Virtual Reality Pain Relief for Burn Victims

The volume of the pain is hard for Randy McAllister to describe.

"You get to the threshold where you can't stand it, then find out it can hurt a lot more," says the 60-year-old farmer from The Dalles. He was severely burned while trying to save equipment from a fire in wheat field in August.

During five weeks at the Oregon Burn Center at Legacy Emanuel Medical Center in Portland, McAllister needed repeated rounds of wound care to remove dead tissue from his extensive burns.

"It's just the most painful thing," he says. "More painful than the fire."

He was ready to try anything when a nurse told him about SnowWorld, a computer game designed to help burn patients escape from agonizing pain. During his next wound care session, McAllister wore headphones and looked through virtual reality goggles. He found himself floating through an icy canyon rendered almost three-dimensional by the wrap-around goggles. By tapping on a computer mouse, McAllister fired snowballs at animated penguins, snowmen and dolphins in the canyon to a soundtrack of upbeat Paul Simon songs.

Strangest of all, the virtual world made his real world pain less overwhelming.

It's one of the most successful examples of non-drug pain management techniques to emerge from the work of psychologists and neuroscientists. The search for non-drug options has gained urgency amid a worsening epidemic of overdoses linked to prescription opioid pain relievers such as oxycodone and hydrocodone, which killed 14,800 Americans in 2008 – more those killed from heroin and cocaine overdoses combined.

In clinical trials, burn patients using SnowWorld reported 35 to 50 percent reductions in pain. The system was developed at the University of Washington by research scientist Hunter Hoffman and psychologist David Patterson, with input from burn care experts at Harborview Burn Center in Seattle.

Virtual reality therapy isn't a substitute for opioids and other pain-relieving medications, but it can boost the effectiveness of drugs – and possibly reduce the dosage. Researchers who developed the technology say it may also help people with chronic pain syndromes, although those clinical trials are incomplete.

Theresa McSherry, burn and wound care coordinator at the Oregon Burn Center, says burn patients desperately need more options. Pharmaceutical research has provided safer and more effective anesthetics and opioid pain relievers, but drugs have limits.

View full sizeBruce Ely / The OregonianRandy McAllister, a 60-year-old farmer who suffered severe burns in August, works with occupational therapist Helen Christians at the Oregon Burn Center along with his wife, Mary. McAllister says the painful recovery was made easier when he entered a virtual reality game designed to distract his mind from the excruciating pain of burn treatments."You just can't safely give burn patients enough to provide adequate pain relief," says McSherry, a registered nurse who has worked with burn patients for more than 10 years. A grant from the Legacy Foundation allowed the Oregon Burn Center to buy the $66,000 virtual reality system in August. About a dozen are being used worldwide.

Preventing pain not only relieves immediate suffering, but also seems to help burn patients weeks and months later. Patterson, the UW psychologist, says the amount of pain during treatment is a stronger predictor of depression, anxiety and distress six months to a year later than the extent of burns or the length of hospital stay.

"If you can control more of the acute pain, it can result in better long-term outcomes," he says.

Scientists have known for decades that the human brain can interpret the same signal transmitted by a pain receptor as painful or not, depending on what a person is thinking. During World War II, a physician named Henry Beecher observed that soldiers seldom required morphine despite horrific combat wounds. Civilian patients with comparable wounds were much more likely to require morphine. Beecher concluded that there was no direct relationship between the severity of the wound and the intensity of pain. He was among the first to propose that the meaning our minds give to an injury greatly determines the level of pain. For soldiers, he theorized, the wound meant surviving combat and returning home.

Mood and expectation also play a big role. German researchers recently showed that a sad mood consistently makes people experience more pain. In another recent experiment, tricking people to think time passed more quickly reduced perception of pain

Hoffman reasoned that entering a rich, three-dimensional and sound-filled virtual reality could command so much of the brain's attention resources that less would be available to process pain.

"We're taking advantage of the malleability of human perception to deliberately divert mental resources away from the pain," he says.

Pain by association

Burn patients come to associate the sights and sounds of the wound treatment room with excruciating pain so that just entering the room can amplify the suffering, Hoffman says. Putting on headphones and goggles blocks the anxiety-stirring sights and sounds.

But distraction of attention appears to be the main way that virtual reality reduces pain. Hoffman's team has compared differing gear and found that the more realistic and "immersive" the gear, the greater the reduction in pain reported.

That matches McAllister's experience. His burned fingers made it difficult to hold the computer mouse during his SnowWorld experience. When the mouse slipped from his hand and he lost engagement with the snowball throwing, the pain of the procedure immediately intruded.

Randy McAllister suffered severe burns in August."Oh boy, yeah," he says. "Absolutely." McAllister expects to continue intensive physical therapy for several months to regain more use of his fingers and hands. He may need additional surgery to remove scar tissue and increase joint mobility. But he's optimistic about returning to work next year.

Patterson believes virtual reality can help treat chronic pain, too. The UW researchers also developed a virtual reality program that induces hypnosis. The goal is to use post-hypnotic suggestion to change the way the brain handles chronic pain signals long after therapy sessions.

In the virtual world, subjects descend through the air, viewing a series of numbers, until they find themselves floating over a lake in a hypnotic state. Some people are resistant to hypnosis, and Patterson speculates that virtual reality systems may help overcome that resistance. Use of virtual reality could make hypnosis more standardized and accessible, he says.

"Chronic pain is a much bigger challenge than acute pain," Patterson says. His group has received a grant from the National Institutes of Health for a controlled clinical trial of virtual reality hypnosis for chronic pain.

-- Joe Rojas-Burke

http://www.oregonlive.com/health/index.ssf/2011/12/in_an_imaginary_world_oregon_b.html

When Pop Psychology Goes Wrong

ARE women attracted to different men when they are fertile? Does handwashing make us feel excused from bad behaviour? Do we cling to our parents when we think about death?

If you quickly agreed with these statements, you might be drawing too much from the psychological experiments the media and self-help gurus regularly use to explain our behaviour.

In an unprecedented year-long project, psychologists from around the world attempted to replicate 100 major studies — and could only reproduce the original result 39 per cent of the time.

Alex Holcombe, associate professor of psychology at the University of Sydney, toldnews.com.au: “Most of the science and health news you see in the media is based on individual studies. Those studies are rightly sometimes called ‘groundbreaking’ because they provide the first evidence. Unfortunately, as is now obvious, a single study is not enough. Possibly about half the studies reported in the media cannot be easily reproduced, which is very disappointing.”

It’s not just psychology that faces this problem, but many other areas where important research is being carried out.

“Concerns about replication have been raised in cancer biology, economics, political science, ecology, and other sciences,” said Dr Holcombe.

“Psychology was simply the first field to get its act together sufficiently to do a systematic, scientific study of how frequently its science replicates. The limited evidence we do have suggests that in cancer biology, reasonable attempts at replication also fail at least 50 per cent of the time.”

Here are some of the popular ideas that couldn’t be confirmed.

MEN CAN’T TELL THE DIFFERENCE BETWEEN FRIENDLINESS AND FLIRTING

Men are known to see women as having greater sexual intent than other women see. A US study claimed this was because men are not as good at distinguishing between friendliness and flirtiness as women. That result couldn’t be replicated. Scientists said this could be because of cultural differences between the US and the UK (where the latest study was attempted), or because the images from the original 2008 test seemed ‘dated’. These caveats aside, there’s no reason to believe men don’t know when you’re flirting.

MOTIVATIONAL WORDS HELP US LEARN

There’s a huge amount of interest in unconscious, unintentional learning, from hypnotherapy to listening to tapes while asleep. Psychologists showed that if people are primed with motivational, goal-directed words, they learn better without even realising it. They claimed participants learned more after completing a word search containing words like ‘ambition’, ‘progress’ and ‘success’, than after a neutral one. But this year’s experimenters found no such effect.

WE TRY TO BRING DOWN MORAL OUTLIERS

The original study said we denigrate ‘moral rebels’, i.e. those who take an unpopular, morally laudable stand, when that choice is different to our own behaviour and can be seen as threatening to our choice. It said that because we think they will look down on us, we consider them as a threat and perform a “pre-emptive strike” to lessen the anticipated sting. The replicated study found no such reaction.

MULTI-TASKING RUINS OUR CONCENTRATION

The first study said task-switching interferes with ‘simultaneous working memory processing’. Our performance was thought to be affected by the difficulty in task-switching and its frequency.

But the new study found that increased switching between tasks doesn’t necessarily make us perform worse, although it may take us longer to process numbers. It suggests that multi-tasking may be fine, depending on what we’re doing.

WE CLING TO OUR PARENTS WHEN WE ARE REMINDED OF DEATH

A study on ‘terror management’ claimed parental attachment helps young adults manage their anxiety over mortality and the inevitability of death. It suggested that insecure individuals were more likely to rely on relationships with their parents for support, whereas secure individuals were more likely to rely on relationships with romantic partners. But the replication of the study did not find that our terror altered the time we allocated to parents, siblings, friends and partners, or affected that specific attachment.

ANGER IS ABOUT POWER-PLAY

Researchers said our response to communicated anger in a bargaining exchange depends on power and knowledge. They claimed that the party with the advantage in terms of information or power will become more determined not to give in and even increase demands in response to anger. The latest experimenters disagreed.

HANDWASHING MAKES US FEEL CLEANSED OF WRONGDOING

Psychologists said that individuals make less severe judgments when they are primed with the concept of cleanliness, or wash their hands after experiencing disgust. But the second-round researchers did not find that physical cleanliness reduced the severity of moral judgments, or that hand-washers could erase feelings of disgust. They also found no evidence for possible opposing predictions that physical self-cleansing would lead to more severe moral judgments.

WE’RE MORE LIKELY TO CHEAT IF WE DON’T BELIEVE IN FREE WILL

Two original studies found reading an essay that undermined a belief in free will led to more cheating in an experimental task. While in the same direction as the original result, the replication result was not statistically significant. Researchers said that the lack of effect could be due to a failure to effectively manipulate free will.

WOMEN ARE ATTRACTED TO DIFFERENT MEN WHEN FERTILE

This study claimed that women who are in a relationship prefer single men when they are ovulating and attached men when they are not ovulating. They suggested that attached women would only leave a relationship for a new partner who is capable of providing resources, whereas an ovulating women should be attracted to a single man who would be more available for sex. But a second attempt could not recreate the link between man’s availability, participant’s conception risk and participant’s partnership status.

LONELY PEOPLE ATTACH FEELINGS TO OBJECTS

The original study said when we are feeling lonely, we attach feelings to inanimate objects and pets. The researchers claimed that socially disconnected people show an increased belief in supernatural agents, a greater propensity to attach social traits to pets and be more likely to detect faces in ambiguous drawings. But the second set of researchers could not replicate any of the three claims.

What we can take away from this

Drawing conclusions from such results can be complicated by all sorts of factors, from tendencies to experiment on people from higher socio-economic backgrounds in the West, to different sample sizes or alterations in the testing environment.

Patrick Goodbourn from the University of Sydney was one of the 270 researchers from 17 countries to be involved in the project. He told news.com.au the number of failures didn’t mean the original research was wrong, but scientists needed to be wary of small things that could affect results.

“The more surprising results were less likely to replicate, but you want a balance between innovative results and reliable or solid ones. There’s also a second stage, which is that you might disagree on what a study means for the human mind.

“It’s not the case that 61 per cent of studies are false. We were keen to make sure the original author was involved so there was no sense we were targeting them.”

While psychologists can find it harder to create large sample sizes than physicists looking at particles, m
Many fields deal with variability in results. There’s a high rate of variability in drug treatment, for example.

What we need to see now is other disciplines doing the same replication work, science journals enforcing more rigorous testing and the public responding with more scepticism. Then maybe we can get a little closer to understanding complicated human beings.

http://www.news.com.au/technology/science/when-pop-psychology-goes-wrong/story-fn5fsgyc-1227517023411

VIDEO Steve Peters and The Chimp Brain

Brain Trauma Widespread in American Football

WEST LAFAYETTE, Ind. - Football is a dangerous sport. Even with the best protective gear, sprained knees, pulled muscles and an occasional broken bone are part of the game. But seven years of research into the impact of head trauma in high school players points to new dangers that parents will find extremely alarming.

"We are seeing changes in brain activity even without a diagnosed concussion, even without any sign or symptoms showing up and that that occurs in a large population of our subjects," Larry Leverenz, a Clinical Professor of Health and Kinesiology at Purdue University.

More than half of the players participating in the trials showed signs of altered neurological function and dramatic changes to the wiring and biochemistry of their brains, according to a series of studies published by the Purdue Neurotrauma Group. They focused their research on pre-concussive head injuries which up until now went largely ignored due to lack of symptoms such as dizziness or disorientation associated with a concussion.

"It's not just the neurons that get damaged, it's the glial cells, it's the vasculature," said Eric Nauman, Professor of Mechanical and Biomedical Engineering at Purdue University.

"Basically in football and woman's soccer about half the team is experiencing these kinds of things, these kinds of changes. Some of them heal and some of them don't by the time they start playing their next season and that was the thing that really got us nervous," he added.

The researchers placed sensors on the athletes to record impact forces and coupled that data with brain scans and cognitive tests to track neurological function over the course of the trial.

They found hits to the head that up until now were considered less dangerous may be the most dangerous of all because they go unnoticed, occur more frequently and cause damage that could result in long lasting neurological problems.

Based on their results, the researchers are developing equipment that better protects the head from high force impacts.

"You're not going to change the game. You are not going to get rid of the game, at least. So how can you make changes that keep the spirit of the game there, keep players enjoying, keep fans enjoying the game but at the same time be safe," said Leverenz.

They say the technology to make these games safer exists. But to get them out of the laboratory and on to the field requires a general consensus that these sports are a lot more dangerous than previously thought.

http://www.reuters.com/article/2015/10/07/us-usa-foodball-head-trauma-idUSKCN0S12AT20151007

'Skully' Gillian Anderson used Hypnotherapy

Gillian Anderson had hypnotherapy before returning to the stage this year.

The 46-year-old actress has won rave reviews for her performance in 'A Streetcar Named Desire' at London's Young Vic theater but had to seek specialist help before her run started after suffering panic attacks brought on by a fear of forgetting her lines.

She said: "I was terrified because I've had panic attacks on stage before so deciding to do this was a lot of pressure.

"I went to a couple of different hypnotists to deal with the anxiety because about six months before I started I was already projecting the fear of the future onto really small moments and struggling to even give a thank you speech.

"I think the combination of hypnotherapy and working my a*s off so that I was comfortable with the material meant that it hasn't been an issue."

Gillian - who has children Piper, 20, Oscar, eight, and Felix, six, from previous relationships - has previously suffered from panic attacks so bad that she "hallucinated".

She recalled in an interview with Stylist magazine: "There was a period of time when I was pregnant with my daughter where I started having panic attacks and they pretty much happened every day for well over a year.

"And it was absolute hell - like hallucinatory - really bad."

http://www.simcoe.com/whatson-story/4961256-gillian-anderson-had-hypnotherapy/

Hypnosis Therapeutic Value

For some time now, medicine has had an interest in the potential of hypnosis. Existing for hundreds of years, hypnosis has always seemed to have an intriguing and almost unbelievable hold on the mind, suggesting its capability to help the human psyche and body alike. But as hypnosis seems to become more relevant in medicine, used in psychological settings, as an alternative anesthetic and a way to reduce symptoms of disease, researchers are wondering if there is a way to test its efficacy. In a new study by researchers from INSERM, a team under lead author Bruno Falissard looked into how effective hypnosis has been in some of its popular applications. Among its many uses, researchers looked at hypnosis involving women’s health, digestive ailments, surgery, and psychiatry. They also looked into the potential risks associated with hypnosis.

According to the researchers, hypnosis exists in between sleep and wakefulness as a state of altered consciousness. When examining the effect hypnosis has on the brain, imaging techniques like MRIs have found that hypnosis creates a change; past researchers have observed differences in brain activity of certain regions of the brain when someone is undergoing hypnosis.

As of now, there are a few common uses of hypnosis in a medical setting. The first is hypnoanalgesia, or using hypnosis as a potential pain reliever. Others include hypnosedation, which uses both anesthesia and hypnosis to sedate a patient, as well as hypnotherapy which utilizes hypnosis in a psychiatric setting. Along with hypnosis, the researchers looked at Eye Movement Desensitization and Reprocessing (EDMR), a form of therapy developed from hypnosis used to treat post-traumatic stress disorder.

Falissard and his team faced several obstacles when conducting their research; because hypnosis training in France can be offered both by universities and private organizations, the qualifications of hypnotists and who can be certified to become a hypnotist are not fixed. Keeping this in mind, researchers selected the conditions they sought to evaluate and looked at the results of 52 clinical trials, along with 17 trials involving EDMR therapy.

When examining the trials, the researchers first observed that hypnotherapy often yielded an improvement in symptoms for patients with irritable bowel syndrome; many reported the reduction of abdominal pain, bloating, and episodes of diarrhea. It then examined the results of hypnosis used in conjunction with anesthesia. Specifically, the team looked at surgical procedures like wisdom tooth extractions, breast biopsies, transcatheter procedures and pregnancy terminations, which were often accompanied by the use of painkillers. Overall, they found that when hypnosis was used along with surgeries, patients’ use of painkillers afterward was reduced.

Even though hypnosis’s benefit for PTSD patients is still questionable, many have previously found that EDMR therapy can be very effective. Out of all the other applications of hypnosis-based therapies, the researchers found that EDMR targeting trauma-centered cognitive behavioral therapies showed the most beneficial outcome. But, so far the team has only observed the potential of EDMR therapy in adults, because very few trials have examined children and adolescents.

Though the team had planned to examine how hypnosis impacts other medical practices, the trials they examined could not produce conclusive data. The INSERM team thus could not determine whether hypnosis was effective in pain management during childbirth, preventing post-partum depression, and helping those with schizophrenia.

When searching for safety repercussions, the researchers found some promising results in the trials; there were no serious, negative effects associated with hypnosis in these environments. They warn, however, that adverse effects are still a possibility, even though the incidence of them was observed to be low.

Though researchers found that medical practitioners are interested in hypnotherapy, the legal standards as they are now must be reexamined. Currently, French laws regarding hypnosis allow health professionals and non-health professionals alike to practice hypnosis. As hypnosis is already an unconventional practice, it is important that it be professionally and safely executed in a medical setting, especially when used in conjunction with anesthesia.

Study: Falissard B, Barry C, Hassler C, et al.  Assessment of the effectiveness of hypnosis. 2015.

http://www.medicaldaily.com/hypnosis-seems-offer-therapeutic-value-experts-still-cant-say-sure-351858

Hypnosis of Awake Surgery

Mind Twisting Optical Illusions

The beautiful and mind-bending illusions in Canadian artist Robert Gonsalves’ paintings have a fun way of twisting your perception and causing you to question what in his paintings, if anything, is real.

Most of his stunning paintings have an unclear boundary between the multiple stories they tell, which forces the viewer to jump back and forth between them – like an optical illusion that changes every time you look at it.

Gonsalves’ interest in art began at an early age, which is why he became comfortable with painting such complex misdirections. He had experience with technique and perspective and architectural art by the age of 12. When he encountered Salvador Dali and Rene Magritte, they clearly left a lasting impact on his amazing paintings as well. Take a look!






























See more here

http://www.boredpanda.com/magic-realism-paintings-rob-gonsalves/