Altered anterior insula activation during anticipation and experience of painful stimuli in expert meditators.

Experientially opening oneself to pain rather than avoiding it is said to reduce the mind's tendency toward avoidance or anxiety which can further exacerbate the experience of pain. This is a central feature of mindfulness-based therapies. Little is known about the neural mechanisms of mindfulness on pain. During a meditation practice similar to mindfulness, functional magnetic resonance imaging was used in expert meditators (> 10,000 h of practice) to dissociate neural activation patterns associated with pain, its anticipation, and habituation. Compared to novices, expert meditators reported equal pain intensity, but less unpleasantness. This difference was associated with enhanced activity in the dorsal anterior insula (aI), and the anterior mid-cingulate (aMCC) the so-called ‘salience network’, for experts during pain. This enhanced activity during pain was associated with reduced baseline activity before pain in these regions and the amygdala for experts only. The reduced baseline activation in left aI correlated with lifetime meditation experience. This pattern of low baseline activity coupled with high response in aIns and aMCC was associated with enhanced neural habituation in amygdala and pain-related regions before painful stimulation and in the pain-related regions during painful stimulation. These findings suggest that cultivating experiential openness down-regulates anticipatory representation of aversive events, and increases the recruitment of attentional resources during pain, which is associated with faster neural habituation.

Reply to Christine Sylvester, “Terro rWars: Boston Iraq”: An examination of differences between counter-terrorism and war as seen through the Iraqi experience of occupation

This response examines what is overlooked in Sylvester’s analysis of similarities between the US police security response to the Boston marathon bombings (2013) and Kevin Powers’ fictionalized account of the US war operations in Al Tafar, Iraq (2004) and evaluates the consequences for our understanding of contemporary war. This is done by highlighting differences between the experience of residents in Boston and the (real) town of Tal Afar, key among them the insecurity, fear and calamity that result from the distinct political realities in these locations. The experience of war from the perspective of the victims adds an important dimension to the debate over the changing nature of war. At a time that is marked by an unprecedented level of technologization and visual mediation, it brings into focus the fragmentary and often one-sided evidence on which our knowledge of contemporary war is based. It reminds us to ask not only what we know about war, but how we know it.

“Very sore nights and days”: the child’s experience of illness in early modern England, c. 1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.

Critical behavior of a contact process with aperiodic transition rates

We performed Monte Carlo simulations to investigate the steady-state critical behavior of a one-dimensional contact process with an aperiodic distribution of rates of transition. As in the presence of randomness, spatial fluctuations can lead to changes of critical behavior. For sufficiently weak fluctuations, we give numerical evidence to show that there is no departure from the universal critical behavior of the underlying uniform model. For strong spatial fluctuations, the analysis of the data indicates a change of critical universality class.

Kvinnors upplevelse av planerad hemförlossning i Skandinavien : Women´s experience of planned home birth in the Scandinavian countries

Background: In Sweden and Norway planned home birth is not included in the health care system. In Denmark women with expected low risk birth have the right to choose home birth. Registrations of home births in the Nordic countries are not completed and women’s experiences of planned home birth in Scandinavian context are not earlier described.Objective: The aim of this study was to describe women’s experiences of planned home birth in the Scandinavian countries.Design: Inductive content analysis. Fifty-three Scandinavian women who have experienced planned home birth have replied an open question in a questionnaire. Findings: In the analysis five categories and twelve subcategories emerged. The categories were, to feel secure, experiences of support, being in control, harmony and insecurity. The women felt secure and calm in their own homes. They felt being in control, secure, support and trust in the midwife, relatives and the own body. What worried the women most in presence of the delivery was that the midwife should not be present. Keywords: Home birth, experiences, women.

Sex, a one mans show : Perceptions and experience of sexuality, contraceptives, unwanted pregnancy and unsafe abortion among young people in Kisumu, Kenya – A qualitative study

This study aimed to explore perceptions and experiences concerning sexuality, contraceptives, unwanted pregnancy and unsafe abortion among young people in Kisumu, Kenya. The design of the study was inductive with a qualitative approach using personal in-depth interviews. Eight participants (four female and four male) were asked to describe their perceptions and experience concerning sexuality, contraceptives, unwanted pregnancies and unsafe abortion. The result showed that culture and norms, misconceptions and gender based power in sexuality are factors that impact Sexual Reproductive Health among young people in Kisumu today. Unwanted pregnancy was described as a shame, a burden and a destroyed life which lead to many unsafely induced abortions. The findings indicate that youth interventions are important, such as engaging young men in unwanted pregnancy and thus unsafe abortions and to empower young women.

Manoeuvring between anxiety and control : Patients experience of learning to live with diabetes: a lifeworld phenomenological study

Research shows that people with diabetes want their lives to proceed as normally as possible, but some patients experience difficulty in reaching their desired goals with treatment. The learning process is a complex phenomenon interwoven into every facet of life. Patients and healthcare providers often have different perspectives in care which gives different expectations on what the patients need to learn and cope with. The aim of this study, therefore, is to describe the experience of learning to live with diabetes. Interviews were conducted with 12 patients afflicted with type 1 or type 2 diabetes. The interviews were then analysed with reference to the reflective lifeworld research approach. The analysis shows that when the afflicted realize that their bodies undergo changes and that blood sugar levels are not always balanced as earlier in life, they can adjust to their new conditions early. The afflicted must take responsibility for balancing their blood sugar levels and incorporating the illness into their lives. Achieving such goals necessitates knowledge. The search for knowledge and sensitivity to changes are constant requirements for people with diabetes. Learning is driven by the tension caused by the need for and dependence on safe blood sugar control, the fear of losing such control, and the fear of future complications. The most important responsibilities for these patients are aspiring to understand their bodies as lived bodies, ensuring safety and security, and acquiring the knowledge essential to making conscious choices.

Older people's experience of utilisation and administration of medicines in a health- and social care context

BACKGROUND: People living at home who lack ability to manage their medicine are entitled to assistance to improve adherence provided by a home care assistant employed by social care. AIM: The aim was to describe how older people with chronic diseases, living at home, experience the use and assistance of administration of medicines in the context of social care. DESIGN: A qualitative descriptive study. METHODS: Ten participants (age 65+) living at home were interviewed in the participants' own homes. Latent content analysis was used. FINDINGS: The assistance eases daily life with regard to practical matters and increases adherence to a medicine regimen. There were mixed feelings about being dependent on assistance; it interferes with self-sufficiency at a time of health transition. Participants were balancing empowerment and a dubious perception of the home care assistants' knowledge of medicine and safety. Physicians' and district nurses' professional knowledge was a safety guarantee for the medicine process. CONCLUSIONS: Assistance eases daily life and medicine regimen adherence. Dependence on assistance may affect self-sufficiency. Perceived safety varied relating to home care assistants' knowledge of medicine. RELEVANCE TO CLINICAL PRACTICE: A well-functioning medicine assistance is crucial to enable older people to remain at home. A person-centred approach to health- and social care delivery is efficient and improve outcome for the recipient of care.