Teresa C. Kam, PharmD, BCOP
- Clinical Pharmacist in Hematology/Stem Cell Transplantation, Indiana University Health, Indianapolis, Indiana
The cellular processes are more familiar hiv infection oral route zovirax cream 5 gm on line, and there are a few groups hiv infection early symptoms rash purchase zovirax cream 5 gm mastercard, like the American Paralysis Association infection cycle of hiv virus zovirax cream 5 gm without a prescription, that sponsor re search more imaginatively than the government agencies antiviral valtrex zovirax cream 5 gm without a prescription. Thus the elec the Self-Mending Net 213 trical problems in spinal healing may be tackled sooner than in other fields. The public imagination has been captured by the computerized mus cle-stimulation techniques being developed by Jerrold Petrofsky, an en gineer at Wright State University in Dayton. The nationally televised sight of his patient Nan Davis and other paraplegics taking tentative steps and pedaling tricycles with their own muscle power was tremen dously exciting. But if we can get the body to do the same things by itself, that will be even better. Even restoring 10 percent of lost function would be an unimaginable blessing to those who are now help less. I feel the electrical manipulation of spinal shock must be tested vigorously now, for this is perhaps the one area where the barriers of tragedy are closest to being broken. The Brain It might seem foolish to expect any regeneration in the most complex of all biological structures, the brain, yet salamanders, some fish, and most frogs in the tadpole stage can replace large parts of it, including the optic lobes and the olfactory lobes, or forebrain, the part from which our prized cerebral hemispheres developed in the course of evolution. Re placement depends on ingrowth of remaining sensory nerves, the olfac tory nerves in the case of the forebrain and the optic nerves for the optic lobes. When these nerves grow back into the area where brain has been destroyed, they stimulate the ependymal cells in the brain ventricles, which proliferate outward into the damaged part and then differentiate into new neurons and glial cells. Thus brain regrowth begins much like that of limbs, with the connec tion of nerve fibers to an epithelial tissue. A form of shock, called the spreading depression of Leao after its discoverer, neurologist A. Start 214 the Body Electric ing at the site of damage, it extends in all directions until the entire cortex becomes electrically positive and all its neurons shut down. Leao studied it only in response to small injuries, when it persists for a few hours. Sup plementation of this ability with even a small amount of regeneration might make recovery nearly complete for many brain-damaged people. For the first time in history, neurologists can hope to progress from describing the brain and cord to mending them. However, many have postulated that the immediate cause of cancer may be genetic changes in somatic cells. Normally suppressed genes held in an unnoticed corner of our genetic bookshelves since long ago in our evolution might be dusted off only when other bodily conditions are "just wrong. Such mistakes happen so often that we would all be riddled with cancer from infancy if that were all it took to start the disease. Something else must go awry before a few misspellings can turn the whole library into gibberish. Three basic criteria by which a doctor diagnoses cancer must serve as the starting point in solving the mystery of its cause. Moreover, this atavism reflects the seriousness of the 216 the Body Electric disease: the simpler the cells, the faster they grow and the harder they are to treat, whereas a tumor that still resembles its tissue of origin is less malignant. Cancer cells multiply wildly, in contrast to the slow, carefully controlled mitosis of normal cells. Going hand in hand with this uncontrolled proliferation is a similar lack of control in the structural arrangement of the cells. As the tumors dis seminate and grow, they consume all available food, and the host wastes away and dies. We can make one crucial observation at this point: Except for the lack of control, all three characteristics?cell simplicity, mitotic speed, and metabolic priority?are hallmarks of two normal conditions, embryonic growth and regeneration. Even though contained within the body of its mother, the embryo is a complete organism, and the controls over its cells are primarily its own, not those of an adult. Andres probed this relationship by implanting frog embryos in various body tissues of adult frogs. As a result, Andres proposed a theory of cancer that remains provocative today: A normal cell becomes cancerous by dedifferentiation. In the latter, a rapid growth of primitive cells having metabolic priority occurs in an adult, but with proper control as in an embryo Those animals that regenerate best are least susceptible to cancer. In general, as complexity increases up the evolutionary ladder to humans, regenera Righting a Wrong Turn 217 tion decreases and cancer becomes more common. Adult frogs, on the other hand, have bodies that are much more specialized for their amphibious way of life; they regenerate very little and are subject to several kinds of cancer. He took pieces of a type of kidney tumor common in frogs and transplanted them to the limbs of salaman ders. These tumors took better than most, and soon killed the animals when allowed to spread unchecked. However, when Rose amputated the leg just below or through the malignancy, normal regeneration fol lowed, and the cancer cells dedifferentiated more fully as the blastema formed. Then as the new leg grew, the former frog tumor cells re differentiated along with the blastema. The frog cells were easily distin guished from salamander cells by their smaller nuclei, and microscopic study showed frog muscle mixed in with salamander muscle, frog car tilage cells amid salamander cartilage, and so on. The reac tion held back cancer research for decades, because the dogma implied that carcinogenesis, like differentiation, was irreversible?once a cancer cell, always a cancer cell. As long as this view was sacred, the only possible way to cure cancer was to cut it out or kill it with drugs and X rays. Therefore chemother Righting a Wrong Turn 219 apy and X rays inevitably produce some damage in normal cells, too. Unfortunately, even though the detooling and retooling of cells have now been accepted by all of biology, the old habits still persist throughout most of the grant 220 the Body Electric ing hierarchy. A few years ago, for example, I met a young research fellow at the National Cancer Institute who wanted to study the re generation-cancer link. A month later he was forced out of the institute, and the project has never been funded. As far back as the 1920s, several experimenters implanted tumors into denervated areas. Without exception the cancer cells took root better and grew faster than where the nerves were intact. The early work on this point was criticized on the grounds that denerva tion might have reduced the efficiency of the circulatory system, which in turn would have enhanced malignant growth. Then in the mid-1950s and 1960s more sophisticated techniques established the same rela tionship. Absence of nerves accelerated tumor growth, and variations in the blood supply had no significant effect. They worked on salamanders, but instead of implanting frog tumor cells they induced skin cancer with large, re peated applications of carcinogenic chemicals. With persistence they eventually got tumors that would invade subsurface tissues, metastasize, and kill the animals. In one series they applied the carcinogen to the base of the tail; the primary tumor formed there, and metastases ap peared at random in the rest of the body. If they then amputated the tail, leaving the primary tumor intact, this malignancy would disappear as the tail regrew. Furthermore, all the secondary tumors vanished, too, as though they were being operated by remote control from the main one. However, if the primary tumor was at a distant point on the body, amputation of the tail had no effect. Even though the tail regenerated, the main cancer and its offshoots all progressed, and the animal died. The electrical currents in nerve and particularly in the neuroepidermal junc tion seem likely candidates, since they suffice to start regeneration in animals normally incapable of it. Back in 1927 Elida Evans, a student of Carl Jung, documented a link between depression and cancer in a study almost totally neglected in the intervening years. Caroline Bedell Thomas at Johns Hopkins School of Medicine, students were given personality tests, and the occurrence of disease among them was charted over several decades.
If a muscle fails to contract properly antiviral drugs ppt 5 gm zovirax cream overnight delivery, it will be impossible to exercise the muscle optimally hiv infection rates new york city cheap 5 gm zovirax cream visa. Discussion Using manual muscle testing it is extremely easy to isolate improperly functioning muscles antiviral used for h1n1 generic zovirax cream 5 gm with amex. Once isolating the inhibited muscle the cause of the inhibition must be addressed and corrected personal hiv infection stories generic zovirax cream 5 gm without a prescription. The most common muscle tests utilized are general joint strength tests like the infamous arm pull down. In shoulder problems, the following exercise is given to strengthen the external rotators. At this angle there is very poor contraction of the infraspinatus the major external rotator of the shoulder. Consequently, doing this exercise is a very poor exercise for the total external rotators of the shoulder. Ideally, if an individual muscle needs to be exercised the best positioning for it is replicating the muscle test. Over the years, muscle testing has evolved into an attempt to isolate the individual muscle is being tested positioning the body part to minimize recruitment from other muscles. The second problem in establishing and exercise routine to rehabilitate muscle involves the number of repetitions. There is no testing to determine what number of repetitions the person can actually perform. In applied kinesiology since 1980, aerobic and anaerobic muscle testing has been used to determine the ability of a muscle to contract consecutively. In the original findings, failure of the muscle to contract repeatedly was related to nutritional imbalances. For example, failure of the muscle to contract repeatedly to slow muscle tests at one per second and have could be related to an iron deficiency related to decreased level of myoglobin in the muscle. To test for this, the person should be tested for multiple failures of muscles in both the upper and lower extremity. It is highly unlikely that an individual will have an iron deficiency in just one muscle. In doing anaerobic fast twitch muscle testing it was originally related to a deficiency of pantothenic acid. As these muscles work with the Krebs cycle of energy it opens up more than just one nutrient but the portions of the B complex that are involved in the whole Krebs cycle. Again, if there is an imbalance in this energy system then there should be multiple weaknesses in both the upper and lower extremity muscles to the anaerobic muscle test. Once the muscle needing rehabilitation has been isolated and the muscle functions properly the muscle is retested for either fast twitch or slow twitch functioning. For the general population this number is two thirds of that to leave a safety factor. For the professional athlete, if the muscle becomes inhibited on the fifth repetition than they were instructed to do sets of four. Using this procedure a combination of number of repetitions along with the speed of the repetitions depending upon whether you wish to rehabilitate fast twitch function or slow twitch function is determined for each individual patient. This procedure has allowed a faster return and rehabilitation of weakened structures in not only athletes but in elderly patients. Conclusion Using muscle testing, a specific exercise routine can be determined for the specific needs of the patient. This paper will discuss improved ways of testing for imbalances in the quadriceps muscles as related to patellar motion and the patellar tendon. Key Indexing Terms Patellar Tendon, Retropatellar Pain, Quadriceps, Fibrosis, Applied Kinesiology, Manual Muscle Testing Introduction the patella has to have and be able to move not only superior and inferior but also slightly medial and lateral to palpation. Limitations in motion of the patella have adverse effects on the relative function of the quadriceps muscle. After injury or repeated stress localized inflammation is common and protein cross-links are formed ?gluing" the tendon to the tibia and restricting motion of the patella. It is also common to find adhesions in the tissue above and superior to the patella. Discussion Adhesions of the patellar tendon decrease the distance from the inferior aspect of the patella to the tibial tuberosity, effectively creating a condition known as patella infera. In extension of the knee, Ahmad found that adhesions decreased the knee extension force created by the quadriceps muscle on the tibia, indicating a decrease in the effective moment arm of the extensor mechanism. Furthermore, as a result of patellar tendon adhesion, the angle formed by the quadriceps and patellar tendons decreased, resulting in an increase in patellofemoral joint reaction force and pain or ache. This suggested that quadriceps avoidance was employed to reduce patellofemoral joint reaction forces. The altered biomechanics in the stair tests were found at the knee and not in the ankle or the pelvis. All of these are indications of potential malfunction of the quadriceps muscle at varying degrees of angulation of the knee. Examination of imbalances in patellar function begins by observing the patient bending their knees. Make sure to instruct the patient to then slowly so that the laser beam does not get on their face. If there is an imbalance in one leg, the person will start to deviate to the side. It is easy to have the patient then look and see where the laser point is located. Make sure that you instruct the person to look straight ahead and not watch the spot. The average right-handed person will have a slightly larger left quadriceps muscle than the right. If the person was involved in athletics or in normal lifting, you tend to use the opposite arm and leg. It should also be remembered that most people driving the car get in and out using only their left leg to support their body weight. This slowly leads to a slightly larger development of the left quadriceps over the right quadriceps. With the patient in a supine position with the leg totally relaxed, the patella should be palpated for motion or restriction in superior, inferior, medial and lateral motion. Standard muscle test for both the rectus femoris and the vastus muscles should be performed. If the muscles are found to be inhibited, normal procedures should be performed to determine if there is a problem within the muscle or potential problems with the nerve supply to the muscle. The knees should then be further flexed at different angles to make sure that the rectus femoris and the vastus are able to adequately contract at these increased angles of knee flexion. Failure of the muscle at an angle may very well indicate adhesions around the patella and this need to be investigated and corrected. In an analysis of 50 patients entering the office with chronic low back and leg symptoms. It was found that 34 of them had an involvement of restricted motion of the patella. This occurred on the side of the short stride and there was mild to moderate atrophy of the quadriceps muscle. In each of these cases, the patient was instructed on how to perform the cross friction massage at home. On re-examining it was found that5 patients showed they needed to continue with the patellar correction and on questioning it was found that three had not performed the massage properly and two had severe atrophy of the quadriceps muscle needing extensive rehabilitation. Conclusion In patients, especially chronic patients, with low back problems or knee problems, it is highly recommended that the quadriceps muscle be tested at multiple degrees of knee flexion in order to determine if there is adequate motion of the patella to ensure proper functioning of the muscle. Abstract Visible light is like a multivitamin, consisting of many different frequencies ranging from approximately 400-700 nm. Selective malabsorption due to emotional trauma, wearing glasses or contact lenses, being indoors etc. Just like prescribing specific nutrients prescribing treatments with specific frequencies of light can help restore normal homeostasis and thus stabilize your patient.
Based on a continuous probability-of-inadequacy scale hiv infection rates nigeria purchase zovirax cream in india, the 66 distribution of the usual intake is used to estimate the probability of in adequacy stages of hiv infection and symptoms 5 gm zovirax cream sale. Based on such data the following questions can be answered: 1) What proportion of the group has a minimal probability of inadequacy? For application purposes antiviral medication for mono purchase zovirax cream with a mastercard, the usual intake of nutrients is an im 68 portant concept hiv infection rates zimbabwe order zovirax cream visa, and usual intake is defned as the average intake over a longer period of time. The distribution curve for nutrient intakes depend on the actual in take, dietary assessment methodology, and sample size (3). Dietary intake data obtained from only a single day (a one-day food record or a single 24-hour recall) will have a relatively wide distribution curve compared with intake obtained over a longer period (Figure 3. Intake data obtained from a single one-day assessment can, therefore, lead to a gross overestimation of the probability of inadequate or excessive intakes. These measurements are not considered suitable for assessment of di etary (in)adequacy unless the intake distribution is adjusted based on the intake of a subgroup of the sample over several days. Several statistical methods are available to obtain ?usual intake? distributions from dietary assessment methods looking at one or several days (4, 5). Sample size is another important factor that will infuence the reliability of the probability of inadequate or excessive intakes (3). Several other issues should also be addressed before making an assessment of nutrient intakes (Table 3. The frequency distribution of a nutrient intake by a group assessed with a one day dietary method and by a method assessing usual intake (including a longer period of time). Checklist for issues to be addressed before assessment of nutrient intake data a) How many days per individual are the nutrient intake data based on? Is the number of days suffcient to estimate the proportion of individuals considered at risk? Water, tea, coffee, and other non-energy beverages are often excluded from the calculated intake, but they might be important sources of certain minerals and trace elements. Underreporting of energy intake is common in dietary assessments and implies underreporting of most nutrients (including vitamins and minerals). Check for underreporting in the group as a whole, and in subgroups, before assessment of nutrient intake. If a subgroup shows low intake of a micronutrient, check for underreporting of energy intake in that group. Is the information on nutrient content and dose in supplements specifc enough for calculating intake from these sources? Is the information on nutrient content in foods specifc enough for calculating intake from these sources? This is particularly important for nutrients such as ascorbic acid and folate, for which substantial losses can occur during cooking/processing. Certain trace elements in particular databases can have missing values even for commonly consumed foods, and this can result in substantial underestimation of calculated intake. Database values for a specifc nutrient can also be based on out-dated analytical methods that might provide systematically higher or lower values than the method currently in use. Dietary assessment How to assess the nutrient intake of a group Micronutrients the goal of assessing nutrient intake of groups is to determine the prev alence of inadequate or excessive nutrient intakes within a pre-defned group of individuals. Assessing nutrient intake of groups is an integral part of dietary monitoring, for example, in national dietary surveys or dietary intervention studies. The key to an appropriate assessment of inadequacy at the group level is to think in terms of a continuous probability-of-inadequacy scale where the prevalence of inadequacy increases as intake decreases (illustrated in Figure 3. Assessment of inadequate or excessive nutrient intakes is based on the distribution intakes of individuals in the group with the underlying assumption that nutrient intakes and requirements are not directly correlated (this is true for most nutrients with the exceptions of a few, such as iron) (Figure 3. What proportion of the group has a relatively high probability of in adequate intake? For a detailed description of this approach and its assumptions, see IoM (6) and example 1. The intake distribution of vitamin C (mg/d) for a group of Danish women 18?75 years old (n = 1785)* Percentile 1st 5th 10th 25th 50th 75th 90th 95th 99th Vitamin C 24 39 50 69 100 144 190 227 321 intake (mg/d) * [7]. If the assessment results in a high prevalence and thus a high probability of inadequate nutrient intake that can only be explained by an implausibly low reported energy intake, the results might indicate that the risk is real. Biochemical measurements of nutritional status, however, are necessary to substantiate whether there is an actual lack of intake of the nutrient in question. The probability approach has recently been successfully applied to a nutrient status biomarker (7), and this can be used as a complementary tool for assessing adequacy or excess. Energy In the assessment of energy intake at the group level, the estimated average energy intake is compared with the reference value for energy intake for the specifc group in which body size, age, sex, and appropriate levels of physical activity are taken into account. The proportion of the group with intakes above or below the reference value can be assessed. A prerequisite for an appropriate assessment of energy intake at the group level is to en sure that energy intake is accurately assessed, and the approach suggested by Black (9) is useful in this regard. In the assessment of the usual energy contribution from protein, fat, and carbohydrates, the proportion of the group that has a usual energy contribution from these macronutrients within or outside the recommended intake range is estimated. In the assessment of the usual energy contribution from macronutrients with a recommended upper threshold. Likewise, when the energy contribution from macronutrients with a recommended lower threshold. In this example, the nutrient intake of two of the individuals (I1 and I2) is above their individual requirements (R1 and R2) and, therefore, both individuals have a minimal probability of inadequate intake of the particular nutrient. The situation for individual 3, who has a usual nutrient intake (I3) below his/her requirement (R3), is diferent and no conclusion can be drawn on the probability of inadequate nutrient intake. Taking into consid eration that it is extremely difcult to obtain the usual nutrient intake and virtually impossible to know the requirement of an individual, biochemi cal and other clinical measurements of nutritional status will, therefore, be necessary in the situation of individual 3 to clarify whether there is an actual situation with inadequate intake of the nutrient in question. The distribution of the nutrient requirement and nutrient intake in a group and highlighting the individual requirement (R) and usual intake (I) of three theoretical individuals 1, 2, and 3. The larger the overlap between the two distributions curves, the higher the risk of inadequacy Energy In the assessment of energy intake of an individual, the estimated average usual energy intake is compared with the reference value for energy intake for the individual in which body size, age, sex, and appropriate levels of physical activity are taken into account. A prerequisite for an appropriate assessment of energy intake at the individual level is that energy intake is accurately assessed. Assessment of energy intakes over a longer period of time should be supported by measurements of body weight at several points of time because changes in body weight will refect an energy imbalance over a period of time. In the assessment, it is estimated whether the usual intake is within the recommended range for protein, fat and carbohydrates. Planning diets for groups includes food planning in the public meal sector, food fortifcation, and assuring food safety. Dietary planning is not intended for use on a daily basis but as an average over a longer period of preferably at least a week. The nutrient intakes are considered as ?net-intake? of nutrients and losses of vitamins and minerals during peeling, cooking, and other handling pro cedures are subtracted. For heterogeneous groups, the nutrient density approach is another ap proach to planning a diet. This approach is especially useful for planning a diet for a week or longer for heterogeneous groups with subgroups such as children, women, men, and the elderly because it ensures that the requirement of the ?most demanding subject? is met. The recommended nutrient density to be used for planning diets for heterogeneous groups is shown in Chapter 1 (Table 1. For homogeneous groups, it is appropriate in the planning of a whole diet over a longer period of time to use the recommended intake for the relevant age and gender group (Chapter 1, Table 1. The nutrient density approach can also be useful for the homogenous groups in question. Here the goal is to plan a diet taking into consideration the entire distribution of 75 usual nutrient intakes within a group (Figure 3. Such planning seeks to achieve a usual intake that meets the requirements of most individu als but at the same time is not excessive. The prerequisite of this method is that the distribution of reported or observed usual intakes of the target group is known. In other words, how far the distribution of the intake curve is shifed to the right of the distribution of the requirement (Figure 3. Current and target vitamin B6 intake distribution (mg/d) for Danish women 18?24 years old (n = 150) and the required change (mg/d) to achieve a target intake with a prevalence of inadequacy in the group of 5% Current intake* Target intake Change mg/d mg/d mg/d Average 1. However, using the probability approach, the distribution of the current intake shows that up to 25% of the women in this group might have a relatively high probability of inadequate intake of vitamin B6, i.
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As a practitioner hiv aids infection stages order zovirax cream online, the progress in understanding behaviour from the brain perspective does very little in some ways hiv infection rate in costa rica cheap generic zovirax cream uk, but an enormous amount in others hiv infection with no symptoms buy zovirax cream 5 gm amex. It can be more than knowledge when the knowledge becomes integrated into your experience hiv infection generic zovirax cream 5 gm. In this context, we will highlight a number of topics that we believe are having an important impact on psychotherapy, or soon will be. Before we look at some of these ?hot topics,? we should clarify that much of what neuroscience is discovering confirms therapeutic techniques whose effectiveness in practice has already been attested. However, confirmation by neuroscience of what were largely intuitive practices opens an unprecedented way forward for us as therapists to refine our technique, and ourselves, for even greater success, while leaving behind those practices revealed to be ineffectual or even detrimental. It is certainly not a recent topic, having been studied since the 1960s, but is nevertheless a vital process in psychotherapy. We will use the explanation given by Joseph LeDoux, a leading researcher in this area, in a recent podcast (Van Nuys, 2010; for more on the work of LeDoux, see LeDoux 1996; 2002; 2010). When we form a memory, protein synthesis is involved in the establishment of synaptic connections that are part of the network representing the memory. During this retrieval process, the memory, or rather the neural connections representing the memory, become a little unstable, and this instability is key: it is what allows us to incorporate new information. Later, a friend of yours explains that Jack had just found out that he had lost his job. As your friend is talking to you, you are remembering your first encounter with Jack, and with the new information, your opinion of Jack is changing. Your memory of Jack has been altered; it is a new memory, and as a new memory, it has to be restored by protein synthesis: an update, if you like. But it is not an update that merely adds information to the existing memory; it is an update that is a new memory. The interesting thing is that if you disrupt this updating mechanism, you can threaten the survival of the memory in its original form. As LeDoux says, taken to the extreme, your memory is only as good as your last memory of that person, event, etc. One of the critical points to make here is that the modification of a recalled memory is not of the episodic part of that memory; in other words, your remembering actually meeting Jack at a certain place at a certain time is not modified, but the emotional components of this may be. These emotional first impressions are liable to change, given new information at the crucial time when the memory is ?unlocked. So we are looking at the implicit, emotional memory formed by the amygdala, rather than the hippocampal formation of cognitive memory. Traumatic memories, as a case in point, can be hugely impacted by a dampening of the emotional memory mediated by the amygdala. Bruce Ecker has for a long time now been developing a therapeutic practice (Coherence Therapy: Ecker, Ticic, & Hulley, 2012) that capitalises on this reconsolidation process. Ecker has a thorough understanding of the research literature and has demonstrated, very effectively, positive therapeutic outcomes of eliminating painful and unhelpful implicit emotional memories. All these techniques may be disrupting the reconsolidation process to dilute the traumatic impact and reverberations of the original implicit memory. This humble class of cells was considered no more than the supportive framework for the neural system, but we are now discovering the very active roll glia play in the whole communication process within the brain. Many of the functions of various glia are well known, such as immune defence, myelination, blood flow control, neuron protection, synapse development, nourishing of neurons, and regulation of neurotransmitters in the extracellular space. For instance, how do astrocytes (the most abundant cells in the brain that have many maintenance and supportive roles, such as nutrition to nerve cells, maintaining extracellular iron balance, and traumatic injury repair) collaborate with neural networks to modulate synaptic signalling? In their research they are discovering the active role astrocytes play in information processing by the brain. Astrocytes form an additional network to neurons, operating on a slower time-frame, carrying large amounts of information across brain regions. There is much to learn about the communication function of glial cells, and computational neuroscientists like De Pitta are on the cutting edge of this research (De Pitta et al. It has been recently shown that memory formation requires the activity of astrocytes in order to create the necessary conditions in the synapse to continue the electrical flow from one neuron to the next (Panatier et al. We have not thought of astrocytes as playing any role other than to supply food and then help in the synaptic cleanup (re-uptake) after a signal had passed. We are still stabbing in the dark (although much less nowadays) in the hope that the response to our therapeutic practice will be beneficial and will be optimal. The exciting news here is that there could be exciting news coming from ongoing research. Could it be that we have been focusing on the highways and freeways of neural transmission and have yet to explore the streets, service roads and alleys of the glial system? Stanley Keleman argues that ?the glia network interacts with the neuronal system and has a regulatory function, since it both regulates metabolism and conducts information. While the neuronal system is a fast-response system of focused anticipated intentions and flash memory, the glial system is a slower response organisation that supports voluntary muscular effort and also regulates the neuronal excitatory pattern through its layers of myelin, helping to create long term memory. These two patterns, the fast and the slow, grow the cortex and our inherited instinctual and social patterns of behaviour and experiencing? (Keleman, 2012, p. How interesting to think of a ?fast? and a ?slow? system like this, with glia as an equally key player to neurons in shaping our brain. Yet while glia may be slow in one respect, another theory suggests they may be part of a super-fast system. Stuart Hameroff has developed a quantum computation model of the brain based on quantum communication in microtubules?implicating the entire glial system in a vast ?quantum computer? type of network (part of the Sir Roger Penrose and Stuart Hameroff ?orchestrated objective reduction? theory of consciousness). While we are not in a position to make a judgment on this theory, it is interesting to note that there may be much more going on in the brain than neuronal transmission. We are beginning to discover more about glia and we need to be mindful that glia are about 80% of our brain. The activities of the glia will certainly affect our approaches to neuropsychopharmacology, but it may be safe to predict that glial cells are positively affected by good lifestyle practices. Time will tell what are the best applications for therapeutic practice, but in the meantime, if we got excited about the brain containing some 100 billion neurons and many thousand synaptic connections between them, then we can safely keep the excitement up glial cells have been noticed. Let us see what they really do and what we can do to encourage their beneficial effects. The critical finding of affective neuroscience for the therapist is that the brain can expand or contract the neural territory and connectivity of regions associated with emotion, through experience, and even through thoughts and intentions. Our very thoughts can alter our physical brain and neurochemical communication patterns to modulate our emotional responsiveness. Through techniques like meditation (Davidson & McEwen, 2012) it is possible to increase specific parts of prefrontal activation while dampening an overactive amygdala, to increase prefrontal influence over the amygdala, and even to bring about structural changes such as an increase in prefrontal volume and a decrease in amygdala volume. These findings are exciting for therapists, because we are starting to see therapy as a non invasive technique to alter brain regions, and it is this capacity for thoughts to affect the biology of the brain that is bringing incredible understanding of how and why therapy can be beneficial to mental health. Daniel Siegel has elegantly summarised the regulating and modulating activities of the pre-frontal cortex (2012) in the context of interpersonal neurobiology. Bonnie Badenoch describes it as ?long integrative fibers of comfort extending from the middle prefrontal cortex down to the amygdala? (Badenoch, 2008, p. The neural basis of emotion is directly related to the make-up of the biochemical milieu that changes in response to stimulus from both sensorial input and mental activity. It is the capacity of the mind to affect the biochemical milieu that enables thought to regulate and moderate emotional responses. In short, something that creates stress can be calmed by various responses, including thoughts. Emotional style is the developed skill, both explicit and implicit, to produce such beneficial reactions as the one described above, by the regulation and modulation of neural activity and the consequent biochemical milieu. On a practical level, this means that when we change the way we think or the way we feel or change our perspective or change the company we are in or change the way we speak or are spoken to , our biochemisty reflects those or any changes that occur. Our living experience is something like an orchestra: many players doing many things and all seeking to be a contributor to the music of life. Even the humble triangle, an instrument which might wait for some time before chiming in, is an integral and functional element of the orchestra. It is interesting to know the finer details of all these changes in the ebb and flow of life, but not vital. It is, however, vital to know this: we function within a finely tuned integrated system into which we add our therapeutic contribution with the specific purpose facilitating some change, that experiential change will be supported by a change in the biochemical milieu. Ernest Rossi describes this as ?state-dependent? memory learning and behaviour (Rossi, 2007, pp. Ongoing research into the interplay between neuronal structures, the biochemical milieu this creates, and how this milieu can be modulated and regulated by mental activity and mind states will help in deepening our understanding of how to resist being buffeted by the emotions and feelings that can sometimes seem to take over our brains, disturbing our capacity to manage the stresses and traumas that befall us. There is a natural preference for wellbeing which can be seen in the current research showing the benefits of positive and caring therapeutic practice in reducing inflammatory gene expression and increasing anti oxidation genes (Atkinson et al.
