Much work has investigated beneficial effects of mindfulness-based meditation methods, but less work has investigated potential risks and differences across meditation methods. We addressed this in a large pre-registered online survey including 613 mediators where we correlated participants’ experience with fifty meditation techniques to psychotic-like experiences - PLEs (e.g. hallucinations) as detrimental outcomes, and mystical experiences as beneficial outcomes. We found a positive correlation for both PLEs and mystical experiences with techniques aiming at reducing phenomenological content (‘null-directed’, NDM) or classified as non-dual or less embodied. In contrast, methods aiming at achieving an enhanced cognitive state also described as ‘attentional’ or strongly embodied, showed negative correlations with PLEs. Interestingly, participants’ subjectively perceived that all types of meditation techniques were preventative of PLEs but less so for NDM. This study provides important information for meditators about the relationship of different techniques with PLEs and the moderating influences of individual traits.
Abstract Many psychiatric symptoms have been linked to threat-related perception and learning processes. In addition, however, there may also be mechanisms for balancing effectively between threat- and reward-related behaviors and these may also vary between individuals. We investigated neural activity associated with spontaneous switching between foraging for rewards and vigilance for threats with 7T fMRI. In a virtual naturalistic environment, participants freely switched between the two modes of behavior. Switching was driven by estimates of likelihood of threat and reward. Both tracking of threat and switching to vigilance were associated with specific but distributed patterns of activity spanning habenula, dorsal raphe nucleus (DRN), anterior cingulate cortex, and anterior insula cortex. Distinct distributed patterns heralded returns to reward-oriented behavior. Individual variation in DRN activity reflected individual variation in vigilance. All activity patterns were replicated in an initially held-out portion of data.
Dorsal anterior cingulate cortex (dACC) mediates updating and maintenance of cognitive models of the world used to drive adaptive reward-guided behavior. We investigated the neurochemical underpinnings of this process. We used magnetic resonance spectroscopy in humans, to measure levels of glutamate and GABA in dACC. We examined their relationship to neural signals in dACC, measured with fMRI, and cognitive task performance. Both inhibitory and excitatory neurotransmitters in dACC were predictive of the strength of neural signals in dACC and behavioral adaptation. Glutamate levels were correlated, first, with stronger neural activity representing information to be learnt about the tasks’ costs and benefits and, second, greater use of this information in the guidance of behavior. GABA levels were negatively correlated with the same neural signals and the same indices of behavioral influence. Our results suggest that glutamate and GABA in dACC affect the encoding and use of past experiences to guide behavior.
Figure: Jacqueline Rogers SchollLoving to work with children is different from having to live with them. I never worried about it be-cause I was sure I'd have a litter of puppies instead. But having my son changed my world and the way I saw it. I always loved working with children, but my approach to pediatric audiology was all wrong. I didn't know “the code,” and none of the books on my shelf taught me what my son did. Here are some clues to help you decode your pediatric patients' behavior. Clue 1: Why babies cry—a lot! Crying is the only way babies have to communicate, so they do it a lot. These are easy codes to decipher. Are they hungry, tired, uncomfortable, sick, or have a dirty diaper? Also, some babies cry more because they are more sensitive to their surroundings than others. Waving toys around will over-stimulate some babies. Keep a blanket handy to “burrito-wrap” babies and let mom or dad feed, burp, and change them in a dimly lit room. Your chances of getting good test results are better if the baby is comfortable. Clue 2: Toddlers are curious Decoding toddlers is more difficult. In fact, they are undeniably the most challenging population to work with. Toddlers want to be in control and they get frustrated easily. Also, a medical office is a scary place because what happens there is often painful. Toddlers use past experiences to interpret the present. So, don't tell them “it won't hurt” because they won't believe you even if it's true. Instead, take this opportunity to do the unexpected. Trying to balance a toy on your nose can buy you the time you need to obtain information. Whether it's entertaining or just plain weird, doing this kind of thing usually helps. Brightly colored toys balanced on your head or a cheap bottle of bubbles works wonders. Stickers are also interesting when stuck on your eyes or nose. Clue 3: Toddlers are stubborn No matter how many tricks you have up your sleeve, you sometimes encounter a child who kicks and screams. Try not to torture the little darling. Instead, reschedule to another day during a time when the child is well rested and fed. Clue 4: Never ask Never ask a toddler if you can do something. The answer will always be “NO!” Tell the child what You're going to do and do it. Clue 5: Toddlers get bored easily If you haven't changed your toys recently, a trip to your office is probably pretty boring for a repeat patient. Buy some plastic fish and a bucket at the local dollar store. Fill the bucket with water and try dropping fish instead of blocks. Or find a basketball hoop with suction cups that attach to your booth wall and shoot baskets. Tomy sells a wonderful Pop-Up Pirate game for $11.99. Use your imagination and make things fun. Mystery solved Toys play an important role. The local dollar store is full of interesting items that don't cost a fortune. Rhode Island Novelty (www.rinovelty.com) has a variety of fiber-optic wands that light up, spin, and change colors. One of my favorites is the Dolphin Rainbow Fiber Optic Wand. Fisher Price Peek A Blocks are a good choice along with pop-up toys. The “Tangle” by Tangle Brand is a simple but intriguing toy. Avoid toys that over-stimulate or can't be easily cleaned. The most important part of breaking the code is having fun. Laughter is contagious. Try infecting your toddlers with lots of it!
My quest for pint-sized ear protection began as a personal mission. My husband downloaded music on my iPod for our 7-year-old son and, much to my dismay, he cranked the volume up really loud! The earbuds were too large for his ears and he turned the volume up to mask the ambient noise. After I got over the shock that my son would listen to such loud music, I set out on a mission to find functional solutions to prevent NIHL for little people and tiny ears. Here are some products that you should be familiar with and make available to your pediatric population. FOR PERSONAL IPOD/MP3/GAMING LoudEnough by Ultimate Ears My favorite find was a pair of volume-limiting earbuds made especially for little ears (age 6+). These fun-colored buds (mint, blueberry, and plum) seal little ear canals by providing a variety of silicone eartips. LoudEnough limits output by approximately 20 dB without sacrificing sound quality. Made by Ultimate Ears, they retail for approximately $40. EarSaver Volume Limiter This simple device is plugged between the music and your earphones. It reduces volume by approximately 17 dB with minimal effect on sound quality. This option assumes you already have a pair of earbuds or headphones that fit well. They cost just $11.95 apiece.Figure: The author's son, Nicholas, protects his ears with LoudEnough.Custom Earmolds Most earmold companies make custom products for personal players. They can be color-customized and they provide the best seal possible. Retail for a set of custom plugs is approximately $110, though prices vary. FOR NOISY ENVIRONMENTS BabyBlues Etymotic Research now makes its ER-20 High-Fidelity Earplugs for small ear canals. These earplugs preserve sound quality while reducing the output by approximately 20 dB. A variety of removable colored cords makes this option a fun noise deterrent. The plugs retail for $10.95, and the optional cord is $1.95. Peltor Junior Earmuffs Designed for infants as young as 3 months, these earmuffs come in powder blue, blue, pink, and black and have a noise-reduction rating (NRR) of 22. These little muffs are safe and can be worn comfortably on small heads. They retail for around $19. Mack's SafeSound Jr. These soft foam earplugs have a 29 NRR and are a fun purple color. Recommended for children over 7, the NRR is directly related to insertion and proper fit. A box of 10 pairs costs $3.95. There are other solutions out there for children, but these were some of my favorites. If you don't already, you should start incorporating pediatric hearing protection into your practice. And don't forget high school bands. ER-20 High-Fidelity Earplugs with matching school color cords will let members hear the subtle nuances while protecting their hearing. I've leveled the battlefield at home with a pair of Loud Enough ear buds in blueberry and a pair of BabyBlues for my son. At work, I'm creating a brochure of the available pediatric products. This is one war I am prepared to win!
Natural environments are complex, and a single choice can lead to multiple outcomes. Agents should learn which outcomes are due to their choices and therefore relevant for future decisions and which are stochastic in ways common to all choices and therefore irrelevant for future decisions between options. We designed an experiment in which human participants learned the varying reward and effort magnitudes of two options and repeatedly chose between them. The reward associated with a choice was randomly real or hypothetical (i.e., participants only sometimes received the reward magnitude associated with the chosen option). The real/hypothetical nature of the reward on any one trial was, however, irrelevant for learning the longer-term values of the choices, and participants ought to have only focused on the informational content of the outcome and disregarded whether it was a real or hypothetical reward. However, we found that participants showed an irrational choice bias, preferring choices that had previously led, by chance, to a real reward in the last trial. Amygdala and ventromedial prefrontal activity was related to the way in which participants' choices were biased by real reward receipt. By contrast, activity in dorsal anterior cingulate cortex, frontal operculum/anterior insula, and especially lateral anterior prefrontal cortex was related to the degree to which participants resisted this bias and chose effectively in a manner guided by aspects of outcomes that had real and more sustained relationships with particular choices, suppressing irrelevant reward information for more optimal learning and decision making.In complex natural environments, a single choice can lead to multiple outcomes. Human agents should only learn from outcomes that are due to their choices, not from outcomes without such a relationship. We designed an experiment to measure learning about reward and effort magnitudes in an environment in which other features of the outcome were random and had no relationship with choice. We found that, although people could learn about reward magnitudes, they nevertheless were irrationally biased toward repeating certain choices as a function of the presence or absence of random reward features. Activity in different brain regions in the prefrontal cortex either reflected the bias or reflected resistance to the bias.
Summary Decisions are based on value expectations derived from experience. We show that dorsal anterior cingulate cortex and three other brain regions hold multiple representations of choice value based on different time-scales of experience organized in terms of systematic gradients across the cortex. Some parts of each area represent value estimates based on recent reward experience while others represent value estimates based on experience over the longer term. The value estimates within these four brain areas interact with one another according to their temporal scaling. Some aspects of the representations change dynamically as the environment changes. The spectrum of value estimates may act as a flexible selection mechanism for combining experience-derived value information with other aspects of value to allow flexible and adaptive decisions in changing environments.
Truman is a survivor. His toothy smile, rowdy nature, and love for Legos and killer whales make him like a lot of other boys. However, don't be fooled. Truman is also a warrior. He has battled the fiercest beast known to mankind—cancer. Meeting Truman led to the relationship between my pediatric practice and the local children's hospital oncology and hematology department. It also started me on a quest for a best practice model for monitoring ototoxicity. The design of these programs depends on various factors, which are different for every child. These factors include, among others, the four discussed here. CLASSES OF DRUGS Several classes of ototoxic agents can destroy the hearing mechanism. These drugs usually involve the following: Platinum coordination complexes, such as cisplatin, carboplatin, oxiloplatin, nedaplatin, and satraplatin. Aminoglycosides, including dihydrostreptomycin, tobramycin, kanamysin, amikacin, and gentamicin. Loop diuretics. The most common ototoxic loop diuretics are bumetanide (Bumex), fuosemide (Lasix), and ethacrynic acid (Edecrin). In designing monitoring protocols, it is important to understand the underlying effect mechanism of these drugs on organs. Peaks and troughs play a vital role in their toxicity. Research what drug(s) your patients are receiving. Many kids get more than one, and these combinations can devastate the hearing and balance system quickly.Figure: Truman and Happy at Relay for Life.PATIENT AGE, TESTING METHODS As with any child, chronological and developmental age determine which testing method(s) will get the most audiologic information. But a child being monitored for ototoxicity is sick and what worked once may not work again. It may take three or four changes of clinicians in the booth with a sick child to get useful information. We rely heavily on high-frequency audiometry and test up to 16,000 Hz. For smaller ones who are less reliable, we use high-frequency headphones in sound field. We use otoacoustic emissions, but tend to find pure tones at the higher frequencies a more reliable precursor to hearing loss. For those little-bitty ones, we monitor with diagnostic ABRs. Parent report is also very valuable and guides our testing. FLEXIBILITY Our clinic's rule is to work in any child who is starting aggressive medical treatment as quickly as possible. From the time we receive the referral, we sometimes have only a couple of days to complete testing. We work closely with the physician and family and remain flexible. We schedule these children when the waiting room is not full, since their treatment puts them at risk of picking up germs that they can't fight off. YOU'RE A TREATMENT PARTNER Consider yourself a partner in the overall treatment of these children. The nature of the illness and the aggressiveness of the treatment will determine your role. The physician determines dosing, which can change unexpectedly. Of course, saving a life outweighs preserving hearing, but with proper monitoring, you should detect loss immediately and be ready to offer aggressive audiologic rehabilitation. My friend, Truman, won his battle, but not without loss. As he struggles to learn to walk with a prosthetic carbon blade for his left leg and use his hearing aids, he teaches others what true grit is all about. And he continuously reminds me how important my work is.
'%3e%3cpath fill='%23012169' d='M0 0v30h60V0z'/%3e%3cpath stroke='%23fff' stroke-width='6' d='m0 0 60 30m0-30L0 30'/%3e%3cpath stroke='%23C8102E' stroke-width='4' d='m0 0 60 30m0-30L0 30' clip-path='url(%23b)'/%3e%3cpath stroke='%23fff' stroke-width='10' d='M30 0v30M0 15h60'/%3e%3cpath stroke='%23C8102E' stroke-width='6' d='M30 0v30M0 15h60'/%3e%3c/g%3e%3c/svg%3e)
