Category Archives: Physiology

Hot and getting hotter 5 essential reads on high temps and human bodies – The Conversation

Launching the National Integrated Heat Health Information System (NIHHIS) and the heat.gov site on July 26, 2022, the Biden administration cited heat waves and the warming climate as serious health threats. As the new initiative promises a science informed response to hotter conditions, five stories from The Conversations archive explain what researchers know about heat and health.

Heat waves can be deadly in a variety of ways, wrote William Calvin, who teaches physiology and neuroscience at the University of Washington.

Heat waves can kill via the dehydration caused by heavy sweating; the altered sodium and potassium concentrations in the blood confuse both heart and nerve cells, and so breathing or heartbeat may suddenly stop, he wrote.

Calvin explained that human bodies have not evolved to handle extreme heat with humidity. Normally, sweat evaporates off your skin and you cool down. But with high humidity, the air is already saturated with water vapor, and so evaporative cooling stops. However, you keep sweating anyway, threatening dehydration.

Read more: How dangerous heat waves can kill

That combination of temperature and humidity whereby the persons core temperature starts to rise is called the critical environmental limit, wrote a group of Penn State University scholars researching the health effects of heat: W. Larry Kenney, Daniel Vecellio, Rachel Cottle and S. Tony Wolf.

In a rare lab test of the human bodys heat tolerance, the researchers found that the limit is lower than previously thought. When the air temperature is around 100 degrees Fahrenheit (38 Celsius), people can begin to feel ill effects at just 60% humidity a higher temperature and lower humidity than researchers determined in 2010.

Above those limits, core temperature rises continuously and risk of heat-related illnesses with prolonged exposures is increased, they wrote. The results of these tests show an even greater cause for concern.

Read more: How hot is too hot for the human body? Our lab found heat + humidity gets dangerous faster than many people realize

Extremely hot whether is particularly dangerous for those over 70, according to family physician Dr. Gabriel Neal, who teaches at the Texas A&M Health Science Center College of Medicine.

In his article on avoiding heat stroke, Neal described factors making older adults vulnerable to heat-related illnesses.

As people age, our bodies ability to cool declines, and the elderly often take medication that further impairs this ability, Neal wrote. In addition, the elderly may not be aware of the dangerous heat wave and may not have working air conditioning in their home, nor have anyone to check on them.

Read more: Heat stroke: A doctor offers tips to stay safe as temperatures soar

Its the heat and the humidity, wrote Mississippi State University exercise physiologist JohnEric Smith.

Hot desert climates are stressful due to extreme temperatures, while humid subtropical climates are stressful because the body has trouble removing heat when sweat doesnt evaporate readily, he wrote.

Smith added that how heat and humidity affect people depends on factors like the weather thats typical where they are, and the cooling systems in local homes and buildings.

Read more: Knowing how heat and humidity affect your body can help you stay safe during heat waves

Tufts University epidemiologist Elena Naumova warns that keeping food safe to eat is becoming more challenging in a warming climate.Thats because warm, wet weather conditions stimulate bacterial growth, she wrote.

Naumova named several climate-related factors in spreading foodborne illnesses. One growing problem is that heat waves, wildfires and severe storms are increasingly triggering power outages, which in turn affect food storage and food handling practices in stores, production and distribution sites and homes, she wrote.

Read more: Climate change is putting food safety at risk more often, and not just at picnics and parties blackouts are a growing problem

Editors note: This story is a roundup of articles from The Conversations archives.

Excerpt from:
Hot and getting hotter 5 essential reads on high temps and human bodies - The Conversation

Leadership Transitions | Office of the Provost | University of Pittsburgh – Office of the Provost

August 4, 2022

Dean James R. Martin, the U.S. Steel Dean of the Swanson School of Engineering, has shared with me his decision to accept a new role as Vice Chancellor for STEM Research and Innovation in the Office of the Senior Vice Chancellor for Research. In his new role, Dr. Martin will work to help integrate our STEM programs and leverage their collaborative potential and build pipelines to further diversify the student body and faculty in STEM. Senior Vice Chancellor Rutenbar and I are grateful for his willingness to take on this important task.

Under Dr. Martins leadership, the Swanson School has advanced several strategic areas, including research funding, PhD enrollments, faculty and student diversity, and government and industry partnerships. Research expenditures within the school increased by over 33% and PhD students enrollments by over 20%, thanks to an added focus on larger, multidisciplinary proposals and restructuring of the business, finance, and research offices. Undergraduate diversity consistently increased for underrepresented minorities, with first year female cohorts nearing 40 percent and first-generation students increasing from 5 to 15 percent. I thank Dr. Martin for his contributions to the School and look forward to working with him in his new role.

I am grateful that Dr. Sanjeev Shroff, Distinguished Professor of and the Gerald E. McGinnis Chair in Bioengineering and the Chair of the Department of Bioengineering, has agreed to serve as Interim Dean of the school effective immediately. Sanjeev came to Pitt from the University of Chicago in 2000 and is deeply respected by his colleagues at Pitt and in the broader community, as well as by his peers in the field of bioengineering.

Sanjeev is a distinguished scholar in cardiovascular physiology and engineering, with special emphasis on cardiac mechano-energetics and cardiovascular structure-function relationships under normal and pathological conditions. His research has been supported by grants from the American Heart Association, National Science Foundation, and the National Institutes of Health. He is also an elected Fellow of the American Physiological Society, the American Institute for Medical and Biological Engineering, the Biomedical Engineering Society, and the International Academy of Medical and Biological Engineering.

I believe the combination of Sanjeevs leadership experience, dedication to and knowledge of Pitt and of the Swanson School, and professional expertise makes him the ideal choice for this interim role.

My sincere thanks to you for your continued dedication to the school and to the University of Pittsburgh.

Best,

Ann E. CuddProvost and Senior Vice Chancellor

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Leadership Transitions | Office of the Provost | University of Pittsburgh - Office of the Provost

The anatomy and physiology of startup lay-offs: what separates futures great brands from the crowd – Economic Times

Lay-offs may be inevitable even when there is a professionally competent management, good fundamentals, and focus on building value. But the critical aspect is how they are executed once the decision is taken.

Massive lay-off at a highly funded startup. Waking up to such headlines has become usual over the last few weeks. Its unfortunate that more than 12,000 people in the Indian startup ecosystem have lost jobs in 2022 so far. But its the hard truth of a funding winter. The reasons cited by the managements are often similar. They blame the global macroeconomic conditions and maintain that harsh decisions need to be taken to stay afloat. But is

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The anatomy and physiology of startup lay-offs: what separates futures great brands from the crowd - Economic Times

Senior Lecturer in Clinical Physiology job with BIRMINGHAM CITY UNIVERSITY | 302932 – Times Higher Education

Senior Lecturer in Clinical Physiology

Department of Life Sciences

Location: City South CampusSalary: 47,778 to 51,931 per annum PermanentPosted On: Tuesday 19 July 2022Closing Date: Tuesday 16 August 2022Interview Date: To be confirmedReference: 072022-403

Are you a talented educator who is passionate about teaching the next generation of Biomedical Scientists and Healthcare students? If so, Birmingham City University is looking to recruit an experienced Life Sciences academic to join our vibrant integrated teaching & research team within the Department of Life Sciences.

Birmingham City University launched its Biomedical Sciences degree in 2017, from its expertise and strong reputation in Health Sciences. Following significant growth in the course, we are seeking to recruit a full-time permanent senior lecturer with the skills and expertise to complement our existing team. Your expertise will develop and enhance our teaching, learning, and research activities in Biomedical Sciences and will influence the design and delivery of the Biomedical Science and Health Science courses (such as Nursing and Paramedicine). It is anticipated that the post holder would be an expert in Physiology or Pharmacology and would act as module lead for the final year (Level 6) Pathophysiology module, although applications from highly innovative educators from any field of the Biomedical Sciences will be considered. The post holder would also be expected to engage with teaching across the Faculty portfolio.

The successful candidate will:

With around 26,900 students from 100 countries, Birmingham City University is a large and diverse learning community. We put students at the heart of everything we do, giving them the best opportunities for future success. The University has an enviable reputation for providing quality, student-focused education in a professional and friendly environment. Our superb courses, state-of-the-art facilities, first-rate academics, and focus on practical skills and professional relevance all support our graduates future employability.

The Department of Life Sciences within the School of Health Sciences is a thriving, vibrant, and inspiring learning community committed to excellence in, high quality learning and teaching and research and impactful stakeholder engagement. We are a practice-based department, with brand new state-of-the-art facilities (41million), making our teaching and research relevant to the evolving Biomedical Sciences field by partnering with local and global enterprise.

Further details:Job Description

Please be aware that this position will require an Enhanced DBS disclosure, please contact HR on 0121 331 6693 for a confidential self-disclosure form should you wish to declare anything in advance.

The University is committed to internationalism and diversity and welcomes applications from all countries, faiths and backgrounds.

It is each individual successful applicants responsibility to ensure that they have permission to work in the UK. Some applicants may require sponsorship from the University and a visa from UKVI to take up the role if successful. More information on this can be found here: https://www.gov.uk/check-uk-visa

Some roles are not capable of sponsorship because they do not meet the UKVI criteria relating to skill and salary level. If you are unsure as to whether you would require sponsorship if successful, or whether the role is capable of sponsorship, please contact us: RTinbox@bcu.ac.uk

Please note on occasions where we receive a large number of applications, we may close the advert ahead of the publicised closing date. If this does happen, we will contact all candidates via email who have started but not yet completed their application, giving 48 hours notice. We would therefore advise that you submit your completed application as soon as possible.

At Birmingham City University we are proud to be an equal opportunities employer. All staff are expected to understand and enact the Universitys commitment to ensuring equality, diversity and inclusion in our employment practice and in all that we do . This commitment is enshrined in our Core Values and is detailed in our Equality, Diversity and Inclusion in Employment Policy. The University values and celebrates the diversity of our staff and students; we welcome people from the many different backgrounds and life experiences that reflect the students and the citizens we serve. We are committed to equality of opportunity for all staff and actively encourage unique contributions, in particular from under-represented groups in respect of age, disability, sex, gender or gender identity, ethnicity, race, religion or belief, sexual orientation or transgender status

Birmingham City University ('BCU') is committed to protecting your personal data and being transparent about what we do with your personal data. One of the ways we do this is through our privacy notices. For further information please click here.

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Senior Lecturer in Clinical Physiology job with BIRMINGHAM CITY UNIVERSITY | 302932 - Times Higher Education

Humans may not be able to handle as much heat as scientists thought – Science News Magazine

More than 2,000 people dead from extreme heat and wildfires raging in Portugal and Spain. High temperature records shattered from England to Japan. Overnights that fail to cool.

Brutal heat waves are quickly becoming the hallmark of the summer of 2022.

And even as climate change continues to crank up the temperature, scientists are working fast to understand the limits of humans resilience to heat extremes. Recent research suggests that heat stress tolerance in people may be lower than previously thought. If true, millions more people could be at risk of succumbing to dangerous temperatures sooner than expected.

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Bodies are capable of acclimating over a period of time to temperature changes, says Vivek Shandas, an environmental planning and climate adaptation researcher at Portland State University in Oregon. Over geologic time, there have been many climate shifts that humans have weathered, Shandas says. [But] were in a time when these shifts are happening much more quickly.

Just halfway through 2022, heat waves have already ravaged many countries. The heat arrived early in southern Asia: In March, Wardha, India, saw a high of 45 Celsius (113 Fahrenheit); in Nawabshah, Pakistan, recorded temperatures rose to 49.5 C (121.1 F).

Extreme heat alerts blared across Europe beginning in June and continuing through July, the rising temperatures exacerbating drought and sparking wildfires. The United Kingdom shattered its hottest-ever record July 19 when temperatures reached 40.3 C in the English village of Coningsby. The heat fueled fires in France, forcing thousands to evacuate from their homes.

And the litany goes on: June brought Japan its worst heat wave since record-keeping began in 1875, leading to the countrys highest-ever recorded temperature of 40.2 C. Chinas coastal megacities, from Shanghai to Chengdu, were hammered by heat waves in July as temperatures in the region also rose above 40 C. And in the United States, a series of heat waves gripped the Midwest, the South and the West in June and July. Temperatures soared to 42 C in North Platte, Neb., and to 45.6 C in Phoenix.

The current global rate of warming on Earth is unprecedented (SN: 7/24/19). And scientists have long predicted that human-caused climate change will increase the occurrence of heat waves. Globally, humans exposure to extreme heat tripled from 1983 to 2016, particularly in South Asia.

The heat already is taking an increasing toll on human health. It can cause heat cramps, heat exhaustion and heat stroke, which is often fatal. Dehydration can lead to kidney and heart disease. Extreme heat can even change how we behave, increasing aggression and decreasing our ability to focus (SN: 8/18/21).

The human body has various ways to shed excess heat and keep the core of the body at an optimal temperature of about 37 C (98.6 F). The heart pumps faster, speeding up blood flow that carries heat to the skin (SN: 4/3/18). Air passing over the skin can wick away some of that heat. Evaporative cooling sweating also helps.

But theres a limit to how much heat humans can endure. In 2010, scientists estimated that theoretical heat stress limit to be at a wet bulb temperature of 35 C. Wet bulb temperatures depend on a combination of humidity and dry bulb air temperature measured by a thermometer. Those variables mean a place could hit a wet bulb temperature of 35 C in different ways for instance, if the air is that temperature and theres 100 percent humidity, or if the air temperature is 46 C and theres 50 percent humidity. The difference is due to evaporative cooling.

When water evaporates from the skin or another surface, it steals away energy in the form of heat, briefly cooling that surface. That means that in drier regions, the wet bulb temperature where that ephemeral cooling effect happens readily will be lower than the actual air temperature. In humid regions, however, wet and dry bulb temperatures are similar, because the air is so moist its difficult for sweat to evaporate quickly.

So when thinking about heat stress on the body, scientists use wet bulb temperatures because they are a measure of how much cooling through evaporation is possible in a given climate, says Daniel Vecellio, a climate scientist at Penn State.

Both hot/dry and warm/humid environments can be equally dangerous, Vecellio says and this is where the bodys different cooling strategies come into play. In hot, dry areas, where the outside temperature may be much hotter than skin temperature, human bodies rely entirely on sweating to cool down, he says. In warm, humid areas, where the air temperature may actually be cooler than skin temperatures (but the humidity makes it seem warmer than it is), the body cant sweat as efficiently. Instead, the cooler air passing over the skin can draw away the heat.

Given the complexity of the bodys cooling system, and the diversity of human bodies, there isnt really a one-size-fits-all threshold temperature for heat stress for everybody. No ones body runs at 100 percent efficiency, Vecellio says. Different body sizes, the ability to sweat, age and acclimation to a regional climate all have a role.

Still, for the last decade, that theoretical wet bulb 35 C number has been considered to be the point beyond which humans can no longer regulate their bodies temperatures. But recent laboratory-based research by Vecellio and his colleagues suggests that a general, real-world threshold for human heat stress is much lower, even for young and healthy adults.

The researchers tracked heat stress in two dozen subjects ranging in age from 18 to 34, under a variety of controlled climates. In the series of experiments, the team varied humidity and temperature conditions within an environmental chamber, sometimes holding temperature constant while varying the humidity, and sometimes vice versa.

The subjects exerted themselves within the chamber just enough to simulate minimal outdoor activity, walking on a treadmill or pedaling slowly on a bike with no resistance. During these experiments, which lasted for 1.5 to two hours, the researchers measured the subjects skin temperatures using wireless probes and assessed their core temperatures using a small telemetry pill that the subjects swallowed.

In warm and humid conditions, the subjects in the study were unable to tolerate heat stress at wet bulb temperatures closer to 30 or 31 C, the team estimates. In hot and dry conditions, that wet bulb temperature was even lower, ranging from 25 to 28 C, the researchers reported in the February Journal of Applied Physiology. For context, in a very dry environment at about 10 percent humidity, a wet bulb temperature of 25 C would correspond to an air temperature of about 50 C (122 F).

These results suggest that there is much more work to be done to understand what humans can endure under real-world heat and humidity conditions, but that the threshold may be much lower than thought, Vecellio says. The 2010 studys theoretical finding of 35 C may still be the upper limit, he adds. Were showing the floor.

And thats for young, healthy adults doing minimal activity. Thresholds for heat stress are expected to be lower for outdoor workers required to exert themselves, or for the elderly or children. Assessing laboratory limits for more at-risk people is the subject of ongoing work for Vecellio and his colleagues.

If the human bodys tolerance for heat stress is generally lower than scientists have realized, that could mean millions more people will be at risk from the deadliest heat sooner than scientists have realized. As of 2020, there were few reports of wet bulb temperatures around the world reaching 35 C, but climate simulations project that limit could be regularly exceeded in parts of South Asia and the Middle East by the middle of the century.

Some of the deadliest heat waves in the last two decades were at lower wet bulb temperatures: Neither the 2003 European heat wave, which caused an estimated 30,000 deaths, nor the 2010 Russian heat wave, which killed over 55,000 people, exceeded wet bulb temperatures of 28 C.

How best to inform the public about heat risk is the part that I find to be tricky, says Shandas, who wasnt involved in Vecellios research. Shandas developed the scientific protocol for the National Integrated Heat Health Information Systems Urban Heat Island mapping campaign in the United States.

Its very useful to have this physiological data from a controlled, precise study, Shandas says, because it allows us to better understand the science behind humans heat stress tolerance. But physiological and environmental variability still make it difficult to know how best to apply these findings to public health messaging, such as extreme heat warnings, he says. There are so many microconsiderations that show up when were talking about a bodys ability to manage [its] internal temperature.

One of those considerations is the ability of the body to quickly acclimate to a temperature extreme. Regions that arent used to extreme heat may experience greater mortality, even at lower temperatures, simply because people there arent used to the heat. The 2021 heat wave in the Pacific Northwest wasnt just extremely hot it was extremely hot for that part of the world at that time of year, which makes it more difficult for the body to adapt, Shandas says (SN: 6/29/21).

Heat that arrives unusually early and right on the heels of a cool period can also be more deadly, says Larry Kalkstein, a climatologist at the University of Miami and the chief heat science advisor for the Washington, D.C.based nonprofit Adrienne Arsht-Rockefeller Foundation Resilience Center. Often early season heat waves in May and June are more dangerous than those in August and September.

One way to improve communities resilience to the heat may be to treat heat waves like other natural disasters including give them names and severity rankings (SN: 8/14/20). As developed by an international coalition known as the Extreme Heat Resilience Alliance, those rankings form the basis for a new type of heat wave warning that explicitly considers the factors that impact heat stress, such as wet bulb temperature and acclimation, rather than just temperature extremes.

The rankings also consider factors such as cloud cover, wind and how hot the temperatures are overnight. If its relatively cool overnight, theres not as much negative health outcome, says Kalkstein, who created the system. But overnight temperatures arent getting as low as they used to in many places. In the United States, for example, the average minimum temperatures at nighttime are now about 0.8 C warmer than they were during the first half of the 20th century, according to the countrys Fourth National Climate Assessment, released in 2018 (SN: 11/28/18).

By naming heat waves like hurricanes, officials hope to increase citizens awareness of the dangers of extreme heat. Heat wave rankings could also help citiestailor their interventions to the severity of the event.Six cities are currently testing the systems effectiveness: four in the United States and in Athens, Greece, and Seville, Spain.On July 24, with temperatures heading toward 42 C, Seville became the first city in the world to officially name a heat wave, sounding the alarm for Heat Wave Zoe.

As 2022 continues to smash temperature records around the globe, such warnings may come not a moment too soon.

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Humans may not be able to handle as much heat as scientists thought - Science News Magazine

Maryland fishing competition aims to collect invasive fish for research – CBS News

BALTIMORE -- An assistant professor of physiology at Salisbury University has received a grant to host a fishing competition from the Maryland Department of Natural Resources, according to state officials.

Dr. Noah Bressman will use the money to host a blue catfish and snakehead tournament on the Nanticoke, Marshyhope, and associated tributaries on July 30, state officials said.

Entry into the tournament is free and there will be prizes for participants, according to state officials.

The goal of the tournament is to collect specimens for research.

Bressman's lab will study the diet, growth, and reproduction habits of the fish. Also, his lab will conduct experiments on the fish bodies, according to state officials.

The state grant aims to educate the public on invasive species and encourage people to catch, kill, and eat them, state officials said.

People can fish wherever they like along the tributaries but the weigh-in for the event will be in Sharptown at the Cherry Beach Boat Launch, according to state officials.

A Maryland Tidal Fishing License is required for participants 16 years old and older, according to a flyer advertising the competition.

The CBS Baltimore Staff is a group of experienced journalists who bring you the content on CBSBaltimore.com.

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Maryland fishing competition aims to collect invasive fish for research - CBS News

The Unexpected Ingredient That Will Majorly Upgrade Your Fish Recipes – Mashed

Unless you're lucky enough to eat fish straight off the dock, it will have a certain level of "fishiness." But the odor isn't synonymous with the fish going bad; it's just science. Thanks to the physiology of fish, a compound called trimethylamine (TMA) is produced when fish die, which is responsible for that "fishy" smell.

According to Cook's Illustrated, soaking fish in milk for 20 minutes will neutralize and remove the offensive odor. The protein in milk, casein, binds to the TMA. After 20 minutes, the milk is drained, taking the TMA with it and leaving a sweet-smelling filet in its place. Susan Olayinka uses this method when preparing her pan-seared swordfish recipe. She notes that milk also tenderizes dense fish and leaves a mellower flavor. Just pat the fish dry and continue with your recipe.

Although freshwater fish, such as trout and catfish, don't get as "fishy" as ocean fish, they can have a "muddy" smell, which isn't pleasant either. Blue-green algaein surface waters where it's warm, shallow, and sunny can produce a toxin that penetrates the fish's skin, causing that smell. With these types of fish, adding an acid, such as lemon juice or vinegar, should remove any offensive odors, perNutrition.

Try this unexpected ingredient the next time you prepare salmon, shellfish, or even the uber-stinky bluefish. It'll save your home from smelling like fish, and maybe you'll convert your carnitarian at home, too.

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The Unexpected Ingredient That Will Majorly Upgrade Your Fish Recipes - Mashed

Let’s Talk About Pain | American Council on Science and Health – American Council on Science and Health

All sensation goes through four stages or processes; lets go through them in turn.

Transduction

Unlike localized, aggregated receptors of the eye (retina), ear (nerve endings of the cochlear nerve found in the middle ear), or tongue (taste buds), pain receptors, nociceptive nerve endings, are scattered throughout our body. They are like the proprioceptive receptors of touch and position. They respond to heat, mechanical deformation, and chemicals, often found in inflamed areas. The majority of studies involve pain receptors in the skin where we can create burns, cuts, or inflammation. The majority of our clinically significant pain is musculoskeletal or visceral (from our organs), and those studies are few and far between if they are to be found.

Transmission

The signal from the pain receptors, written like Morse code, as a pattern and frequency, travels from these peripheral sites to the more central spinal cord. At this point, the signal splits into two. One signal, remaining local, initiates a withdrawal reflex, a behavior. Burn your finger, and you withdraw your hand from the heat source. A second signal is sent upwards into areas within our brain. The two major sites are the thalamus and medial reticular formation of the brain stem. We will not be pursuing how those signals move about the brain; it is sufficient to know that further processing of those signals, and ultimately detection and identification of our perception of pain, occurs here.

This split of the signal means that most of our animal studies focus on pain identified as a behavior that reflex to noxious stimuli. But we have no accurate means of quantifying the signal traveling into the brain, no real way of measuring the experience of pain we must always speak in necessarily fuzzy terms, be it emojis or numbers, including morphine milligram equivalents.

Our other senses also create these split signals. For example, the visual receptors in the retina send a signal inward to convert that information about light and color into an image. Meanwhile, like the withdrawal reflex, behavioral reflexes respond to those retinal signals. The vestibulo-ocular reflex coordinates the position of your head with the incoming visual information keeping your image of the world stable despite the movement of your head and eyes.

Our senses also elicit an additional emotional (affective) response, our likes and dislikes regarding art, music, or food. Pain, on the other hand, is unidirectional; we want less of it and want it to go away. Pains emotional component acts more like a deep drive, say hunger, resulting in actions to terminate the noxious stimulus. When we hear music we do not like or a displeasing picture; we do not experience the same emotional, visceral, response. This is a crucial distinction between pain from our other senses

The biological duality between the sensory reflex of withdrawal and the more centrally formed emotional response makes measuring pain difficult. In a laboratory setting, we can define a sensory threshold for pain reception, the reflex; heating the skin between 43-46 C will elicit a pain response. But the tolerance of pain, the affective, emotional component, can vary widely.

The tolerance for pain is a complex function that may be modified by personality traits, attitudes, previous experience, economic factors, gender, and the particular circumstance under which the pain is experienced.

Modulation

As with all senses, our nervous system can up and down-regulate our affective experience of pain.

Consider that perennial summer favorite, the sunburn. The normally warm water of your evening shower on that sunburn is now suddenly more painful you are more sensitized to the experience of pain. When overly active, our sympathetic nervous system, our fight or flight system, causes us to experience a greater degree of pain. Makes sense that when we are already in a heightened state of fear, noxious stimuli will get additional attention and response.

Anxiety and stress are common reasons for sympathetic nervous system arousal. To some degree, this can create a self-fulfilling cycle; fear of pain increases our perception of pain, which in turn increases our fear. This may well explain the therapeutic benefits of adjunctive pain relief, like music, which reduces the sympathetic tone and down-regulates our experience of pain.

Neural pathways rather than pain receptors can also produce pain. Perhaps the most common example would be the pain after an episode of shingles a late result of having had chickenpox. While the acute pain of this often debilitating rash is due to the pain receptors in your skin, the chronic pain, which can last for months, is not. Post-herpetic neuralgia, its medical name, is a longer-term (up to six months or more in those over age 60) inflammation of the nerve pathways that can result in continued chronic pain long after the skin rash has disappeared.

Perception

These three processes, transduction, transmission, and modulation, come together to form our perceptional experience of pain. Because our perception of pain requires all three of these biological processes, all of which may differ from one individual to another. For a given painful stimulus, my experience of pain may well differ from yours, and my experience of that painful stimuli may vary over time.

When the rubber hits the road, What we have here is a failure to communicate.

We can listen to music, view the sunset, or experience a rough surface and have some basis to share and communicate those experiences. Pain, unlike those other senses, remains subjective; it is your experience, not mine. One of the great difficulties we have in medical care is finding a way to communicate our experience of pain. Unlike temperature or blood pressure, there is no convenient instrument or numerical value to quantify pain. Without the ability to quantify pain or at least place it on some shared scale, physicians are without guidance on treating pain effectively. In the not-so-distant past, to fill that communication void, physicians would substitute their experience of pain for the ambiguous description by the patient; or, more commonly, would follow the rule of thumb prescription taught to them by the intern or resident. [1]

Much of the consternation in the community of patients with chronic pain results from our biological inability to readily share our experience of pain. Patients are often left with rigid guidelines, a one-size-fits-all approach that clearly is incompatible with our understanding of pains biology. Or left with a physician, substituting their experience, training, and subjective beliefs about addiction, malingering, doing no harm, and serving the best interests of their patients, in prescribing treatment. That is why pain is both under and overtreated; despite all our scientific knowledge, the experience of pain remains a black box. We are all blind men seeking to describe the elephant.

What we have here is a failure to communicate. It neednt be the case, but getting into the mind of another is more difficult than we might think, especially in a healthcare system driven by the clock. Need proof? Look at how vehement the opposing views on any public concern where there is objective data we can all see, hear and touch

[1] Like an entire generation of physicians, I was taught that the routine treatment for post-operative pain was Demerol 75mg and Vistaril 50mg given every 3 to 4 hours by intramuscular injection. I learned this from my intern when I was a fourth-year medical student writing orders.

Sources: The Anatomy and Physiology of Pain National Library of Medicine

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Let's Talk About Pain | American Council on Science and Health - American Council on Science and Health

Westerly Hospital earns accreditation for services in emergency elderly care – The Westerly Sun

WESTERLY With about 23% percent of the town's population estimated to be at least 65, coupled with a nationwide aging trend, officials at Westerly Hospital anticipate the number of seniors seeking emergency care to grow. With that in mind the facility, along with all others in the Yale New Haven Health system, recently earned special geriatric accreditation.

Westerly Hospital and seven other facilities in the Yale New Haven Health system are now among a small group of health systems across the country to receive the American College of Emergency Physicians' Health System Geriatric Emergency Department accreditation designating the eight facilities as senior friendly.

The Westerly Hospital Emergency Department saw 11,234 individuals who were 65 or older in 2021 which accounted for 56% of the hospital's emergency department volume. According to the U.S. Census Bureau, slightly more than 23% of Westerly's population is at least 65. The demographics in Washington and New London counties are similar but both have slightly lower percentages of adults who are 65 or older.

To earn the accreditation staff and emergency department leads at Westerly Hospital and the other facilities underwent training to sharpen their focus on the physiological differences between seniors and other patients. Clinicians in the Emergency Department also learned about and have begun to use the Confusion Assessment Method screening tool for delirium. The tool helps clinicians determine whether a patient is presenting with traits associated with normal aging, dementia, or delirium, which can signal "a new onset illness," said Niki Akaka, a registered nurse and clinical coordinator, during a recent interview at Westerly Hospital.

The Confusion Assessment Method involves clinicians asking patients more than 65 questions. Determining whether a patient is experiencing delirium caused by an underlying ailment can be critical, said Bethany Gingerella, Westerly Hospital nurse manager. "If the result of the screening tool is positive for delirium we dig a little deeper to see if there is an infection that we might not be seeing," Gingerella said.

With individuals 85 and older expected to increasingly make up a major segment of those treated in emergency departments, Dr. Nader Bahadory, medical director of the Westerly Hospital Emergency Department, said physicians and other medical providers look to educate each other on health challenges seniors face.

"They are a special population because their physiology is a little different. There has been a realization at least for a few years that we need to figure out their physiology because we tend to miss subtle things among these elderly patients...they can get really sick fast and it's often a very subtle beginning," Bahadory said.

To attain the accreditation the hospital also worked on establishing an optimal environment for seniors by ensuring room lights can be dimmed to improve vision and reduce anxiety. The facility also ensured an adequate number of walkers and canes are available, and dietary staff were asked to help develop meals that are likely to appeal to seniors. "Eating is a big thing with them. We don't want them not to eat when they are with us," Gingerella said.

Amplification devices are available for doctors and nurses working with seniors whose hearing is diminished and magnifying devices are available for seniors who need the assistance for reading. Clinicians also consult with hospital pharmacists to check for potential problems tied to drug interactions.

In all, the Geriatric Emergency Department program provides specific criteria and goals for emergency clinicians and administrators to target. The accreditation process provides more than two dozen best practices for geriatric care. The goal is successful treatment, returning seniors to their homes, and determining whether they need new support, Bahadory said

As part of the accreditation process the hospitals are auditing charts and sending data to the American College of Emergency Physicians for review and recommendations.

The other facilities in the Yale system to receive the accreditation are Lawrence + Memorial in New London, Pequot Health Center in Groton, Bridgeport (Milford and Bridgeport campuses), Greenwich, Yale New Haven (York Street and Saint Raphael campuses) and Shoreline Medical Center in Guilford.

The designation has been awarded to just 13 health systems nationwide.

Each year in the United States, adults aged 50 years and older make more than 40 million visits to an emergency department, according to a news release from Yale New Haven Health.

"We know that older people seeking care in the emergency department have unique needs to address symptoms and requirements that are specific to their age group, said Dr. Ula Hwang, professor of Emergency Medicine at Yale School of Medicine and an attending physician at Yale New Haven Hospital. "Through this accreditation process our providers are trained to look for signs and symptoms of syndromes and illness in the elderly that could be potentially life threatening if left untreated.

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Westerly Hospital earns accreditation for services in emergency elderly care - The Westerly Sun

Obesity in America: Seeking answers to nation’s overweight epidemic – USA TODAY

More than 4 in 10Americans now fit the medical definition for having obesity, putting them at risk for serious health problems, including diabetes, heart disease and some types of cancer.The pandemic increased the stakes. In its first year, nearly one-third of severe COVID-19 cases were blamed on excess weight.

USA TODAY decided to take a look at how Americas weight has been changing in recent years, including advances in treatments and the scientific understanding of obesity. We spoke with more than 50 experts in nutrition, endocrinology, psychology, exercise physiology and neuroscience and people who are intimately familiar with the challenges of extra pounds.

The answers arent simple.

But they get to the essence of America: our issues with race, stigma, personal responsibility, economic stability and the power of corporations.

Many people feel shame and guilt when they can't lose weight. Human biology, which evolved to hold onto extra calories, makes it extremely tough to lose weight on your own. Help is hard to find, but it is out there.

Obesity was long considered a personal failing. Science shows it's not.

Despite rising rates of overweight and obesity,the stigma of excess weight remains in virtually every aspect of society. Some people are fighting back, but it isn't easy to counter decades of stereotyping and falsely simple solutions.

Extra weight increases health risk in the long run. Fat shaming hurts now.

Biology makes it hard to lose weight. Our food environment makes it very easy to add excess pounds. What to eat if you're trying to shed that extra weight or avoid unnecessary pounds? Scientists are still searching for answers.

What we eat matters. Researchers are still searching for the 'best' diet.

Extra weight is often considered a personal failing, but lots of factors beyond an individual's power contribute to weight gain,including food deserts, the cost of healthy food, stress and prejudice. The situation isn't hopeless.

Americans don't choose to be fat. Many live within a 'system they don't control.'

Until recently, the only way to lose a substantial amount of weight was through surgery. New medications promise to change that,offering the possibility of shedding 15% to more than 20% of excess pounds. The challenge will be making these medicationsavailable to those who want them.

New drugs and surgery can deliver major weight loss. But they come at a cost.

Any solutionwill have to start with children, experts say. Starting almost from birth, kids learnpatternsthey follow for the rest of their lives, so there's a lot at stake in teaching them to eat healthy, exercise regularly and get enough sleep.

How will the obesity epidemic end? With kids.

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Obesity in America: Seeking answers to nation's overweight epidemic - USA TODAY