Monday, January 31, 2011

Escape from pain

Caleb SpringerCaleb has had skin grafted from his back to his arms and legs

Burn patients in the US are being helped to escape the pain of burn injuries by immersing them in the virtual reality of a computer game during treatment.

Agony from severe burns can be one of the most intense and prolonged types of pain you can experience. And for many, the rehabilitation treatment is as painful as the initial burn.

Caleb Springer, aged 23, from Valdez in Alaska suffered second and third degree burns when he was set on fire in a motor bike accident.

Petrol spilled out of his scooter and a stray spark from a cigarette ignited it.

"I was engulfed in flames for probably two minutes. It was the worst pain I've ever felt, it was just excruciating. I looked down and just saw skin hanging from my legs," he said.

His burns were so bad he was airlifted from Alaska to a specialist centre in Seattle where his rehabilitation has been helped by pioneering treatment using a virtual reality computer game.

SnowWorld, set in an icy 3D canyon, was developed by Professor Hunter Hoffman and Professor David Patterson at the University of Washington Harborview Burn Centre in Seattle.

It evolved out of the scientific advances in the last decade in understanding pain.

Caleb SpringerCaleb Springer wears the SnowWorld helmet

The aim of the game is "to make a very attention grabbing experience for the patient and basically to give them a place to escape from their pain" says Professor Hoffman.

Scientists have found many different elements can affect how we experience pain, including our emotions, environment, context and distractions.

"Because pain has such a strong psychological component to it, psychological treatments can be used to counteract the pain," said Prof Hoffman.

"Because humans are so visually dominant wherever you're looking typically that's where your attention is focused.

"(For patients) during wound care, when they're getting their bandages changed, they're looking at these different tools that the nurses are using to treat them, and just looking at those objects makes them anxious.

"They begin to associate objects in the room with high pain so you can imagine that day after day they start to develop psychological associations between the treatment room and pain, amplifying how much pain they experience."

SnowWorld game imageThe virtual snowball fight with snowmen and penguins is more immersive than music or movies

Being immersed in SnowWorld puts a "curtain between the patient and reality", he explains.

Patients wear a helmet hooked up to the virtual world and wear noise cancelling headphones, cutting off all the sights and sounds associated with the painful treatment.

It is a fairly simple computer game. Patients can throw snowballs at various objects, including snowmen, igloos, mammoths, and penguins.

"When they put you in SnowWorld, the snowmen throw snowballs at you and you have to throw snowballs back at them," says Caleb Springer.

"If you hit the penguins, they freeze, and if you hit them a second time, they explode. There's a lot of action in it. You never stop to think about anything else."

The game is quite simple, intentionally, because patients could not concentrate on regular computer games.

The icy world was chosen, so patients would not be reminded of the fire that caused their burns.

"When I was in SnowWorld, I didn't think about the pain at all. There was pretty much no pain - there were at some points, but the most part there was no pain," said Caleb.

Caleb Spring and Dr Hunter HoffmanDr Hoffman supervises Caleb's physiotherapy while he is using SnowWorld

There is a limit to how much information the brain processes at any one time, so although Caleb's brain received exactly the same amount of pain signals, he did not register them.

"They basically become oblivious to what's happening in the hospital room," explains Professor Hoffman.

"There are other studies showing you feel less pain during music or watching movies, but this takes it to a much more stronger level, because it's so immersive.

"It isolates the patient from the real world, unlike any other media that's ever been tried. That's part of the reason we're getting such strong results".

Over the last two years, Prof Hoffman has been collecting brain scans from his patients.

Pain-related brain activity "lights up their brains like a Christmas tree when there's no virtual reality".

Dr HoffmanDr Hoffman shows the difference in brain activity in patients after using the virtual reality game

"When you compare it to pain stimuli when they were in virtual reality, some regions showed a 50% reduction in brain activity.

"This is consistent with the idea that there is so much attention devoted to SnowWorld that there is not enough attention available to process the pain signals anymore."

A growing number of burn centres around the world are showing interest in using SnowWorld with their patients, including hospitals in New York, Hawaii, Copenhagen and Holland


Comments
 
Editors' Picks All Comments (9) loading
5. Zulu

20 years ago I caught fire and I ended up with burns to 66% of my body, not good for an 19 year old young man. Being on fire is just terrible, but it is nothing compared to having to get better. This is such a fantastic idea, if it can just take some poor soul away from such a horrid place for even a short while, well, its just got to be a good thing.

4. relativity1

The concept behind this is fascinating but the mask looks claustrophobic to me. It seems a similar idea to training the brain through guided imagery.I would think with practice it would be possible to 'roll' a film in the mind that involves activity (I think this is the key) it's not enough to just lie back and think of something relaxing. This works for me at dentists - can't have anaesthesia.

3. laura here 01

I am a sufferer of Reflex Sympathetic Dystrophy, while it is not burn related i have severe pain all the time. It makes physio, as well as many simple tasks like changing my clothes difficult if not impossible due to the level of pain. it has left me completely bedbound for several years now. This is a brilliant idea and i hope they make it available for more conditions soon.

 
 

This article is from the BBC News website. � British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.

Source: http://www.bbc.co.uk/go/rss/int/news/-/news/health-12297569

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EU sanctions on Tunisia ex-leader

Ousted Tunisian President Zine al-Abidine Ben Ali (l) and his wife LeilaMr Ben Ali and his wife and associates are believed to have controlled much of Tunisia's economy

The European Union has frozen the assets of ousted Tunisian President Zine al-Abidine Ben Ali and his wife.

The sanctions were approved by EU foreign ministers, after a request from Tunisia's new interim government.

Mr Ben Ali fled Tunisia earlier this month after a series of protests against poverty and corruption, ending his 23 years in power.

He and his family are accused of having enriched themselves over many years at the country's expense.

Tunisia generally enjoyed steady economic growth under Mr Ben Ali, but many - including the young men who launched the protests in December - remained poor.

The president's family and his associates are believed to have controlled a large portion of the country's economy.

A number of associates of the deposed president may face similar sanctions, EU officials said.

The EU is looking at resuming talks, begun with Tunisia while Mr Ben Ali was in power, on improving trade terms with the country.

This article is from the BBC News website. � British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.

Source: http://www.bbc.co.uk/go/rss/int/news/-/news/world-europe-12327180

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750,000 'to pay higher tax rate'

Sterling notesThe IFS estimates the average household will be £200 worse off

Three-quarters of a million more people are set to become higher-rate taxpayers in April, according to a leading economic research body.

About 750,000 people will start paying the higher 40% income tax rate on their earnings from 5 April, says the Institute for Fiscal Studies (IFS).

The threshold at which the higher rate kicks in is to be £35,001, down from £37,400 this financial year.

Chancellor George Osborne told the BBC he had to make hard economic decisions.

Speaking to the Politics Show on Sunday Mr Osborne said no politician liked cutting spending and increasing taxes, but he was trying to clear up the "mess" Labour had left.

He added: "I feel every day a huge responsibility to get these decisions right for Britain."

The IFS estimates the average household will be £200 a year worse off as a result of tax increases and benefit cuts.

From the start of the next tax year, the government is also increasing the main rate at which National Insurance is charged.

However, the IFS also says half a million people will no longer pay income tax, following the £1,000 increase in the amount people can earn tax-free being raised to £7,475.

This article is from the BBC News website. � British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.

Source: http://www.bbc.co.uk/go/rss/int/news/-/news/business-12321524

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Clashes over Dhaka airport plans

Police carry a comrade injured by bricks thrown by villagersPolice found themselves being pelted with bricks by angry villagers
Related stories

Police in Bangladesh have fired tear gas and rubber bullets to disperse villagers protesting against government plans to build a new airport south of the capital Dhaka.

The farmers, whose land the government wants to acquire for the project, set fire to a police camp, burned a police vehicle and blocked roads.

One policemen was killed and more than 50 people injured in the clashes.

The government says the farmers will be adequately compensated for their land.

Critics of the plans say the country's existing airports are not operating at capacity.

Police say about 20,000 villagers demonstrated on Monday against plans to build Bangabandhu International Airport, in Munshiganj district.

Protesters, some armed with sticks and axes, attacked police at the site in Srinagar sub-district, 40km (25 miles) south of the city.

Villagers say they will lose homes and farmlands.

The government wants the planned airport to be named after independence leader Sheikh Mujibur Rahman - the father of current Prime Minister Sheikh Hasina.

He was killed along with most of his family members in a coup in 1975, four years after Bangladesh won independence from Pakistan.

This article is from the BBC News website. � British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.

Source: http://www.bbc.co.uk/go/rss/int/news/-/news/world-south-asia-12325667

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Sri Lanka web offices set on fire

Photo courtesy lankaenews.com The attack came in the middle of the night
Related stories

Unidentified attackers in Sri Lanka have set fire to the offices of a website critical of the government.

The staff at Lankaenews.com website had been coming under threat for some time. Police are now guarding the bungalow which the website uses as its office.

The attackers broke the door and burned the rooms where the stock of newspapers going back 20 years was kept.

The attack at about 2am (2030GMT) came six months after a TV station owned by opposition supporters was fire-bombed.

Like earlier attacks on media premises, this one came in the middle of the night.

At dawn the website's photographer, Sanjay Dassanayake, took pictures inside the building.

They show mangled and burnt-out wreckage.

“Vehicles with no number plates had been visiting our office premises”

Bennett Rupasinghe Lankaenews.com News Editor Bennett RupasingheConcern over missing reporter

"It is well to note that under the President Rajapakse regime the free media had suffered most and sustained losses to persons and property on an unprecedented scale in the media history of Sri Lanka," a statement released by the website said.

Mr Dassanayake said that "all the computers [were] destroyed and we had a mini-library. And all the documents we had, that means all papers, all books and things like that, were all destroyed".

President Mahinda Rajapaksa has ordered the police to launch an urgent inquiry.

Communications Minister Keheliya Rambukwella said that the attack "was carried out by a group in an attempt to destroy the image of the Government in the eyes of the people".

"They committed this heinous crime... to direct the blame on the government and to create problems for us," he told the Daily Mirror newspaper.

The website's news editor, Bennett Rupasinghe, told the BBC that the site had written many stories critical of what he said was corruption, wastage and cheating "especially on the part of the government".

"We had a lot of threats, varied threats, even before this incident.

"People came here and snooped around two days ago so we could easily say this was well planned," he said.

Last year, the website editor fled the country after getting threatening phone calls.

"Our editor was questioned several times by the Criminal Investigation Department. He went into exile because during the last presidential election, he got threatening phone-calls and emails and vehicles with no number plates had been visiting our office premises," Mr Rupasinghe added.

One of the website's writers, Prageeth Eknaligoda, vanished without trace, the victim of suspected abduction.

The human rights group Amnesty International says that at least 14 media workers have been unlawfully killed in Sri Lanka in the past five years.

This article is from the BBC News website. � British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.

Source: http://www.bbc.co.uk/go/rss/int/news/-/news/world-south-asia-12322916

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Parents 'don't recognise obesity'

Obese boyOne in 3 children in England leave primary school overweight

Childhood obesity is a growing problem, but parents are often surprised, even angry, when told that their child is too heavy.

In this week's Scrubbing Up, consultant paediatrician Professor Mary Rudolf, who advises the government on obesity, asks why it is so difficult to recognise when children are overweight.

Do you know whether your child is overweight?

Most of us are aware that obesity is a problem, and we may even know that the UK is in the middle of a child obesity epidemic.

But many parents are unable to tell when their own child is overweight.

A National Opinion Poll involving over 1,000 parents of children aged 4-7, showed that only 14% of those with an obese child considered that their child was overweight.

The problem is that we have all adjusted to overweight as being the norm. Understandably, parents compare their own child with the children around them.

“Did you know that a healthy ten-year old's ribs should be clearly visible? Many parents would consider that such a child was quite underweight.”

Professor Mary Rudolf Obesity expert

When one in three children at primary school is overweight, it is not surprising that it is hard to identify when a child has a problem.

Did you know that a healthy 10-year-old's ribs should be clearly visible?

Many parents would consider that such a child was quite underweight.

Parents are not alone in having difficulty recognising when children have an unhealthy weight.

Studies in the US and the UK show that health professionals often underestimate children's weight too.

When shown pictures they invariably mis-categorise children as being a healthier weight than they are, unless the child is exceptionally obese.

In fact, health professionals do not even recognise when they themselves are overweight; a good half of those who were overweight reported that their weight was healthy!

In 2005, the National Child Measurement Programme was introduced in primary schools.

The programme was introduced to monitor the epidemic in childhood obesity, by weighing and measuring all children as they start primary school and again in their last year.

In many areas, parents receive a letter to let them know the outcome and how healthy their child's weight is.

Some feel surprise and even anger if they are told that their child is overweight.

They have difficulty marrying up the term 'overweight' with the healthy child in front of them.

The lack of recognition is very common.

Another reason for the lack of knowledge may be that the media often portrays and highlights extreme cases of child obesity.

Most children identified by the National Child Measurement Programme do not look obviously overweight.

By comparison to the images shown of very obese children in the media, they look slim.

Yet lesser degrees of being overweight and obesity can be accompanied by health concerns and are a marker for obesity and health problems later in life.

The letter is not intended to make parents feel they have failed in any way.

Information is offered to help them make positive decisions about their child's lifestyle.

Many parents, while not necessarily welcoming the information they receive, have taken it as a 'wake-up call' to ensure that their family become more active and develop healthier attitudes to eating.

Schools have also taken the impetus to make sure that children under their care spend time in a healthier environment with better opportunities for healthy food choices and physical activity.

Once obesity is established, it is extremely difficult to reverse, as most of us know.

Less serious levels of being overweight can more easily be reduced by lifestyle changes.

It is for this reason that it can be so helpful to inform parents when their child's weight is of concern.

Without doubt, the introduction of the National Child Measurement Programme has been controversial, but hopefully most parents will appreciate that it offers the potential for improving children's lives and protecting them from the very real problems that accompany obesity and unhealthy lifestyles.

This article is from the BBC News website. � British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.

Source: http://www.bbc.co.uk/go/rss/int/news/-/news/health-12226744

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Government NHS analysis 'misleading'

Prof John Appleby: "The figures quoted are factually right but the impression given is wrong."

This article is from the BBC News website. � British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.

Source: http://news.bbc.co.uk/go/rss/int/news/-/today/hi/today/newsid_9379000/9379104.stm

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