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Showing posts with label sports. Show all posts
Showing posts with label sports. Show all posts

Monday, March 23, 2020

Anxiety about coronavirus can increase the risk of infection — but exercise can help

Anxiety about coronavirus can increase the risk of infection — but exercise can help



Stress about the coronavirus pandemic can actually increase your risk of infection, but exercise can alleviate the immune system’s stress response. Above, a lone jogger in Ottawa, on March 17, 2020. THE CANADIAN PRESS/Adrian Wyld
Jennifer J. Heisz, McMaster University
Worried about COVID-19? You may be putting yourself at undue risk, because chronic anxiety suppresses the immune system and increases our risk for infection.
The psychological impact of the COVID-19 pandemic is causing incredible distress. I ran into a friend at the grocery store the other day. She was wiping down her cart with antiseptic. Under normal circumstance, this behaviour would seem bizarre, but in the current COVID-19 climate, it has become acceptable.
Although it is important to be prepared during this pandemic, we do not need to panic. Physical activity can help protect the immune system from the effects of stress.

Fear of the unknown

As an associate professor in the department of kinesiology at McMaster University, I direct a team of researchers in the NeuroFit Lab, where we’ve shown that psychological distress can compromise mental health.
Anxiety about the unknown (such as our risk of COVID-19) can hyperactivate the fear centre in the brain called the amygdala. In terms of evolution, this is one of the oldest parts of the brain and its operations are quite primitive; it acts like a trigger-happy alarm that interfaces with the stress system to keep our body and mind on high alert for as long as we are feeling anxious. Research shows that the mere suggestion of danger, even if it never is experienced, is enough to trigger the amygdala and activate the stress response. This is what keeps people awake at night, lying in bed worrying about COVID-19.
The problem is that chronic activation of the stress systems can damage our cells and upset many of the body’s functions. Our immune system bears the brunt. Although psychological stress is not pathogenic per se, the damage it causes to the body’s cells triggers an immune response that makes us more susceptible to a foreign pathogen. This may increase our risk for infection with SARS-CoV-2, the coronavirus that causes COVID-19.

Worried sick

The immune system acts like border security, patrolling the body for cells that are foreign and harmful to it. It works a lot like the Nexus or Global Entry programs for pre-approved travellers; anyone enrolled in the program has their iris scanned to quickly confirm their identity for fast border crossing. But instead of iris scanning, the immune system scans the outer surface of a cell for its biological passport, or what scientists call a motif.
The body’s cells have a motif (a “self” motif) that’s different from the “non-self” motif of foreign cells and pathogens, like SARS-CoV-2. This non-self motif is known as a pathogen-associated molecular pattern (PAMP).


Concerns about COVID-19 led crowds to stock up on supplies. Here, people line up at a Costco in Ottawa on March 13, 2020. THE CANADIAN PRESS/Justin Tang

Another type of motif is the “damaged self” motif, known as a damage-associated molecular pattern, or DAMP. This motif is expressed by a damaged or dying cell that no longer serves the body. Stress damages the body’s cells, transfiguring self motifs into damaged self motifs. This elevates inflammation throughout the body in a similar way as if it were infected. This response, in the absence of an actual infection, is called a sterile immune response.
Chronic over-worrying about COVID-19 can intensify our vulnerability to viruses by creating an imbalance in immune function. This is because the immune system reacts to multiple breaches in immunity in a similar way that airport security reacts to multiple breaches in safety, by escalating the response. Think back to how vigilant airport security became after 9/11, implementing the strictest screening procedures for all passengers and luggage.

Read more: Coronavirus weekly: expert analysis from The Conversation global network

Excessive anxiety about COVID-19 can trigger an immune response that increases inflammation and readies the immune system’s equivalent of special forces, known as inflammasomes. If SARS-CoV-2 acts like other viruses, then upon infection the inflammasomes will be called to action to escalate inflammation even further. But too much inflammation does more harm than good; it deregulates immune function, increasing our risk of a viral infection.
My lab recently demonstrated how quickly our health declines under chronic stress. We tracked sedentary but otherwise healthy students during the weeks leading up to their final exams, and we observed how six weeks of stress gave rise to the symptoms of depression.

Resisting the effects of anxiety

What can we do to prevent panic and bolster immune protection?
Physical activity can protect your body from chronic stress-induced inflammation.
In our study, during that same stressful six-week period, we enrolled some of the students in a new exercise program in which they cycled on a stationary bike at moderate intensity for approximately 30 minutes, three times per week. Moderate intensity exercise is about 40 per cent of maximum workload: the point at which someone can still talk, but can’t sing.
Blood samples were collected to track changes in inflammation. Although the exercisers were exposed to the same psychological stressors as the sedentary students, their inflammation remained low and their mood remained high with no increase in symptoms of anxiety or depression.
But the intensity of the exercise mattered. Higher intensity exercise was not as effective at protecting mental health or reducing inflammation. The vigorous nature of the intense exercise may have exacerbated an already stressed-out system, especially in individuals who were not accustomed to exercise.
The key take-away from our research: a brisk walk, jog or bike ride can help keep you calm and healthy during these uncertain times so you can be prepared without the panic.The Conversation
Jennifer J. Heisz, Associate Professor in Kinesiology and Associate Director (Seniors) of the Physical Activity Centre of Excellence, McMaster University
This article is republished from The Conversation under a Creative Commons license. Read the original article.

Wednesday, November 12, 2014

Mindfulness Based Stress Reduction: Learn online or from an actual human teacher?

Around 40 years ago, I studied with one of the greatest Tai Chi Ch'uan masters of the last century,  Cheng Man-ch'ing. The thing is, I never studied with him in person. I had his book, which was illustrated with photographs of him doing the movements; The Golden Pheasant Stands On One Leg, Grasp The Sparrow's Tail, The Crane Spreads It's Wings, Step Forward to the Seven Stars of the Dipper, Snake Creeps Down, The Fairy Weaving at the Shuttle, etc. By looking in a mirror I thought I was able to string together a series of movements. Wrong!  I was only twisting and hurting my back and other places doing the exercises. Seven years later I met a Tai Chi Ch'uan teacher and the realization that this ancient art can only be learned by being passed down from teacher to student.

That was before the age of the ubiquitous computer. Nowadays I can watch Tai Chi instructional videos on Youtube all day. I can even switch to other physical activities and watch instructional videos about how to improve my tennis forehand. Ultimately though, I need to really practice the actual art or sport in order to derive any benefit. To really improve at all I should practice with a teacher or coach. There comes a time when we do need to meet human instructors in person to really learn. This is especially true for some of the physiotherapy exercises you can watch on Youtube because I think it is be better to have a physiotherapist prescribe the exercises.  I do know a Tai Chi practitioner who learned the Chan form of Tai Chi by watching videos he had borrowed. He was exceptional in that he already knew and practiced many other of the Tai Chi forms. And this brings me to Mindfulness Based Stress Reduction (MBSR) learning online.

Before I comment about what it is like to learn MBSR online, let's look at the movie the Matrix. If you have seen the movie, you know that when Neo was hooked-up into the Matrix, he learned and later mastered Kung-fu, in addition to several other martial arts, at the speed of digital data transfer and integration into programming. That would be the epitome of hooked-up online learning. The next computerized training ground, that is not science fiction, maybe be Oculus Rift, a newer virtual reality headset that brings into visual perception an immersion experience of three dimensions.

It wasn't that long ago, virtually since the dawn of the WWW, when educators had to face the dilemma of evaluating whether or not one can learn just as well by studying online as one could in a classroom. We can see now how technology, even in science fiction, has grown exponentially to make online learning as common as the air that we breath. That is why before MOOCs there were online courses where you could even get a BA or a college diploma - a real one - without almost seeing a human in person. These initial studies had to look at usability, user interface and digital literacy. They had to research even cognitive measures, how the mind pays attention to a screen, visual studies on effects on the eyes, even worries about the health effects of Wi-Fi wireless transmissions. Anyway, eLearning has made it's mark, and it is going to stick around for a long time.

I have been practicing meditation for many years so I knew about MBSR and the research that has been developed on meditation in neuroscience and medicine. There have been research studies on the effectiveness of meditation not only from Jon Kabat-Zinn, founder of MBSR, but also from Herbert Benson, Richard Davidson, and so many others. I knew that the Buddhist monk Matthieu Ricard (in picture here at left) was in Davidson's fMRI and EEG studies on compassion and the meditating brain.  Just yesterday a new article on the benefits of MBSR and Tai Chi exercise for healing those surviving from breast cancer appeared on the Kurzweil Accelerating Intelligence website.  Cheng Man-ch'ing is smiling and proven right again, as Tai Chi really helped helped him recover from illness.

I have admired the work Jon Kabat-Zinn for many years, though I had never studied his works - until now. I am e-Learning my way through a free online 8 week course based on MBSR, about how it was developed and delivered, as well as the benefits for health that the research has shown.  Before I only knew about the benefits his teachings were having on those in palliative care or who were diagnosed with chronic illness - the meditation as healing medicine model - stress is the silent killer.  I also liked the secular, or one might say, the scientific approach. Now that I have been taking the MBSR course, I really have no qualms about doing so without a human for guidance. This is mostly due to my own experience and learning from meditation teachers, going on retreats, reading, and doing daily practice. I have also studied Buddhism in India, Nepal and Korea. Can't really say that I ever learned meditation before through an online interface. Call me misguided if you will, but I trust my instincts. Well, I did learn Vipassana in a semi-remote sort of way.

Many of the basic techniques in MBSR come from a meditation practice called Vipassana, or insight meditation. The main focus is on watching the breath or mindful awareness of breathing, called Anapanasati in Sanskrit. I did an 11 day Vipassana retreat in Massachusetts taught by S. N. Goenka from Burma. He was not there, but he may as well have been, because they used videos and tapes in the meditation hall to present the instructions. He has many other centres around the world. I thought it was very effective, even though my previous experience with meditation teaching was  learning discipline by sitting at the feet of the masters. This is the main reason why I feel confident in doing an 8 week online MBSR course. Another reason is that the course is exceptionally well designed with guided meditations, readings, video instructions, research articles, teachers with lots of experience- the whole works.  I will provide the link to The MBSR online course that I am following at the end of this post. The online course I am taking is free, but I have looked around and seen some that are not. That 11 day Vipassana course I took in Massachusetts, which including a place to sleep and food, was also free. You give "dana" according to what you think you can.

Generally speaking I would always advise studying with a human presence for a traditional discipline that has been past down for generations, if not millennium. The Tibetan people call the Dali Lama "Kundun", which means "The Presence". Call me a conservative in this respect, but there are just too many subtle things that can go wrong without the guidance of a teacher. On the other hand, I am very, very impressed with the secular or scientific approach of Kabat-Zinn in the design and delivery of the MBSR course.  It would be great however to take the course from him or some of his qualified fellow instructors in person, and I have looked around and there centers and courses locally where it is taught. It is all over the map now.

One criticism I have is learning some basic yoga exercises online, which is one part of the overall MBSR program. Listening or watching videos of yoga postures, and trying to follow along, creates risks of injury, for practitioners of any age. Injury can happen even in a center where a teacher is present, but the presence of the teacher is more reassuring. Learning dynamic movements or mental training is not like reading a book; it is immersive, interactive and interpersonal.  When I was trying to learn Tai Chi Ch'uan from the Cheng Man-ch'ing book by looking in a mirror, I developed aches and pains from unusual twisting of my body. Something similar is happening as I am lying on the floor receiving audio instructions on yoga postures. OK, maybe blame myself for not being careful.  I heard once that physiotherapists are getting a lot of business from people who are just taking up yoga. There are a lot of not so qualified instructors out there. To be fair, there may also be a lot of people who may not have realistic expectations about how to train properly and do not know their limits.

In fact after I took the MBSR online course and kindly received my certificate, Dave Potter changed the yoga links to emphasis watching the videos over listening to the audio. Hopefully this will make remote learning easier for people, who may not have the added benefit of prior experience doing yoga or having an instructor or someone with experience for guidance.

The online MBSR course I am taking is here:
http://palousemindfulness.com/selfguidedMBSR.html
















Monday, August 13, 2012

Public Health Syndromic Surveillance at the London 2012 Olympics

In my M.Sc. eHealth degree I took a course where I dipped my toes into the murky depths of public health informatics.  This article on syndromic surveillance at the London 2012 Olympics just touches on the panoply of data sources now available to track and predict disease outbreaks:
http://www.popsci.com/science/article/2012-07/how-it-works-worlds-largest-health-surveillance-system


How The Largest Health Surveillance System Ever Created Is Preventing An Olympic-Size Pandemic

How do you tell if a flu is dangerous enough to bring down the Olympics? Map diseases in real-time, throughout the entire country

From a Public Health Perspective, the Olympics Can Be a Dangerous Place Athlete's at the 2009 Mexican National Olympics wear masks to protect themselves from an outbreak of swine flu.

Right now in London and various sites around the UK, more than half a million international travelers are sharing stories, beers, doner kebabs, close living quarters and--let’s be frank--the occasional mattress. Roughly 17,000 athletes and officials from hundreds of countries are packed into the Olympic Village alone, and that doesn’t take into account the spectators--more than 8 million tickets will be punched at the Games--who have piled on top of greater London’s nearly 8 million inhabitants. Culturally speaking, it’s a marvel that we can do this and all get well enough along. Epidemiologically speaking, it’s a nightmare scenario.

An international gateway city like London is certainly no stranger to the comings and goings of large numbers of people, but when this many people settle into close proximity over an extended period--eating the same things and sharing the same spaces for several days or weeks at a time--it’s the perfect recipe for pathogen outbreaks. A microorganism that might be fairly benign in one part of the world can blossom among a population with low immune resistance. Food-borne illnesses threaten at every food stall. Something flu-like, that spreads through normal human contact, could potentially clean house.

The key to maintaining the public health during something as massive as the Olympic Games isn’t battling every individual bug but quickly containing any pathogen that does get loose in the population, and to do this the UK’s Health Protection Agency (HPA) has developed what is being billed as “the world’s largest health surveillance system.” By rapidly meshing many different streams of information pouring in from hospitals, general practitioners, clinics, infirmaries, and health care hotlines across the UK, the HPA has developed a way to measure and monitor the public health in near-realtime, ensuring that any pathogen outbreak is quickly identified, diagnosed, and contained before the whole of London comes down with the sniffles--or worse.

While the HPA’s system is imperfect, stitched together from a mash-up of pre-existing information channels (reports emailed and phoned in to regional health authorities), and newer, digital data streams (online systems that beam anonymized patient data from hospital databases to authorities automatically), it's likely the most ambitious public health monitoring system ever deployed. It’s not just a model for future Olympic Games, but for the future in general; as global populations continue to swell and our urban centers become both larger and more connected, systems like this will help cities and states keep vigilant watch on their people's collective health. Here’s how it works.

SYNDROMIC SURVEILLANCE

"In this kind of epidemiology, timeliness trumps complete data sets. The threat picture is constantly evolving."The HPA has collected certain kinds of data from hospitals, clinicians, and general practitioners for some time now, but to be truly useful the data needs to be centralized as quickly as possible. To that end, the HPA has automated as much of the data flow as was feasible for the 2012 games. Anonymized diagnostic data now pours in from emergency rooms and hospital labs in realtime via automated systems--when nurses and doctors enter a patient’s information into their in-house computer systems, an anonymized report is automatically generated and sent to the HPA immediately. The HPA has also asked doctors around the country to include a notation in such reports for Olympics links, designating the patient as an athlete or coach, a staffer, a spectator, or someone who has otherwise been in or around an Olympic venue. Even in cases where doctors cannot diagnose an infectious illness, the HPA has created a means of cataloging the symptoms and defining as much as possible the condition, allowing it to identify new or emerging infectious diseases that haven't been seen before.

This near-realtime clinical data builds the foundation of what becomes an evolving threat picture. The HPA models include data from hospital labs as it streams in over the Web via a secure system called CoSurv, but the models don't wait for lab work (which can take hours or days to process) to begin painting that picture. Clinicians have been put on alert for a spcific list of infectious diseases (authorities are actually particularly concerned about food borne illnesses, as stomach bugs can spread with impunity in close quarters like the Olympic village--just look at historical examples of cruise ship outbreaks for an example of this) as well as symptoms of chemical contamination. When they see symptoms of any of these they report them to the HPA immediately based on clinical (rather than lab) diagnosis. In this kind of epidemiology, timeliness trumps complete data sets. The threat picture is constantly evolving as more and better data comes in (from the lab, for instance), but that the HPA is always working from the most immediate information it can get.

For the HPA, that paints a pretty decent picture of what’s happening in hospital wards, but to fill in the holes in their canvas officials there wanted more data from alternative sources--general practitioners, walk-in clinics, or people calling into national health hotlines--that aren’t plugged into the same system. This data isn’t quite so automated--generally doctors or hotline operators have to phone or email it in to the HPA--but it adds another layer geographically-relevant symptomatic data to the HPA’s ongoing assessment.

IF THERE'S AN OUTBREAK


Say a clinic in East London begins showing a spike in incidences of extreme stomach pain and nausea that is considered above normal levels for this kind of illness. This symptom data passes through the HPA's regional office first, and a flag goes up. Perhaps it's an anomaly, but now it's on the authorities' radar. This data travels on to the HPA's West Midlands office where it is fed into an algorithm-based computing system that quickly extrapolates the overall public health picture of the UK at that moment. Here, the system notes that a spike in similar symptoms has been reported at Weymouth and Portland on the South Coast, where the sailing events are held. The system makes connections between the two; a potential outbreak of some kind of stomach-pain inducing pathogen is brewing. Health authorities are now on alert.

As one day turns over to the next, more data comes streaming in from both regions. In East London, it turns out several members of a large tour group dining at the hotel restaurant got ahold of some salmonella. On the south coast, a bout of stomach flu is circulating among some locals unrelated to the Olympics--a blessing, since Olympic athletes, staff, and spectators are doing a lot of traveling around. The cases are unrelated and crisis is averted, but the important thing is that the HPA and other health authorities were able to connect the dots almost immediately and take precautions. By centralizing symptom and diagnostic data and running it through these algorithms, the HPA can not only monitor the entire UK at once, but can identify trends, outliers, and abnormalities in the public well being with unprecedented speed.

Computationally speaking, this is tough work. A very small and mostly harmless incidence of a rare pathogen might raise an immediate statistical flag while a potentially hazardous symptomatic change in a known pathogen might fall within the statistical “safe zone” while actually representing the greater threat. The algorithms try to mitigate for these kinds of statistical problems, and as algorithms do, they will get better via time and testing. For now, they provide the best rolling picture of an entire nation’s realtime health that authorities have ever seen.


The Health Protection Agency is Monitoring the UK's Health Around the Clock for the Olympics:  Courtesy Health Protection Agency

BETTER DATA, BETTER HEALTH


While the HPA’s system is far from flawless--relying on general physicians and nurses to phone in symptom reports not only opens the door to under-reporting but also pulls them away from their primary jobs--it is an ambitious attempt to leverage the power of Big Data into better public health. It’s a fairly strong argument for the digitization of the medical field in general, and with more information fed automatically into the loop, future systems built on this model could be powerful tools for threat prediction and preventative care.

A system where nationwide, anonymized symptom data flowed freely and automatically to centralized computing centers like that at the HPA’s West Midlands office could revolutionize the ability of authorities to rapidly respond to emerging threats. But the HPA isn’t even tapping some of the richest data streams available--those provided freely by citizens themselves. We’ve seen how systems like Google Flu Trends can accurately predict incidences of flu outbreak in a given area simply by trolling search terms for indicators of flu activity. And just this week we learned about an algorithm that scanned geotagged tweets in NYC to accurately predict which users were about to get sick up to eight days before they even showed symptoms. That kind of data is everywhere, and it’s ideal for taking the pulse of large groups of people--the same kind of large groups currently tweeting so much from London that Olympic organizers have asked them to tone it down (it’s disrupting television coverage apparently). That’s why the UK plans to leave large parts of its health surveillance system in place after the Games are overwith (it will likely scale back the frequency of some kinds of reporting, though it will keep the technology in place to ramp it back up during an emergency). As global populations continue to swell and our metropolises become bigger, denser, more diverse, and better connected, epidemiological situations like that presented by the Olympics will become less the exception and more the norm. The ability to quickly crunch disparate data streams into a perfect picture of public health will be the difference between staying out in front of emerging biological threats and constantly trying to chase them down from behind.

Thursday, April 19, 2012

Fitbit

Fitbit is quite a useful and potentially revolutionary device. When I was doing research for a computer science and software engineering paper, I was wondering how data from the fitbit could be wirelessly transmitted into personal health records, and stored in the HL7 standard. The problem is, there is a lot of data, so only certain trends need to be recorded. The other problem is how to program an XML or HL7 standard self-journalling area in the personal health record. I know the HL7 standards group is working on PHRs now, because I participated in one of their lunchtime teleconferences. I am not sure how this particular problem was addressed. This is one device the people in the self-tracking movement cannot afford to be without. In fact, they have latched on it, and the systems deployed with them and other similar devices they call "Health Mashups".

Saturday, April 14, 2012

Wimbledon in 25 years time?

I play tennis and like to follow ATP tournaments throughout the seasons - clay, grass, hardcourt. Last year, Wimbledon had a fascinating website on what tennis will be like 25 years from now (around the time of the Singularity?) The tennis player, for example:
The major change for players, will be the ability for them to monitor their performance during a game:
Sensors will monitor muscular contractions, measuring fatigue and minimising strain on tiring muscles
Sweat levels will be monitored to gauge hydration levels and, along with heart-rate monitors provide indications of stress
This information will enable them to regulate their intake of water, supplements and of course even bananas to the exact level required to maximise their performance levels