonic. Look at the example in Fig. 7. The muscle strip at its starting length is under a resting tension termed the preload. When caused to contract the muscle tenses from point A to point B in an isometric (no change in length) fashion. At that length the muscle is capable of developing much more force (D) than the load...

The Structure of Cognitive Therapy Behavioural Techniques Cognitive Techniques and Homework

The first class of therapeutic approaches focus on the client's behaviour. The rationale is that for some people behaviour monitoring, behavioural activation and behavioural change can lead to substantive gains. For example, people with more severe depression often become withdrawn and inactive, which can feed into and exacerbate depression. They withdraw and then label themselves as 'ineffectual', fuelling the depression. By focussing on this relationship and gradually increasing the person's sense of daily structure and participation in masterful and pleasurable activities the person can take the first steps in combating depression (Beck et al., 1979). Other behavioural strategies include scheduling pleasurable activities, breaking down large tasks (such as finding employment) into more manageable graded tasks (buying a newspaper with job advertisements, preparing a resume ), teaching relaxation skills, desensitising a person regarding feared situations, role playing and...

Pulsatile Coronary Arterial and Venous Flow

Coronary arterial blood flow is phasic, which is caused by the aortic pressure wave and compression of the intramural coronary vessels by contraction of the cardiac muscle. This compression effect causes mean systolic arterial flow to be lower than mean diastolic flow, although the driving pressure in systole is higher. Figure 2 illustrates the characteristic features of pressure and flow waveforms in the left coronary artery of a dog. The systolic flow wave has an initial and a late dip, which are related to the rapid changes in systolic left ventricular pressure and correspond to the phases where the stiffness of the heart muscle is increasing and decreasing, respectively. During the relaxation phase, diastolic flow initially increases sharply above systolic levels and then decreases gradually with aortic pressure.

Urinary Bladder Dysfunction

Urodynamic studies have been conducted in small samples of PD patients with persistent bladder complaints to elucidate the nature of the problem. Berger et al. (60) studied 29 patients and found that detrusor hyperreflexia was present in 90 and that incomplete sphincter relaxation during involuntary detrusor contractions as shown

Project Title Calcium Regulation In The Diabetic Heart

Summary Heart disease is the leading cause of death in diabetic patients, and considerable evidence is now available to support the existence of a specific diabetic cardiomyopathy that is independent of coronary artery disease and hypertension. Functional and biochemical data acquired from multicellular cardiac preparations of diabetic animals support the view that cellular mechanisms controlling cytosolic Ca2+ on a beat-to-beat basis are abnormal and contribute to impaired relaxation. The goal of this project is to characterize diabetes-induced changes in the expression and function of Ca2+ regulating proteins in isolated cardiac myocytes, and to determine the role of hyperglycemia in the pathogenesis and pathophysiology of diabetic cardiomyopathy. To test the hypothesis that abnormal Ca2+ handling occurs at the single cell level, biophysical assessment of excitation-contraction coupling will be carried out in ventricular myocytes isolated from diabetic rats. Voltage clamp techniques...

Application Of Computational Methods To Copper Proteins

In order to study the dynamical properties of the solvent-protein interface, a detailed analysis of the time relaxation behavior of the hydration shells around each atom of copper plastocyanin has been performed by means of a time-correlation function technique (77). In computing the function, which allowed the authors to extract average water residence times and coordination numbers within atomic shells of a given radius, attention has been focused on the short and long time limits of the function itself, also in connection with a detailed analysis of the statistical uncertainty. Water residence times distribution around plastocyanin has been calculated for the first coordination shell. Water residence times near charged and polar atoms were found to be longer than those of nonpolar ones moreover, side-chain oxygens and nitrogens, which form hydrogen bonds with solvent molecules, show water residence times larger than other atom types, and for negatively and positively charged...

Anaplastic Astrocytoma

The AA can be quite variable in location but nearly all are supratentorial and most are centered in the deep white matter and may secondarily involve the deep gray-matter structures. These masses generally have poorly defined margins and are somewhat heterogeneous in signal intensity characteristics on all MR pulse sequences, most evident on the FLAIR and T2-weighted images (Fig. 1). The amount of surrounding vasogenic edema is quite variable but more commonly relatively mild and frequently indistinguishable from the margins of the nonenhancing component of the mass. Consequently, it is difficult to determine the true extent of neoplastic cell invasion when planning complete resection by MRI. FLAIR and T2-weighted images certainly demonstrate the extent of parenchymal involvement better than the T1-weighted images but tumor cells can extend into parenchyma that is normal in signal intensity on all pulse sequences. Of the two, the FLAIR images generally make it easier to appreciate the...

Essential Distinctions

In contrast to a state of calm relaxation, anxiety reflects nervousness, tension, apprehension, and at the extreme is characterized by dread. In contrast, depression involves sadness, sorrow, unhappiness, and at the extreme includes despair. Anger varies from mild irritation and annoyance to rage. These emotional constructs are also distinguished in terms of the cognitive content that accompanies them. Threat and perceived vulnerability to harm are associated with anxiety loss, deprivation, separation, hopelessness, and failure are associated with depression and frustrated goals, interpersonal transgression, and victimization are associated with anger (Beck, 1976 Lazarus, 1991).

The Spiritual Dimension

Revival of spirituality one of the pleasures of aging is relaxation of defenses, freeing individuals for new tasks. The wisest of the aged are advocates for the aged. Hope tends to accompany advocacy it is the hope that is experienced not only in providing a better life for oneself but providing better treatment for older persons in general.

Mechanism of Transcription and Replication

HDAg shares some properties with transcription factors. Thus, direct or indirect binding of HDAg with the host polymerase (and or other transcription factors) may lead to a relaxation of normal template requirements. Indeed, HDAg has been shown to bind to both HDV RNA and pol II (Lin et al. 1990 Chao et al. 1991 Yamaguchi et al. 2001).

Coping Interventions for Disease Populations

Antoni and his colleagues developed a 10-week cognitive behavioral stress management intervention involving relaxation, cognitive restructuring, and coping skills training for women being treated for non-metastatic breast cancer. This intervention led to improved psychosocial outcomes (Antoni et al, 2006a, b). It also led to greater reductions in cortisol levels through a 12-month follow-up, compared with a control group (Phillips et al, 2008), and

Magnetic Resonance Imaging

MRI is emerging as a particularly advantageous modality for MI because of its high spatial resolution (when compared with PET and SPECT), very good sample penetration (when compared with optical imaging methods), it's widespread clinical availability, and lack of ionizing radiation. A tremendous drawback, however, is its low sensitivity compared with these other methods, which necessitates the development ofpowerful amplification strategies. MR contrast agents that could serve as potential bases for molecular imaging probes are in clinical use but specific derivatives for molecular imaging have not yet been approved (23). In general, MR contrast agents are designed to shorten the relaxation times of the tissue of interest and therefore increase the relaxation rates (37). There are two major classes of MR contrast agents paramagnetic contrast agents which are designed to predominantly affect T1 and thus tend to provide increased MR signal and superparamagnetic agents and agents...

Molecular Imaging With Iron Oxides

Ultrasmall superparamagnetic iron oxides (USPIO) are potent MRI contrast agents. The iron produces strong local disruptions in the magnetic field which leads to increased T2* relaxation. This increased relaxation causes decreased image intensity in areas with iron oxide accumulation (also known as susceptibility artifacts). Because of the extremely large change in MRI signal induced by superparamagnetic particles, they offer a potential solution to the problem of MR insensitivity, and have been developed for a wide variety of contrast agent applications, including imaging vasculature, bowel, liver, spleen, lymphatics, tumors, and stem cell therapy (38-40). In particular, dextran-coated USPIO particles with a 15 - to -25-nm diameter have a very long circulating half-life and are preferentially taken up by macrophages and the reticuloendothelial system (RES) in the body. This uptake allows them to be employed for passive targeted imaging of pathological inflammatory processes, such as...

Origin of genome duality

The hypothesis that nuclear dualism enables ciliates to evolve proteins in novel manners is supported by phylogenetic analyses based on protein-coding genes, such as elongation factor 1 alpha, heat shock protein 70, and eukaryotic release factor 1, that are unable to recover a consistent topology of ciliates due to rapid rates of substitution in this lineage (Budin and Philippe 1998 Bhattacharya and Ehlting 1995 Moreira et al. 2002 Moreira et al. 1999). A striking example of rapid protein evolution in ciliates is seen in histone H4, which is highly conserved in most eukaryotes but shows dramatic patterns of diversification in ciliates (Katz et al. 2004). Analyses of histone H4 and five other proteins show that ciliates tend to have more rapid rates of substitution and higher ratios of non-synonymous substitutions per non-synonymous site to synonymous substitutions per synonymous site (dN dS) than other major lineages of eukaryotes. In addition, both substitution rate and subscripts dN...

Functional Development of the ENS

In recent years, pharmacologic and physiologic studies have provided evidence that nitric oxide (NO) is the most important mediator in nonadrenergic, noncholin-ergic relaxation of the gastrointestinal tract. By 12 weeks' gestation, nitrergic neurons appear in the myenteric ganglia, at all levels of the gut, and begin plexus formation. Nitrergic innervation in the submucous plexus becomes evident after 14 weeks. As gestational age increases, ni-trergic innervation becomes richer and more organized. Increasing numbers of nitrergic nerve fibers are seen in the circular muscle some of these fibers project from the myenteric plexus. Thus, the onset and pace of development of nitrergic innervation are similar to adrenergic and cholinergic innervation and occur before peptider-gic innervation 33 .

Nitric Oxide and Carbon Monoxide as Neurotransmitters

In the PNS, nitric oxide is released by some neurons that innervate the gastrointestinal tract, penis, respiratory passages, and cerebral blood vessels. These are autonomic neurons that cause smooth muscle relaxation in their target organs. This can produce, for example, the engorgement of the spongy tissue of the penis with blood. In fact, scientists now believe that erection of the penis results from the action of nitric oxide, and indeed the drug Viagra works by increasing this action of nitric oxide (as described in chapter 20 see fig. 20.23). Nitric oxide is also released as a neurotransmitter in the brain, and has been implicated in the processes of learning and memory. This will be discussed in more detail later in this chapter.

Other Autonomic Neurotransmitters

These parasympathetic axons have been shown to use the gas nitric oxide (chapter 7) as their neurotransmitter. In a similar manner, nitric oxide appears to function as the autonomic neurotransmitter that causes vasodilation of cerebral arteries. Studies suggest that nitric oxide is not stored in synaptic vesicles, as are other neurotransmitters, but instead is produced immediately when Ca2+ enters the axon terminal in response to action potentials. This Ca2+ indirectly activates nitric oxide synthetase, the enzyme that forms nitric oxide from the amino acid L-arginine. Nitric oxide then diffuses across the synaptic cleft and promotes relaxation of the postsynaptic smooth muscle cells. Nitric oxide can produce relaxation of smooth muscles in many organs, including the stomach, small intestine, large intestine, and urinary bladder. There is some controversy, however, about whether the nitric oxide functions as a neurotransmitter in

Mechanism Of Action

Effect of pilocarpine and atropine on intramuscular spaces within the ciliary muscle of vervet monkey. (A) Intracameral heavy pilocarpine solution induced crowding of muscle bundles within the anterior part of the longitudinal muscle. Arrows indicate zone of localized contraction. (B) Intramuscular pilocarpine followed by intracameral heavy atropine solution (atropine was allowed to act for 3 minutes) induced loose arrangement of anterior longitudinal muscle bundles. Arrows indicate boundary between zone of localized relaxation and other contracted parts of the muscle. (C) Same protocol as in B, but atropine was allowed to act for 10 minutes. Zone of loosely arranged muscle bundles reaches far toward posterior region. Only the posterior extremity of muscle appears intensely contracted. Arrows indicate boundary between contracted and relaxed muscle portions (Heidenhain's Azan stain, ( x 35). Reprinted with permission from Bar ny EH, Rohen JW. Localized contraction and...

Antibodyhapten Interactions

Lancet (1977) in Chemical Relaxation in Molecular Biology (I. Pecht & R. Rigler, eds.) pp. 2-3, Springer-Verlag, Berlin. 2M. Eigen (1974) in Quantum Statistical Mechanics in the Natural Sciences (S. L. Minz & S. M. Wiedermayer, eds.) pp. 37-61, Plenum Press, New York.

Functional Properties Of Cardiovascular Gap Junctions

Where gmax and gmin are maximal and minimal con-ductanes obtained at lowest and highest Vj , V0 is the voltage at which the voltage-sensitive component of gj (gmax - gmin) is reduced by 50 , and A is a slope factor from which the equivalent number of gating changes, n, can be calculated (Spray et al., 1981a). Evaluation of voltage sensitivity after the exogenous expression of connexins in mammalian cells or in weakly endoge-nously coupled cell pairs has indicated that for most connexins, the steady-state conductance is symmetric around 0 mV and is well fit to Boltzmann relationships (Fig. 7). Moreover, Boltzmann parameters are now known to be distinct for gap junction channels formed of each connexin subtype, as is described in more detail in Section D. For most of the gap junction channels that have been studied, the relaxation of junctional current from its initial to steady-state levels is well fit by a single

Nuclear magnetic resonance relaxometry and imaging

Nuclear magnetic resonance (NMR) relaxometry and imaging have been evaluated as a technique to measure mealiness. Barreiro and colleagues used magnetic resonance techniques to assess mealiness in apples (Barreiro et al., 1999) and peaches (Barreiro et al., 1998b). Magnetic resonance techniques rely on the magnetic properties that some atomic nuclei have. When placed in a magnetic field, the natural magnetic dipoles of the nuclei reorient themselves along the magnetic field. After excitation they return to their equilibrium position. The rate at which this happens can be expressed by two relaxation times (T1 and T2) and is a function of the texture of the material (Smith and Lange, 1998). Barreiro et al. (1999) found that the variability of the T2 values inside an apple was larger than that between apples. However, a difference between the average T2 value of fresh apples and that of apples stored in mealiness-enhancing conditions was noticed minimum T2 values were shown to be...

The Evidence Base For Behaviour Therapy

Behaviour therapy has been shown to reduce symptoms compared with relaxation (Abramowitz, 1997) and anxiety management training (Lindsay, Crino & Andrews, 1997). Foa & Kozak (1996) reviewed 12 outcome studies and found 83 of patients who completed exposure and response prevention treatment were post-treatment responders. Stanley & Turner (1995) concluded that about 75 of OCD patients show substantial improvement after 12 to 15 sessions of behaviour therapy. O'Sullivan & Marks (1991) reviewed nine follow-up studies of OCD exposure and response prevention treatment completers. The follow-up duration was between one and six years with a mean follow up of three years. Seventy-nine per cent of patients had improved or were much improved and symptom improvement was maintained irrespective of the length of follow up. However, these results are for treatment completers. About 25 of OCD patients offered ERP refuse it (Kozak, 1999) and others drop out or do not improve with ERP. Hiss, Foa &...

Aspartate Carbamoyltransferase

Selected entries from Methods in Enzymology vol, page(s) Activation, 64, 177 concerted allosteric model, 64, 173 isotope exchange properties, 64, 10 negative cooperativity, 64, 189 rapid relaxation measurement, 64, 188, 189 sequential model, 64, 173 site-directed mutagenesis, 202, 717, 725 structure-function analysis, 202, 694 supersecondary structures, genetic exchange within domains, 202, 704 allosteric mechanism, 259, 614, 627 binding site number, 259, 615-616 concentration, 259, 615 differential scanning calorimetry assembly effects, 259, 624-625 buffer sensitivity, 259, 625 ligation effects, 259, 625 mutation effects, 259, 626 electrostatic interactions, 259, 626-628 Escherichia coli ATCase cooperativity in (allosteric structures and model testing, 249, 554-555 experimental evaluation, 249, 548554 heterotropic, 249, 552-553 homotropic, 249, 551-552 mutational analysis, 249, 554 structural model, 249, 549-551) inter-subunit ligand binding sites, 249, 559-560 site-directed mutants,...

Excitation Contraction Coupling

Muscle contraction is turned on when sufficient amounts of Ca2+ bind to troponin. This occurs when the Ca2+ concentration of the sarcoplasm rises above 10-6 molar. In order for muscle relaxation to occur, therefore, the Ca2+ concentration of the sar-coplasm must be lowered to below this level. Muscle relaxation is produced by the active transport of Ca2+ out of the sarcoplasm into the sarcoplasmic reticulum (fig. 12.15). The sarcoplasmic reticulum is a modified endoplasmic reticulum, consisting of interconnected sacs and tubes that surround each myofibril within the muscle cell.

Selfhelp Books And Computer Programmes

There are many self-help books for OCD, such as Living with Fear (Marks, 1978) and The OCD Workbook (Hyman & Pedrick, 1999). An international group has developed and tested a computer-administrated system, called BT STEPS, for assessing and treating OCD via the telephone and computer. An initial trial (Bachofen et al., 1999), of the computer programme treatment found an average 33 improvement on Yale-Brown Obsessive Compulsive Scale (Y-BOCS), with significant change in YBOCS only in those who completed at least two exposure and response-prevention sessions. A recent trial of 218 patients compared the computer-guided behaviour treatment to clinician-guided behaviour treatment and relaxation (Griest et al., 2002). The relaxation was ineffective, whereas both the behaviour therapy conditions were effective, with a significantly greater improvement in the clinician-guided group. Patients in the computer-guided treatment group improved more the longer they spent telephoning the computer...

Other Neuroimaging Modalities eg Perfusion Mri Mtr

Magnetization transfer (MT) attempts to obtain a signal from macromolecules, which are otherwise invisible to MRI, because the T2 relaxation times of their protons (less than 200 ms) are orders of magnitude below that of free water. MTI applies an extra off-resonance saturation pulse intended to resonate with the bound protons in macromolecules, yielding a signal once the magnetization is transferred to the surrounding free water. Hence MTI is considered to have partial sensitivity

Energy Requirements of Skeletal Muscles

Skeletal muscles at rest obtain most of their energy from the aerobic respiration of fatty acids. During exercise, muscle glycogen and blood glucose are also used as energy sources (fig. 12.21). Energy obtained by cell respiration is used to make ATP, which serves as the immediate source of energy for (1) the movement of the cross bridges for muscle contraction and (2) the pumping of Ca2+ into the sarcoplasmic reticulum for muscle relaxation.

Alpha and Gamma Motoneurons

Rapid stretching of skeletal muscles produces very forceful muscle contractions as a result of the activation of primary and secondary endings in the muscle spindles and the monosynaptic stretch reflex. This can result in painful muscle spasms, as may occur, for example, when muscles are forcefully pulled in the process of setting broken bones. Painful muscle spasms may be avoided in physical exercise by stretching slowly and thereby stimulating mainly the secondary endings in the muscle spindles. A slower rate of stretch also allows time for the inhibitory Golgi tendon organ reflex to occur and promote muscle relaxation.

Physical characteristics

The internal anatomy of kinorhynchs is related to the outer segmentation, nervous system, muscles, and glandular system, which are all distinctively segmented. Simultaneous contraction of segmental dorsoventral muscles increases the pressure of the body-cavity fluid in the trunk, displaces it forward, and everts the head. Scalids move forward, plow backward through the interstices around and propel the kynorhynch forward. Special head retractor muscles retract the introvert back into the trunk in synchrony with relaxation of the dorsoventral muscles.

Cardiac Cycle and Heart Sounds

The two atria fill with blood and then contract simultaneously. This is followed by simultaneous contraction of both ventricles, which sends blood through the pulmonary and systemic circulations. Contraction of the ventricles closes the AV valves and opens the semilunar valves relaxation of the ventricles causes the semilunar valves to close. The closing of first the AV valves and then the semilunar valves produces the lub-dub sounds heard with a stethoscope. The cardiac cycle refers to the repeating pattern of contraction and relaxation of the heart. The phase of contraction is called systole, and the phase of relaxation is called diastole. When these terms are used without reference to specific chambers, they refer to contraction and relaxation of the ventricles. It should be noted, however, that the atria also contract and relax. There is an atrial systole and diastole. Atrial contraction occurs toward the end of diastole, when the ventricles are relaxed when the ventricles...

Oxytocin and Vasopressin Information from Animal Models

Response systems, the serotonin, dopamine, and GABA mood and affect responsive systems, and the opioidergic and other pain regulating systems. Uvnas-Moberg (1998) has proposed that oxytocin is the central response system involved in what she has labeled the relaxation and growth response and the calm and connection response. This response is a complementary system to which behavioral medicine terms the flight or fight response, which involves activation of HPA and sympathetic stress-responsive systems. Not surprisingly, oxy-tocin activity can be enhanced after these systems are activated, as part of a negative feedback loop acting to turn off these systems and keep their activation to a short-term response. In the brain, the neural connections between the oxy-tocin tracts and the dopaminergic tracts, sometimes called the reward system , are assumed to activate together and may partly explain why contact between mother and infant and even nonsexual contact between bonded partners and...

Paracrine Regulation of Blood Flow

The endothelium produces several molecules that promote smooth muscle relaxation, including nitric oxide, bradykinin, and prostacyclin (chapter 11). The endothelium-derived relaxation factor that earlier research had shown to be required for the vasodilation response to nerve stimulation appears to be nitric oxide. The endothelium of arterioles contains an enzyme, endothelial nitric oxide synthase (eNOS), which produces nitric oxide (NO) from L-arginine. The NO diffuses into the smooth muscle cells of the tunica media of arterioles and activates the enzyme guanylate cyclase, which converts GTP into cyclic GMP (cGMP) and pyrophosphate (PPi). The cGMP serves as a second messenger that, through a variety of mechanisms, acts to lower the cytoplasmic Ca2+ concentration. This leads to smooth muscle relaxation and thus vasodilation (see chapter 20, fig. 20.23). In many arterioles, a baseline level of NO production helps regulate the resting tone (degree of vasoconstriction vasodilation) of...

Regulation of Coronary Blood Flow

Most of the vasodilation that occurs during exercise, however, is due to intrinsic metabolic control mechanisms. The intrinsic mechanisms occur as follows (1) as the metabolism of the myocardium increases, there are local accumulations of carbon dioxide, K+, and adenosine in the tissue, together with depletion of oxygen (2) these localized changes act directly on the vascular smooth muscle to cause relaxation and vasodilation.

The Normal Enteric Nervous System

The mature ENS is absolutely unique and different from any other region of the peripheral nervous system (PNS). First, the ENS is independent and can function in the absence of input from the brain or spinal cord 3, 4 . Second, in contrast to the remainder of the PNS, the ENS can mediate reflexes, even when it is isolated from the central nervous system (CNS). This ability of the ENS is often overlooked, even though it has long been known to be true. As the 19th Century turned to the 20th, Bayl-iss and Starling reported that enteric reflexes could be mediated by the local nervous mechanism of the gut 14, 15 . These investigators described what they called the law of the intestine (now known as the peristaltic reflex) in extrinsically denervated loops of dog intestine. This is a reflex, evoked by increased intraluminal pressure, that consists of a wave of oral excitation and anal relaxation that descends in the bowel and is propulsive.

Review Of Anger Treatment Outcomes

By contrast, the term Integrative Constituent was used to describe those circumstances where addressing anger, although remaining integrated within broader therapeutic activity, is more clearly delineated. Examples of such an approach can be found within both the psychoanalytic and cognitive behavioural literatures but, as yet, the only systematic outcome evidence that falls into this category comprises 'component' CBT procedures for addressing client anger difficulties. In this regard evidence has been accrued indicating the utility of relaxation procedures (O'Donnell & Worell, 1973), exposure-based procedures (Brondolo, DiGuiseppe & Tafrate, 1997 Grodnitzky & Tafrate, 2000) systematic desen-sitisation (Rimm et al., 1971) and cognitive-based techniques (Dahlen & Deffenbacher, 2000 Tafrate & Kassinove, 1998). It is to be noted that this work has, again, predominantly involved student samples, hence its application to more serious clinical populations cannot be assured.

Endothelium Derived Dilating Factors

The level of arterial tone in vivo is thought to be dynamically modulated by factors released from the vascular endothelium. Indeed, endothelial cells are thought to regulate vascular smooth muscle tone primarily by releasing nitric oxide, EDHF, and or prosta-cyclin. From a wealth of studies, it is generally believed that nitric oxide is a major chemical mediator of endo-thelium-derived relaxation in both conduit and resistance arteries, whereas EDHF may be more involved in the relaxation of resistance arteries. For example, acetylcholine-induced relaxation of large arteries may be mediated entirely by the release of nitric oxide, and exposing large arteries to nitric oxide synthase inhibitors eliminates acetylcholine-induced relaxation. The vaso-dilating action of nitric oxide and other nitro-containing compounds may rely on the activation of BKCa channels and possibly KATP channels to hyperpolarize the smooth muscle membrane. In instances in which nitric oxide has been shown to...

Storagefilling symptoms

The normal detrusor muscle undergoes receptive relaxation to allow urine storage, without causing a rise in intravesical pressure. When the bladder capacity is reached, sensory stimuli generate a desire to void and, when socially appropriate, the detrusor muscle contracts and voiding takes place due to the rise in intravesical pressure. If the ability for receptive relaxation is lost, the sensory stimuli are produced before the bladder is full and an intense urge to void is experienced. This recurs again as the bladder refills. The urge to void can be so intense that the patient becomes incontinent. This is known as urge incontinence and often includes the triad of symptoms

Evidencebased Psychotherapy With Older People

To date the only meta-analytic review of the nonpharmacological treatment of anxiety disorders has been carried out by Nordhus & Pallesen (2003). For this meta-analysis, the authors identified 15 psychosocial studies looking at the treatment of anxiety disorders in older people. The selection criteria used were quite flexible in order to include enough studies to permit an adequate meta-analysis. The studies varied in quality and many used relaxation as a primary treatment approach for anxiety reduction. Some of the studies were pilot studies and some were published as proceedings of a conference. Overall, Nordhus & Pallesen (2003) calculated a mean effect size for psychosocial treatments of 0.55. Using the classification adopted for the behavioural sciences (Cohen, 1977) 0.2 is considered a small effect size, 0.5 is considered a moderate effect size and 0.8 is considered a large effect size. It was noted that effect sizes are reduced when considering psychosocial treatments with...

The Hypothalamic PituitaryGonadal Axis

Severe chronic stress and HPA axis activation results in suppression of the hypothalamic-pituitary-gonadal axis at all levels (hypothalamus, pituitary, gonads) and a decrease in reproductive activity in general. In women, stress-induced secondary hypothalamic amenorrhea due to glucocorticoid hypersecretion has been observed in melancholic depression, chronic alcoholism, and eating disorders (Chrousos and Gold, 1998 Kyrou et al, 2006). In men, severe stress in real life, i.e., exposure to war, to an earthquake or to a critical life event may lead to impaired sperm quality (Abu-Musa et al, 2008 Fukuda et al, 1996 Gollenberg et al, 2010). Interestingly, a psychological profile of being an active, competitive person may coincide with a low sperm count, possibly through activity-induced activation of the SNS and a deficiency of testicular blood flow. Behavioral therapy focusing on relaxation strategies appear to increase sperm counts and reproductive success in these men (Hellhammer and...

Tendon Or Muscle Stretch Reflexes

The extent and duration of the response Normally, only the quadriceps contracts in response to patellar tendon stretching and not all of the quadriceps. In an abnormal reflex more of the muscle contracts, it lasts longer, and other muscles (adductors or even the opposite quadriceps) may also contract. A normal knee reflex might be visible contraction of the quadriceps and no movement of the leg. The abnormal knee reflex might consist of extension of the knee to a straight leg position and a slow relaxation.

Mechanics of Breathing

Normal, quiet inspiration results from muscle contraction, and normal expiration from muscle relaxation and elastic recoil. These actions can be forced by contractions of the accessory respiratory muscles. The amount of air inspired and expired can be measured in a number of ways to test pulmonary function.

Regulation of Breathing

Inspiration and expiration are produced by the contraction and relaxation of skeletal muscles in response to activity in somatic motor neurons in the spinal cord. The activity of these motor neurons is controlled, in turn, by descending tracts from neurons in the respiratory control centers in the medulla oblon-gata and from neurons in the cerebral cortex.

A MC1R Gene Evolution and Population Allele Frequencies

In contrast, the high MC1R polymorphism in other human populations is thought to be due to either a relaxation of functional constraint on the MC1R gene in those regions where UVR levels are not as high,229 or positive selection of MC1R alleles linked to fair skin, which would allow for increased vitamin D synthesis in regions with limited sunlight.227,228 There is some MC1R polymorphism in the Asian population, in particular the R163Q weak r variant has a high frequency of approximately 70 (depending on which Asian population is analyzed) compared to non-Asian populations where the frequency is low.222,228,229,233,234 Recently, it was reported that the V92M allele also has a relatively high frequency in southeast Asians of 44 .222 The V92M allele has been associated with freckling and severe solar lentigines in the Japanese population however, the R163Q allele actually had a negative association with freckling and severe solar lentigines.235

Functional Magnetic Resonance Imaging

In the longitudinal relaxation of various tissue classes. After a slice of tissue is excited by RF energy, the alignment of spinning protons within the slice gradually returns to alignment with the magnetic field, and as a result the resonant signal decays smoothly. The speed at which this signal decays (longitudinal relaxation time or T1) depends on the ability of the surrounding tissue lattice to efficiently absorb resonant energy, and this varies according to tissue type. Fat, for example, is more efficient at absorbing energy, therefore resonant signals from fat decay more quickly than neural tissue or water. Structural MRI uses a pulse sequence which maximizes the differences in signal decay as different tissues realign themselves with the static magnetic field.

T1 and T2 Relaxometry

Contrast in most human neuroimaging studies is a function of the T1 and T2 relaxation times of the brain tissues. Consequently, regional signal differences in brain images are often caused by differences in the relaxation properties. T1 is the recovery time of the longitudinal magnetization and T2 is the decay constant associated with the transverse magnetization. Both characteristic times are highly sensitive to bulk water of the tissue and tend to increase with water content. Significant changes in both T1 and T2 are observed with early brain maturation (e.g., Miot et al. 1995 Miot-Noirault et al. 1997 Sie et al. 1997 Steen et al. 1997 Paus et al. 2001) and aging (Jernigan et al. 1991 Autti et al. 1994 Salonen et al. 1997). In development, these changes are likely caused by decreased water content and increased water binding and compartmentalization including during premyelination periods when lipids, proteins, and glial cells are increasing. T2 appears to be more sensitive to the...

Applications of Magnetic Resonance Imaging to the Study of Development

MRI has had a dramatic impact in the diagnosis of a variety of diseases and the in vivo study of the developing brain. This technique provides high spatial resolution images of the brain based on the nuclear magnetic resonance (NMR) properties of water protons and other nuclei found in brain tissue (Young, 1988). NMR consists of applying a radio frequency (RF) pulse (with an excitation frequency coinciding with the natural frequency of the system, known as the Larmor frequency) to the tissue. The RF pulse flips the net magnetization perpendicular to the main field. The MR image is generated by differences in the concentration of nuclei and their nuclear magnetic relaxation times (Tx and T2) in the different tissue environments (Bloch, 1946 Hahn, 1950). Tj relaxation refers to the return of precessing nuclei to alignment with the main field after excitation (i.e., longitudinal relaxation, or spin-lattice). This relaxation is related to surrounding tissue composition in that small water...

Behaviour Therapy Rationale

Behaviour therapies for depression are underpinned by learning theory as a means of explaining the decline into and resolution of the depressive state and are primarily aimed at engaging or re-engaging the patient in pleasurable and consequently positively reinforcing behaviours. Relative to psychotherapy, behaviour therapy concentrates more on behaviour itself and less on a presumed underlying cause. The basic premise of behavioural treatments is that depression is a learned response in light of low rates of positively reinforcing behaviours and insufficient positive reward from routine behaviour. The aim therefore is to increase the reward experience through behavioural activation. Interventions combine skills based learning such as relaxation skills and problems solving with distress tolerance for negative emotions. Two studies have shown this approach to outperformed control conditions. Shaw (1977) found that although behaviour therapy patients did not outperform those in CT, they...

Bladder Bowel and Sexual Disturbances

Disturbances of defecation and especially micturition are among the most disabling features of MS, occurring in up to 78 during the course of the illness (134). Patients may complain of urinary frequency, urgency, and incontinence. Alternatively, the urge to urinate may be accompanied by an inability to voluntarily initiate urine flow. History alone is an unreliable indicator of the physiological status of micturition and must be supplemented by further investigation (135,136). Usually, this requires only a determination of voided volume followed by measurement of residual urine volume, either by direct catheterization or by some other method for estimation, such as ultrasonography or radionuclide study (137). Disturbances of micturition may be divided into failure to store urine, failure to empty the bladder adequately, or a combination of both. In some patients, good contraction of the bladder detrusor is inappropriately associated with contraction of the external ure-thral...

Calcium Ion Indicator Dyes

Kao and Tsien3 studied the Ca2+-binding kinetics of fura-2 and azo-1 by temperature-jump relaxation methods. In 140 mM KCl at 20 C, the respective association and dissociation rate constants for fura-2 were 6 X 108 M V1 and 97 s 1 these kinetic properties were insensitive to hydrogen ion concentration over the pH range from 7.4 to 8.4. Azo-1 was studied in 140 mM KCl At 10 C, azo-

Bloodinjury And Injection Phobia

Not addressed Four groups stress inoculation, six sessions training or semi-automated behaviour therapy (modelling, relaxation, video-exposure) Waiting-list 'positive dental experience' from dentist hypnotherapy (relaxation reinforced with suggestions) or behaviour therapy (relaxation, exposure to anxiety provoking hierarchy, biofeedback) systematic desensitisation (SD) (to graded video scenes, relaxation, EMG biofeedback) alone or SD and 'cognitive coping' SDCC, challenging negative self-statements) Four groups allocated to self-instruction training or applied relaxation 'cognitive or physiological reactors' high low arousal and coping no coping instruction cf. relaxation control group Three groups 10 sessions EMG feedback, progressive relaxation control group (seIf-relaxation) Two groups massed spaced cognitive therapy and relaxation desensitisation (audio presented hierarchy), video modelling and relaxation and imaginal desensitisation relaxation placebo. Waiting-list

Facioscapulohumeral Muscular Dystrophy

Recently, four models attempting to explain the pathomechanism of FSHD have been postulated (97). In a cis-spreading scenario, interstitial deletion of D4Z4 leads to local chromatin relaxation with spreading of upregulation (94,98,99). The insulator mechanism predicts inefficiency of the contracted D4Z4 boundary element to the distally located heterochromatin (100) and in the chromatin cis-loop model, the number of D4Z4 repeats determines the 3D chromatin structure and, thus, direct interactions between D4Z4 and the upstream genes (95). The fourth model supplements the third one and implies the perturbation of 4qter with nuclear lamina and subsequent misbalance of chromatin and transcription factors (101-102).

Theory of Nuclear Magnetic Resonance

Nuclear magnetic resonance (NMR) spectroscopy detects the interaction of radiofrequency (rf) radiation with the nuclear spins of molecules placed in an applied magnetic field. Because the spins are sensitive to their environment, and may be coupled to one another both through chemical bonds and through space, NMR can provide a wealth of information on the structure and dynamics of macromolecules. In particular, NMR has proven to be a powerful technique for investigating the structure-function relationship of hemoglobin (Hb). In this chapter, we focus on the procedures involved in applying one-dimensional and two-dimensional NMR spectroscopy to Hb and give examples of the information that may be obtained from this method. We begin with a brief outline of theory a more complete treatment can be found in several excellent books (1-8). A typical NMR sample may contain approx 3 x 10-7 mol of Hb, which include 1021 hydrogen atoms, each of which has a nucleus (i.e., a proton) with a nuclear...

Spin Spin Coupling and 2D NMR

Effective field depending on whether spin A points up or down. This electron-mediated scalar coupling is expressed as JIA-IB, in which J (expressed in Hertz) is independent of the applied field B0. Its effect is to split the resonance lines at vA and vB by J. In heteronuclear NMR experiments (discussed in Subheading 1.4.), it is usually desirable to remove the effects of coupling between each proton and its bonded 13C or 15N nucleus during acquisition, so that the resonance lines appear as singlets. Such broadband decoupling can be achieved by specifically designed, composite pulse sequences (3,6). Generally, NMR can detect scalar couplings between nuclear spins separated by up to three bonds. Nuclear spins are also coupled through space by means of the dipoledipole interaction. Consider a spin IA subjected to a continuous selective pulse. The population of the two energy levels will be equalized, so the intensity of the corresponding resonance line will vanish (saturation). A nearby...

Cognitive And Behavioural Therapies

Over the past decade, a number of studies have examined the efficacy of psychological (mostly cognitive-behavioural) treatments for social anxiety disorder. The most commonly investigated treatments have been in vivo exposure (with or without the addition of cognitive restructuring techniques), social skills training, and relaxation training. The International Consensus Group on Depression and Anxiety's 'Consensus Statement on Social Anxiety Disorder' concluded that there is good evidence for the efficacy of exposure-based cognitive-behavioural interventions for social anxiety (Ballenger et al., 1998). Accordingly, these interventions receive the bulk of our attention in this review. Exposure to feared situations is a central component of most treatments for social anxiety disorder. Exposure can be conducted either imaginally, in role plays or in vivo, to help clients habituate to anxiety-provoking situations and to provide an opportunity to gather disconfirmatory information and...

Social Anxiety In Children And Adolescents

Other existing controlled trials examining the efficacy of cognitive restructuring and exposure therapy for anxious children have included mixed diagnostic samples, limiting the specificity of the results for social anxiety disorder. In the following studies, socially anxious children comprised 24 to 33 of the total samples. Kendall's (1994) Coping Cat programme combines relaxation training with exposure and cognitive restructuring to alleviate children's fears. This programme provides an age-appropriate format for leading younger children through cognitive restructuring steps. Parental involvement in therapy is mainly in a supportive role and collaboration within session is variable. After 16 sessions, this intervention was superior to a wait-list condition for children (ages 9 to 13) with either overanxious disorder, separation anxiety disorder or DSM-III-R (American Psychiatric Association, 1987) avoidant disorder of childhood, which was later subsumed under social anxiety disorder...

Image Segmentation Layer

The GMM approach does not consider the spatial arrangement of class labels in an image, which can be quite useful for relaxation labeling 28 . Markov random fields (MRF) have been shown as a powerful class of techniques 29-31 for modeling the spatial arrangement of class labels. MRF can be expressed in terms of a probabilistic framework and they can be combined with a statistical observed model of the mammogram. An MRF can increase the homogeneity of the formed regions that leads to a reduction in the false positives.

Endothelium Derived Vasoactive Substances

Endothelium plays a central role in the regulation of vascular smooth muscle tone, including that of coronary artery. Although multiple pathways are involved in en-dothelium-induced relaxation, the major mechanism is via release of NO. L-NAME, an inhibitor of NO synthesis from l-arginine, has been a widely used tool to determine the role of NO. For example, exposure to L-NAME decreases hyperpolarization and relaxation of smooth muscle by acetylcholine demonstrating the participation of NO (69). The release of NO contributes to flow-related vasodilatation, reactive hyperemia, hy-percapnic acidosis, the vasodilatation by adenosine, and the maintenance of flow in the presence of coronary artery stenosis (70). Endothelium-derived hyperpolarizing factors appear to play important roles, especially in the microvascula-ture (82). The chemical identity of EDHF has been related to several factors, such as epoxyeicosatrienoic acid (EET) (83), K+ (84), and anandamide (85). There is an emerging...

Intelligence Artificial Intelligence Embodiment and What the Book Is About

How does the body shape the way we think Is this even the right question, or should it perhaps be the other way around how does our thinking influence the body It seems obvious that the way we move, walk, talk, write, dance, and sing are all controlled by the brain, i.e., the brain quite obviously controls the body.We decide that we want to drink a cup of tea, go see a movie, or do some push-ups, and then we do it. But the brain controls the body not only at the conscious but also at the unconscious level. The basic digestive and life maintenance functions such as breathing and heartbeat, on the one hand, and automatic movements on the other are only a few examples we do not explicitly tell our stomach to digest, and when walking we do not consciously control the movement of our legs the control is largely automatic, unless there are disturbances. If we do try and consciously control our movements, we are likely to trip over this is a phenomenon that many of us will have experienced...

Cardiac Disease Introduction

Prior to the eagerly awaited outcome of the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) trial, detailed below, much of the literature had relied on cardiac nurse-led psychosocial interventions (often termed psychological interventions or counselling), with variable outcomes. This led to conflicting views about the efficacy of addressing psychological issues in cardiac patients. Linden's (2000) review of psychological treatments in cardiac rehabilitation programmes commented on the differing treatment approaches ranging from relaxation breathing retraining, unstructured support or psychoeducation to improve compliance, to psychological interventions to reduce emotional distress. He concluded that critical differences in study outcomes can be explained by the finding that studies which failed to have an impact on levels of psychological distress also fail to have an impact on mortality or event recurrence.

Psychosocial Interventions Optimizing Health Survival and Improving Quality of Life

A large number of studies indicate that group-based interventions in cancer reduce psychological distress (e.g., Gustafsson et al, 1979), including anxiety and depression (e.g., Fawzy et al, 1997) improve coping (e.g., Lieberman, 1988) and reduce physical symptoms such as pain, nausea, and vomiting (e.g., Meyer and Mark, 1995). Psychosocial interventions tailored to meet the needs of cancer patients include supportive-expressive group therapy (Luebbert et al, 2001), psychoeducational interventions (e.g., Lieberman, 1988), and multimodal intervention approaches. Research shows that effective components include (e.g., Gregoire et al, 1997) strategies, such as relaxation training (e.g., guided imagery) to lower arousal, disease information and management an emotionally supportive environment where participants can address fears and anxieties behavioral and cognitive coping strategies and social support. In a meta-analysis of relaxation interventions targeting patients undergoing cancer...

Inward Rectifier K Channels

Inward rectifier K+ channels have been identified in cerebral, mesenteric, and coronary arteries (Edwards et al., 1988 Quayle et al., 1993). In these arterial cells, stimulation with high K+ produced vascular relaxation instead of contraction (Edwards and Hirst, 1988 McCarron and Halpern, 1990). This peculiar property was well explained by the presence and activation of this inward rectifier K+ channel. In general, inward rectifier K+ channels are thought to stabilize the membrane potential at low levels in cardiac cells however, in these arteries these channels are thought to stabilize the membrane potential at a high level by channel closure (Quayle et al., 1993 Kubo et al., 1993). The Kir2.0 family is thought to provide these inward rectifier K+ channels

Conventional NMR Spectroscopy

Nmr Plant Extracts

100-500 L of sample) is placed in a 5-mm glass tube and inserted into the bore of a superconducting magnet at field strengths ranging from 9.4 to 18.7 T. These are commonly referred to as 400-800-MHz NMR systems on the basis of the proton resonance frequency. The relaxation of nuclei following a train of RF pulses is then measured and translated into chemical shifts, coupling constants, and integration data. The resulting signals are presented typically as a 1-dimensional (1D) proton NMR spectrum (Figure 8.1). The term 1D refers to one dimension of frequency, as the y axis is the signal intensity. The spectrum is representative of a urine sample from a healthy volunteer the most common urinary and plasma metabolites are catalogued elsewhere 17, 22 . The presence of a metabolite tends to be confirmed by spiking available standards into the biofluid sample. Thus, the main signals are often readily assigned. However, overlapping signals and multiplicity patterns tend to complicate...

Four Categories Of Psychophysiological Relationships

Noted in discussions of the scientific method and is perhaps equally often violated in scientific practice (Platt, 1964). Skin conductance, forinstance, has been a major dependent measure in psychological research because emotional arousal is thought to lead to increased skin conductance. Similarly, EMG activity over the forehead region has been a frequent target measure in relaxation biofeedback because tension has been found to increase EMG activity over this region. As noted in the previous section, however, simply knowing that that manipulating a particular element in the psychological domain leads to a particular response in the physiological domain does not logically enable one to infer anything about the former based on observations of the latter, because one does not know what other antecedents might have led to the observed physiological response. Procedures such as holding constant any variations in the elements in the psychological domain that are not of interest, measuring...

Musculoskeletal System

Age-related structural changes in the musculoskeletal system include a decrease in the total amount of muscle in body tissue after age 40 and its replacement by fat tissue, an increase in deposits of mineral salts in the bones, a decrease in cartilage around joints, and a decrease in the quantity of synovial fluid in the joints. Muscular tone, strength, flexibility, speed, and stamina decline the relaxation contraction time of muscles increases and injured muscles heal more slowly.

Vincent L Sorrell MDa Navin C Nanda MDb

More than 10 of those aged 80 to 89 years have HF, making congestive HF extremely common in the elderly 1 . Although HF remains a clinical diagnosis, echocardiography assists in determining the etiology, systolic and diastolic function, and hemodynamic state. The cardiovascular systems of elderly people have important differences from those of the general population and those differences need to be taken into consideration. For example, the rate of myocardial contraction and relaxation in the elderly is prolonged. This abnormality in relaxation may account for the higher prevalence of normal LV systolic function seen in elderly patients with HF, where more than 50 of patients older than 80 years have normal or near-normal systolic function 2 . Although diastolic dysfunction has been defined clinically as HF in the presence of a normal ejection fraction, an echocardiographic assessment of diastolic function is important in confirming the diagnosis 39 . Importantly, any process that...

Theoretical Formulations

The standard therapies for GAD, evaluated in clinical trials from 1980 to 2000, have been broadly based on the procedures and principles of cognitive therapy as applied to the appraisal of threat (Beck, Emery & Greenberg, 1985) and behaviour therapy as applied to reducing muscle tension through relaxation training (Bernstein & Borkovec, 1973 Ost, 1987). These approaches will be familiar to therapists with a basic training in cognitive behaviour therapy (CBT). The primary emphasis is on a process of self-regulation in which the sufferer learns to understand and then interrupt his or her particular cycle of anxiety triggers, bodily responses and worries with coping strategies based on either reducing arousal and muscle tension or changing the beliefs, and appraisal processes that underlie worrisome thinking. Clinical and research evidence suggests that confidence in either approach can bring about significant reductions in the severity of GAD but confidence in both is probably most...

Myocardial Blood Flow

The coronary arterial tree terminates in muscular vessels 60150 m in diameter termed arterioles. The arterioles are the major locus of resistance to blood flow (MBF), and contraction or relaxation of the smooth muscle in the walls of the arterioles (vasomotion) provides the mechanism for control of the rate of blood flow into the myocardium. The regulatory signals can be classified as having feedback or feed-forward characteristics the final common response to these signals is relaxation of the vascular smooth muscle cells that make up the resistance vessels that control coronary blood flow (Fig. 3). Several major feedback mechanisms resulting from increased cardiomyocyte metabolism (including adenosine, nitric oxide NO , and other less-defined signals) cause opening of ATP-sensitive potassium channels (KATP) on the sarcolemma of smooth muscle cells of the coronary arterioles. Opening of these channels allows potassium to escape from the cytosol of the smooth muscle cells, resulting...

Energy Minimization Method

Is stochastic based, such as simulated annealing 56-58 , Geman and Geman's Gibbs sampler 22 , etc. They are all stochastic relaxation methods and theoretically can reach global minima by reducing the temperature slowly enough. Unfortunately, these algorithms normally require a huge amount of time and are intolerable for practical applications due to the extensive computation. The other category are deterministic methods, e.g., Besag's iterative conditional mode (ICM) 20 and highest confidence first (HCF) 21 proposed by Chou and Brown. These numerical approximation algorithms have much faster convergence speed and are often used as computationally efficient alternatives. ICM can be regarded as a special case of Gibbs sampler with an annealing temperature (T 0). It may converge only to a local minimum and the results depend strongly on the initial estimate and order of updates, while the HCF algorithm, rather than updating the segmentation results via a raster scan order as that in ICM,...

Psychosocial Behavioral Interventions with Acute Coronary Syndrome Patients

The Recurrent Coronary Prevention Project (RCPP) randomized 862 post-MI patients (90 men 98 white) into either a control condition receiving group-based traditional risk factor counseling (diet, exercise, medication adherence) or an intervention condition receiving group-based risk factor counseling plus cognitive behavior therapy (CBT) to reduce type A behaviors (i.e., hostility, impatience, time urgency) and relaxation training to decrease behavioral arousal (Friedman et al, 1986). Patients were enrolled at least 6 months after their MI. The average control participant attended 25 (76 of total available) sessions and the average intervention participant attended 38 (61 of total available) sessions over 4.5 years. Rate of combined fatal and nonfatal recurrence was significantly lower in the intervention than in the control group. Participants in the intervention group also showed significant decreases in hostility, time urgency, impatience, and depressed mood as well as reliable...

Pharmacological Toxicological Effects 51 Neurological Effects

The neurological effects of kava are attributed to a group of substituted dihydropyrones called kava lactones (1). The main bioactive constituents include yangonin, desmethoxyyangonin, 11-methoxyyangonin, kavain (kawain), dihydrokavain, methysticin, dihydromethysticin, and 5,6-dehydromethysticin (8). It is believed that the components present in the lipid-soluble kava extract, or kava resin, are responsible for the central nervous system (CNS) activities of kava including sedation, hypnosis, analgesia, and muscle relaxation (9). Aqueous kava extract was not active orally in mice or rats. Another study compared the cognitive effects of this same kava extract at a dose of 200 mg three times daily for 5 days to oxazepam 15 mg, followed by 75 mg on the experimental day (12). The results suggest that kava is less likely to affect cognitive function than oxazepam, but the oxazepam dosing regimen used was not typical of that seen in practice. Nevertheless, kava is purported to promote...

Preoperative Preparation And Operating Room Setup

Instruments Operating Room

General endotracheal anesthesia is always used. Muscular relaxation is not a priority but the surgeon must be aware of the patient's condition to know the degree of contraction that can be expected when approaching the main nerves in the neck. A bloodless field will decrease the operating time and help the identification of neck structures. We do not routinely use infiltration of local anesthetics.

Sabu Thomas MD Michael W Rich MD

Relaxation and compliance Diminished responsiveness to beta-adrenergic stimulation Impaired mitochondrial energy deposition in the media and adventitia of the large and medium-sized arteries results in decreased vascular elasticity and increased impedance to left ventricular (LV) ejection 9,10 . These changes lead to a progressive increase in systolic blood pressure with advancing age, which in turn contributes to the development of LV hypertrophy and altered diastolic filling. Increased cardiac interstitial collagen content, compensatory myocyte hypertrophy in response to apoptosis, and impaired calcium flux during diastole further contribute to age-related impairments in LV diastolic relaxation and compliance 11 . These changes lead to an increase in LV end-diastolic pressure and left atrial size and pressure, and they also predispose older individuals to atrial fibrillation.

Neuromuscular Disorders

Sphincter (UES) relaxation, and low lower esophageal sphincter (LES) pressures. Cricopharyngeal myotomy or UES dilation may be effective in temporarily improving dysphagia in these patients however, the long-term prognosis is unchanged after intervention (9). Spinal muscular atrophies (SMAs) comprise a group of neuromuscular disorders with varied clinical presentations, most of which occur early in childhood. Over one-third of patients with SMAs suffer from dysphagia. Parkinson's disease is a progressive degenerative disorder caused by the degeneration of dopamine-containing neurons in the substantia nigra. The resulting disorder is characterized by rigidity and resting tremor. The rigidity is caused by simultaneous contraction of agonist and antagonist muscle groups that are usually coordinated to produce fine muscle movements. The resulting dysphagia is a result of poor bolus transport during the oral phase, early spill into the pharynx, and a prolonged pharyngeal transit time. The...

Cardiac Maturation

There are also developmental changes of potential functional significance within the regulatory proteins of the sarcomere. More specifically, the fetal heart expresses both a- and p-tro-pomyosin, a regulatory filament, in nearly equal amounts after birth, the proportion of p-tropomyosin decreases, and a-tro-pomyosin increases, potentially to optimize diastolic relaxation (28,41,42). Interestingly, an expression of high levels of p-tro-pomyosin in the neonatal heart has been linked to early death caused by myocardial dysfunction (43).

Constipation

In addition to slowed colonic motility due to dopaminergic denervation of the GI tract, anal sphincter dysfunction has been reported in PD patients, which may contribute to constipation. Mathers (49) described paradoxical anal sphincter muscle contraction during simulated defecation straining in five of six patients with PD studied with anal electromyography (EMG), and they suggested, based on this finding, that functional anal outlet obstruction may contribute to constipation. In four of these patients, they noted improvement in the defecatory mechanism following apo-morphine, suggesting that this anal dyscoordination may occur on the basis of dopaminergic deficiency. Stocchi et al. (50) confirmed the finding of impaired anal relaxation during straining in PD and added that anal sphincter EMG was normal in PD patients by comparison, sphincter EMG in MSA patients showed denervation and chronic neurogenic signs.

Overview

The primary function of the respiratory system is supplying oxygen to the blood and expelling waste gases, of which carbon dioxide is the main constituent, from the body. This is achieved through breathing we inhale oxygen and exhale carbon dioxide. Respiration is achieved via inhalation through the mouth or nose as a result of the relaxation and contraction of the diaphragm. The air, in essence oxygen, then passes through the larynx and trachea to enter the chest cavity. The larynx, or voice box, is located at the head of the trachea, or windpipe. In the chest cavity, the trachea branches off into two smaller tubes called the bronchi, which enter the hilus of the left and right lungs. The bronchi are then further subdivided into bronchioles. These, in turn, branch off to the alveolar ducts, which lead to grape-like clusters called alveoli found in the alveolar sacs. The anatomy of the respiratory system is shown in Fig. 1.1. The walls of alveoli are extremely thin (less than 2 m) but...

Treatment

Insomnia-related symptoms Fragmented sleep with difficulty in sleep onset and sleep maintenance Nonpharmacologic measures Avoidance of nighttime alcohol, caffeine, tobacco Increase in daytime physical activity and ensuring exposure to daylight Psychological therapies relaxation training, cognitive therapies, biofeedback training Pharmacologic strategies Short-acting benzodiazepines clonazepam, temazepam, diazepam Nonbenzodiazepine hypnotics zopiclone

Cardiac cycle

Until the aortic and pulmonary valves open. A period of ejection follows and ends when the aortic and pulmonary valves close. Diastole commences with a period of isovolumetric relaxation which lasts until the atrioventricular valves open. This is followed by a period of rapid inflow of blood into the ventricle, diastasis, and atrial systole. Atrial contraction is important and contributes up to 25 of the filling of the ventricle.

Inotropes

Importantly, cAMP activation causes the opposite effect in vascular smooth muscle. In smooth muscle, cAMP leads to calcium uptake by the sarcoplasmic reticulum and resultant smooth muscle relaxation. These contrasting effects of cAMP account for the inotropy and systemic and pulmonary vasodilation (inodilation) seen with a majority of inotropes.

Spectroscopy

MR spectroscopy (MRS) is becoming more commonplace in the routine evaluation of patients with intracranial masses as the software becomes more widely available and user-friendly on MR machines. Proton MRS can be practically implemented on any 1.5T MR system with clinically useful exam times, signal-to-noise, and spatial resolution. Higher field systems (e.g., 3.0 Tesla T ) provide the theoretical advantages of improved signal to noise, shorter exam times, and improved spectral resolution (peak separation). The actual improvements in signal-to-noise are closer to 20-50 resulting from greater line width at 3.0T as a result of greater field inhomogeneities and shorter T2 and T2* relaxation times (104,105). Certainly, most studies are performed at 1.5T. The most practical considerations affecting the visibility of metabolites in MR spectra are the relaxation times of the metabolites and the sequence parameters. In single voxel techniques, chemical-shift imaging, or 3D multivoxel...

The Muscle Pump

In dynamic exercise the rhythmic contraction and relaxation of the skeletal muscles actively pump blood into the large veins. The muscle pump's effect on the circulation would be the same as an increase in blood volume or a decrease in venous capacitance, which are indistinguishable in the venous function curve (Fig. 3). Bevegard and Lodin (1962) studied patients with a congenital absence of venous valves. Although these individuals were still able to increase their cardiac output during exercise, they did so with a marked reduction in central venous pressure as compared to subjects with normal veins. Thus the decreased venous capacitance is a mixture of mechanical events within the contracting muscles as well as a systemic autonomic venocon-striction. An increase in heart rate accompanies the increase in contractility and acts to keep stroke volume within a workable range. A foreshortening of the systolic period through a reduction in action potential duration and an increased rate...

Opioidresistant pain

A variety of non-drug treatments are also available for the management of intractable pain. These may consist of simple counter-irritation with cold compresses, hot water bottles or ointments. Transcutaneous electrical nerve stimulation (TENS) is of benefit in a wide range of conditions causing localized pain, particularly of muscle origin. This is believed to be due to stimulation of large nerve fibres which release the inhibitory neurotransmitter 7-aminobutyric acid (GABA) in the dorsal horn. A similar effect may account for the success of acupuncture whether by deep needling alone or combined with electrostimulation. A number of psychological methods of pain relief (e.g. relaxation therapy) are also employed.

MRI Segmentation

Many regular image segmentation techniques can be employed in MS lesion segmentation, such as edge detection, thresholding, region growing, and model-based approaches. However, because of MR field inhomogeneities and partial volume effect, most of the methods are integrated in nature, in which pre-and postprocessing are involved to correct these effects and remove noise, or a priori knowledge of the anatomical location of brain tissues is used 36, 39, 41 . Johnston et al. 35 used a stochastic-relaxation-based method, a modified iterated conditional modes (ICM) algorithm in 3D 6 on PD- and T2-weighted MR images. Inhomogeneities in multispectral MR images are corrected by applying homomorphic filtering in the preprocessing step. After initial segmentation is obtained, a mask containing only the white matter and the lesion is generated by applying multiple steps of morphological filter and thresholding, on which a second pass of ICM is performed to produce the final segmentation....

Manometry

Intra-oesophageal pressure readings are measured using catheters with multiple fluid-filled channels, or miniature pressure transducers. Manometry is commonly performed in a laboratory over a very short time period. It is possible to carry out 24-h ambulatory assessments, which may be combined with pH studies, for a more representative view of motility. Primary peristalsis is initiated by swallowing and progresses from the pharynx, terminating in relaxation of the lower oesophageal sphincter. Secondary peristalsis is initiated by distension of the oesophagus (e.g. by food bolus) and progresses in a similar fashion. Tertiary contractions do not result in peristaltic waves, and occur as isolated, sporadic events. Motility disorders include achalasia, where failure of both normal peristaltic activity and relaxation of the lower oesophageal sphincter results in dysphagia and a dilated oesophagus proximal to the gastro-oesophageal junction (GOJ) and diffuse oesophageal spasm, where...

Drug Interactions

Conversely, because PGF2a relaxes the cholinomimetically precontracted ciliary muscle,60 latanoprost and PGF2a may actually enhance the IOP-lowering effect of cholinomimetics by inhibiting their obstruction of uveoscleral outflow, in addition to enhancing uveoscleral outflow themselves. However, PG-induced relaxation of the ciliary muscle might also reduce cholinomimetic enhancement of facility via the TM route, which depends upon contraction of the muscle.2 Furthermore, a small PG enhancement of facility via the TM cannot be entirely excluded in humans.61 The apparent effect of the eicosanoids on cholinomimetic-induced IOP lowering will be the net resultant of these processes.

Mlv3 Mlv5 3ao

The commercialization of fluorescent nanocrystals offers advantages over organic dyes (Rosenthal 2001 Sukhanova et al., 2002). Fluorescent nanocrystals are nanometer-sized particles of semiconductor materials, e.g., cadmium selenide (CdSe), engineered with a coating shell, e.g., zinc sulfide (ZnS) that eliminates nonradiative relaxation pathways, thus improving quantum yield and reducing photodegradation. Additionally, coating shells tune excitation emission characteristics, confer desired physicochemical features, and enable labeling of biomolecules. Fluorescent nano-crystals are commercially available in a wide range of emissions, as nonderivatized core shells that may be cast into self-assembled films for instrument calibration, and as streptavidin- or carboxyl-derivatized core shells that may be coupled with primary or secondary antibodies. The photostability of these crystals makes possible nondegraded time-lapsed measurements (e.g., to evaluate excitation lamp stability). In our...

Cognitive Therapies

The one area that does now contain five controlled studies is that of anger and aggression. The cognitive therapy tested is that based on Novaco's analysis of anger and aggression, which emphasises the misinterpretation of internal and external cues, which leads to the individual perceiving threat in a situation which may be ambiguous or neutral. Novaco's (1975) model of anger expression and anger management has led to a three-phase anger treatment consisting of education about anger and understanding the relationship between anger and other emotions (phase one), perception of situations and emotional arousal in order to manage anger in general anger-provoking situations (phase two), and treatment involving specific, individual anger-provoking situations (phase three). An early controlled trial (Benson, Johnson Rice & Miranti, 1986) compared anger management treatment with other relaxation-based procedures both separately and in co-ordination. They found that four different treatment...

Base Pairing

Selected entries from Methods in Enzymology vol, page(s) Catalysts of proton exchange concentration in base pair lifetime determination, 261, 405-406 efficiency, 261, 388 external proton acceptor, 261, 389-391 intrinsic catalysis, 261, 390-391 mechanism, 261, 386 pK values, 261, 387 selection, 261, 404405 kinetics of opening and proton exchange mechanism of proton exchange, 261, 385-386, 388-389 pH dependence, 261, 385 time scale of exchange, 261, 391, 393 proton exchange measurement by NMR base pair lifetime determination, 261, 404-406 B-DNA, 261, 406-407 B'-DNA, 261, 408, 410-411 cross-relaxation effects, 261, 396-397 cytidine imino proton exchange, 261, 411-413 data processing, 261, 401, 403 dissociation constant determination, 261, 403-404 imino proton chemical shift, 261, 404 luzopeptin-DNA complex, 261, 411 magnetization transfer from water protons, 261, 393-395, 399 proton deuterium exchange in real time, 261, 391-393 relaxation rate increments, 261, 395, 401 sample...

Counselling

The authors include a list of the 92 papers included in their meta-analysis of counselling. A quick review of these references shows that the studies in the meta-analysis included the following counselling techniques anger management, assertiveness training, social skills training, exposure treatment for obsessive compulsive disorder, desensitisation, relaxation training, cognitive therapy, group cognitive behaviour therapy, shaping, reinforcement of non-depressed behaviours and implosion. Hence, the possibility that the apparent effectiveness of counselling was due largely to the inclusion of traditional behaviour therapy cannot be excluded. At this time we must conclude that there are very limited data to support the use of counselling with people with intellectual disabilities.

Sensory Therapies

Lindsay et al. (1997, 2001) conducted a comparison of hand massage, physical therapy, Snoezelen and relaxation therapy with eight subjects using a counter balanced, crossover design. They found that hand massage and active therapy either produced no improvements in a range of measures or were mildly aversive. 1994 Hagger & Hutchinson, 1991). However, all of these studies lacked control conditions, and used non-blind measurement or retrospective data collection. Lindsay etal. (1997,2001) in the study already described above found that although there were improvements in rated enjoyment and relaxation in the Snoezelen condition, they were no greater than those in the relaxation condition which was considerably less expensive to implement. Meijs-Roos (1990) in a study of six individuals found no effects from Snoezelen exposure on affective behaviour, stereotypies and other challenging behaviours. The best controlled study is that of Martin, Gaffan & Williams (1998) in which 27 adults...

MRI imaging

MRI imaging has become rapidly the primary tool for investigation of the CNS. MRI is based on the fact that a nucleus can have one of two magnetic spins with differing energy levels. The nucleus will preferentially hold the lower energy state but can be changed to the higher state through a radiofre-quency pulse which once withdrawn allows the nucleus to relax and give up off the absorbed energy. It is the relaxation time of giving up this energy is the basis of MRI. The unit of magnetic field strength is the Tesla, the MR scanning magnets into which the patient is inserted are 0.5-2.0 Tesla.

Hypoglycemia

Howorka and colleagues (2000) examined EEG parameters interpreted as reflecting vigilance to the hypoglycemic state in Type 1 diabetes patients who had a history of hypoglycemia. The EEG was obtained during relaxation, while participants were in a non-hypoglycemic state. In comparison to

Biofeedback

The field of behavioral medicine was initiated in part because of the scientific and public interest in the reported success of biofeedback as a treatment modality. Biofeedback of EEG contributed to this initial enthusiasm and continued to be an important modality for biofeedback treatment. Our search terms yielded a relatively small number of applications of EEG biofeedback to physical disease. EEG biofeedback often is offered as a relaxation technique. Indeed our review suggests that EEG biofeedback assists patients with coping with their disease, although specific changes in the EEG do not seem to mediate this.

Calmodulin

Selected entries from Methods in Enzymology vol, page(s) Calmodulin purification and fluorescent labeling, 102, 1 assay of calmodulin by Ca2+-dependent phosphodiesterase, 102, 39 myosin light chain phosphorylation in smooth muscle and nonmuscle cells as a probe of calmodulin function, 102, 62 spectroscopic analyses of calmodulin and its interactions, 102, 82 Ca2+ binding to calmodulin, 102, 135 preparation of fluorescent labeled calmodulins, 102, 148 techniques for measuring the interaction of drugs with calmodulin, 102, 171 detection of calmodulin-binding polypeptides separated in SDS-polyacrylamide gels by a sensitive 125I calmodulin gel overlay assay, 102, 204 use of calmodulin affinity chromatography for purification of specific calmodulin-depen-dent enzymes, 102, 210 chemical approaches to the calmodulin system, 102, 296 13C chemical shift, 239, 369 contamination in creatine phosphokinase, 238, 76 removal of endogenous calmodulin, 238, 77 heteronuclear relaxation studies, 239,...

Flying Phobia

Claustrophobies and spider snake phobies given in vivo exposure and relaxation (ER) or in vivo exposure and disconfirmation of misappraisals of bodily sensation (ESF) Five groups Ss assessed as 'behavioural' or 'physiological' reactors both groups divided to receive exposure or applied relaxation over eight sessions. Waiting-list control All groups improved on all measures but greater improvement on all measures in 'behavioural reactors' given exposure and in 'physiological reactors' given relaxation desensitisation to film similar procedure without grading of exposure, similar without relaxation, relaxation only and placebo 1 0 Ss in four groups stress inoculation, applied relaxation. 'Cognitive' and 'physiological' responders sessions imaginal desensitisation, flooding, implosion, relaxation and no treatment Two groups extensive virtual reality (VR) and relaxation In conclusion, relaxation training or exposure to the experience of simulated flying can reduce the fear of flying....

Carbon Monoxide

Selected entries from Methods in Enzymology vol, page(s) Hemoglobin binding, stepwise CO combination and dissociation rate constants, double mixing experiment, 232, 432-436 infrared spectra, 232, 140-151 interaction with partially liganded hemoglobin intermediates, double mixing experiments, 232, 432-445 rebinding to hemoglobin after photodissociation, 232, 72-73, 416 after photolysis, 232, 80-83, 416 carboxyhemoglobin Fe-C-O configuration, 232, 280-281 optical spectroscopy, 232, 62-63 structural relaxation dynamics studies, 232, 345, 348 .

NMR Spectrum of Hb

In both oxyhemoglobin (HbO2 A) and HbCO A, the heme iron atoms are in the low-spin, diamagnetic ferrous state. However, in other ligated states, as well as deoxyHb, the iron atoms adopt nonzero values of S, corresponding to various degrees of paramagnetism (9,12). Methemoglobin (MetHb) is in the high-spin ferric state, with S 5 2. The low spin (S 1 2) ferric state is occupied by cyanomet-Hb and azidomet-Hb. Unliganded (deoxy) Hb adopts the high-spin ferrous state with S 2. The presence of one or more paramagnetic ions in a protein affects both the chemical shifts and relaxation properties of nearby nuclear spins. Unpaired electron spins on the iron induce paramagnetic hyperfine shifts by means of two contributions (9,12). The scalar or Fermi contact contribution 5con arises from unpaired spin delocalization onto resonating protons through chemical bonds or hyperconjugation. The pseudo-contact or dipolar shift

Defecation

After electrolytes and water have been absorbed, the waste material that is left passes to the rectum, leading to an increase in rectal pressure, relaxation of the internal anal sphincter, and the urge to defecate. If the urge to defecate is denied, feces are prevented from entering the anal canal by the external anal sphincter. In this case the feces remain in the rectum, and may even back up into the sigmoid colon. The defecation reflex normally occurs when the rectal pressure rises to a particular level that is determined, to a large degree, by habit. At this point, the external anal sphincter relaxes to admit feces into the anal canal.

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