Atrial remodeling, autonomic tone, and lifetime training hours in nonelite athletes

Endurance athletes have an increased risk of developing atrial fibrillation (AF) at 40 to 50 years of age. Signal-averaged P-wave analysis has been used for identifying patients at risk for AF. We evaluated the impact of lifetime training hours on signal-averaged P-wave duration and modifying factors. Nonelite men athletes scheduled to participate in the 2010 Grand Prix of Bern, a 10-mile race, were invited. Four hundred ninety-two marathon and nonmarathon runners applied for participation, 70 were randomly selected, and 60 entered the final analysis. Subjects were stratified according to their lifetime training hours (average endurance and strength training hours per week × 52 × training years) in low (<1,500 hours), medium (1,500 to 4,500 hours), and high (>4,500 hours) training groups. Mean age was 42 ± 7 years. From low to high training groups signal-averaged P-wave duration increased from 131 ± 6 to 142 ± 13 ms (p = 0.026), and left atrial volume increased from 24.8 ± 4.6 to 33.1 ± 6.2 ml/m(2) (p = 0.001). Parasympathetic tone expressed as root of the mean squared differences of successive normal-to-normal intervals increased from 34 ± 13 to 47 ± 16 ms (p = 0.002), and premature atrial contractions increased from 6.1 ± 7.4 to 10.8 ± 7.7 per 24 hours (p = 0.026). Left ventricular mass increased from 100.7 ± 9.0 to 117.1 ± 18.2 g/m(2) (p = 0.002). Left ventricular systolic and diastolic function and blood pressure at rest were normal in all athletes and showed no differences among training groups. Four athletes (6.7%) had a history of paroxysmal AF, as did 1 athlete in the medium training group and 3 athletes in the high training group (p = 0.252). In conclusion, in nonelite men athletes lifetime training hours are associated with prolongation of signal-averaged P-wave duration and an increase in left atrial volume. The altered left atrial substrate may facilitate occurrence of AF. Increased vagal tone and atrial ectopy may serve as modifying and triggering factors.

Competencies in arts therapies: A rating of importance, training and performance by practitioners and referring professionals in Switzerland

This survey was conducted in developing a final specialized examination for all arts therapists in Switzerland by the Council of Swiss Arts Therapy Associations (CSATA). Forty-eight generic key competencies (GKC) were sent to all 1235 arts therapists in five different disciplines in Switzerland (response 47.5%) and to 384 referring professionals and employers (RPE) listed by therapists (response 42%). The mean importance of GKC was rated high (4 points of 5) by practitioners and RPE. Different opinions on importance of GKC in disciplines included artistic ability and psychotherapeutic relative to medical orientation. The training of competencies was rated lower by practitioners (3.48 points) and different in the eight competence categories and five disciplines. Areas of weak training were identified. The performance of GKC was rated by referring professionals equally to its importance (mean +0.3 points) and showed a good understanding of competencies by RPE. Judging of performance was difficult for RPE in more than 20% of items. The results provide criteria for detailed outcome assessments and the advancement of a final examination for arts therapists in Switzerland.

Developing synaesthesia: A primer (Editorial)

Synaesthesia is a variation of human experience that involves the automatic activation of unusual concurrent experiences in response to ordinary inducing stimuli. The causes for the development of synaesthesia are not well understood yet. Synaesthesia may have a genetic basis resulting in enhanced cortical connectivity during development. However, in some cases synaesthesia has a sudden onset, for example, caused by posthypnotic suggestions, drug exposure, or brain injury. Moreover, associative learning during a critical developmental period also seems to play an important role. Synaesthesia may even be acquired by training in adulthood. In this research topic, we bring together topical hypotheses, theories and empirical studies about the development of synaesthesia.

Developing Synaesthesia

Synaesthesia is a condition in which a stimulus elicits an additional subjective experience. For example, the letter E printed in black (the inducer) may trigger an additional colour experience as a concurrent (e.g., blue). Synaesthesia tends to run in families and thus, a genetic component is likely. However, given that the stimuli that typically induce synaesthesia are cultural artefacts, a learning component must also be involved. Moreover, there is evidence that synaesthetic experiences not only activate brain areas typically involved in processing sensory input of the concurrent modality; synaesthesia seems to cause a structural reorganisation of the brain. Attempts to train non-synaesthetes with synaesthetic associations have been successful in mimicking certain behavioural aspects and posthypnotic induction of synaesthetic experiences in non-synaesthetes has even led to the according phenomenological reports. These latter findings suggest that structural brain reorganization may not be a critical precondition, but rather a consequence of the sustained coupling of inducers and concurrents. Interestingly, synaesthetes seem to be able to easily transfer synaesthetic experiences to novel stimuli. Beyond this, certain drugs (e.g., LSD) can lead to synaesthesia-like experiences and may provide additional insights into the neurobiological basis of the condition. Furthermore, brain damage can both lead to a sudden presence of synaesthetic experiences in previously non-synaesthetic individuals and a sudden absence of synaesthesia in previously synaesthetic individuals. Moreover, enduring sensory substitution has been effective in inducing a kind of acquired synaesthesia. Besides informing us about the cognitive mechanisms of synaesthesia, synaesthesia research is relevant for more general questions, for example about consciousness such as the binding problem, about crossmodal correspondences and about how individual differences in perceiving and experiencing the world develop. Hence the aim of the current Research Topic is to provide novel insights into the development of synaesthesia both in its genuine and acquired form. We welcome novel experimental work and theoretical contributions (e.g., review and opinion articles) focussing on factors such as brain maturation, learning, training, hypnosis, drugs, sensory substitution and brain damage and their relation to the development of any form of synaesthesia.