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With the technique of biofeedback it has become possible for humans to enter into a direct and objective dialogue with their body functions. By this method one can, for example, try to reduce muscle tension, increase peripheral blood flow or influence cortical activity. It has been clinically applied in neuromuscular rehabilitation, as an adjunct therapy of cardiovascular disorders such as cardiac arrhythmias and hypertension, in the treatment of headache and epileptic seizures as well as for bodily relaxation.
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The investigation of afferent cardiovascular influences upon central nervous processes needs a methodology which allows for independent and systematic manipulation of circulatory processes. By mechanical manipulation of posture (tilt table, orthostasis) and compression of lower body parts (by anti-G-suit) reliable changes in heart rate and blood pressure can be induced. In fourty subjects (study 1) it could be shown that sustained (30 min.) changes in heart rate (e.g. orthostatic tachycardia, decrease of heart rate during compression) and mean arterial blood pressure (increase during orthostasis with and without compression) occur. Although changes in heart rate could be achieved irregardless of whether the venous "pooling" was suppressed by an air- or water-filled pressure suit, the pressor effect did differ quite considerably. In fourty-four subjects (study 2) it could be demonstrated that only by means of an water-filled suit further increases in mean arterial blood pressure could be evoked during orthostasis. Changes in hemodynamic also lead to changes in sympatho-vagal control of cardiac activity. In study 3 (ten subjects) it could be shown, that orthostasis mainly evokes alterations in sympathetic activity whereas lower body compression leads to additional increases of vagal activity and respiratory sinus arrhythmia during orthostasis.
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During the last two decades, research on interoception has experienced a surprising renaissance. New experimental approaches and methods have revealed much about the processing of afferent signals from the inner organs of the body, and have allowed more accurate descriptions of these processes, as well as a more accurate determination of their functional significance in the experience and behavior of humans. Besides neuromuscular, respiratory, and gastrointestinal interoceptive processes, the cardiovascular afferent influences are now known to be very important. Invariably, the central questions concern sensitivity to signals from the body, factors which may influence judgement of perception, and the degree to which conventional hypotheses regarding the interoceptive capabilities of humans may require revision. Findings from general psychological and clinical studies have shown that humans may attain remarkable levels of interoceptive performance. On the other hand, they also show how deep the chasm is between visceral processes and perception, and between that which is perceived and the reports thereof. Only interdisciplinary approaches to these complex processes promise success.
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This survey-study represents the psycho-social conditions of death in West-German hospitals as seen from different occupational groups. The test, developed for this task, has been applied in 70 hospitals of different federal states, medical-departments and supporters. It is shown that following factors have an essential influence on the attitudes of people to the needs of the dying patient: amount of medical engineering at ward, time of professional activity and status of the personnel. In sum, the study gives a dark picture of death situation. Most helpers hold that situation inhumane. This is a burden for the helpers themselves. The results of the study tell against the efficiency of actual engagement in dying patients. The author develops some proposals, how the requests of thanatology that were adequat to improve the actual situation, could better be transferred to the practice.
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