This study examined survey data and neural reactivity associated with voluntarily engaging in high arousal negative experiences (VANE). Here we suggest how otherwise negative stimuli might be ...experienced as positive in the context of voluntary engagement. Participants were recruited from customers who had already purchased tickets to attend an "extreme" haunted attraction. Survey data measuring self-report affect, expectations, and experience was collected from 262 adults (139 women and 123 men; age M = 27.5 years, SD = 9.3 years) before and after their experience. Changes in electroencephalographic (EEG) indices of reactivity to cognitive and emotional tasks were further assessed from a subsample of 100 participants. Results suggested that participants' reported affect improved, particularly for those that reported feeling tired, bored, or stressed prior to the experience. Among those whose moods improved, neural reactivity decreased in response to multiple tasks. Together, these data suggest that VANE reduces neural reactivity following stress. This result could explain post-VANE euphoria and may be adaptive in that it could help individuals to cope with subsequent stressors. To the extent that this phenomenon replicates in clinical situations, it could inform clinical interventions by using VANE principles to reduce neural reactivity to subsequent stressors.
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CEKLJ, FFLJ, NUK, ODKLJ, PEFLJ, UPUK
Background: In this study, we compare management of patients with high-risk chronic obstructive pulmonary disease (COPD) in the United States to national and international guidelines and quality ...standards, including the COllaboratioN on QUality improvement initiative for achieving Excellence in STandards of COPD care (CONQUEST). Methods: Patients were identified from the DARTNet Practice Performance Registry and categorized into three high-risk cohorts in each year from 2011 to 2019: newly diagnosed (≤12 months after diagnosis), already diagnosed, and patients with potential undiagnosed COPD. Patients were considered high-risk if they had a history of exacerbations or likely exacerbations (respiratory consult with prescribed medication). Descriptive statistics for 2019 are reported, along with annual trends. Findings: In 2019, 10% (n = 16,610/167,197) of patients met high-risk criteria. Evidence of spirometry for diagnosis was low; in 2019, 81% (n = 1228/1523) of patients newly diagnosed at high-risk had no record of spirometry/peak expiratory flow in the 12 months pre- or post-diagnosis and 43% (n = 651/1523) had no record of COPD symptom review. Among those newly and already diagnosed at high-risk, 52% (n = 4830/9350) had no evidence of COPD medication. Interpretation: Findings suggest inconsistent adherence to evidence-based guidelines, and opportunities to improve identification, documentation of services, assessment, therapeutic intervention, and follow-up of patients with COPD. Funding: This study was conducted by the Observational and Pragmatic Research Institute (OPRI) Pte Ltd and was partially funded by Optimum Patient Care Global and AstraZeneca Ltd. No funding was received by the Observational & Pragmatic Research Institute Pte Ltd (OPRI) for its contribution.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
In this study, we compare management of patients with high-risk chronic obstructive pulmonary disease (COPD) in the United States to national and international guidelines and quality standards, ...including the COllaboratioN on QUality improvement initiative for achieving Excellence in STandards of COPD care (CONQUEST).
Patients were identified from the DARTNet Practice Performance Registry and categorized into three high-risk cohorts in each year from 2011 to 2019: newly diagnosed (≤12 months after diagnosis), already diagnosed, and patients with potential undiagnosed COPD. Patients were considered high-risk if they had a history of exacerbations or likely exacerbations (respiratory consult with prescribed medication). Descriptive statistics for 2019 are reported, along with annual trends.
In 2019, 10% (n = 16,610/167,197) of patients met high-risk criteria. Evidence of spirometry for diagnosis was low; in 2019, 81% (n = 1228/1523) of patients newly diagnosed at high-risk had no record of spirometry/peak expiratory flow in the 12 months pre- or post-diagnosis and 43% (n = 651/1523) had no record of COPD symptom review. Among those newly and already diagnosed at high-risk, 52% (n = 4830/9350) had no evidence of COPD medication.
Findings suggest inconsistent adherence to evidence-based guidelines, and opportunities to improve identification, documentation of services, assessment, therapeutic intervention, and follow-up of patients with COPD.
This study was conducted by the Observational and Pragmatic Research Institute (OPRI) Pte Ltd and was partially funded by Optimum Patient Care Global and AstraZeneca Ltd. No funding was received by the Observational & Pragmatic Research Institute Pte Ltd (OPRI) for its contribution.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The COllaboration on QUality improvement initiative for achieving Excellence in STandards of COPD care (CONQUEST) aims to improve the quality of COPD care in primary care. The CONQUEST target ...population includes patients diagnosed with COPD, and those undiagnosed but with COPD-like exacerbations, who are at high but modifiable risk of COPD exacerbations, increased morbidity, and mortality. Timely diagnosis and optimized management to reduce these risks is vital. There is a need for a quality improvement program (QIP) that enables long-term improvement of patient clinical outcomes via integration of the program into routine clinical care. Core to the CONQUEST program is the adoption of four specifically designed, globally applicable, and expert-agreed quality standards (QS) for modifiable high-risk COPD patients. Translation of the QS into clinical practice, and implementation of the QIP, is guided by the CONQUEST global operational protocol provided to sites meeting the minimum healthcare system requirements. Initial analyses of current practices are conducted to generate baseline assessments of need within healthcare systems and sites looking to implement the QIP. Implementation is supported by the provision of CONQUEST resources and tools, such as clinical decision support, that promote prompt identification and treatment of patients. Utilization of electronic medical record (EMR) and patient-reported data are integral components of the QIP. Regular, automated collection and analysis of data, combined with a cyclical review of the implementation process, will be conducted for long-term, continuous improvement and health impact evaluation. The CONQUEST QIP will be an important resource in the identification and management of patients with modifiable high-risk COPD. Embedding the CONQUEST QS into routine clinical practice with regular evaluation and feedback will result in long-term quality of care improvement. Keywords: patient-reported outcome, patient-reported information, clinical decision support, primary care, quality standards, integrated care
...infrasound, sound waves of 20 hertz or less, mostly inaudible to the human ear. Over the past 20 years, fMRI and EEG studies of Tibetan monks, Carmelite nuns, psychics and the hyper-religious have ...revealed the neurological manifestations of mystical experiences. ...those who suffer from temporal lobe epilepsy have reported experiences comparable to supernatural encounters, including feelings of heightened spirituality, a "sensed presence" and euphoria collectively known as Gastaut-Geschwind syndrome.
...infrasound, sound waves of 20 hertz or less, mostly inaudible to the human ear. Over the past 20 years, fMRI and EEG studies of Tibetan monks, Carmelite nuns, psychics and the hyper-religious have ...revealed the neurological manifestations of mystical experiences. ...those who suffer from temporal lobe epilepsy have reported experiences comparable to supernatural encounters, including feelings of heightened spirituality, a "sensed presence" and euphoria collectively known as Gastaut-Geschwind syndrome.
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