tag:theconversation.com,2011:/fr/topics/breathing-41472/articles
Breathing – The Conversation
2024-02-05T13:30:00Z
tag:theconversation.com,2011:article/219169
2024-02-05T13:30:00Z
2024-02-05T13:30:00Z
Why do people and animals need to breathe? A biologist explains why you need a constant source of oxygen
<figure><img src="https://images.theconversation.com/files/567973/original/file-20240104-26-jrvms0.jpg?ixlib=rb-1.1.0&rect=419%2C364%2C3255%2C2085&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Your blood's natural limit to how much oxygen it can hold means you can't stockpile it.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/girl-swimming-in-idyllic-caribbean-sea-take-a-royalty-free-image/1394071551">Lisa520/E+ via Getty Images</a></span></figcaption></figure><figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=293&fit=crop&dpr=1 600w, https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=293&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=293&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=368&fit=crop&dpr=1 754w, https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=368&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=368&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><em><a href="https://theconversation.com/us/topics/curious-kids-us-74795">Curious Kids</a> is a series for children of all ages. If you have a question you’d like an expert to answer, send it to <a href="mailto:curiouskidsus@theconversation.com">curiouskidsus@theconversation.com</a>.</em></p>
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<p><strong>Why do humans and animals have to breathe? – Tennessee, age 7, Hartford, Kentucky</strong></p>
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<p>You need to breathe for the same reason you need to eat: It helps you make the energy your body requires. </p>
<p>You probably already know that food is fuel for your body. When you eat, food gets broken down in your stomach and <a href="https://www.vattenhallen.lu.se/english/experiences/from-mouth-to-rectum/">enters your bloodstream</a>.</p>
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<a href="https://images.theconversation.com/files/568258/original/file-20240108-16-q7f3ve.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A plastic object on a stand that is tube shaped with part of it cut off showing an interior space with fuzzy looking walls with dividers." src="https://images.theconversation.com/files/568258/original/file-20240108-16-q7f3ve.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/568258/original/file-20240108-16-q7f3ve.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=801&fit=crop&dpr=1 600w, https://images.theconversation.com/files/568258/original/file-20240108-16-q7f3ve.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=801&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/568258/original/file-20240108-16-q7f3ve.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=801&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/568258/original/file-20240108-16-q7f3ve.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1006&fit=crop&dpr=1 754w, https://images.theconversation.com/files/568258/original/file-20240108-16-q7f3ve.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1006&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/568258/original/file-20240108-16-q7f3ve.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1006&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">A plastic model of a mitochondrion.</span>
<span class="attribution"><a class="source" href="https://coimages.sciencemuseumgroup.org.uk/images/24/460/large_2010_0084__0001_.jpg">Science Museum Group Collection © The Board of Trustees of the Science Museum</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-sa/4.0/">CC BY-NC-SA</a></span>
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<p>From there, it gets delivered to your cells. Inside your cells are even <a href="https://collection.sciencemuseumgroup.org.uk/objects/co505977/plastic-organelle-model-of-a-mitochondrion-from-a-cell-model-representation">tinier structures called mitochondria</a>, which are the engines that power your entire body. Your mitochondria use the nutrients from food as fuel. But to turn it into energy, they need one more ingredient – oxygen.</p>
<p><a href="https://scholar.google.com/citations?hl=en&user=tuuK7xcAAAAJ">I am a biologist who studies</a> animals and plants. All living things need oxygen, except for <a href="https://en.wikipedia.org/wiki/Obligate_anaerobe">some bacteria</a> and <a href="https://www.doi.org/10.1186/1741-7007-8-30">a few tiny animals</a> that don’t. You might be surprised to learn how many ways there are to get oxygen – breathing is only one of them.</p>
<h2>Lungs and their linings</h2>
<p>When you breathe in, your lungs temporarily trap oxygen, allowing it to pass through very <a href="https://www.britannica.com/science/pulmonary-alveolus">thin surfaces in your lungs</a> into your bloodstream. </p>
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<a href="https://images.theconversation.com/files/567972/original/file-20240104-19-n4vt7u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A central tube comes down, which then branches and rebranches over and over." src="https://images.theconversation.com/files/567972/original/file-20240104-19-n4vt7u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/567972/original/file-20240104-19-n4vt7u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=603&fit=crop&dpr=1 600w, https://images.theconversation.com/files/567972/original/file-20240104-19-n4vt7u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=603&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/567972/original/file-20240104-19-n4vt7u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=603&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/567972/original/file-20240104-19-n4vt7u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=758&fit=crop&dpr=1 754w, https://images.theconversation.com/files/567972/original/file-20240104-19-n4vt7u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=758&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/567972/original/file-20240104-19-n4vt7u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=758&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">A CT scan of healthy lungs.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/healthy-lungs-ct-scan-royalty-free-image/1786377109">RAJAAISYA/Science Photo Library via Getty Images</a></span>
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<p>Because you need a lot of oxygen, your lungs need a lot of surface area to do their job. They achieve this by having millions of <a href="https://upload.wikimedia.org/wikipedia/commons/b/bb/Lung_structure_normal.jpg">little air sacs</a> lined with tiny blood vessels called capillaries.</p>
<p>If you could somehow flatten out all the capillary surface area in your lungs, it would more than cover the floor of <a href="https://seatingchartmaker.app/articles/average-classroom-size-square-feet/#classroom-size-by-us-state">an average classroom</a> – around <a href="https://www.sciencedirect.com/topics/engineering/pulmonary-capillary">1,350 square feet (125 square meters)</a>. </p>
<h2>Getting enough oxygen</h2>
<p>If breathing is kind of like eating, why can’t you just take three breaths a day?</p>
<p>One reason is that <a href="https://climate.nasa.gov/news/2915/the-atmosphere-getting-a-handle-on-carbon-dioxide/">air on Earth</a> is only 21% oxygen – the rest is mostly nitrogen. That means you need to take five breaths just to get the equivalent of one complete lungful of oxygen. </p>
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<a href="https://images.theconversation.com/files/567971/original/file-20240104-14-2jppnf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="An illustration depicting the tunnel-like inside of a blood vessel, with vaguely donut-shaped spheres flowing through it." src="https://images.theconversation.com/files/567971/original/file-20240104-14-2jppnf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/567971/original/file-20240104-14-2jppnf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/567971/original/file-20240104-14-2jppnf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/567971/original/file-20240104-14-2jppnf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/567971/original/file-20240104-14-2jppnf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/567971/original/file-20240104-14-2jppnf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/567971/original/file-20240104-14-2jppnf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Your blood can carry only so much oxygen.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/3d-render-of-red-blood-cells-or-corpuscle-flowing-royalty-free-image/1144992100">libre de droit/iStock via Getty Images</a></span>
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<p>Also, when you take a breath, only some of the oxygen makes it into your bloodstream. Even though people and many animals make specialized <a href="https://teachchemistry.org/chemmatters/february-2010/the-many-colors-of-blood">proteins to grab and carry oxygen</a>, there’s a limit to how much they can hold at once. To keep your body’s oxygen levels high enough to power all your cells, you need to keep breathing.</p>
<p>Of course, once you breathe in, you also have to breathe out. The gas you breathe out is called <a href="https://learningzone.oumnh.ox.ac.uk/respiration">carbon dioxide</a>. You can think of it as the exhaust from your mitochondria engines, the leftovers once the mitochondria burn oxygen and nutrients to release energy.</p>
<h2>Other animals and plants</h2>
<p>Most living things get oxygen without lungs. </p>
<p>Many aquatic animals use gills, which are sort of like lungs turned inside out. Instead of a bunch of capillaries wrapped around air sacs, <a href="https://theconversation.com/curious-kids-how-do-gills-work-150375">gills are a bunch of capillaries</a> sticking out into the water. Just like in your lungs, the blood vessels take in oxygen from the water and release carbon dioxide.</p>
<p>Insects take in oxygen through a network of little <a href="https://askabiologist.asu.edu/how-insects-breathe">air tubes just under their skin</a>, sort of like the chimneys of a building. This system works because insects are small, so the tubes are already close enough to their cells to give them oxygen. When large insects need extra energy, they <a href="https://askabiologist.asu.edu/how-insects-breathe">pump air through the tubes</a> with their muscles.</p>
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<a href="https://images.theconversation.com/files/567945/original/file-20240104-28-4qdii8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A microscopic photo showing a green mouth shape." src="https://images.theconversation.com/files/567945/original/file-20240104-28-4qdii8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/567945/original/file-20240104-28-4qdii8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=507&fit=crop&dpr=1 600w, https://images.theconversation.com/files/567945/original/file-20240104-28-4qdii8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=507&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/567945/original/file-20240104-28-4qdii8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=507&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/567945/original/file-20240104-28-4qdii8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=637&fit=crop&dpr=1 754w, https://images.theconversation.com/files/567945/original/file-20240104-28-4qdii8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=637&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/567945/original/file-20240104-28-4qdii8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=637&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">A close-up look at the underside of this tomato leaf shows where the air goes in and out.</span>
<span class="attribution"><a class="source" href="https://upload.wikimedia.org/wikipedia/commons/8/85/Tomato_leaf_stomate_cropped_and_scaled.jpg">Vojtěch Dostál</a>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
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<p>Plants have <a href="https://www.rhs.org.uk/advice/understanding-plants/how-plants-breathe">little holes in their leaves called stomata</a>. They open and close to let in air when plants need it. Plant roots need oxygen, too, which they usually get from the soil.</p>
<p>You may have heard that plants are the opposite of people: They <a href="https://www.britannica.com/story/do-plants-emit-oxygen-and-carbon-dioxide-at-night">breathe in carbon dioxide and breathe out oxygen</a>. That’s true because carbon dioxide is a crucial ingredient in <a href="https://www.britannica.com/science/photosynthesis">photosynthesis</a> – the process plants use to make their own sugar fuel – and oxygen is a byproduct. But plants’ mitochondria also need oxygen to make energy, just like yours do.</p>
<p>Even though most animals and plants don’t breathe in and out the way people do, they all have ways of getting enough oxygen. Learning how organisms solve the same problem in different ways is one of my favorite things about biology.</p>
<hr>
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<p class="fine-print"><em><span>Christina S. Baer does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
Inhaling air is how you get the oxygen your body needs to turn your food into energy. Other living things use different strategies.
Christina S. Baer, Assistant Professor of Biological Sciences, Binghamton University, State University of New York
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/213627
2023-09-26T17:13:32Z
2023-09-26T17:13:32Z
Breathing through your nose when you exercise may make your runs easier
<figure><img src="https://images.theconversation.com/files/550048/original/file-20230925-29-u3eqzc.jpg?ixlib=rb-1.1.0&rect=8%2C8%2C5343%2C3554&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Nose breathing during intense exercise takes practice. </span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-black-couple-jogging-brooklyn-park-787058611">Monkey Business Images/ Shutterstock</a></span></figcaption></figure><p>Breathing is subconscious. We don’t have to think about it – it just happens. But when we exercise, many of us become more aware of it than we normally are – sometimes thinking about <a href="https://journals.physiology.org/doi/abs/10.1152/jappl.1983.55.4.1160">every breath we take</a>.</p>
<p>During low and moderate-intensity exercises (such as walking and cycling), the majority of us breathe in through our nose and out through our mouths. But the more intense the exercise becomes, the more we tend to breathe entirely through <a href="https://www.researchgate.net/publication/338558548">our mouths</a>. </p>
<p>Most of us would assume that breathing through the mouth is the best technique to use during intense exercise, as it allows more oxygen to reach our muscles. But evidence shows the contrary – and that breathing through your nose may actually be a better technique to use during intense exercise (such as running).</p>
<p>A series of studies have shown that when exercising at different intensities, <a href="https://journals.aiac.org.au/index.php/IJKSS/article/view/3079">less oxygen is used</a> when breathing through the nose compared to breathing through your mouth. While this might not sound like a benefit, this basically means that the body can still perform the same amount of exercise while using less oxygen to perform it.</p>
<p>This could be a real advantage especially for endurance athletes as <a href="https://www.tandfonline.com/doi/pdf/10.2147/OAJSM.S141657">economy of movement</a> is fundamental to success. Think of oxygen like fuel for car. The fewer miles per gallon of fuel a car uses the better its “fuel economy” is. The same applies to oxygen. The less oxygen used per footfall, the less energy a person uses (and therefore the more economical they are). This means you may be able to run further without becoming exhausted as quickly. </p>
<p>Further to this, breathing through your nose is associated with <a href="https://journals.physiology.org/doi/abs/10.1152/jappl.1991.71.2.546">reduced volumes of air</a>. This makes sense, as the nostrils are much smaller than your mouth is, so you can’t draw in as much oxygen at one time. But this study also found that people breathed less frequently through their nose when exercising, which seems less logical.</p>
<p>The key here is understanding that air moves from high pressures to lower pressures to help it go from the air and into the lungs. So although the volume of air is lower in the nasal cavity compared to the mouth, the pressure is higher – meaning the air <a href="https://pubmed.ncbi.nlm.nih.gov/2033006/">moves more quickly</a> into the respiratory system. The result is that oxygen can then be delivered more quickly to the working muscles.</p>
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<img alt="A man takes a deep breath of air through his nose." src="https://images.theconversation.com/files/550050/original/file-20230925-24-9tk98s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/550050/original/file-20230925-24-9tk98s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/550050/original/file-20230925-24-9tk98s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/550050/original/file-20230925-24-9tk98s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/550050/original/file-20230925-24-9tk98s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/550050/original/file-20230925-24-9tk98s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/550050/original/file-20230925-24-9tk98s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Breathing through the nose delivers air to the muscles more quickly.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/relaxed-adult-man-breathing-fresh-air-1517688029">Antonio Guillem/ Shutterstock</a></span>
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<p>More oxygen is also <a href="https://journals.aiac.org.au/index.php/IJKSS/article/view/4400">released per breath</a>, which explains why there’s no difference in heart rate when breathing orally or nasally during the same exercise. So despite lower volumes of oxygen coming in, this indicates the heart doesn’t need to work harder to deliver it to the muscles. This means the heart is under no additional stress when breathing through your nose during exercise.</p>
<p>Researchers also suggest that breathing through your nose increases production of <a href="https://www.sciencedirect.com/science/article/pii/S1569904819301648?casa_token=d6EkP8L8_OoAAAAA:z8e9EZdgANUVznukTVDIN49aDOFgdzaYkguy7gFZjMvHGPptJaM0tErvEUqyFy1NwEXser6CaeM">nitric oxide</a>, which not only makes it easier for oxygen to reach the lungs and muscles, it may also prevent <a href="https://anatomypubs.onlinelibrary.wiley.com/doi/pdfdirect/10.1002/ar.20782">airborne pathogens</a> (such as viruses) from causing harm. Nitric oxide does this by lowering blood pressure and helping blood flow more easily, allowing that <a href="https://physoc.onlinelibrary.wiley.com/doi/full/10.1113/jphysiol.2011.216341?casa_token=M5dXRBbaMmsAAAAA%3AnnhD50fmBeHwquiWryYFwXmrCuDidd6AOTl5mnhQd_43FABsoFUPPSWpjTZ1G0i-DRuJfRYtE-psA77u">much-needed oxygen</a> to reach the working muscles. </p>
<p>In all, it looks like breathing through your nose may actually be of benefit when running. It makes you your movements more economical, reduces the amount of airborne particles your breathe, reduces exercising blood pressure and helps oxygen reach the working muscles more effectively.</p>
<p>Evidence is less clear for other types of exercises (such as weight lifting) which require short, sharp bursts of effort. These types of exercise rely on <a href="https://www.nature.com/articles/s42255-020-0251-4">drawing energy</a> from other sources than oxygen – such as stored sugar (glucose) in our muscles. But these metabolic processes, which become depleted during the exercise, <a href="https://onlinelibrary.wiley.com/doi/full/10.1046/j.1365-201X.1998.0331e.x">still need oxygen to recover</a>. Taking deep breaths through your nose while recovering between sets may help this process to happen <a href="https://journals.physiology.org/doi/abs/10.1152/jappl.1983.55.3.860">more optimally</a>.</p>
<p>But while this all sounds incredibly positive and encouraging, there are some negatives to be aware of. </p>
<p>Breathing only through your nose during exercise is very much a <a href="https://books.google.co.uk/books?hl=en&lr=&id=jp0vEAAAQBAJ&oi=fnd&pg=PA68&dq=learning+to+breathe+nose&ots=5icXxEC7-E&sig=74_FU82oKx7GlxJ7Boo6eF7aGDU&redir_esc=y#v=onepage&q=learning%20to%20breathe%20nose&f=false">learnt process</a>. It shouldn’t be introduced instantly. If you introduce it without training first, it could lead to “<a href="https://vtechworks.lib.vt.edu/handle/10919/114177">air hunger</a>” – a process whereby a small amount of carbon dioxide is retained at the end of each breath. This can cause discomfort and hyperventilation.</p>
<p>As with anything, practice makes perfect. When learning to breathe through your nose, make sure you don’t force air in. Try and relax into the process. Ensure you’re tongue is at the top of your mouth, as this relaxes the jaw and face muscles making it easier to draw a deep breath through your nose. You also may want to alternate between breathing through your nose and your mouth at first until you get more used to breathing solely through your nose. The more you do this, the more the process will become subconscious. </p>
<p>Breathing through your nose while exercising can be very effective. Just be sure to practice and give your body time to adjust to avoid harm.</p><img src="https://counter.theconversation.com/content/213627/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jonathan Melville owns Breakaway Coaching and Analytics. </span></em></p><p class="fine-print"><em><span>Chloe French and Dan Gordon do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
Breathing through your nose may help oxygen reach your working muscles faster.
Dan Gordon, Associate Professor, Cardiorespiratory Exercise Physiology, Anglia Ruskin University
Chloe French, PhD Candidate in Sport and Exercise Science, Anglia Ruskin University
Jonathan Melville, PhD Candidate, Sport and Exercise Science, Anglia Ruskin University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/213982
2023-09-24T20:02:03Z
2023-09-24T20:02:03Z
How to manage exam season: don’t forget to take regular breaks and breathe
<figure><img src="https://images.theconversation.com/files/549261/original/file-20230920-21-nb1q6o.jpg?ixlib=rb-1.1.0&rect=57%2C57%2C4192%2C2752&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.pexels.com/photo/woman-closing-her-eyes-against-sun-light-standing-near-purple-petaled-flower-plant-321576/">Oleksandr P/Pexels </a></span></figcaption></figure><p>Around Australia, Year 12 students are heading into the final stretch of study before exams start in early term 4. This is typically seen as a very intense period of preparation. But, <a href="https://www.tandfonline.com/doi/abs/10.1080/20590776.2023.2225700">as our research shows</a>, it is also important to rest during this time if you want to maximise your performance. </p>
<p>Intuitively, we understand breaks are important. We can take rest breaks across different times in our lives. They include <a href="https://hbr.org/2023/02/research-the-transformative-power-of-sabbaticals">sabbaticals</a>, <a href="https://theconversation.com/study-links-a-gap-year-to-better-university-grades-18275">gap years</a> and <a href="https://theconversation.com/why-a-holiday-is-good-for-you-even-before-you-take-time-off-209406">holidays</a>, weekends and nightly <a href="https://theconversation.com/screen-time-is-contributing-to-chronic-sleep-deprivation-in-tweens-and-teens-a-pediatric-sleep-expert-explains-how-critical-sleep-is-to-kids-mental-health-204436">sleep</a>. </p>
<p>But rest breaks can be beneficial on even shorter time frames, during study sessions and even during exams themselves. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/self-compassion-is-the-superpower-year-12-students-need-for-exams-and-life-beyond-school-192086">Self-compassion is the superpower year 12 students need for exams ... and life beyond school</a>
</strong>
</em>
</p>
<hr>
<h2>Firstly, try and get some sleep</h2>
<figure class="align-left ">
<img alt="An alarm clock on a shelf." src="https://images.theconversation.com/files/549258/original/file-20230920-19-y20eo4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/549258/original/file-20230920-19-y20eo4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=801&fit=crop&dpr=1 600w, https://images.theconversation.com/files/549258/original/file-20230920-19-y20eo4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=801&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/549258/original/file-20230920-19-y20eo4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=801&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/549258/original/file-20230920-19-y20eo4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1006&fit=crop&dpr=1 754w, https://images.theconversation.com/files/549258/original/file-20230920-19-y20eo4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1006&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/549258/original/file-20230920-19-y20eo4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1006&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Use an old-school alarm clock, so you are not tempted to mindlessly scroll through TikTok before sleep.</span>
<span class="attribution"><a class="source" href="https://www.pexels.com/photo/close-up-photo-of-teal-digital-clock-2397363/">Oladimeji Ajegbile/ Pexels</a></span>
</figcaption>
</figure>
<p>Students may be tempted to stay up late, trying to cram for an exam the following day. The big risk here is that lack of sleep can do more harm than good. </p>
<p>Sleep plays an important role in a range of brain functions, including <a href="https://pubmed.ncbi.nlm.nih.gov/12683469/">maintaining attention</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3768102/">consolidating memories</a>. So getting a poor night of sleep before an exam may mean the topics you’ve tried to cram aren’t well-formed in your long-term memory. Even if they were, the brain fog from lack of sleep means you may not recall what you’ve learned under the pressure of exam conditions. </p>
<p>In the lead-up to your exams, here are some specific things to consider:</p>
<ul>
<li><p><strong>try and keep all screens out of the bedroom:</strong> people often struggle with sleep because they’re tempted to check their phone at bedtime.</p></li>
<li><p><strong>screens also emit <a href="https://www.sleepfoundation.org/bedroom-environment/blue-light">blue light</a>:</strong> this can interfere with your body’s circadian rhythms. Blue light during the day enhances attention, but too much of it in the evening can interfere with sleep quality. </p></li>
<li><p><strong>so don’t use a smartphone as an alarm:</strong> get an old-fashioned alarm clock instead. </p></li>
</ul>
<p>For more information about sleep, the Sleep Health Foundation has <a href="https://www.sleephealthfoundation.org.au/quick-facts-and-faq-about-sleep-for-high-school-students.html">specific advice</a> for high school students. </p>
<h2>You need study breaks</h2>
<p>When we study, we’re using our <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4207727/">working memory</a> (processing of small amounts of information, needed for things like comprehension and problem-solving). This builds our understanding of a topic. We then want to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2657600/">encode that understanding into long-term memory</a> for use later, such as in an exam. </p>
<p>Without breaks, over time, these working memory resources become depleted and we notice it’s harder and harder to concentrate. </p>
<p>In our <a href="https://www.tandfonline.com/doi/abs/10.1080/20590776.2023.2225700">2023 study</a>, we found that a short (five minute) break following a period of difficult cognitive work (solving mental arithmetic problems) made a substantial difference to how much students learned during a lesson on a mental mathematics strategy. </p>
<p>Students who took a “do nothing” break performed 40% better than the no-break students on a subsequent test. Students who watched a first-person perspective video of <a href="https://www.youtube.com/watch?v=qHZ3rV6TzMs">a walk in an Australian rainforest</a> for five minutes also performed better (57%) than the no-break students. </p>
<p>This suggests building in short rest breaks during study can help you learn. </p>
<h2>How do you build in breaks?</h2>
<p>Here are some specific strategies to help you get the rests you need: </p>
<ul>
<li><p><strong>when you plan your <a href="https://education.nsw.gov.au/student-wellbeing/stay-healthy-hsc/resources/hsc-exam-tips-for-the-lead-up-to-exams#Tip0">study schedule</a> build in short breaks:</strong> drawing on the <a href="https://francescocirillo.com/products/the-pomodoro-technique">Pomodoro</a> time management technique, we recommend using a timer (but not one on a smartphone). Aim to take a five-minute break after 25 minutes of study. </p></li>
<li><p><strong>again, don’t use a smartphone:</strong> many of the features of a phone are purpose-built to <a href="https://www.google.com.au/books/edition/Stolen_Focus/3L1UEAAAQBAJ?hl=en&gbpv=0">capture and keep your attention</a>, which you need for studying! These short breaks could take many forms: getting a cup of tea, playing with a pet, getting some sun outside, doing some star jumps to wake yourself up, or some breathing exercises (I explain these below). </p></li>
<li><p><strong>longer breaks are important too:</strong> following the Pomodoro technique, aim to take a longer break (15-30 minutes) after four rounds of 25 minutes study/five minutes rest. Use at least some of these longer breaks for your physical and mental health away from your desk (and screens) – such as <a href="https://theconversation.com/exercise-the-body-build-the-brain-3294">exercise</a>, <a href="https://theconversation.com/its-not-all-in-your-mind-how-meditation-affects-the-brain-to-help-you-stress-less-97777">meditation</a>, or a <a href="https://theconversation.com/short-naps-can-improve-memory-increase-productivity-reduce-stress-and-promote-a-healthier-heart-210449">20-30-minute nap</a>. </p></li>
</ul>
<figure class="align-center ">
<img alt="A young woman holds a cup." src="https://images.theconversation.com/files/549257/original/file-20230920-21-y20eo4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/549257/original/file-20230920-21-y20eo4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=397&fit=crop&dpr=1 600w, https://images.theconversation.com/files/549257/original/file-20230920-21-y20eo4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=397&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/549257/original/file-20230920-21-y20eo4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=397&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/549257/original/file-20230920-21-y20eo4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=499&fit=crop&dpr=1 754w, https://images.theconversation.com/files/549257/original/file-20230920-21-y20eo4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=499&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/549257/original/file-20230920-21-y20eo4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=499&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Have regular breaks as part of your study timetable.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/HycIct9V-DM">Anh Nguyễn/ Unsplash</a></span>
</figcaption>
</figure>
<h2>Also take breaks during exams</h2>
<p>It’s reasonable to think we should be using every minute of an exam for answering questions. But just as rest breaks during study can help restore attention, breaks during exams themselves may also be helpful. </p>
<p>Breaks are a common part of exams for students with <a href="https://educationstandards.nsw.edu.au/wps/portal/nesa/11-12/hsc/disability-provisions/provisions/rest-breaks">disability provisions</a>, but with some planning, all students might benefit from breaks.</p>
<p>A common strategy you can use to prepare for Year 12 exams is to complete past exam papers. When you do this, use the same “short break” study strategy described above. When it seems like a good break point (for example, in between finishing one section of the paper and starting another), stop for a few minutes and practise taking a short break. </p>
<p>Under exam conditions, you’re more limited in what type of break you can take. But simple controlled breathing routines such as “<a href="https://www.medicalnewstoday.com/articles/321805">box breathing</a>” or the “<a href="https://www.medicalnewstoday.com/articles/324417">4-7-8 method</a>” can help you refocus. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/tEmt1Znux58?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Box breathing.</span></figcaption>
</figure>
<p>These routines can also activate the “<a href="https://www.health.harvard.edu/blog/using-the-relaxation-response-to-reduce-stress-20101110780">relaxation response</a>” – the opposite of the “flight-or-flight” response we experience under stressful conditions (including exams). </p>
<p>An even shorter form of breathwork to reduce stress in the moment is the <a href="https://www.youtube.com/watch?v=rBdhqBGqiMc">physiological sigh</a> – two inhales, followed by an exhale. </p>
<p>When it comes to the actual exam, you’ll be using the reading time to plan how you’ll complete the various sections. Take this time to also think carefully about when you’ll take some short breaks. When the exam begins, you might even write “take a two-minute break now” at suitable points in the exam booklet. </p>
<p>There is so much to think about in the lead-up to and during exams. If you schedule in and practise taking breaks, you will get better at doing it and give yourself and your brain a really important rest. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-to-beat-exam-stress-106065">How to beat exam stress</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/213982/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Paul Ginns does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
Final school exams are typically seen as a very intense period of preparation. But it is also important to rest during this time if you want to maximise your performance.
Paul Ginns, Associate Professor in Educational Psychology, University of Sydney
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/206057
2023-05-22T12:26:52Z
2023-05-22T12:26:52Z
Wildfire smoke can harm human health, even when the fire is burning hundreds of miles away – a toxicologist explains why
<figure><img src="https://images.theconversation.com/files/534623/original/file-20230628-27-qecwmv.jpg?ixlib=rb-1.1.0&rect=24%2C66%2C4001%2C2728&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Wildfire smoke filled the air at Chicago's Wrigley Field on June 27, 2023.</span> <span class="attribution"><a class="source" href="https://newsroom.ap.org/detail/CanadaWildfiresAirQualityGreatLakesBaseball/e86f2c376cb040da87a614b0abdb8861/photo">AP Photo/Kim Johnson</a></span></figcaption></figure><p><em>Smoke from <a href="https://www.ciffc.ca/">more than 100 wildfires</a> burning across Canada has been rolling into North American cities far from the flames. New York City, Denver, Chicago, Minneapolis and Detroit each made the list of the <a href="https://www.iqair.com/us/world-air-quality-ranking">most polluted cities in the world</a> at times in May and June 2023 because of the fires. The smoke has triggered air quality alerts in several states.</em></p>
<p><em>We asked <a href="https://www.umt.edu/biomedical-pharmaceutical-sciences/people/faculty.php?ID=1345">Chris Migliaccio</a>, a toxicologist at the University of Montana who studies the impact of wildfire smoke on human health, about the health risks people can face when smoke blows in from distant wildfires.</em></p>
<h2>What’s in wildfire smoke that’s a problem?</h2>
<p>When we talk about air quality, we often talk about PM2.5. That’s particulate matter 2.5 microns or smaller – small enough that it can travel deep into the lungs.</p>
<p>Exposure to PM2.5 from smoke or other air pollution, such as vehicle emissions, can exacerbate health conditions like asthma and reduce lung function in ways that can worsen existing respiratory problems and even heart disease.</p>
<p>But the term PM2.5 only tells you about size, not composition – what is burning can make a significant difference in the chemistry.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/534612/original/file-20230628-19-5wd03e.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A map of North America shows wildfire smoke from fires in Alberta and Ontario, Canada, detected strongly with poor air quality in the Great Lakes region, Northeast and Midwestern U.S." src="https://images.theconversation.com/files/534612/original/file-20230628-19-5wd03e.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/534612/original/file-20230628-19-5wd03e.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/534612/original/file-20230628-19-5wd03e.PNG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/534612/original/file-20230628-19-5wd03e.PNG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/534612/original/file-20230628-19-5wd03e.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/534612/original/file-20230628-19-5wd03e.PNG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/534612/original/file-20230628-19-5wd03e.PNG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Smoke from wildfires in Canada was detected across a large part of the U.S. on June 28, 2023. Dark purple dots indicate hazardous air quality. Light purple indicates very unhealthy air; red is unhealthy; orange is unhealthy for sensitive groups; and yellow indicates moderate risk. AirNow.gov.</span>
<span class="attribution"><a class="source" href="https://fire.airnow.gov/">AirNow.gov</a></span>
</figcaption>
</figure>
<p>In the northern Rockies, where I live, most fires are fueled by vegetation, but <a href="https://doi.org/10.1289/EHP3450">not all vegetation is the same</a>. If the fire is in the wildland urban interface, manufactured fuels from homes and vehicles may also be burning, and that’s going to <a href="https://nap.nationalacademies.org/catalog/26460/the-chemistry-of-fires-at-the-wildland-urban-interface">create its own toxic chemistry</a>, as well. Chemists often talk about <a href="https://www.cdc.gov/climateandhealth/effects/wildfires.htm">volatile organic compounds</a>, (VOCs), carbon monoxide and PAHs, or <a href="https://www.cdc.gov/biomonitoring/PAHs_FactSheet.html">polycyclic aromatic hydrocarbons</a> produced when biomass and other matter burns having the potential to harm human health.</p>
<h2>How does inhaling wildfire smoke harm human health?</h2>
<p>If you have ever been around a campfire and got a blast of smoke in your face, you probably had some irritation. With exposure to wildfire smoke, you might get some irritation in the nose and throat and maybe <a href="https://agupubs.onlinelibrary.wiley.com/doi/full/10.1029/2021GH000578">some inflammation</a>. If you’re healthy, your body for the most part will be able to handle it. </p>
<p>As with a lot of things, the dose makes the poison – almost anything can be harmful at a certain dose.</p>
<p>Generally, cells in the lungs called <a href="https://www.ncbi.nlm.nih.gov/books/NBK513313/">alveolar macrophages</a> will pick up the particulates and clear them out – at reasonable doses. It’s when the system gets overwhelmed that you can have a problem.</p>
<figure class="align-right ">
<img alt="Illustration of a small section of lungs showing the alveoli and, within the alveoli, a close up of a microphage" src="https://images.theconversation.com/files/527320/original/file-20230519-27-a7wgjx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/527320/original/file-20230519-27-a7wgjx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=914&fit=crop&dpr=1 600w, https://images.theconversation.com/files/527320/original/file-20230519-27-a7wgjx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=914&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/527320/original/file-20230519-27-a7wgjx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=914&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/527320/original/file-20230519-27-a7wgjx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1148&fit=crop&dpr=1 754w, https://images.theconversation.com/files/527320/original/file-20230519-27-a7wgjx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1148&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/527320/original/file-20230519-27-a7wgjx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1148&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Where macrophages are found in alveoli, the tiny air sacs in the lungs.</span>
</figcaption>
</figure>
<p>One concern is that smoke can <a href="https://doi.org/10.1038/s41598-018-31459-6">suppress macrophage function</a>, altering it enough that you become more susceptible to respiratory infection. A colleague who looked at lag time in the effect of wildfire smoke exposure found an <a href="https://doi.org/10.1016/j.envint.2020.105668">increase in influenza cases after a bad fire season</a>. Studies in developing countries have also found increases in <a href="https://doi.org/10.1016/j.atmosenv.2022.119055">respiratory infections</a> with people who are <a href="http://dx.doi.org/10.1136/thx.2010.147884">cooking on open fires</a> in homes.</p>
<p>The stress of an inflammatory response can also exacerbate existing health problems. Being exposed to wood smoke won’t independently cause someone to have a heart attack, but if they have underlying risk factors, such as significant plaque buildup, the added stress can increase the risk.</p>
<p>Researchers are also studying potential <a href="https://theconversation.com/breathing-wildfire-smoke-can-affect-the-brain-and-sperm-as-well-as-the-lungs-166548">effects on the brain</a> and <a href="https://ehp.niehs.nih.gov/doi/full/10.1289/EHP10498">nervous system</a> from <a href="https://www.epa.gov/isa/integrated-science-assessment-isa-particulate-matter">inhaled particulate matter</a>.</p>
<h2>When smoke blows over long distances, does its toxicity change?</h2>
<p>We know that the chemistry of wildfire smoke changes. The longer it’s in the atmosphere, the more the <a href="https://theconversation.com/wildfire-smoke-changes-dramatically-as-it-ages-and-that-matters-for-downwind-air-quality-heres-what-we-learned-flying-through-smoke-plumes-151671">chemistry will be altered</a> by ultraviolet light, but we still have <a href="http://doi.org/10.1016/j.etap.2017.08.022">a lot to learn</a>.</p>
<figure class="align-center ">
<img alt="A woman walks past the New York Stock Exchange building in the Wall Street district of New York. The sky is yellow-orange with wildfire smoke, a sky color common in apocalyptic films." src="https://images.theconversation.com/files/534624/original/file-20230628-17-7l230z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/534624/original/file-20230628-17-7l230z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/534624/original/file-20230628-17-7l230z.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/534624/original/file-20230628-17-7l230z.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/534624/original/file-20230628-17-7l230z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/534624/original/file-20230628-17-7l230z.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/534624/original/file-20230628-17-7l230z.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Wildfire smoke from Canada turned the skies in New York City an apocalyptic shade of orange on June 7, 2023.</span>
<span class="attribution"><a class="source" href="https://newsroom.ap.org/detail/CanadaWIldfiresPhotoGallery/1601ea44e9bb4515ba755b4f6a7d5fa9/photo">AP Photo/J. David Ake</a></span>
</figcaption>
</figure>
<p>Researchers have found that there seems to be a higher level of oxidation, so oxidants and free radicals are being generated the longer smoke is in the air. The specific health effects aren’t yet clear, but there’s some indication that more exposure leads to <a href="https://doi.org/10.1155/2017/8416763">greater health effects</a>.</p>
<p>The supposition is that more <a href="https://ec.europa.eu/research-and-innovation/en/horizon-magazine/four-times-more-toxic-how-wildfire-smoke-ages-over-time">free radicals are generated</a> the longer smoke is exposed to UV light, so there’s a greater potential for health harm. A lot of that, again, comes down to dose.</p>
<figure class="align-center ">
<img alt="The city skyline disappears as the viewer looks farther into the haze, which is coming from wildfire smoke." src="https://images.theconversation.com/files/534619/original/file-20230628-17-fz8urj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/534619/original/file-20230628-17-fz8urj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=397&fit=crop&dpr=1 600w, https://images.theconversation.com/files/534619/original/file-20230628-17-fz8urj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=397&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/534619/original/file-20230628-17-fz8urj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=397&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/534619/original/file-20230628-17-fz8urj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=499&fit=crop&dpr=1 754w, https://images.theconversation.com/files/534619/original/file-20230628-17-fz8urj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=499&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/534619/original/file-20230628-17-fz8urj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=499&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Haze from wildfire smoke envelopes the Minneapolis skyline on June 14, 2023.</span>
<span class="attribution"><a class="source" href="https://newsroom.ap.org/detail/CanadianWildfiresAirQuality/4dedf9a42ab04009a3f199e415fb66b1/photo">AP Photo/Abbie Parr</a></span>
</figcaption>
</figure>
<p>Chances are, if you’re a healthy individual, going for a bike ride or a hike in light haze won’t be a big deal, and your body will be able to recover. </p>
<p>If you’re doing that every day for a month in wildfire smoke, however, that raises more concerns. I’ve worked on studies with residents at Seeley Lake in Montana who were exposed to hazardous levels of PM2.5 from wildfire smoke for 49 days in 2017. We found a <a href="https://doi.org/10.3390/toxics8030053">decrease in lung function a year later</a>. No one was on oxygen, but there was a significant drop.</p>
<p>This is a relatively new area of research, and there’s still a lot we’re learning, especially with the increase in wildfire activity as the planet warms.</p>
<h2>What precautions can people take to reduce their risk from wildfire smoke?</h2>
<p>If there is smoke in the air, you want to decrease your exposure. </p>
<p>Can you completely avoid the smoke? Not unless you’re in a hermetically sealed home. The PM levels aren’t much different indoors and out unless you have a really good HVAC system, such as those with <a href="https://www.epa.gov/indoor-air-quality-iaq/what-merv-rating">MERV 15 or better filters</a>. But going inside decreases your activity, so your breathing rate is slower and the amount of smoke you’re inhaling is likely lower.</p>
<figure class="align-center ">
<img alt="A satellite animation shows smoke moving from fires in Alberta across Canada and into New England." src="https://images.theconversation.com/files/527359/original/file-20230521-119053-ul9mif.gif?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/527359/original/file-20230521-119053-ul9mif.gif?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=406&fit=crop&dpr=1 600w, https://images.theconversation.com/files/527359/original/file-20230521-119053-ul9mif.gif?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=406&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/527359/original/file-20230521-119053-ul9mif.gif?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=406&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/527359/original/file-20230521-119053-ul9mif.gif?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=511&fit=crop&dpr=1 754w, https://images.theconversation.com/files/527359/original/file-20230521-119053-ul9mif.gif?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=511&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/527359/original/file-20230521-119053-ul9mif.gif?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=511&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A satellite captures wildfire smoke on May 16, 2023.</span>
<span class="attribution"><a class="source" href="https://www.earthdata.nasa.gov/worldview/worldview-image-archive/canada-fires-16-may-2023">NASA EarthData</a></span>
</figcaption>
</figure>
<p>We also tend to advise people that if you’re in a susceptible group, such as those with asthma, create a safe space at home and in the office with a high-level stand-alone air filtration system to create a space with cleaner air.</p>
<p>Some <a href="https://doi.org/10.1038/s41370-020-00267-4">masks can help</a>. It doesn’t hurt to have a high-quality N95 mask. Just wearing a cloth mask won’t do much, though.</p>
<p>Most <a href="https://www.airnow.gov/">states have air quality monitors</a> that can give you a sense of how bad the air quality is, so check those sites and act accordingly.</p>
<p><em>This article was updated June 28, 2023, with smoke in Chicago, Minneapolis and Detroit and the latest map of smoke conditions.</em></p><img src="https://counter.theconversation.com/content/206057/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Christopher T. Migliaccio has received funding from the NIH and HRSA for his work in wood smoke health effects.
. </span></em></p>
Fires in Canada have sent smoke across several US states, leaving cities including New York, Chicago and Denver with some of the worst air quality in the world – even far from the flames.
Christopher T. Migliaccio, Research Associate Professor in Toxicology, University of Montana
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/198381
2023-02-05T12:54:24Z
2023-02-05T12:54:24Z
The science of holding your breath: How could Kate Winslet stay underwater for over 7 minutes in Avatar 2?
<figure><img src="https://images.theconversation.com/files/508138/original/file-20230203-6934-sjo14p.jpg?ixlib=rb-1.1.0&rect=28%2C0%2C4639%2C3047&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Kate Winslet promoting 'Avatar: The Way of Water' in London in December 2022. Winslet held her breath for over seven minutes during filming of the movie.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>Kate Winslet reportedly held her breath for <a href="https://variety.com/2022/film/news/kate-winslets-filmed-avatar-2-underwater-breath-hold-record-die-1235459216/">seven minutes and 15 seconds</a> on set for <em>Avatar: The Way of Water</em>. Some of the movie’s scenes were <a href="https://www.nytimes.com/2022/12/16/movies/avatar-2-fx-cgi.html">filmed underwater</a>.</p>
<p>It’s a remarkable feat; anyone (including professional freedivers) would acknowledge that a breath hold over seven minutes is extremely difficult. Most professional freedivers must train for years before reaching a number like that — many never achieve it. Winslet apparently trained only for a few weeks. </p>
<p>While Winslet now holds the record for a breath hold on a movie set, let’s put it in wider context. The current world record for breath holding, using a technique that is likely the same one the actor employed, is <a href="https://www.guinnessworldrecords.com/news/2021/5/freediver-holds-breath-for-almost-25-minutes-breaking-record-660285">24 minutes and 37 seconds</a>. This is held by Budimir Šobat — a professional breath hold diver with whom I have worked closely. </p>
<h2>Longest recorded breath holds</h2>
<p>I and other researchers have performed <a href="https://doi.org/10.1113/ep086269">extensive physiologic measures</a> on these professional divers to figure out how they can hold their breath for so long. One thing is certain: oxygen is important. In respect to the breath hold of almost 25 minutes by Šobat, it was accomplished by pre-breathing 100 per cent oxygen prior to holding the breath. Keep in mind the ratio of oxygen that we normally breathe in the atmosphere <a href="https://climate.nasa.gov/news/2491/10-interesting-things-about-air/">is 21 per cent</a>. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/VYfwxLn_KWc?wmode=transparent&start=59" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Actor Kate Winslet reacts after holding her breath for over seven minutes.</span></figcaption>
</figure>
<p>The world record for a <a href="https://www.aidainternational.org/WorldRecords/History">non-oxygen-assisted breath hold</a> is 11:35 minutes* by Stéphane Mifsud. For women it is 9:02 minutes, held by Natalia Molchanova. These are people who have trained for many years, and are the <a href="https://www.aidainternational.org/">top professional apneists</a> (apnea means temporarily stopped breathing). </p>
<p>How did Winslet do it then? And if you were to try this, why is it that you (probably) couldn’t come close to seven minutes, even after a few weeks of training? You would need to do what Winslet likely did, and that is pre-breathe with 100 per cent oxygen before holding your breath. Winslet also most likely hyperventilated (breathed faster and deeper than normal) on the 100 per cent oxygen. </p>
<p>To understand how this can increase the breath hold time, a brief overview of the control of breathing is needed. </p>
<h2>What happens when you hold your breath</h2>
<p>The most important signal to breathe comes from clusters of specialized cells in your brain and neck called chemoreceptors. These chemoreceptors respond to the level of carbon dioxide (CO2) and, to a lesser extent, the level of oxygen (O2) in your blood (yes, CO2 is more important in this case). </p>
<p>There are also signals from the brain stem itself (central controller) and lungs (pulmonary stretch receptors), but they are generally less important in relation to the topic at hand. Accordingly, the rate and depth of breathing is primarily controlled by these chemoreceptors that maintain the optimal level of blood O2 and CO2. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/4NJko3CIMl4?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Professional breath hold diver Budimir Šobat’s world record of 24 minutes and 37 seconds holding his breath underwater.</span></figcaption>
</figure>
<p>During a breath hold, the level of blood CO2 rises, and the O2 declines. The initial increase in the urge to breathe — let’s say 30 seconds into the breath hold — primarily comes from the rising CO2. At a particular threshold, the chemoreceptors also respond to the declining O2, at which point the drive to breathe increases dramatically. </p>
<p>Eventually, the urge to breathe intensifies to the point that the diaphragm (the primary respiratory muscle) contracts involuntarily — referred to as an <a href="https://doi.org/10.1113/ep086269">involuntary breathing movement</a>. This is the point at which the untrained breath holder will typically break and begin to breathe again (around three minutes if motivated and oxygen-unassisted). </p>
<h2>Pre-breathing oxygen</h2>
<p>However, with prior O2 inhalation, the onset of involuntary breathing movements is dramatically delayed. There is no longer any signal from O2 sensing. With about 15 minutes of prior 100 per cent O2 inhalation, a breath hold can be extended to nearly 20 minutes and the <a href="https://doi.org/10.1177/0271678X16686093">blood oxygen will still be higher than normal</a>. </p>
<p>Still, even with 100 per cent O2, CO2 (the primary stimulus for breathing) rises during the breath hold. However, fortunately for the oxygen-assisted breath holder, elevated blood O2 <a href="https://doi.org/10.1113/jphysiol.2010.187211">blunts the chemoreceptor response to CO2</a>. The combined effect of an absent O2 response, and a dampened CO2 response, allows someone to hold their breath for much longer. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/508140/original/file-20230203-14078-ltl7gz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A man in a red wetsuit seen from underwater, holding his breath at the surface while a man in blue leggings assists him." src="https://images.theconversation.com/files/508140/original/file-20230203-14078-ltl7gz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/508140/original/file-20230203-14078-ltl7gz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/508140/original/file-20230203-14078-ltl7gz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/508140/original/file-20230203-14078-ltl7gz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/508140/original/file-20230203-14078-ltl7gz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/508140/original/file-20230203-14078-ltl7gz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/508140/original/file-20230203-14078-ltl7gz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A freediver training in shallow water.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>Another trick is hyperventilating prior to breath holding. This will lower the initial blood CO2 levels. This lengthens the time before CO2 creeps above normal. </p>
<p>It’s important to note that hyperventilation before breath holding without prior 100 per cent O2 is dangerous in freediving because it increases the risk for <a href="https://www.ncbi.nlm.nih.gov/books/NBK554620/">shallow water blackout</a>. </p>
<p>It’s likely that Winslet’s trainers had a keen understanding of respiratory physiology and that she benefited from that knowledge. Although Winslet’s impressive breath hold is a record on movie sets, it isn’t record-shattering off sets — even for previously untrained people. </p>
<p>Even as far back as 1959, <a href="https://doi.org/10.1152/jappl.1959.14.5.689">researchers demonstrated</a> in seven untrained volunteers that breathing 100 per cent O2 prior to a breath hold resulted in maximum breath hold durations of six to 14 minutes. So Winslet’s seven-minute breath hold with only a few weeks’ training is definitely possible. </p>
<p><em>*The International Association for the Development of Apnea (AIDA) is the recognized governing body for the apnea disciplines, which does not recognize apnea with 100 per cent oxygen-assisted breathing. <a href="https://www.deeperblue.com/new-guinness-world-record-serbian-freediver-branko-petrovic/">Branko Petrovic</a> holds an oxygen-unassisted breath hold of 11:54 minutes through Guinness World Records, not accredited through AIDA.</em></p><img src="https://counter.theconversation.com/content/198381/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Anthony Bain receives funding from the National Science and Engineering Research Council (NSERC) of Canada. </span></em></p>
Kate Winslet held her breath for an impressive 7 minutes and 15 seconds while filming, but the current world record is over 24 minutes. Here’s how people learn to stay underwater for extended periods of time.
Anthony Bain, Associate Professor, Kinesiology, University of Windsor
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/184925
2022-06-15T19:48:33Z
2022-06-15T19:48:33Z
How mindfulness and dance can stimulate a part of the brain that can improve mental health
<figure><img src="https://images.theconversation.com/files/468854/original/file-20220614-2481-nqq3dd.jpg?ixlib=rb-1.1.0&rect=350%2C35%2C5335%2C3898&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Activating the somatosensory cortex may help us connect to our bodies, develop our sensitivity, sensuality and capacity to feel pleasure.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>Like a thick velvety headband, the <a href="https://www.simplypsychology.org/somatosensory-cortex.html">somatosensory cortex</a> arcs across the top of brain from just above one ear to the other. </p>
<p>I fell in love with the brain as an undergraduate student and pursued a career in neuroscience, but for years I had largely ignored this structure, since it appeared to be involved “only” in processing of bodily sensations. In my mind, that meant it was not as fascinating as areas implicated in emotion or higher cognitive function. </p>
<p>However, over the past decade, during my training in mindfulness-based interventions and dance movement therapy, I’ve come to realize that a well-functioning and developed somatosensory cortex may help us experience the world and ourselves more deeply and completely. It may enrich our emotional experience and improve our mental health.</p>
<p>For decades, the somatosensory cortex was considered to only be responsible for processing sensory information from various body parts. However, recently it became apparent that this structure is also involved in various stages of emotion processing, including <a href="https://doi.org/10.1523/JNEUROSCI.20-07-02683.2000">recognizing</a>, <a href="https://doi.org/10.1038/79871">generating and regulating emotions</a>.</p>
<p>Moreover, structural and functional changes in the somatosensory cortex have been found in individuals diagnosed with depression, anxiety and psychotic disorders. <a href="https://doi.org/10.1590/1516-4446-2018-0183">These studies suggest that the somatosensory cortex may be a treatment target</a> for certain mental health problems, as well as for preventive measures. Some researchers have even suggested neuromodulation of the somatosensory cortex with <a href="https://www.hopkinsmedicine.org/psychiatry/specialty_areas/brain_stimulation/tms/">transcranial magnetic stimulation</a> or <a href="https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Deep-Brain-Stimulation">deep brain stimulation</a>. </p>
<figure class="align-center ">
<img alt="While training in mindfulness-based interventions and dance movement therapy, it became clear that a well-functioning and developed somatosensory cortex may help people experience the world and themselves more deeply." src="https://images.theconversation.com/files/468855/original/file-20220614-26-ml3or2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/468855/original/file-20220614-26-ml3or2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=427&fit=crop&dpr=1 600w, https://images.theconversation.com/files/468855/original/file-20220614-26-ml3or2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=427&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/468855/original/file-20220614-26-ml3or2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=427&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/468855/original/file-20220614-26-ml3or2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=537&fit=crop&dpr=1 754w, https://images.theconversation.com/files/468855/original/file-20220614-26-ml3or2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=537&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/468855/original/file-20220614-26-ml3or2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=537&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">While training in mindfulness-based interventions and dance movement therapy, it became clear that a well-functioning and developed somatosensory cortex may help people experience the world and themselves more deeply.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>However, before we decide to use an invasive technology, we may want to consider mindfulness-based interventions, dance movement therapy or other body-centred approaches to psychotherapy. These methods use the entire body to enhance sensory, breath and movement awareness. <a href="https://doi.org/10.3389/fpsyg.2019.00103">Those factors can enhance overall self-awareness, which contributes to improvement of mental health</a> through potential reorganization of the somatosensory cortex.</p>
<h2>Functional significance of the somatosensory cortex</h2>
<p>One of the amazing qualities of the somatosensory cortex is its <a href="https://doi.org/10.1111/jnc.14012">pronounced plasticity</a> — the ability to reorganize and enlarge with practice (or atrophy without practice). This plasticity is critical when we consider mindfulness-based interventions and dance movement therapy because, as mentioned above, through working directly with the body sensations and movement, we can modify the somatosensory cortex.</p>
<p>Another important aspect is its numerous connections with other areas of the brain. In other words, the somatosensory cortex has a power to affect other brain regions, which in turn affect other regions, and so on. The brain is heavily interconnected and none of its parts acts in isolation. </p>
<p>The somatosensory cortex receives information from the entire body, such that the left part of the cortex processes information from the right side of the body and vice versa. However, the proportion of the cortex devoted to a particular part of the body depends on its functional importance rather than its physical size. </p>
<p>For example, a large proportion of the somatosensory cortex is devoted to our hands, and so just moving and feeling our hands might be an interesting option for dance therapy for those with restricted mobility.</p>
<p>The somatosensory cortex mediates exteroception (touch, pressure, temperature, pain, etc.), proprioception (postural and movement information) and interoception (sensations inside the body, often related to the physiological body states, such as hunger and thirst), although its role in the interoceptive awareness is only partial. </p>
<h2>The somatosensory cortex and emotion</h2>
<p>A scent, a song or an image can suddenly bring a deeply buried and forgotten event to mind. Similarly, feeling a texture — like cashmere — against our skin, or moving our body in a certain way (such as doing a backbend, or rocking back and forth) can do the same and more. It can bring repressed memories to the surface, <a href="https://doi.org/10.3389/fpsyg.2020.579518">provoke emotional reactions, and create state shifts</a>. This is one of the superpowers of mindfulness-based interventions and dance movement therapy. </p>
<p>This response is <a href="https://sensoryhealth.org/basic/your-8-senses">mediated via the somatosensory cortex</a>, just like emotional and cognitive reactions to a song are mediated via the auditory cortex, and reactions to scents are mediated via the olfactory cortex. Nevertheless, if the information stopped flowing at a purely sensory level (what we feel, hear, see, taste and smell), then a significant portion of the emotional and cognitive consequences would be lost.</p>
<figure class="align-center ">
<img alt="A man in a chair in white shirt, in a white room, with his eyes closed." src="https://images.theconversation.com/files/468856/original/file-20220614-12-4h4mw2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/468856/original/file-20220614-12-4h4mw2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/468856/original/file-20220614-12-4h4mw2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/468856/original/file-20220614-12-4h4mw2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/468856/original/file-20220614-12-4h4mw2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/468856/original/file-20220614-12-4h4mw2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/468856/original/file-20220614-12-4h4mw2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Some evidence comes from studies of meditation and mindfulness-based interventions, which often involve the practice of body scans and/or returning to bodily sensations as anchors in meditation.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>Dance/movement therapists and body-centered practitioners have known about this connection between posture/movement and emotion/cognition since the inception of the field. Neuroscientists have now delineated — still roughly — the implicated neural networks. For example, research shows <a href="https://doi.org/10.1016/j.bpsc.2017.12.004">a relationship between developing our sensory sensitivity and emotion regulation</a>.</p>
<p>Some evidence comes from studies of meditation and mindfulness-based interventions, which often involve the practice of body scans (paying attention to parts of the body and bodily sensations in a gradual sequence, for example from feet to head) and/or returning to bodily sensations as anchors in meditation. </p>
<p>Overall, the studies show that people who train in body scans and/or develop sensory awareness of the breath (feeling the breath travelling through the nostrils, throat, etc.) are <a href="https://doi.org/10.1177%2F070674371205700203">less reactive and more resilient</a>. <a href="https://doi.org/10.3389/fpsyg.2017.00220">This effect is mediated, at least partly, through the somatosensory cortex</a>. </p>
<h2>Clinical implications</h2>
<p>Given the emerging role of the somatosensory cortex in emotion and cognitive processing, it is not surprising that alterations in the structure and function of this brain region have been found in several mental health problems, including depression, bipolar disorder and schizophrenia. </p>
<p>For example, reductions in the cortical thickness and the gray matter volume of the somatosensory cortex have been observed in individuals with major depressive disorder (<a href="https://doi.org/10.1038/mp.2016.60">especially those with early onset</a>) and in the <a href="https://doi.org/10.1177%2F0004867417746001">bipolar disorder</a>. In schizophrenia, lower levels of activity in the somatosensory cortex have been observed, <a href="https://doi.org/10.1016/0006-3223(87)90170-3">especially in unmedicated patients</a>. </p>
<p>Activating the somatosensory cortex may help us connect to our bodies, develop our sensitivity, sensuality and capacity to feel pleasure. That is how moving mindfully, dancing consciously and meditating with the whole body may help people regulate their emotions and connect with themselves and the world more deeply and meaningfully.</p><img src="https://counter.theconversation.com/content/184925/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Adrianna Mendrek does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
The brain’s somatosensory cortex may help enrich our emotional experiences and improve our mental health. Mindfulness and dance movement therapy may be effective ways to activate it.
Adrianna Mendrek, Professor, Psychology Department, Bishop's University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/176249
2022-02-10T03:12:54Z
2022-02-10T03:12:54Z
At home with COVID? 5 easy tips to help you breathe more easily
<figure><img src="https://images.theconversation.com/files/445551/original/file-20220210-23-3b49ib.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C1000%2C660&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/close-calm-african-female-rest-leaned-1733456774">Shutterstock</a></span></figcaption></figure><p>Shortness of breath, persistent cough and fatigue are common COVID signs and symptoms. And the <a href="https://www.health.gov.au/health-alerts/covid-19/case-numbers-and-statistics">vast majority</a> of people will be managing their symptoms at home.</p>
<p>As a cardiorespiratory physiotherapist, I help people with heart and breathing problems manage and recover from a range of illnesses. </p>
<p>Here are some simple exercises to help you navigate COVID at home.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/ive-tested-positive-to-covid-what-should-i-do-now-174458">I've tested positive to COVID. What should I do now?</a>
</strong>
</em>
</p>
<hr>
<h2>Why should I exercise when I have COVID?</h2>
<p>Your body does need some rest when you are sick. However, doing simple, gentle exercises while convalescing with COVID can <a href="https://www.sciencedirect.com/science/article/pii/S1744388121000633?casa_token=DtZHFwAh5-8AAAAA:dmR3Lcvu331IedCvgbEioJ6eJTOSD2jGRD7L3sobJRJBvERfvl2xZfc5InNPZktW--YkUmYH">help improve</a> your symptoms.</p>
<p>People who are older, overweight, or have a chronic condition, such as diabetes, or cardiovascular (heart/circulation) and respiratory (lung) disease, are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7543371/">more likely</a> to have COVID symptoms.</p>
<p>So these groups are among those who would particularly benefit from simple, gentle exercise at home.</p>
<h2>1. Relaxed breathing</h2>
<p>This exercise is particularly useful if you feel short of breath:</p>
<ul>
<li><p>get into a stable and comfortable position. Drop your shoulders and breathe in slowly</p></li>
<li><p>purse your lips (as if you’re blowing through a straw)</p></li>
<li><p>breathe out slowly and steadily through your mouth</p></li>
<li><p>repeat the exercise for a minute.</p></li>
</ul>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/dDpX7pGdPR4?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Here’s what relaxed breathing looks like.</span></figcaption>
</figure>
<p>You can perform this exercise as often as you like. But <strong>stop if you feel dizzy</strong> as taking too many breaths in a row will cause light headiness. </p>
<p>Perform the exercise in a room with windows open. If you are feeling hot, you can cool your face with a damp towel while doing it.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/445543/original/file-20220209-18418-18fi99b.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Person lying on their side on the bed" src="https://images.theconversation.com/files/445543/original/file-20220209-18418-18fi99b.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/445543/original/file-20220209-18418-18fi99b.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=394&fit=crop&dpr=1 600w, https://images.theconversation.com/files/445543/original/file-20220209-18418-18fi99b.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=394&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/445543/original/file-20220209-18418-18fi99b.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=394&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/445543/original/file-20220209-18418-18fi99b.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=495&fit=crop&dpr=1 754w, https://images.theconversation.com/files/445543/original/file-20220209-18418-18fi99b.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=495&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/445543/original/file-20220209-18418-18fi99b.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=495&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Some people will need to lie on their side for this exercise.</span>
<span class="attribution"><a class="source" href="https://apps.who.int/iris/bitstream/handle/10665/344472/WHO-EURO-2021-855-40590-59892-eng.pdf?sequence=1&isAllowed=y">WHO</a></span>
</figcaption>
</figure>
<p>Adopting a comfortable position is key to this exercise. Sitting in a supportive chair may be the easiest for most people. </p>
<p>However, for some people with COVID, sitting in a chair is too strenuous. In these instances, try this exercise in other positions such as lying on your side, as <a href="https://www.euro.who.int/en/health-topics/Life-stages/disability-and-rehabilitation/publications/support-for-rehabilitation-self-management-after-covid-19-related-illness,-2nd-ed">recommended</a> by the World Health Organization.</p>
<h2>2. Deep breathing</h2>
<p>This can improve oxygen intake and calm your nerves:</p>
<ul>
<li><p>get into an upright position. Relax your shoulders</p></li>
<li><p>breathe in deeply through your nose for two to three seconds. Hold your breath for three seconds, if able</p></li>
<li><p>breathe out through your nose or mouth, whichever is more comfortable</p></li>
<li><p>repeat the exercise for a minute. </p></li>
</ul>
<p>Again, <strong>stop if you feel dizzy.</strong> You may cough and bring up some phelgm after this exercise. If you do have to cough, cover your mouth with a tissue and dispose of the tissue immediately in a sealed bag after each use. Wash your hands thoroughly after.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-to-look-after-your-mental-health-if-youre-at-home-with-covid-174536">How to look after your mental health if you're at home with COVID</a>
</strong>
</em>
</p>
<hr>
<h2>3. Lie on your tummy (if you can)</h2>
<p>You may have heard from others, such as Harry Potter author <a href="https://www.health.com/condition/infectious-diseases/coronavirus/jk-rowling-breathing-technique-covid-19">JK Rowling</a>, about the benefits of lying on your stomach (proning) during breathing exercises to improve oxygenation.</p>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/445545/original/file-20220209-19-f58vmq.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Person lying on their front on the bed" src="https://images.theconversation.com/files/445545/original/file-20220209-19-f58vmq.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/445545/original/file-20220209-19-f58vmq.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=274&fit=crop&dpr=1 600w, https://images.theconversation.com/files/445545/original/file-20220209-19-f58vmq.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=274&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/445545/original/file-20220209-19-f58vmq.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=274&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/445545/original/file-20220209-19-f58vmq.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=344&fit=crop&dpr=1 754w, https://images.theconversation.com/files/445545/original/file-20220209-19-f58vmq.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=344&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/445545/original/file-20220209-19-f58vmq.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=344&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Lying on your front isn’t for everyone and can be painful.</span>
<span class="attribution"><a class="source" href="https://apps.who.int/iris/bitstream/handle/10665/344472/WHO-EURO-2021-855-40590-59892-eng.pdf?sequence=1&isAllowed=y">WHO</a></span>
</figcaption>
</figure>
<p>Proning is common in hospital for people who need extra oxygen. However, the evidence for proning at home is unclear and it is not for everyone.</p>
<p>As you need to stay on your stomach for at least 30 minutes, some people may find this extremely uncomfortable, especially if they have neck and lower back pain. For these people, sitting upright or lying on their side while doing breathing exercises may be better alternatives.</p>
<p>Nonetheless, if you would like to try proning, here are some tips:</p>
<ul>
<li><p>do not try proning after a meal</p></li>
<li><p>choose a firm surface to lie on. Soft beds can make lying on your stomach even more uncomfortable for your back</p></li>
<li><p>turn your head to the side. Place a pillow under your stomach, feet, arms and head for comfort</p></li>
<li><p>ensure you have someone with you at all times, especially when trying this for the first time. Both you and your helper should wear a mask to minimise cross-infection </p></li>
<li><p>do not attempt proning with children under one year old.</p></li>
</ul>
<h2>4. Move regularly</h2>
<p>Even people with relatively mild COVID symptoms may continue to be fatigued after other symptoms have resolved. </p>
<p>Doing simple exercises regularly throughout the day while in isolation can help minimise the effects of reduced mobility during COVID.</p>
<p>You can try sitting on a chair and standing, then repeating that for a minute. Or you could march on the spot for two minutes. </p>
<p><a href="https://www.euro.who.int/en/health-topics/Life-stages/disability-and-rehabilitation/publications/support-for-rehabilitation-self-management-after-covid-19-related-illness,-2nd-ed">Pacing and prioritising</a> your activities to ensure you do regular activities throughout the day can also help manage your fatigue.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/whats-a-pulse-oximeter-should-i-buy-one-to-monitor-covid-at-home-174457">What's a pulse oximeter? Should I buy one to monitor COVID at home?</a>
</strong>
</em>
</p>
<hr>
<h2>5. Know when to seek further medical attention</h2>
<p>If you or a family member experience chest pain, difficulty breathing despite home management, dizziness, new weakness in your face, arm or leg, increased confusion, difficulty staying awake, or have thoughts of self-harm, you will need to seek <a href="https://theconversation.com/covid-can-worsen-quickly-at-home-heres-when-to-call-an-ambulance-166889">urgent medical attention</a>. </p>
<p>You can also use online <a href="https://www.healthdirect.gov.au/symptom-checker/tool/basic-details">symptom checkers</a> for advice on your next immediate action, including when to call an ambulance.</p>
<p>If your COVID symptoms last longer than two weeks, see your local doctor. They may be able to <a href="https://www.aci.health.nsw.gov.au/__data/assets/pdf_file/0005/605525/ACI-Respiratory-Rehab-Following-COVID-19.pdf">refer you</a> to a pulmonary (lung) rehabilitation service or physiotherapist who specialises in lung conditions.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/covid-can-worsen-quickly-at-home-heres-when-to-call-an-ambulance-166889">COVID can worsen quickly at home. Here's when to call an ambulance</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/176249/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Clarice Tang receives funding from Multicultural NSW, Department of Health and Maridulu Budyari Gumal. She is affiliated with Western Sydney University and is a member of the Australian Physiotherapy Association, Thoracic Society of Australia and New Zealand and the American Thoracic Society. </span></em></p>
Exercise might be the last thing on your mind if you’re at home with COVID. But these gentle breathing exercises can help.
Clarice Tang, Senior lecturer in Physiotherapy, Western Sydney University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/174187
2022-01-20T13:45:54Z
2022-01-20T13:45:54Z
Pain and anxiety are linked to breathing in mouse brains – suggesting a potential target to prevent opioid overdose deaths
<figure><img src="https://images.theconversation.com/files/440880/original/file-20220114-15-fjrex1.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C2121%2C1412&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A part of the brain called the lateral parabrachial nucleus regulates pain, anxiety and breathing.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/illustration/panic-attack-stress-fear-concept-royalty-free-illustration/1222762541">Aleksei Morozov/iStock via Getty Images Plus</a></span></figcaption></figure><p>You’re startled by a threatening sound, and your breath quickens. You smash your elbow and pant in pain. Why does your breathing rate increase dramatically when you’re hurting or anxious?</p>
<p>As neurobiologists studying <a href="https://scholar.google.com/citations?user=OYfm9kMAAAAJ&hl=en">how the brain responds to environmental threats</a> and the <a href="https://scholar.google.com/citations?user=7bSQmUMAAAAJ&hl=en">neural circuitry of emotion</a>, we were curious about the answer to this question ourselves. In our <a href="https://doi.org/10.1016/j.neuron.2021.11.029">recently published study</a>, we discovered that one particular circuit of the brain in mice underlies this tight connection between pain, anxiety and breathing. And this discovery may eventually help us develop safer pain killers for humans.</p>
<h2>The part of the brain that takes the breath away</h2>
<p>One of the most common symptoms of both pain and anxiety disorders is shortness of breath, or <a href="http://www.heraldopenaccess.us/openaccess/hyperventilation-syndrome-a-diagnosis-usually-unrecognized">hyperventilation</a>. On the other hand, <a href="https://doi.org/10.1111/j.1526-4637.2011.01243.x">slow, deep breathing</a> can reduce pain and distress. The simplest way to explain this, we reasoned, is the existence of a common pathway in the brain that regulates breathing, pain and anxiety simultaneously.</p>
<p>So we searched for brain regions previously reported to regulate breathing, pain and emotion. A small area in the brainstem called the <a href="https://doi.org/10.1016/j.tins.2018.03.007">lateral parabrachial nucleus</a> caught our attention. Not only is it part of the breathing regulation center of the brain, it also mediates pain and negative emotions like fear and anxiety. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/440364/original/file-20220112-13-hlljgr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Scan of mouse brain colored green, with the lateral parabrachial nucleus highlighted to the middle right." src="https://images.theconversation.com/files/440364/original/file-20220112-13-hlljgr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/440364/original/file-20220112-13-hlljgr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=451&fit=crop&dpr=1 600w, https://images.theconversation.com/files/440364/original/file-20220112-13-hlljgr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=451&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/440364/original/file-20220112-13-hlljgr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=451&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/440364/original/file-20220112-13-hlljgr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/440364/original/file-20220112-13-hlljgr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/440364/original/file-20220112-13-hlljgr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A cluster of neurons with highly active opioid receptors, highlighted in neon green, is located in a small area of the mouse brainstem called the lateral parabrachial nucleus.</span>
<span class="attribution"><span class="source">Salk Institute</span>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span>
</figcaption>
</figure>
<p>Searching through a public database of <a href="https://www.nature.com/scitable/topicpage/gene-expression-14121669/">gene expression</a> patterns, or how genetic material is translated into proteins that let cells function, in the mouse brain, we serendipitously found that one type of opioid receptor called the <a href="https://medlineplus.gov/genetics/gene/oprm1/">µ-opioid receptor</a> is highly expressed in parabrachial neurons.</p>
<p>Opioids are chemical compounds that decrease pain and promote positive emotions. But they can also <a href="https://doi.org/10.1073/pnas.2022134118">slow breathing rates</a> to dangerously low levels, or stop breathing altogether. This repression of breathing is the <a href="https://www.capnoacademy.com/2018/10/03/capno-101-what-is-opioid-induced-respiratory-depression/">main reason</a> opioid overdoses cause death. </p>
<p><a href="https://doi.org/10.1038/383819a0">Previous studies</a> have shown that the effects opioids have on the body are mainly mediated by µ-opioid receptors. We therefore focused our investigation on how pain and breathing interact with each other in neurons that express these receptors.</p>
<p>We labeled the neurons projecting to the breathing and pain centers with multicolored fluorescent proteins. In doing this, we were able to identify two subsets of neurons that express µ-opioid receptors. These neurons were arranged in a core-shell shape, where one subset of neurons are wrapped around the other subset. The outer shell neurons regulate breathing by sending their axons – the long part of the neuron that transmits electrical signals – to the part of the brainstem that controls breathing. The inner core neurons, on the other hand, mediate pain and anxiety by sending their axons to the brain’s pain and emotion center, the amygdala.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/440367/original/file-20220112-27-p8jqla.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Image showing mu-opioid receptor expressing shell neurons in green and core neurons in red." src="https://images.theconversation.com/files/440367/original/file-20220112-27-p8jqla.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/440367/original/file-20220112-27-p8jqla.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/440367/original/file-20220112-27-p8jqla.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/440367/original/file-20220112-27-p8jqla.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/440367/original/file-20220112-27-p8jqla.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/440367/original/file-20220112-27-p8jqla.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/440367/original/file-20220112-27-p8jqla.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Shell neurons, colored in green, project to the brain’s breathing center in the brainstem. Core neurons, colored red, project to the pain/emotion center called the amygdala.</span>
<span class="attribution"><span class="source">Salk Institute</span>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span>
</figcaption>
</figure>
<p>What we found even more interesting was that the core and shell neurons interact with each other – activating one subset of neurons will send a signal to the other. This interconnected loop can explain why breathing, pain and anxiety are often regulated simultaneously and influence one another. </p>
<p>If a similar loop exists in humans, this may also explain why your breath shortens when you are afraid or in pain.</p>
<h2>Why is breathing linked to anxiety and pain?</h2>
<p>When animals encounter a harmful or threatening situation, their oxygen levels rapidly increase to <a href="https://dx.doi.org/10.1002%2Fcphy.c120003">help them escape from danger</a>. This might be why breathing and pain are tightly coupled. </p>
<p>Previous studies have shown that neurons in the parabrachial nucleus are critically important in inducing shortness of breath during conditions like <a href="https://doi.org/10.1016/j.resp.2008.10.009">hypercapnia</a>, where there is too much carbon dioxide in the blood from breathing too shallowly, and <a href="https://doi.org/10.1016/j.resp.2008.10.007">hypoxia</a>, where the body is deprived of oxygen. Telling the body to increase its breathing rate helps decrease carbon dioxide levels and replenish vital oxygen stores.</p>
<p>Going further, our results suggest that these neurons serve as a central alarm system in the brain. When these neurons fire, they trigger behavioral and physiological responses that help animals cope with external threats, like predators, and internal threats, like low oxygen levels.</p>
<h2>Designing safer drugs to alleviate pain</h2>
<p>Our findings could lead to the development of safer pain-relieving drugs that don’t dangerously repress breathing. </p>
<p>From 1999 to 2018, <a href="https://www.cdc.gov/nchs/products/databriefs/db356.htm">opioid overdoses killed 4.5 million people</a> in the U.S. alone. Directly causing these deaths are the dangerously low breathing rates, or <a href="https://www.capnoacademy.com/2018/10/03/capno-101-what-is-opioid-induced-respiratory-depression/">opioid-induced respiratory depression</a>, that are a side effect of these drugs. </p>
<p>Neurons in the parabrachial nucleus affect breathing and pain in different ways and harbor <a href="https://doi.org/10.1073/pnas.2022134118">numerous receptors</a> that could be used as drug targets. Our research team is now performing genetic analyses of these neurons in mice to identify receptors that can specifically turn up or turn down these pain and breathing pathways.</p>
<p>If similar neurons are found in humans, we would move one step closer to developing safer pain-relieving drugs and potentially reducing opioid overdose deaths.</p>
<p>[<em>Get fascinating science, health and technology news.</em> <a href="https://memberservices.theconversation.com/newsletters/?nl=science&source=inline-science-fascinating">Sign up for The Conversation’s weekly science newsletter</a>.]</p><img src="https://counter.theconversation.com/content/174187/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sung Han receives funding from the National Institute of Mental Health, and the Brain Research Foundation.</span></em></p><p class="fine-print"><em><span>Shijia Liu receives funding from the Mary K. Chapman Foundation and the Jesse & Caryl Philips Foundation.</span></em></p>
Opioids can cause death by slowing breathing to dangerously low levels, or stopping it altogether. Examining one area of the brain may eventually lead to safer painkillers.
Sung Han, Assistant Professor at Salk Institute for Biological Studies, Assistant Adjunct Professor of Neurobiology, University of California, San Diego
Shijia Liu, PhD Candidate in Neurobiology at Salk Institute for Biological Studies, University of California, San Diego
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/160162
2021-06-02T12:26:35Z
2021-06-02T12:26:35Z
Urban oil wells linked to asthma and other health problems in Los Angeles
<figure><img src="https://images.theconversation.com/files/403471/original/file-20210530-22-hfz0x0.jpg?ixlib=rb-1.1.0&rect=8%2C17%2C2986%2C1976&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Hundreds of active oil wells are hiding in plain sight across the Los Angeles area.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/jet-lands-at-los-angeles-international-airport-as-oil-rigs-news-photo/80864709">David McNew/Getty Images</a></span></figcaption></figure><p>When California Gov. Gavin Newsom announced a goal to <a href="https://www.gov.ca.gov/2021/04/23/governor-newsom-takes-action-to-phase-out-oil-extraction-in-california/">phase out oil drilling</a> statewide by 2045, he focused on its <a href="https://www.epa.gov/ghgemissions/global-greenhouse-gas-emissions-data">impact on climate change</a>. But oil drilling is also a health problem, particularly in Los Angeles, where thousands of oil wells still dot the city. </p>
<p>These wells can emit toxic chemicals such as benzene and other irritants into the air, often just feet from homes, schools and parks.</p>
<p>As <a href="https://scholar.google.com/citations?user=t4m6sjAAAAAJ&hl=en">environmental health</a> <a href="https://www.researchgate.net/profile/Bhavna-Shamasunder">researchers</a>, we study the impacts of oil drilling on surrounding communities. <a href="https://doi.org/10.1016/j.envres.2021.111088">Our research</a> shows that <a href="http://doi.org/10.3390/ijerph15010138">people living near these urban oil operations</a> suffer higher rates of asthma than average, as well as wheezing, eye irritation and sore throats. In some cases, the impact on residents’ lungs is worse than living beside a highway or being exposed to secondhand smoke every day. </p>
<h2>LA was once an oil town with forests of derricks</h2>
<p>Over a century ago, before Hollywood, the <a href="https://doi.org/10.2307/3985379">first industry to boom</a> in Los Angeles was oil. </p>
<p>Oil was abundant and flowed close to the surface. In early 20th-century California, sparse laws governed mineral extraction, and rights to oil accrued to those who could pull it out of the ground first. This ushered in a period of rampant drilling, with wells and associated machinery crisscrossing the landscape. By the mid-1920s, Los Angeles was one of the <a href="https://www.jstor.org/stable/3985379?seq=2#metadata_info_tab_contents">largest oil-exporting regions</a> in the world. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/402241/original/file-20210523-102683-u0ildq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A historic black-and-white photo shows a street with houses, old cars and dozens of oil derricks on the hill behind them." src="https://images.theconversation.com/files/402241/original/file-20210523-102683-u0ildq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/402241/original/file-20210523-102683-u0ildq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=382&fit=crop&dpr=1 600w, https://images.theconversation.com/files/402241/original/file-20210523-102683-u0ildq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=382&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/402241/original/file-20210523-102683-u0ildq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=382&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/402241/original/file-20210523-102683-u0ildq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=480&fit=crop&dpr=1 754w, https://images.theconversation.com/files/402241/original/file-20210523-102683-u0ildq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=480&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/402241/original/file-20210523-102683-u0ildq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=480&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A 1924 photo shows the oil derricks on Signal Hill.</span>
<span class="attribution"><a class="source" href="https://waterandpower.org/museum/Early_City_Views%20(1925%20+).html">Water and Power Museum Archive</a></span>
</figcaption>
</figure>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/402245/original/file-20210523-23-dk3nal.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="An old black-and-white photo of a roller coaster on a pier, with the city behind it and then a long row of oil derricks behind that on a ridge." src="https://images.theconversation.com/files/402245/original/file-20210523-23-dk3nal.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/402245/original/file-20210523-23-dk3nal.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=453&fit=crop&dpr=1 600w, https://images.theconversation.com/files/402245/original/file-20210523-23-dk3nal.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=453&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/402245/original/file-20210523-23-dk3nal.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=453&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/402245/original/file-20210523-23-dk3nal.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=569&fit=crop&dpr=1 754w, https://images.theconversation.com/files/402245/original/file-20210523-23-dk3nal.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=569&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/402245/original/file-20210523-23-dk3nal.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=569&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The view across The Pike amusement park and downtown Long Beach, California, in 1940 shows a forest of oil derricks in the background.</span>
<span class="attribution"><a class="source" href="https://waterandpower.org/museum/Early_City_Views%20(1925%20+).html">Water and Power Museum Archive</a></span>
</figcaption>
</figure>
<p>Oil rigs were so pervasive across the region that the Los Angeles Times described them in 1930 as “<a href="https://doi.org/10.1093/jahist/jas079">trees in a forest</a>.” Working-class communities were initially supportive of the industry because it promised jobs but later <a href="https://doi.org/10.2307/3985379">pushed back</a> as their neighborhoods witnessed explosions and oil spills, along with <a href="https://doi.org/10.1007/s00254-004-1159-0">longer-term damage to land, water and human health</a>.</p>
<p>Tensions over land use, extraction rights and subsequent drops in oil prices due to overproduction eventually resulted in curbs on drilling and a long-standing practice of oil companies’ voluntary “<a href="https://doi.org/10.1093/jahist/jas079">self-regulation</a>,” such as noise-reduction technologies. The industry began touting these voluntary approaches to deflect governmental regulation.</p>
<p>Increasingly, oil companies disguised their activities with approaches such as operating <a href="https://www.lamag.com/citythinkblog/hidden-oil-wells/">inside buildings, building tall walls</a> and <a href="https://lbbusinessjournal.com/thums-oil-islands-half-a-century-later-still-unique-still-iconic">designing islands off Long Beach</a> and other sites to blend in with the landscape. Oil drilling was hidden in plain sight. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/403472/original/file-20210530-17-ozo882.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A silhouetted student with a backpack walks past an oil derrick covered with drawings of flowers outside a school." src="https://images.theconversation.com/files/403472/original/file-20210530-17-ozo882.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/403472/original/file-20210530-17-ozo882.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=347&fit=crop&dpr=1 600w, https://images.theconversation.com/files/403472/original/file-20210530-17-ozo882.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=347&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/403472/original/file-20210530-17-ozo882.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=347&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/403472/original/file-20210530-17-ozo882.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=436&fit=crop&dpr=1 754w, https://images.theconversation.com/files/403472/original/file-20210530-17-ozo882.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=436&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/403472/original/file-20210530-17-ozo882.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=436&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Beverly Hills High School earned money from an oil well, hidden behind walls covered with flower drawings, that operated until 2017 but raised health concerns.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/decorative-flowery-exterior-masks-an-oil-rig-along-olympic-news-photo/566019401">Luis Sinco/Los Angeles Times via Getty Images</a></span>
</figcaption>
</figure>
<p>Today there are over 20,000 active, idle or abandoned wells spread across a county of 10 million people. About <a href="https://news.usc.edu/184929/urban-oil-wells-drilling-lung-health-los-angeles-usc-research/">one-third of residents</a> live less than a mile from an active well site, <a href="https://maps.conservation.ca.gov/doggr/wellfinder/#openModal/-118.23225/33.87983/12">some right next door</a>.</p>
<p>Since the 2000s, the advance of extractive technologies to access harder-to-reach deposits has led to a resurgence of oil extraction activities. As extraction in some neighborhoods has ramped up, people living in South Los Angeles and other neighborhoods in oil fields have noticed frequent <a href="https://www.latimes.com/local/la-xpm-2013-sep-21-la-me-0922-oil-20130922-story.html">odors, nosebleeds and headaches</a>. </p>
<h2>Closer to urban oil drilling, poorer lung function</h2>
<p>The City of Los Angeles currently requires no buffers or setbacks between oil extraction and homes. Approximately <a href="https://doi.org/10.1016/j.envres.2021.111088">75% of active oil or gas wells are located within 500 meters</a> (1,640 feet) of “sensitive land uses,” such as homes, schools, child care facilities, parks or senior residential facilities.</p>
<p>Despite that proximity and over a century of oil drilling in Los Angeles, there have been few studies on how it affects residents’ health. We have been working with <a href="https://envhealthcenters.usc.edu/2021/04/harnessing-the-expertise-of-community-health-workers-for-environmental-health-research.html">community health workers</a> to gauge the impact oil wells are having on residents, particularly on its historically Black and Hispanic neighborhoods.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/cSfXx7cMNWc?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Oil drilling in Los Angeles.</span></figcaption>
</figure>
<p>The first step was a door-to-door survey of 813 neighbors from 203 households near wells in Las Cienegas oilfield, just south and west of downtown. We found that <a href="https://doi.org/10.3390/ijerph15010138">asthma</a> was significantly more common among people living near South Los Angeles oil wells than among residents of <a href="https://ask.chis.ucla.edu">Los Angeles County as a whole</a>. Nearly half the people we spoke with, 45%, didn’t know oil wells were operating nearby, and 63% didn’t know how to contact local regulatory authorities to report odors or environmental hazards. </p>
<p>Next, we measured lung function of 747 long-term residents, ages 10 to 85, living near two drilling sites. Poor lung capacity, measured as the amount of air a person can exhale after taking a deep breath, and lung strength, how strongly the person can exhale, and are both predictors of health problems including <a href="https://doi.org/10.1007/s10654-012-9750-2">respiratory disease, death from cardiovascular problems</a> and <a href="http://dx.doi.org/10.1136/thorax.58.5.388">early death in general</a>.</p>
<p>We found that the closer someone lived to an active or recently idle well site, <a href="https://doi.org/10.1016/j.envres.2021.111088">the poorer that person’s lung function</a>, even after adjusting for such other risk factors as smoking, asthma and living near a freeway. This research demonstrates a significant relationship between living near oil wells and worsened lung health.</p>
<p>People living up to 1,000 meters (0.6 miles) downwind of a well site showed lower lung function on average than those living farther away and upwind. The effect on their lungs’ capacity and strength was similar to impacts of living near a freeway or, for women, being exposed to secondhand smoke.</p>
<p><iframe id="4KEam" class="tc-infographic-datawrapper" src="https://datawrapper.dwcdn.net/4KEam/14/" height="400px" width="100%" style="border: none" frameborder="0"></iframe></p>
<p>Using a community monitoring network in South Los Angeles, we were able to <a href="https://doi.org/10.1016/j.atmosenv.2020.117519">distinguish oil-related pollution</a> in neighborhoods near wells. We found short-term spikes of air pollutants and methane, a potent greenhouse gas, at monitors <a href="https://doi.org/10.1016/j.scitotenv.2021.146194">less than 500 meters, about one-third of a mile, from oil sites</a>.</p>
<p>When oil production at a site <a href="https://doi.org/10.1039/D1EM00048A">stopped</a>, we observed significant reductions in such toxins as benzene, toluene and n-hexane in the air in adjacent neighborhoods. These <a href="https://www.atsdr.cdc.gov/ToxProfiles/tp123-p.pdf">chemicals</a> are known irritants, carcinogens and reproductive toxins. They are also associated with dizziness, headaches, fatigue, tremors and respiratory system irritation, including difficulty breathing and, at higher levels, impaired lung function. </p>
<h2>Vulnerable communities at risk</h2>
<p>Many of the dozens of active oil wells in South Los Angeles are in historically Black and Hispanic communities that have been marginalized for decades. These neighborhoods are already considered among the <a href="https://oehha.ca.gov/calenviroscreen/report/calenviroscreen-30">most highly polluted, with the most vulnerable residents</a> in the state.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/403473/original/file-20210530-15-1w5wltk.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Map showing active well sites." src="https://images.theconversation.com/files/403473/original/file-20210530-15-1w5wltk.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/403473/original/file-20210530-15-1w5wltk.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=500&fit=crop&dpr=1 600w, https://images.theconversation.com/files/403473/original/file-20210530-15-1w5wltk.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=500&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/403473/original/file-20210530-15-1w5wltk.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=500&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/403473/original/file-20210530-15-1w5wltk.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=629&fit=crop&dpr=1 754w, https://images.theconversation.com/files/403473/original/file-20210530-15-1w5wltk.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=629&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/403473/original/file-20210530-15-1w5wltk.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=629&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A state app called well finder locates active oil wells, including in Los Angeles County.</span>
<span class="attribution"><a class="source" href="https://maps.conservation.ca.gov/doggr/wellfinder/#openModal/-118.00909/33.92186/12">State of California</a></span>
</figcaption>
</figure>
<p>But while the governor declared that “<a href="https://www.gov.ca.gov/2021/04/23/governor-newsom-takes-action-to-phase-out-oil-extraction-in-california/">California needs to move beyond oil</a>,” his current timeline would allow oil wells to continue operating for the next two decades. A variety of policies, including buffers, phaseouts and emissions controls, will need to be considered to protect public health and accelerate the transition to cleaner energy sources.</p>
<p>[<em>Get the best of The Conversation, every weekend.</em> <a href="https://theconversation.com/us/newsletters/weekly-highlights-61?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=weeklybest">Sign up for our weekly newsletter</a>.]</p><img src="https://counter.theconversation.com/content/160162/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jill Johnston receives funding from NIH and the Robert Wood Johnson Foundation. </span></em></p><p class="fine-print"><em><span>Bhavna Shamasunder receives funding from NIH, NSF, and Robert Wood Johnson Foundation </span></em></p>
Photos from the early 1900s show LA’s forests of oil derricks. Hundreds of wells are still pumping, and new research finds people living nearby are struggling with breathing problems.
Jill Johnston, Assistant Professor of Preventive Medicine, University of Southern California
Bhavna Shamasunder, Associate Professor of Urban and Environmental Policy, Occidental College
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/154371
2021-02-08T05:29:09Z
2021-02-08T05:29:09Z
Drawing inspiration in a pandemic — breath has always been central to theatre
<figure><img src="https://images.theconversation.com/files/382908/original/file-20210208-15-7r2iyu.jpg?ixlib=rb-1.1.0&rect=119%2C44%2C4857%2C3248&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Eryn Jean Norvill in Sydney Theatre Company's The Picture of Dorian Gray. </span> <span class="attribution"><span class="source">Dan Boud/STC</span></span></figcaption></figure><p>Wrapped in COVID Safe vigilance, Australian theatre has <a href="https://www.theguardian.com/culture/2020/oct/26/australias-theatres-are-slowly-reopening-but-will-subscribers-return">cautiously begun</a> to welcome back guests. <a href="https://www.thesaturdaypaper.com.au/culture/theatre/2021/01/23/sydney-festival/161132040010953#hrd">The Sydney Festival</a> withstood border closures and local outbreaks to offer a wide variety of events to summer revellers in the open air, online and in theatres. The Perth festival has scrambled to reschedule performances after the city’s short, sharp lockdown. Across the nation, performers are still holding their breath. </p>
<p><a href="https://www.coronavirus.vic.gov.au/entertainment-and-culture">In Victoria</a>, they must remain two metres apart when rehearsing or performing and singers must wear masks. In NSW, <a href="https://www.nsw.gov.au/covid-19/covid-safe/outdoor-music-rehearsal-and-performance">no more than five singers</a> should perform indoors and they should face outwards. Arts special interest groups have prepared useful, if complex, tables of <a href="https://paca.org.au/projects/coronavirusresources2/">state-by-state rules and restrictions</a>.</p>
<p>My first trip back to theatre in person was <a href="https://theconversation.com/the-picture-of-dorian-grey-review-eryn-jean-norvill-stuns-in-all-26-roles-150165">The Picture of Dorian Gray</a> late last year. It was strange not being able to enjoy a pre-show drink in the foyer and the sea of masks in the audience was an unsettling sight. Uncannily, the one-woman show conveyed isolation in a social world obsessed by appearance. I found it a bit hard to breathe in the auditorium.</p>
<p>Inspiration — <a href="https://www.etymonline.com/word/inspiration">meaning</a> both to draw breath and the power that brings forth creativity — has always been integral to theatre and performance. Of course, the two are intimately linked.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/the-power-of-proximity-and-the-theatre-of-touch-what-losing-live-audiences-may-mean-for-theatre-133515">The power of proximity and the theatre of touch: what losing live audiences may mean for theatre</a>
</strong>
</em>
</p>
<hr>
<h2>Controlling and conveying emotions</h2>
<p>Breath is one of the few functions of the body that can both occur automatically and also be <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/control-of-breathing">controlled consciously</a>, although we still have so much more to learn about it.</p>
<p>Breath control is <a href="https://www.sciencedirect.com/science/article/abs/pii/S0892199788800560">crucial to actor training and performance</a>. It supports the voice, punctuates spoken phrases, sustains concentration, allows relaxation, and can assuage performance anxiety.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/382922/original/file-20210208-19-25cv0s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="person exhaling smoke" src="https://images.theconversation.com/files/382922/original/file-20210208-19-25cv0s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/382922/original/file-20210208-19-25cv0s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/382922/original/file-20210208-19-25cv0s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/382922/original/file-20210208-19-25cv0s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/382922/original/file-20210208-19-25cv0s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/382922/original/file-20210208-19-25cv0s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/382922/original/file-20210208-19-25cv0s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">These days, we are more consciously aware of breath.</span>
<span class="attribution"><a class="source" href="https://images.unsplash.com/photo-1520259075182-da7db177117b?ixid=MXwxMjA3fDB8MHxwaG90by1wYWdlfHx8fGVufDB8fHw%3D&ixlib=rb-1.2.1&auto=format&fit=crop&w=1500&q=80">Pavel Lozovikov/Unsplash</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>Inspiration literally means to “<a href="https://medlineplus.gov/ency/anatomyvideos/000018.htm#:%7E:text=The%20first%20phase%20is%20called,and%20decreases%20the%20pressure%20inside.">breathe in</a>”, as the atmosphere of the outside world enters into our body. In theatrical terms, breath has long been harnessed to fuel an emotional connection with an audience. </p>
<p>First century CE Roman orator and teacher <a href="https://penelope.uchicago.edu/Thayer/E/Roman/Texts/Quintilian/Institutio_Oratoria/6A*.html">Quintilian tells a devastating story</a> of his own grief when he breathed in the last exhalation of his dying son. The act was driven by the belief that it would allow his child’s spirit to live on in his own body, a reversal of a practice whereby sons would do this for their parent.</p>
<p>Quintilian went on to develop a theory of rhetoric and the communication of emotion. His 12-volume <a href="http://rhetoric.byu.edu/Primary%20Texts/Quintilian.htm">Institutio Oratoria</a> established the theory and practice of rhetoric, and provided a lifelong manual for the public speaker. </p>
<p>The key point is that in order to convey emotion, you first need to feel it yourself and then transmit it through breath. </p>
<p>Centuries later, <a href="https://www.backstage.com/magazine/article/the-definitive-guide-to-the-stanislavsky-acting-technique-65716/">Constantin Stanislavski</a>, Russian director and founder of modern acting, drew on <a href="https://www.tandfonline.com/doi/full/10.1080/20567790.2018.1507071?casa_token=ieAJ106CLjEAAAAA%3A-JUybkeAo3hqG7GgZDFgLbs39cJlcNrZroxHkj0uW42VNnMhC-6R8fYcNKhJ9GPECZeoTnoMDJ49O4I">the theory of breath in yoga</a>. </p>
<p>Stanislavski’s approach — which later developed into Method Acting employed by players from Marlon Brando, Daniel Day-Lewis, and Angelina Jolie to the late Heath Ledger - uses <a href="https://www.yogajournal.com/how-to/pranayama/"><em>prana</em></a> breath and visualises the different parts of his system as a set of lungs.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/iB1fPZX5Zgk?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Harnessing breath, Stanislavski’s teaching influenced generations of actors.</span></figcaption>
</figure>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/the-method-gone-bananas-how-motion-capture-actors-are-embracing-their-inner-ape-78257">The Method gone bananas? How motion capture actors are embracing their inner ape</a>
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</em>
</p>
<hr>
<p>Around the same period, avant-garde French theatre theorist <a href="https://www.bl.uk/20th-century-literature/articles/antonin-artaud-and-the-theatre-of-cruelty">Antonin Artaud</a> wrote about a “<a href="https://www.tandfonline.com/doi/pdf/10.1080/13528165.2003.10871934">hieroglyphics of breath</a>” whereby performers can communicate directly with the audience through a language of breathing grounded in nature.</p>
<p>In contrast, the modernist playwright Samuel Beckett <a href="https://www.openculture.com/2015/03/take-a-breath-and-watch-samuel-becketts-one-minute-play.html">did away with actors altogether</a> in his one-minute play <a href="https://search.proquest.com/openview/7a73350cbdcd3197fb4fb4aad89ae778/1?pq-origsite=gscholar&cbl=416399">Breath</a>, which consisted of a pile of rubbish, lights fading up to the sound of a baby’s first cry and then fade to black. The body is cut off from breath.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/3-lessons-from-musical-improvisation-to-help-navigate-2021-152385">3 lessons from musical improvisation to help navigate 2021</a>
</strong>
</em>
</p>
<hr>
<h2>Breath and ritual</h2>
<p>If we take <a href="https://www.sutori.com/story/evolution-of-theatre-from-religious-rituals--wekFRYXXpNNBY1NnFqXYRemw">theatre’s origin to lie in religious ceremony</a>, it is worth noting the role that <a href="https://religionnews.com/2020/07/08/breath-the-divine-metaphor/">breath plays is crucial to rituals too</a>. In the Christian tradition, The Holy Spirit is depicted as a divine and invisible breath that can enter one’s body. </p>
<p>In Islam, the Qu’ran is a set of practices intended to <a href="https://aboutislam.net/muslim-issues/science-muslim-issues/breath-of-life/">keep the lungs healthy</a>, in one sense. </p>
<p>In Buddhism, <a href="https://thebuddhistcentre.com/text/mindfulness-breathing">practices of the breath</a> can illuminate the world like a moon freed from a veil of clouds.</p>
<p>In physical terms, singing and dancing bring a group’s breath in sync and <a href="https://www.healthline.com/health/benefits-of-singing#benefits">increase oxygen to the brain with positive effect</a>.</p>
<p>To breathe the same air in an intimate space brings us close together. Theatre and performance afford that opportunity. </p>
<p>For now, we must be safe but the precautions will be worth it. As <a href="http://shakespeare.mit.edu/romeo_juliet/full.html">Shakespeare’s Romeo</a> says,</p>
<blockquote>
<p>Ah, Juliet, if the measure of thy joy</p>
<p>Be heaped like mine, and that thy skill be more</p>
<p>To blazon it, then sweeten with thy breath</p>
<p>This neighbours air, and let rich music’s tongue</p>
<p>Unfold the imagined happiness that both</p>
<p>Receive in either by this dear encounter</p>
</blockquote>
<p>We will wait a bit longer for such a close encounter of breath again.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/latest-arts-windfalls-show-money-isnt-enough-we-need-transparency-154725">Latest arts windfalls show money isn't enough. We need transparency</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/154371/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Daniel Johnston does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
Theatre and audiences are slowly beginning to share the same airspace again. We are freshly conscious of breath, but it has always been intimately linked with the dramatic arts.
Daniel Johnston, Research Affiliate, University of Sydney
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/148861
2020-11-04T13:44:06Z
2020-11-04T13:44:06Z
‘Smartphone pinky’ and other injuries caused by excessive phone use
<figure><img src="https://images.theconversation.com/files/367489/original/file-20201104-15-f61v7g.jpg?ixlib=rb-1.1.0&rect=17%2C8%2C5953%2C3965&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">'Smartphone pinky' is just the latest injury caused by excessive smartphone use.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/mockup-image-mans-hand-holding-white-774841732">Farknot Architect/ Shutterstock</a></span></figcaption></figure><p>We use our phones <a href="https://www.theguardian.com/lifeandstyle/2019/aug/21/cellphone-screen-time-average-habits">three hours and 15 minutes</a> a day on average. So perhaps it’s hardly surprising people are reporting a “new” injury on social <a href="https://www.ladbible.com/news/weird-people-are-reporting-a-physical-condition-called-smartphone-pinky-20201022">media</a> and <a href="https://www.mirror.co.uk/lifestyle/health/health-expert-explains-what-smartphone-22870634">in the news</a> – “smartphone pinky”. People claiming to have the condition report a change in position of their pinky finger, or having developed a dent in their little finger, on the middle bone.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1318580994627297282"}"></div></p>
<p>There hasn’t yet been any research looking into smartphone pinky, so it’s prevalence, causes are unclear. But the way we hold our mobile devices is of interest – as the weight of a phone is naturally placed on the pinky. This places strain on the pinky, forcing it in a direction it doesn’t normally bend, stretching the soft tissue and ligaments which normally function to limit movement. The dent is likely a compression of the soft tissues of the finger from continued exposure to the weight of the phone.</p>
<p>But “smartphone pinky” is just the latest in a growing list of injuries that researchers have been able to link to the use of mobile devices.</p>
<h2>Cell phone elbow</h2>
<p>Holding mobile phones up to the ear, or holding it up while lying in bed for a long period can cause discomfort, pain, and tingling in the forearm and little finger. Nicknamed “cell phone elbow”, this condition is known clinically as <a href="https://www.jhandsurg.org/article/S0363-5023(14)00534-6/pdf">cubital tunnel syndrome</a> and is caused by your shoulder rubbing against the ulnar nerve. This is one of the arm’s major nerves, and is the same nerve you whack when you hit your “funny bone”.</p>
<p>Normally, this nerve stretches up to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2599973/">5mm in length</a> when we bend our elbow to maintain function. But prolonged bending puts pressure on the nerve and cuts off blood supply to it. Studies have shown cell phone use places a <a href="https://pubmed.ncbi.nlm.nih.gov/31438805/">69% increase</a> in strain on the ulnar nerve. </p>
<p>It has also been shown that a short <a href="https://www.sciencedirect.com/science/article/abs/pii/S1388245716300669?via%3Dihub">six minute period</a> of assuming the phone call posture – with the elbow continually bent to hold the phone up to your ear – can significantly reduce the speed at which the nervous impulse courses along this nerve. This impacts a person’s ability to get sensory information to the brain, and makes reflexive movements slower.</p>
<p>“Cell phone elbow” now ranks as the <a href="https://journals.lww.com/ajnonline/FullText/2009/09000/NewsCAPS__Cubital_tunnel_syndrome__or_cell_phone.12.aspx">second most common</a> upper limb nerve injury after carpal tunnel syndrome. Pain and tingling in the hand is the most common symptom and is easily remedied by changing position. But longer term problems can cause muscles supplied by the ulnar nerve to waste away.</p>
<h2>Text claw</h2>
<p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6559090/">Thumb</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7260896/">wrist pain</a> associated with <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4387778/">smartphone use</a> are also common. Often referred to as “text claw”, the repetitive strain injury is caused by the constant bending and small repetitive movements of the thumb against the screen. This appears reversible with reduced use but its prevalence is not known.</p>
<p>As such, research suggests holding phones <a href="https://www.sciencedirect.com/science/article/abs/pii/S0003687015300272">with two hands</a> is preferential, as it shares the workload between hands and reduces the likelihood of permanent changes. </p>
<p>Not all changes are completely bad though. <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(14)01487-0">One study showed</a> smartphone users had increased sensitivity from prolonged use, particularly in the thumb, that was was detected in the brain, suggesting adaptation of the brain to increased use, which is typically seen in musicians or elite athletes. This may result in better reaction time and ability to detect subtle changes with those fingers.</p>
<h2>Neck and breathing</h2>
<p>Prolonged smartphone also changes the <a href="https://journals.sagepub.com/doi/pdf/10.1177/1071181319631137">position of the head</a> on the neck the longer a person spends <a href="https://pubmed.ncbi.nlm.nih.gov/31451087/">staring down at a screen</a>. This results in neck pain and poorer posture. These posture changes also affect the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4756000/">scapula</a> (shoulder blade), which changes its resting position and increases strain on the muscles attached to it. This is especially problematic, given many of these muscles are essential for arm movement.</p>
<p>But more concerning is the fact that research shows these postural changes from the <a href="https://pubmed.ncbi.nlm.nih.gov/27313358/">way we sit</a> while using our devices have a detrimental change on lung function, <a href="https://pubmed.ncbi.nlm.nih.gov/26957754/">reducing</a> their <a href="https://www.nhs.uk/conditions/peak-flow-test/">peak expiratory flow</a> (the volume of air you can expel in a breath), which indicates how obstructed the airways are. Over time, these changes can reduce the body’s respiratory function, decreasing the amount of air you can inhale and exhale, and increasing heart rate in order to ensure the body has all the oxygen it needs. Significant declines in lung function have even been <a href="https://pubmed.ncbi.nlm.nih.gov/32614490/">seen in children</a>, suggesting earlier access to, and increasing use of, smartphones may cause detrimental postural changes at an early age.</p>
<figure class="align-center ">
<img alt="Man sitting on couch looking at his phone." src="https://images.theconversation.com/files/367491/original/file-20201104-23-8s21jg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/367491/original/file-20201104-23-8s21jg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/367491/original/file-20201104-23-8s21jg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/367491/original/file-20201104-23-8s21jg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/367491/original/file-20201104-23-8s21jg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/367491/original/file-20201104-23-8s21jg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/367491/original/file-20201104-23-8s21jg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Be mindful of your posture while looking at your phone.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/smiling-african-american-man-sit-relax-1701296272">fizkes/ Shutterstock</a></span>
</figcaption>
</figure>
<p>Limiting screen time and ensuring proper posture while using your phone can mitigate against damage.</p>
<h2>Addiction</h2>
<p>Of course, there are also mental and social impacts of excessive smartphone use – including smartphone addiction, which <a href="https://pubmed.ncbi.nlm.nih.gov/26690625/">is becoming</a> an <a href="https://pubmed.ncbi.nlm.nih.gov/27279515/">increasingly</a> <a href="https://www.researchgate.net/profile/Debasish_Basu/publication/287539113_Mobile_phone_use_by_resident_doctors_Tendency_to_addiction-like_behaviour/links/589a421fa6fdcc32dbdef3bc/Mobile-phone-use-by-resident-doctors-Tendency-to-addiction-like-behaviour.pdf">common</a> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4336980/">problem</a> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6422909/">globally</a>. </p>
<p>Smartphone use triggers many of the signalling pathways in the brain linked to reward and feeling good, such as releasing <a href="https://www.sciencedirect.com/science/article/pii/S0166432817305090">dopamine</a>. This can cause us to become reliant on our phones and use them more frequently to continue achieving this dopamine rush. Symptoms of smartphone addiction include interrupted sleep, trouble completing tasks, becoming isolated from people, and concealing phone use. Excessive, problematic use can also cause <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7504166/">nomophobia</a> – the fear of being without a mobile phone. This results in anxiety when without your phone, sweating, agitation, and trembling.</p>
<p>Many injuries from smartphones or other mobile devices show a remarkable overlap with some other technology-induced pains and strains associated with overuse – such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4049654/">tenosynovitis</a>, (caused by excessive text messaging), <a href="https://www.nejm.org/doi/pdf/10.1056/NEJMc070670">Wiiitis</a> (shoulder pains in the absence of physical exercise), and <a href="https://pubmed.ncbi.nlm.nih.gov/2330022/">Nintendinitis</a> which is similar to the repetitive thumb strain from excessive smartphone use.</p>
<p>But regardless of the type of technology you use, it is the prolonged use of devices that can cause body adaptations.</p><img src="https://counter.theconversation.com/content/148861/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Adam Taylor is affiliated with the Anatomical Society. </span></em></p>
It’s almost impossible to be without a smartphone these days – but the way we hold and sit while using them can cause an array of physical health problems.
Adam Taylor, Professor and Director of the Clinical Anatomy Learning Centre, Lancaster University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/147409
2020-10-28T12:26:45Z
2020-10-28T12:26:45Z
Cigarette smoke can reprogram cells in your airways, causing COPD to hang on after smoking ends
<figure><img src="https://images.theconversation.com/files/362044/original/file-20201006-14-51yv5o.jpg?ixlib=rb-1.1.0&rect=1107%2C209%2C4036%2C2834&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Chronic obstructive pulmonary disease is the third leading cause of death in the United States.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/illustration-of-a-toxic-smoke-in-lung-cancer-or-royalty-free-image/1179207088">Pascal Kiszon via Getty Images</a></span></figcaption></figure><p>Smoking is the most common cause of chronic obstructive pulmonary disease, an often fatal respiratory condition that <a href="https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/learn-about-copd">afflicts millions</a> of Americans. But for many patients living with COPD, stopping smoking isn’t the end of the battle.</p>
<p>Cigarette smoke is a complex mixture of gases, chemicals and even bacteria. When it enters the lungs, it generates an inflammatory response much like pneumonia. </p>
<p>Inflammatory cells normally clear from the lungs when an infection ends or a patient quits smoking, but in patients with COPD, these cells may persist for years. Destructive enzymes produced by these cells – intended to destroy bacteria – cause progressive lung damage and respiratory failure characteristic of COPD.</p>
<p>It’s been a mystery why these cells continue triggering inflammation in the lungs after people stop smoking. Now, <a href="https://www.vumc.org/viiii/person/bradley-w-richmond-md-phd">research indicates</a> a defect in the immune system induced by cigarette smoke is to blame. Cigarette smoke <a href="https://pubmed.ncbi.nlm.nih.gov/25078120/">reprograms the cells lining the airways</a>, making the lungs of COPD patients who have quit smoking more susceptible to bacterial invasion.</p>
<h2>Good fences make good neighbors</h2>
<p>The lungs are continuously bombarded by inhaled bacteria and other irritants. At the same time, they are tasked with getting oxygen into the bloodstream, so they can’t have an impermeable physical barrier like skin. </p>
<p>To solve this dilemma, the lungs have developed a multi-pronged defense system. A key component of this system is an antibody called secretory IgA. These antibodies latch on to bacteria to prevent them from invading the lungs. Secretory IgA doesn’t directly kill microbes, but it prevents them from triggering a damaging immune response before they can be cleared by other mechanisms. </p>
<figure class="align-center ">
<img alt="Illustration of how SIgA operates in the lining of a person's airway." src="https://images.theconversation.com/files/361436/original/file-20201002-23-zfx5uq.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/361436/original/file-20201002-23-zfx5uq.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=558&fit=crop&dpr=1 600w, https://images.theconversation.com/files/361436/original/file-20201002-23-zfx5uq.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=558&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/361436/original/file-20201002-23-zfx5uq.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=558&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/361436/original/file-20201002-23-zfx5uq.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=701&fit=crop&dpr=1 754w, https://images.theconversation.com/files/361436/original/file-20201002-23-zfx5uq.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=701&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/361436/original/file-20201002-23-zfx5uq.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=701&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Our airways are lined with a layer of cells called the airway epithelium. When bacteria and other germs are inhaled, one way the airway epithelium protects itself is by transporting secretory immunoglobulin A (SIgA) to the airway surface. SIgA attaches to bacteria to prevent them from invading and causing inflammation. SIgA is made by plasma cells beneath the airway epithelium and transported by polymeric immunoglobulin receptors. People with COPD lack SIgA in their airways, which allows bacterial invasion, inflammation and lung damage.</span>
<span class="attribution"><span class="source">Dayana Espinoza/Vanderbilt University</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<p>In patients with COPD, lower levels of the <a href="https://pubmed.ncbi.nlm.nih.gov/25078120/">polymeric immunoglobulin receptor</a> and secretory IgA <a href="http://doi.org/10.1164/rccm.201604-0759OC">allow bacteria easier access to the airway surface</a>, triggering <a href="http://doi.org/10.1164/rccm.201612-2509ED">an inflammatory response</a> that persists after the patient quits smoking. </p>
<p>Mice that have been genetically manipulated to lack secretory IgA <a href="https://doi.org/10.1038/ncomms11240">also develop inflammation and a pattern of lung damage</a> resembling patients with COPD. Antibiotics can prevent them from developing lung disease, suggesting bacteria cause continued inflammation after smoking ends.</p>
<h2>The double-edged sword of anti-inflammatories</h2>
<p>Since inflammation is central to COPD, it makes sense that anti-inflammatory therapies might be beneficial. However, patients with COPD are also susceptible to lung infections, and anti-inflammatories run the risk of deactivating the body’s natural defenses against infection. The threat is more than theoretical: A <a href="http://doi.org/10.1183/09031936.00150208">clinical trial</a> studying an anti-inflammatory drug called rituximab was stopped early due to an increased rate of pulmonary infections.</p>
<p>Many antibiotics also have serious side effects when taken chronically, and prolonged use might encourage growth of bacteria resistant to these drugs.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/361994/original/file-20201006-14-1v4fjov.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/361994/original/file-20201006-14-1v4fjov.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=315&fit=crop&dpr=1 600w, https://images.theconversation.com/files/361994/original/file-20201006-14-1v4fjov.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=315&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/361994/original/file-20201006-14-1v4fjov.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=315&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/361994/original/file-20201006-14-1v4fjov.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=396&fit=crop&dpr=1 754w, https://images.theconversation.com/files/361994/original/file-20201006-14-1v4fjov.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=396&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/361994/original/file-20201006-14-1v4fjov.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=396&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
<span class="attribution"><a class="source" href="https://www.nhlbi.nih.gov/health-topics/education-and-awareness/copd-learn-more-breathe-better">National Heart, Lung and Blood Institute</a></span>
</figcaption>
</figure>
<h2>A new target for treating COPD?</h2>
<p>While studying mice lacking secretory IgA, our research team at Vanderbilt University Medical Center and colleagues at the University of Florida recently found these mice have increased numbers of a relatively uncommon type of cell called monocyte-derived dendritic cells, or moDCs, in the lungs.</p>
<p>Dendritic cells don’t directly destroy bacteria, but they ring the alarm that a bacterial infection is brewing and coordinate the subsequent immune response. Unlike typical dendritic cells, moDCs begin their lives as a different cell type, called a monocyte. But when chronic inflammation sets in, they can become a type of dendritic cell.</p>
<p>We showed that in mice genetically engineered to lack secretory IgA, <a href="https://doi.org/10.1038/s41385-020-00344-9">moDCs activate T lymphocytes</a> – white blood cells that fight off viruses and can destroy cells in the process – and those T lymphocytes in turn damage the lungs. These data implied that moDCs might also coordinate a pathologic immune response in patients with COPD who also lack secretory IgA in the airways. </p>
<p>Because moDCs weren’t known to exist in human lungs, we <a href="https://doi.org/10.1038/s41385-020-00344-9">used a cutting-edge technique called mass cytometry</a> to detect them. It allows us to distinguish moDCs from other cell types that appear very similar under a microscope.</p>
<p>Like secretory IgA-deficient mice, we found that human COPD patients lacking secretory IgA had increased numbers of moDCs in their lungs. Together, these data suggest that loss of secretory IgA makes the airways more susceptible to bacterial invasion, which activates moDCs to drive ongoing lung inflammation. Therefore, targeting moDCs through medical treatments might block inflammation and lung damage in patients with COPD.</p>
<h2>New drugs are urgently needed for COPD</h2>
<p>There are still many questions to answer, including how best to target moDCs. It also remains to be seen whether such a strategy would compromise the ability of COPD patients to defend against infection.</p>
<p>However, for a disease as common and debilitating as COPD, potential new drug targets come as a breath of fresh air.</p>
<p>COPD is the <a href="https://www.cdc.gov/nchs/fastats/copd.htm">fourth leading cause of death in the U.S.</a> and the <a href="https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death">third leading cause of death worldwide</a>. While many drugs are available to decrease symptoms and hospitalization rates in patients with COPD, none has been proven to prolong life.</p>
<p>Most patients with COPD don’t die from it, <a href="https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/learn-about-copd">but those who live with COPD</a> suffer from chronic breathlessness which negatively impacts their quality of life. The burden of COPD is felt not just by individual patients, but by families, workplaces and economies.</p>
<p>Though cigarette smoking rates are <a href="https://www.cdc.gov/media/releases/2019/p1114-smoking-low.html">declining in the United States</a>, they are <a href="https://www.who.int/gho/tobacco/use/en/">increasing in many other countries</a>, making COPD a global health issue.</p><img src="https://counter.theconversation.com/content/147409/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Bradley Richmond receives funding from the U.S. Department of Veterans Affairs, the National Institutes of Health, and has an investigator-initiated grant from 4D Medical related to an investigational imaging technology not discussed here.</span></em></p>
A new discovery offers hope for ways to treat a debilitating disease that has become a leading cause of death in the US..
Bradley Richmond, Assistant Professor of Medicine, Vanderbilt University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/145181
2020-10-05T04:19:50Z
2020-10-05T04:19:50Z
Curious Kids: what happens if you breathe pure oxygen?
<figure><img src="https://images.theconversation.com/files/358790/original/file-20200918-14-19ewyu1.jpg?ixlib=rb-1.1.0&rect=1%2C4%2C997%2C582&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Breathing pure oxygen would be like fireworks exploding in your body. And that's not always a good thing.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/abstract-colored-firework-background-free-space-516676762">Shutterstock</a></span></figcaption></figure><blockquote>
<p><strong>What happens if you breathe pure oxygen and why? Stephen, age 9, Muntinlupa City, The Philippines</strong></p>
</blockquote>
<p><a href="https://theconversation.com/au/topics/curious-kids-36782"><img src="https://images.theconversation.com/files/291898/original/file-20190911-190031-enlxbk.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=90&fit=crop&dpr=1" width="100%"></a></p>
<p>Hi Stephen!</p>
<p>That’s a great question. We can’t live without <a href="https://kids.britannica.com/kids/article/oxygen/353585">oxygen</a>. But too much can harm us. Let’s find out why.</p>
<p>Our bodies make the energy we need to run around, play and do schoolwork, by burning the food we eat. Think of this a bit like a candle burning. To burn our food, we need oxygen, which we get from breathing in the air around us.</p>
<p>Oxygen isn’t the only gas in the air. In fact, air’s mostly made of <a href="https://kids.britannica.com/kids/article/nitrogen/353537">nitrogen</a>. This has a very important job. Nitrogen slows down the burning process so you get enough energy through the day, bit by bit.</p>
<p>If you breathed pure oxygen, the energy from your food would be released all at once. So forget candles. This is more like a firework exploding. Bang! If you breathed pure oxygen, you wouldn’t actually explode. But you would damage your body.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/curious-kids-when-i-swipe-a-matchstick-how-does-it-make-fire-116673">Curious Kids: when I swipe a matchstick how does it make fire?</a>
</strong>
</em>
</p>
<hr>
<p>Breathing pure oxygen sets off a series of runaway chemical reactions. That’s when some of that oxygen turns into its dangerous, unstable cousin called a “radical”. Oxygen radicals harm the fats, protein and DNA in your body. This damages your eyes so you can’t see properly, and your lungs, so you can’t breathe normally.</p>
<p>So breathing pure oxygen is quite dangerous.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/m6haYrvAQ5s?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Food, oxygen and explosions!</span></figcaption>
</figure>
<p>But breathing pure oxygen can sometimes be necessary. <a href="https://www.nasa.gov/audience/forstudents/k-4/stories/nasa-knows/what-is-a-spacewalk-k4.html">Astronauts</a> and <a href="https://www.scubadoctor.com.au/scuba-diving-gas-analysis.htm">deep-sea scuba divers</a> sometimes breathe pure oxygen because they work in very dangerous places.</p>
<p>The length of time they breathe pure oxygen, and how much they breathe, is carefully controlled so they’re not harmed.</p>
<p>Sick people, including <a href="https://medlineplus.gov/ency/article/007242.htm">premature babies in hospital</a> or people in hospital <a href="https://theconversation.com/how-are-the-most-serious-covid-19-cases-treated-and-does-the-coronavirus-cause-lasting-damage-134398">with the coronavirus</a>, might also need some extra help breathing. They might be given a bit of extra oxygen on top of what’s in the air. It acts like a medicine to help calm and settle their breathing. </p>
<p>Again, too much oxygen can be dangerous. That’s why doctors and nurses keep a close eye to make sure people get just the right amount they need.</p>
<p>So we need oxygen to help us get energy from our food. We might also need a little extra if we’re sick in hospital, or if we’re an astronaut or deep-sea diver. But too much oxygen can harm us.</p>
<hr>
<p><em>Hello, Curious Kids! Do you have a question you’d like an expert to answer? Ask an adult to send your question to curiouskids@theconversation.edu.au</em></p><img src="https://counter.theconversation.com/content/145181/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Mark Lynch does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
You might think the more oxygen you breathe in the better. But too much oxygen can make you sick.
Mark Lynch, Lecturer in Chemistry, University of Southern Queensland
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/142233
2020-07-09T12:14:17Z
2020-07-09T12:14:17Z
Aerosols are a bigger coronavirus threat than WHO guidelines suggest – here’s what you need to know
<figure><img src="https://images.theconversation.com/files/346474/original/file-20200708-3974-kkocl9.jpg?ixlib=rb-1.1.0&rect=7%2C247%2C4823%2C3375&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Aerosols are made up of tiny respiratory droplets suspended in the air.</span> <span class="attribution"><a class="source" href="http://gettyimages.com/detail/photo/man-sneezing-royalty-free-image/94989536">Jeffrey Coolidge via Getty Images</a></span></figcaption></figure><p><em>Leer en <a href="https://theconversation.com/que-son-los-aerosoles-y-por-que-son-tan-peligrosos-ante-la-pandemia-de-covid-19-143515">español</a></em></p>
<p>When someone coughs, talks or even breathes, they send tiny respiratory droplets into the surrounding air. The smallest of these droplets can float for hours, and there is strong <a href="https://doi.org/10.1038/s41586-020-2271-3">evidence</a> that they can <a href="https://dx.doi.org/10.3201/eid2606.200412">carry live coronavirus</a> if the person is infected.</p>
<p>Until mid-July, however, the risk from these aerosols wasn’t incorporated into the World Health Organization’s <a href="https://www.who.int/publications/i/item/advice-on-the-use-of-masks-in-the-community-during-home-care-and-in-healthcare-settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak">formal guidance</a> for nations. The WHO instead suggested that the coronavirus was primarily transmitted by coughing or sneezing large droplets into someone’s face, rather than being a longer-term threat that can float in the air.</p>
<p>It took pressure from scientists to start to change that.</p>
<p>More than 200 scientists published an open letter to the WHO on July 6 warning about airborne transmission of COVID-19 via aerosols and urging the organization to recognize the risks. The <a href="https://www.who.int/news-room/commentaries/detail/transmission-of-sars-cov-2-implications-for-infection-prevention-precautions">WHO responded</a> Thursday afternoon with an update in which it acknowledged the growing evidence of airborne spread of the disease, but it did so with hesitation.</p>
<p>As <a href="https://www.clarkson.edu/people/andrea-ferro">professors</a> <a href="https://www.clarkson.edu/people/byron-erath">who study</a> <a href="https://www.clarkson.edu/people/goodarz-ahmadi">fluid dynamics</a> and aerosols, we believe it is important for people to understand the risks and what they can do to protect themselves.</p>
<h2>What is an aerosol and how does it spread?</h2>
<p>Aerosols are particles that are suspended in the air. When humans breathe, talk, sing, cough or sneeze, the emitted respiratory droplets mix in the surrounding air and form an aerosol. Because larger droplets quickly fall to the ground, respiratory aerosols are often described as being made up of smaller droplets that are less than 5 microns, or about one tenth the width of a human hair. </p>
<p>In general, droplets form as a sheet of liquid breaks apart. You’ve probably experienced this phenomenon by blowing soap bubbles. Sometimes the bubble doesn’t fully form, but instead breaks apart into many droplets. </p>
<p>Similarly, in humans, small sheets and strands of liquid – mucus – often stretch across portions of the airway. This most often occurs in locations where the airway opens and closes again and again. That happens deep within the lungs as the bronchioles and alveolar sacs expand and contract during breathing, within the larynx as the vocal folds vibrate during speech, or at the mouth, as the tongue and lips move while talking. The airflow produced by breathing, speaking and coughing breaks apart these sheets of mucus, just like blowing the soap bubble. </p>
<p>[<em>Deep knowledge, daily.</em> <a href="https://theconversation.com/us/newsletters/the-daily-3?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=deepknowledge">Sign up for The Conversation’s newsletter</a>.]</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/piCWFgwysu0?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Slow-motion video of a sneeze shows suspended droplets. Credit: Prof. L Bourouiba/JAMA Network https://bit.ly/3exRYc3.</span></figcaption>
</figure>
<p>The size of the droplets varies based on how and where they are produced within the airway. While coughing generates the largest quantity of droplets, <a href="https://doi.org/10.1038/s41598-019-38808-z">research has shown</a> that just two to three minutes of talking can produce as many droplets as one cough.</p>
<p>Droplets that are smaller than 5 microns <a href="https://doi.org/10.1371/journal.pone.0021481">can remain suspended in the air for many minutes to hours</a> because the effect of air drag relative to gravity is large. In addition, the water content of virus-carrying droplets evaporates while they are airborne, decreasing their size. Even if most of the fluid evaporates from a virus-laden droplet, the droplet does not disappear; it just becomes smaller, and the smaller the droplet, the longer it will stay suspended in the air. Because smaller diameter droplets are more <a href="http://journals.sagepub.com/doi/abs/10.1260/1757-482X.4.2.159">efficient at penetrating deep into the pulmonary system</a>, they also pose a much greater infection risk. </p>
<p>The <a href="https://reliefweb.int/report/world/advice-use-masks-context-covid-19-interim-guidance-5-june-2020">WHO guidelines</a> suggested that the virus RNA found in small droplets wasn’t viable in most circumstances. However, early research on the SARS-CoV-2 virus has shown that it is <a href="https://www.nejm.org/doi/full/10.1056/nejmc2004973">viable as an aerosol for up to 3 hours</a>.</p>
<h2>Do masks protect from aerosol transmission?</h2>
<p>Face coverings and masks are absolutely necessary for protection against aerosol transmission. They serve a twofold purpose. </p>
<p>First, they filter the air expelled by an individual, capturing respiratory droplets and thereby reducing the exposure risk for others. This is particularly important as they are most effective at capturing larger droplets that are more likely to have larger quantities of viruses encapsulated within them. This prevents the larger droplets from directly affecting someone, or evaporating down to a smaller size and circulating in the air. </p>
<p>They also <a href="https://www.youtube.com/watch?v=9Mkb4TMT_Cc&feature=youtu.be">reduce the speed</a> of the puff of air that is produced when sneezing, coughing or talking. Decreasing the velocity of the expelled air reduces the distance that droplets are initially transported into the person’s surroundings. </p>
<p>It is important to realize, however, that the protection provided by masks and face coverings varies depending on the material they are constructed from and how well they fit. Nevertheless, <a href="https://theconversation.com/why-wear-face-masks-in-public-heres-what-the-research-shows-135623">wearing face coverings</a> to decrease airborne exposure risk is critical.</p>
<h2>Is staying 6 feet away enough to stay safe?</h2>
<p>The recommendation to maintain a 6-foot separation is based on a <a href="https://doi.org/10.1093/oxfordjournals.aje.a118097">study by W. F. Wells in 1934</a> that showed an expelled water droplet either falls to the ground, or evaporates, within a distance of roughly 2 meters, or 6 feet. The study did not, however, account for the fact that following evaporation of the water in a virus-laden droplet, <a href="https://www.ncbi.nlm.nih.gov/books/NBK143281/">the droplet nuclei remains</a>, thereby still posing a risk of airborne infection.</p>
<p>Consequently, while staying 6 feet from other people reduces exposure, it might not be sufficient in all situations, <a href="https://doi.org/10.1101/2020.04.16.20067728">such as in enclosed, poorly ventilated rooms</a>.</p>
<h2>How can I protect myself from aerosols indoors?</h2>
<p>Strategies to mitigate airborne exposure are similar to strategies for staying dry when it’s raining. The longer you stay in the rain, and the harder it’s raining, the wetter you will get. Similarly, the more droplets you are exposed to, and the longer you stay in that environment, the higher the exposure risk. Mitigating risk is therefore based on decreasing both aerosol concentration levels and exposure time. </p>
<p>Aerosol concentrations can be reduced with increased ventilation, although recirculating the same air should be avoided unless the air can be effectively filtered prior to reuse. When possible, open doors and windows to increase fresh air flow. </p>
<p>Decreasing the number of emission sources – people – within a space, and ensuring that face coverings are worn at all times can further decrease concentration levels. </p>
<p>Methods of deactivating the virus, such as <a href="https://doi.org/10.1213/ANE.0000000000004829">germicidal ultraviolet light</a>, can also be used.</p>
<p>Finally, reducing the amount of time you spend in poorly ventilated, crowded areas is a good way to reduce airborne exposure risk. </p>
<p><em>This article has been updated with the WHO response.</em></p>
<p><em><a href="https://scholar.google.com/citations?user=HWAlZA8AAAAJ&hl=en">Amir Mofakham</a>, a research associate in mechanical engineering at Clarkson University, contributed to this article.</em></p><img src="https://counter.theconversation.com/content/142233/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Byron Erath receives funding from the National Science Foundation and the National Institutes of Health. He is affiliated with the American Society of Mechanical Engineers, and the American Physical Society, Division of Fluid Dynamics.</span></em></p><p class="fine-print"><em><span>Andrea Ferro receives funding from the National Science Foundation. She is affiliated with the American Association for Aerosol Research, the International Society of Indoor Air Quality and Climate, and the International Society for Exposure Analysis. </span></em></p><p class="fine-print"><em><span>Goodarz Ahmadi receives funding from the National Science Foundation. He is a Fellow of American Society of Mechanical Engineers (ASME), and also a Fellow of American Society of Thermal and Fluid Engineers (ASTFE). He is life member of International Society for Porous Media (InterPore).</span></em></p>
More than 200 scientists wrote to the World Health Organization, warning about aerosol transmission of the coronavirus.
Byron Erath, Associate Professor of Mechanical Engineering, Clarkson University
Andrea Ferro, Professor of Civil & Environmental Engineering, Clarkson University
Goodarz Ahmadi, Professor of Mechanical Engineering, Clarkson University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/140695
2020-06-19T12:09:16Z
2020-06-19T12:09:16Z
The right way to breathe during the coronavirus pandemic
<figure><img src="https://images.theconversation.com/files/342278/original/file-20200616-23231-1a26olq.jpg?ixlib=rb-1.1.0&rect=90%2C90%2C5402%2C4376&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Breathing in through the nose is an integral part of meditation and delivers virus-fighting gases to the lungs.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/couple-meditating-at-park-royalty-free-image/1193844429?adppopup=true">triloks / Getty Images</a></span></figcaption></figure><p>Inhale through your nose and exhale through your mouth. It’s not just something you do in yoga class – breathing this way actually provides a powerful medical benefit that can help the body fight viral infections. </p>
<p>The reason is that your nasal cavities produce the molecule <a href="https://en.wikipedia.org/wiki/Nitric_oxide">nitric oxide</a>, which chemists abbreviate NO, that increases blood flow through the lungs and boosts oxygen levels in the blood. Breathing in through the nose delivers NO directly into the lungs, where it <a href="http://doi.org/10.1086/425357">helps fight coronavirus infection</a> by <a href="https://doi.org/10.1128/JVI.79.3.1966-1969.2005">blocking the replication of the coronavirus in the lungs</a>. But many people who exercise or engage in yoga also receive the benefits of <a href="https://doi.org/10.1046/j.1365-201X.1996.557321000.x">inhaling through the nose</a> instead of the mouth. The higher oxygen saturation of the blood can make one feel more refreshed and provides greater endurance.</p>
<p><a href="https://www.nobelprize.org/prizes/medicine/1998/ignarro/facts/">I am one of three pharmacologists who won the Nobel Prize in 1998</a> for discovering how nitric oxide is produced in the body and how it works. </p>
<h2>The role of nitric oxide in the body</h2>
<p>Nitric oxide is a widespread signaling molecule that triggers many different physiological effects. It is also used clinically as a gas to selectively dilate the pulmonary arteries in newborns with pulmonary hypertension. Unlike most signaling molecules, NO is a gas in its natural state. </p>
<p>NO is produced continuously by the 1 trillion cells that form the inner lining, or <a href="https://en.wikipedia.org/wiki/Endothelium">endothelium</a>, of the 100,000 miles of arteries and veins in our bodies, especially the lungs. <a href="https://doi.org/10.1046/j.1365-201X.1996.557321000.x">Endothelium-derived NO</a> acts to relax the smooth muscle of the arteries to prevent high blood pressure and to promote blood flow to all organs. Another vital role of NO is to <a href="https://doi.org/10.1161/hh0801.089861">prevent blood clots in normal arteries</a>. </p>
<p>In addition to relaxing vascular smooth muscle, NO also <a href="https://en.wikipedia.org/wiki/Biological_functions_of_nitric_oxide">relaxes smooth muscle in the airways</a> – trachea and bronchioles – making it easier to breathe. Another type of NO-mediated smooth muscle relaxation occurs in the erectile tissue (corpus cavernosum), which results in penile erection. In fact, <a href="https://doi.org/10.1056/NEJM199201093260203">NO is the principal mediator of penile erection and sexual arousal.</a> This discovery led to the development and marketing of <a href="https://www.history.com/this-day-in-history/fda-approves-viagra">sildenafil</a>, trade name Viagra, which works by enhancing the action of NO.</p>
<p>Other types of cells in the body, including circulating white blood cells and tissue macrophages, produce nitric oxide for <a href="https://doi.org/10.1371/journal.pone.0199998">antimicrobial purposes</a>. The NO in these cells reacts with other molecules, also produced by the same cells, to form antimicrobial agents to destroy invading microorganisms including bacteria, parasites and viruses. As you can see, NO is quite an amazing molecule.</p>
<h2>Nitric oxide gas as an inhaled therapy</h2>
<p>Since NO is a gas, it can be administered with the aid of specialized devices as a therapy to patients by inhalation. Inhaled NO is used to treat infants born with <a href="https://doi.org/10.1097/ALN.0000000000002579">persistent pulmonary hypertension</a>, a condition in which constricted pulmonary arteries limit blood flow and oxygen harvesting. </p>
<p>Inhaled NO dilates the constricted pulmonary arteries and increases blood flow in the lungs. As a result, the red blood cell hemoglobin can extract more lifesaving oxygen and move it into the general circulation. Inhaled NO has literally turned blue babies pink and allowed them to be cured and to go home with mom and dad. Before the advent of inhaled NO, most of these babies died.</p>
<p>Inhaled NO is <a href="https://clinicaltrials.gov/ct2/show/NCT04338828?term=nitric+oxide&cond=COVID&draw=2&rank=1">currently in clinical trials</a> for the treatment of patients with <a href="https://www.healio.com/news/primary-care/20200520/evidence-mounts-supporting-inhaled-nitric-oxide-as-covid19-treatment">COVID-19</a>. Researchers are hoping that three principal actions of NO may help fight covid: dilating the pulmonary arteries and increasing blood flow through the lungs, dilating the airways and increasing oxygen delivery to the lungs and blood, and directly killing and inhibiting the growth and spread of the coronavirus in the lungs.</p>
<h2>How nitric oxide kills viruses</h2>
<p>In an in vitro study done in 2004 during the last SARS outbreak, experimental compounds that release NO increased the survival rate of nucleus-containing mammalian cells infected with SARS-CoV. This suggested <a href="https://doi.org/10.1016/j.ijid.2004.04.012">that NO had a direct antiviral effect</a>. In this study, NO significantly inhibited the replication cycle of SARS-CoV by blocking production of viral proteins and its genetic material, RNA. </p>
<p>In a small clinical study in 2004, inhaled NO <a href="https://doi.org/10.1086/425357">was effective</a> against SARS-CoV in severely ill patients with pneumonia. </p>
<p>The SARS CoV, which caused the 2003/2004 outbreak, shares most of its genome with SARS CoV-2, the virus responsible for COVID-19. This suggests that inhaled NO therapy may be effective for treating patients with COVID-19. Indeed, <a href="https://www.healio.com/news/primary-care/20200520/evidence-mounts-supporting-inhaled-nitric-oxide-as-covid19-treatment">several clinical trials of inhaled NO</a> in patients with moderate to severe COVID-19, who require ventilators, are currently ongoing in several institutions. The hope is that inhaled NO will prove to be an effective therapy and lessen the need for ventilators and beds in the ICU.</p>
<p>The <a href="https://doi.org/10.1002/ar.20782">sinuses in the nasal cavity</a>, but not the mouth, continuously produce NO. The NO produced in the nasal cavity is chemically identical to the NO that is used clinically by inhalation. So by inhaling through the nose, you are delivering NO directly into your lungs, where it increases both airflow and blood flow and keeps microorganisms and virus particles in check. </p>
<p>While anxiously awaiting the results of the clinical trials with inhaled NO, and the development of an effective <a href="https://www.healthline.com/health-news/heres-exactly-where-were-at-with-vaccines-and-treatments-for-covid-19">vaccine against COVID-19</a>, we should be on guard and practice breathing properly to maximize the inhalation of nitric oxide into our lungs. Remember to inhale through your nose; exhale through your mouth. </p>
<p>[<em>You need to understand the coronavirus pandemic, and we can help.</em> <a href="https://theconversation.com/us/newsletters?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=upper-coronavirus-help">Read The Conversation’s newsletter</a>.]</p><img src="https://counter.theconversation.com/content/140695/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Louis J. Ignarro does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
The body has many natural defenses against viruses and other pathogens. One antiviral molecule produced in the body is nitric oxide and it is created when we breathe in through the nose.
Louis J. Ignarro, Distinguished Professor Emeritus of Molecular & Medical Pharmacology, School of Medicine, University of California, Los Angeles
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/136270
2020-05-05T13:52:57Z
2020-05-05T13:52:57Z
Coronavirus: how physiotherapists are helping patients recover
<figure><img src="https://images.theconversation.com/files/332708/original/file-20200505-83740-er8htu.jpg?ixlib=rb-1.1.0&rect=21%2C0%2C4771%2C3190&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Physiotherapists can help improve a patient's breathing.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/doctor-wearing-ppe-suit-surgical-mask-1691900056">theskaman306/ Shutterstock</a></span></figcaption></figure><p>Most people who contract coronavirvus (COVID-19) recover. But about 14% will have a severe infection, and a further <a href="https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf">6% will become critically ill</a>. Research shows 16% of those hospitalised need an <a href="https://jamanetwork.com/journals/jama/fullarticle/2763188">intensive care bed</a> – often for <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2004500">prolonged periods of time</a>. Some will need to be placed in a <a href="https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/C0167-specialty-guide-surge-based-on-current-hospital-experience-v2.pdf">medical coma on a ventilator</a>.</p>
<p>During this critical period, specialist physiotherapists will remotely monitor patients and decide if they’re needed to help a patient’s <a href="https://www.sciencedirect.com/science/article/pii/S183695532030028X">respiratory function and physical recovery</a> by looking at factors such as a person’s oxygen levels, blood test results, lung scans, and following discussion with their colleagues. </p>
<p>Here are some of the problems that physiotherapists can assist with when people are in hospital with COVID-19.</p>
<h2>Low blood oxygen</h2>
<p>People with severe COVID-19 infections suffer from low blood oxygen. Patients with difficulty breathing because of the virus will have worsening lung function and won’t be able to circulate oxygen properly to the body’s essential organs.</p>
<p>In moderate to severe cases of COVID-19, <a href="https://www.ncbi.nlm.nih.gov/pubmed/32222812">prone positioning (lying face down)</a> is recommended. Lying face down for hours at a time <a href="https://www.ncbi.nlm.nih.gov/pubmed/32222812">can increase oxygen levels in the blood</a>. This is because it helps match <a href="https://www.ncbi.nlm.nih.gov/pubmed/27400909">air to blood supply</a> in the lungs, and also opens up areas of lung tissue to allow more gas exchange. </p>
<p>Often, this treatment is used when patients are <a href="https://www.ncbi.nlm.nih.gov/pubmed/32309812">still critically unwell</a> due to COVID-19. Moving the patient in and out of prone positioning requires a <a href="https://ers.app.box.com/s/jrgddvp49stn3w5hxwq5u8784p09xx77">large team of specialist staff</a> which can include physiotherapists. Physiotherapists may also <a href="https://ers.app.box.com/s/jrgddvp49stn3w5hxwq5u8784p09xx77">recommend other positions</a>, such as side lying, to assist lung function depending on the patient’s condition.</p>
<p>Physiotherapists can be involved in the treatment of people using <a href="https://breathe.ersjournals.com/content/15/2/110">non-invasive ventilation</a>, or may in some cases suggest or set up this equipment to <a href="https://err.ersjournals.com/content/27/149/180029">improve lung function</a>.</p>
<p><a href="https://www.ncbi.nlm.nih.gov/pubmed/23709194">Non-invasive ventilation</a> is a form of breathing support that doesn’t involve inserting a tube into the airways. This is usually done through a face mask, or a “<a href="https://www.ncbi.nlm.nih.gov/pubmed/32331217">helmet</a>”, which can limit droplet spread of the virus. </p>
<p>However, the use of non-invasive ventilation in treating COVID-19 is still being debated. Research indicates that non-invasive ventilation did not work well for people with <a href="https://www.ncbi.nlm.nih.gov/pubmed/30884185">other types of viral illnesses</a> such as the Middle East respiratory syndrome (MERS), which might mean there may be a <a href="https://www.ncbi.nlm.nih.gov/pubmed/28101605">high failure rate</a> in COVID-19. Early intubation (placing a tube in the airways) and ventilation is often <a href="https://www.ncbi.nlm.nih.gov/pubmed/32222812">preferred for severe COVID-19</a>.</p>
<p>Non-invasive ventilation can work for some patients with a <a href="https://www.thelancet.com/action/showPdf?pii=S2213-2600%2820%2930181-8">less severe infection</a>, especially if they’re not considered suitable for more intensive forms of treatment, or if ventilators are in low supply. </p>
<h2>Mucus in the lungs and difficulty breathing</h2>
<p>While many people with COVID-19 have a dry cough and don’t have problems with <a href="https://www.sciencedirect.com/science/article/pii/S183695532030028X">excess mucus build up</a> data from one Chinese study reported that 34% of patients with severe COVID-19 had <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2002032">excess mucus</a>. This build up may happen after being admitted to critical care.</p>
<p>For some people very unwell with COVID-19, physiotherapists might deliver ventilator hyperinflation to <a href="https://www.physiotherapyjournal.com/article/S0031-9406(14)00090-X/fulltext">mimic larger breaths</a>, or use a flexible catheter to <a href="https://link.springer.com/content/pdf/10.1007/s00134-014-3565-4.pdf">suction mucus out</a> without the need to disconnect the person from the ventilator.</p>
<p>Patients can also be taught breathing exercises to help them cough up mucus on their own. Those experiencing breathlessness or difficulty breathing can be advised about positioning, relaxed breathing techniques, and about modifying their daily activities. </p>
<p>However, some breathing techniques used to clear mucus will result in coughing. This may spread coronavirus, so physiotherapists will need full <a href="https://link.springer.com/content/pdf/10.1007/s00134-020-06022-5.pdf">personal protective equipment</a>. A <a href="https://link.springer.com/content/pdf/10.1007/s00134-020-06022-5.pdf">negative pressure room</a> (where air can’t be circulated outside the room) is also useful for preventing further virus spread.</p>
<h2>Weakness</h2>
<p>A big focus of physiotherapy during the pandemic will be to get patients <a href="https://www.sciencedirect.com/science/article/pii/S183695532030028X">moving as soon as possible</a>. But this can only happen when the <a href="https://www.sciencedirect.com/science/article/pii/S183695532030028X">patient is well enough</a>. </p>
<p>This can start with simply getting patients to move their arms, legs and body in the bed. Physiotherapists will closely manage vital signs such as oxygen levels, respiratory rate and blood pressure to ensure movements are safely tolerated.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/332714/original/file-20200505-83764-bujvz4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/332714/original/file-20200505-83764-bujvz4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/332714/original/file-20200505-83764-bujvz4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/332714/original/file-20200505-83764-bujvz4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/332714/original/file-20200505-83764-bujvz4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/332714/original/file-20200505-83764-bujvz4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/332714/original/file-20200505-83764-bujvz4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Exercises like sitting on the edge of the patient’s bed can help them build up strength.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/image-blur-happy-asian-elderly-people-1165014496">JOKE_PHATRAPONG/ Shutterstock</a></span>
</figcaption>
</figure>
<p>Rehabilitation will also vary depending on the patient’s condition. Tiredness or fatigue is reported in about <a href="https://www.ncbi.nlm.nih.gov/pubmed/32240670">40% of patients</a>, so physiotherapists will pace activity and potentially see patients more often for shorter treatment sessions. It can be hard sometimes for people to comply with treatment due to factors such as delirium causing confusion and anxiety, so remembering and building on prior sessions may be affected.</p>
<p>For those with severe infections, even the smallest movements can be exhausting and cause rapid drops in oxygen levels. Rehabilitation will be carefully planned and progress gradually to the patient sitting on the edge of their bed, standing, marching on spot, and walking, depending on how well each is tolerated.</p>
<p>Patients hospitalised with COVID-19 are more commonly people who are older and have <a href="https://www.ncbi.nlm.nih.gov/pubmed/32240670">underlying conditions</a>, such as kidney problems, high blood pressure, diabetes, coronary heart disease and obesity. Some patients can also develop <a href="https://www.ncbi.nlm.nih.gov/pubmed/32105632">lung and kidney, cardiac and liver damage</a> while in critical recovery. All of these factors influence their ability to recover and physiotherapists must carefully judge their rehabilitation.</p>
<p>People may also develop post-intensive care syndrome, which can develop <a href="https://www-atsjournals-org.eu1.proxy.openathens.net/doi/pdf/10.1164/rccm.2018P15">after a critical illness</a>. People commonly experience problems with their physical function, mental health, or cognitive ability. Where possible, physiotherapists will help patients make a full physical recovery so they can return home. Physiotherapists will work alongside a team to help patients during rehabilitation.</p>
<p>Since recovery and rehabilitation take some time, using technologies such as “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5544892/">tele-rehabilitation</a>” or other forms of remote physiotherapy can help patients return to good health even after they’ve left the hospital.</p><img src="https://counter.theconversation.com/content/136270/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
Physiotherapists can help patients during and after coronavirus infections.
Julie Broderick, Assistant Professor, Physiotherapy, Trinity College Dublin
Catherine L. Granger, Associate Professor of Physiotherapy, The University of Melbourne
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/130349
2020-05-05T12:46:15Z
2020-05-05T12:46:15Z
How does a baby ‘breathe’ while inside its mom?
<figure><img src="https://images.theconversation.com/files/332496/original/file-20200504-83721-wei11m.jpg?ixlib=rb-1.1.0&rect=1134%2C396%2C6214%2C4506&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Her deep breath has to get to the baby.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/pregnant-woman-sitting-outside-royalty-free-image/1132797740">electravk/Moment via Getty Images</a></span></figcaption></figure><p>“Mothering” is synonymous with “nurturing,” probably because moms start providing for their kids even before they’re born. </p>
<p>A fetus relies on its mother to provide all the essentials. The placenta is key here; this organ develops in the uterus and is like a gateway that lets mom pass baby everything it needs to support its development.</p>
<p>After the mother eats, her body breaks the food down into glucose, amino acids, fatty acids and cholesterol that travel through channels or <a href="https://doi.org/10.3390/ijms150916153">transporters in the placenta to the fetus</a>. They provide the energy and the building blocks that the growing fetus uses as it develops organs, tissues and bones.</p>
<p>Vital electrolytes like <a href="https://doi.org/10.1093/bjaceaccp/mku013">sodium, chloride, calcium and iron</a> pass through their own specific channels in the placenta or just diffuse from the mother’s side to the fetus’s.</p>
<p>Fetuses require oxygen for growth, too. Since their lungs are not exposed to air, they can’t breathe on their own. Instead they rely on their mothers to provide the required oxygen through a remarkable biochemical process. </p>
<p><a href="https://scholar.google.com/citations?user=DL4ZkpIAAAAJ&hl=en">I’m a biochemist</a>, and it’s this process that made me fall in love with the discipline when I was a student. It’s my favorite topic to present to my students today and helps explain why pregnant women can get so easily winded. </p>
<h2>Oxygen running through your veins</h2>
<p>Some ingenious biochemistry is at the root of how oxygen travels throughout the human body.</p>
<p>A protein called hemoglobin is responsible for picking up oxygen in your lungs and carrying it via your bloodstream to all of your tissues. <a href="https://www.acs.org/content/acs/en/education/resources/highschool/chemmatters/past-issues/archive-2009-2010/chemmatters-february-2010-issue.html">Hemoglobin contains iron</a>, and it’s responsible for <a href="https://theconversation.com/blood-in-your-veins-is-not-blue-heres-why-its-always-red-97064">blood’s red color</a>. It’s made up of four subunits, two each of two different types. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/326586/original/file-20200408-118674-h9npux.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/326586/original/file-20200408-118674-h9npux.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/326586/original/file-20200408-118674-h9npux.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=307&fit=crop&dpr=1 600w, https://images.theconversation.com/files/326586/original/file-20200408-118674-h9npux.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=307&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/326586/original/file-20200408-118674-h9npux.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=307&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/326586/original/file-20200408-118674-h9npux.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=386&fit=crop&dpr=1 754w, https://images.theconversation.com/files/326586/original/file-20200408-118674-h9npux.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=386&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/326586/original/file-20200408-118674-h9npux.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=386&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Hemoglobin’s four subunits – two blue and two green in the illustration – can bind to one oxygen molecule each.</span>
<span class="attribution"><span class="source">Image generated from PBD ID 1C7B by Julie Pollock</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<p>Each subunit contains one iron atom bound to a special compound called a heme that can interact with one oxygen molecule. It’s an all-or-nothing situation; for hemoglobins in the same vicinity, they’re either all holding onto oxygen or have all released their oxygen. It depends on the concentration of oxygen in the environment the hemoglobin finds itself in. </p>
<p>When you take a good breath, the concentration of oxygen is high in your lungs. Hemoglobin in the area automatically picks up oxygen. Then it travels via your blood to tissues with lower oxygen concentrations, where it gives up the oxygen.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/332492/original/file-20200504-83740-1j3brd.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/332492/original/file-20200504-83740-1j3brd.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/332492/original/file-20200504-83740-1j3brd.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=270&fit=crop&dpr=1 600w, https://images.theconversation.com/files/332492/original/file-20200504-83740-1j3brd.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=270&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/332492/original/file-20200504-83740-1j3brd.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=270&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/332492/original/file-20200504-83740-1j3brd.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=339&fit=crop&dpr=1 754w, https://images.theconversation.com/files/332492/original/file-20200504-83740-1j3brd.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=339&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/332492/original/file-20200504-83740-1j3brd.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=339&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">BPG binds to hemoglobin to facilitate the release of oxygen.</span>
<span class="attribution"><a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<p>A molecule called 2,3-bisphosphoglycerate, or BPG, facilitates oxygen’s release. It binds to the center cavity between the four subunits of hemoglobin to help the oxygen molecules pop free. </p>
<h2>Getting oxygen to the fetus</h2>
<p>Fetuses are not exposed to air, and their <a href="https://doi.org/10.1146/annurev.ph.46.030184.003153">lungs don’t fully develop until after they’re born</a>, so oxygen is another on the long list of things they must get through the placenta from their mothers.</p>
<p>Hemoglobin proteins are too big to cross the placenta. The maternal hemoglobins must give up their oxygen molecules on their side so the oxygen can cross over and be picked up by the fetal hemoglobins on the other side. The predicament is that since this is all happening in such close quarters, the hemoglobins should either all be holding on to oxygen or all be releasing it.</p>
<p>In order to circumvent this problem, <a href="https://www.wiley.com/en-us/Essential+Biochemistry%2C+3rd+Edition-p-9781118441688">fetal hemoglobin differs in structure</a> from maternal hemoglobin. With just a few changes to the amino acids in its protein sequence, fetal hemoglobin does not bind well to BPG, the molecule that helps oxygen get loose from adult hemoglobin. Fetal hemoglobin also has a stronger affinity for oxygen than the adult version does.</p>
<p>So at the placental interface, where there’s a lot of BPG, the maternal hemoglobin lets go of the oxygen and the fetal hemoglobin grabs ahold of it tightly. This process allows for effective and efficient transfer of oxygen from the mother to the fetus.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/332493/original/file-20200504-83740-101e5wu.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/332493/original/file-20200504-83740-101e5wu.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/332493/original/file-20200504-83740-101e5wu.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=359&fit=crop&dpr=1 600w, https://images.theconversation.com/files/332493/original/file-20200504-83740-101e5wu.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=359&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/332493/original/file-20200504-83740-101e5wu.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=359&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/332493/original/file-20200504-83740-101e5wu.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=451&fit=crop&dpr=1 754w, https://images.theconversation.com/files/332493/original/file-20200504-83740-101e5wu.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=451&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/332493/original/file-20200504-83740-101e5wu.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=451&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Effective transfer of oxygen from maternal hemoglobin (blue and green) to fetal hemoglobin (purple and green) is facilitated by BPG at the placenta.</span>
<span class="attribution"><a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<p>Shortly before babies are born, they start making some adult hemoglobin so that when they are breathing on their own, they can perform appropriate oxygen transfer throughout their little bodies. <a href="https://doi.org/10.1016/j.ebiom.2016.11.032">Usually by the time a baby reaches six months of age</a>, the levels of fetal hemoglobin are very low, replaced almost completely by adult hemoglobin.</p>
<p>Academically, I knew about this remarkable biochemical process. But it wasn’t until I was pregnant with my son that I really understood it. My miles in spinning class decreased, I lagged behind my husband and dog on our daily walks, and I ran out of breath climbing the three flights of stairs to my office. My son’s hemoglobin was stealing my oxygen, so I had to breathe in more to complete routine tasks.</p>
<p>Once my baby was on the outside, breathing on his own with his mature hemoglobin functioning appropriately, I was more amazed than ever at the perfection of the science.</p>
<p>[<em>Insight, in your inbox each day.</em> <a href="https://theconversation.com/us/newsletters?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=insight">You can get it with The Conversation’s email newsletter</a>.]</p><img src="https://counter.theconversation.com/content/130349/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Julie Pollock has received research funding from the Virginia Academy of Sciences and the Jeffress Memorial Trust. </span></em></p>
A fetus needs oxygen long before its lungs work and it’s exposed to the air. Some ingenious biochemistry explains how the mother’s blood delivers it.
Julie Pollock, Associate Professor of Chemistry, University of Richmond
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/135935
2020-04-08T05:40:48Z
2020-04-08T05:40:48Z
Does JK Rowling’s breathing technique cure the coronavirus? No, it could help spread it
<p>Harry Potter author JK Rowling says a breathing technique has helped her coronavirus-like respiratory symptoms, a claim that has been <a href="https://thenewdaily.com.au/entertainment/celebrity/2020/04/07/coronavirus-breathing-jk-rowling/">widely reported</a> and shared on social media.</p>
<p>Her tweet includes a video from a UK hospital doctor describing the technique, a type of controlled coughing. This involves taking six deep breaths and on the last one covering your mouth and coughing. </p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1247121896082157568"}"></div></p>
<p>The internet is full of home grown cures for the coronavirus. And when doctors propose them, they appear credible. </p>
<p>While special breathing techniques have their place in hospital, under the supervision of a respiratory physiotherapist or respiratory doctor, and for certain medical conditions, using them at home to manage coronavirus symptoms could be dangerous.</p>
<p>The technique in the video could help spread the coronavirus to people close by. </p>
<p>By coughing, you could directly infect people with droplets, or these droplets on someone’s hands can be transferred to a surface others can touch.</p>
<p>So JK Rowling’s well-meaning advice could inadvertently help spread the virus to your family, or to the person next to you on the bus.</p>
<h2>Controlled coughing helps with cystic fibrosis</h2>
<p>The cells in our lungs produce a sticky mucus as part of our body’s defence system. And when we have a viral lung infection, such as with the virus that causes COVID-19 or the influenza virus, we produce more of it. </p>
<p>The mucus traps the invading pathogen. Normally, this mucus is removed from the lungs by the movement of tiny hair-like projections in our airways. From there, we either swallow the mucus or cough it out as phlegm. </p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-why-do-i-have-a-cough-and-what-can-i-do-about-it-119172">Health Check: why do I have a cough and what can I do about it?</a>
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</em>
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<p>However, sometimes we produce so much mucus it is difficult to breathe. The mucus can block our tiny airways, preventing us from obtaining oxygen from our lungs.</p>
<p>In other diseases, such as <a href="https://www.cff.org/What-is-CF/About-Cystic-Fibrosis/">cystic fibrosis</a>, controlled coughing <a href="https://books.google.com.au/books?id=mOqODwAAQBAJ&pg=PA107&lpg=PA107&dq=hypoxemia++%22controlled+cough%22&source=bl&ots=k254DYbDkD&sig=ACfU3U2C5lJuGblV3mgKdKX2Ej5Dcp1XyA&hl=en&sa=X&ved=2ahUKEwjOqdm0xtfoAhUQzDgGHWAVDuQQ6AEwA3oECAgQNQ#v=onepage&q=controlled%20cough&f=false">can help</a> remove the mucus and make it easier for people to breathe. </p>
<p>This technique may be done as part of chest physiotherapy, along with other lung clearance techniques, in a hospital. The technique is not dangerous, but the contents of what is coughed out can be.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/explainer-what-is-cystic-fibrosis-and-how-is-it-treated-59681">Explainer: what is cystic fibrosis and how is it treated?</a>
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</em>
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<hr>
<h2>So can it help with the coronavirus?</h2>
<p>So what’s the evidence controlled coughing could help people manage their coronavirus symptoms? Put simply, there are no clinical trials or good evidence. </p>
<p>One common COVID-19 symptom is a <a href="https://www.who.int/news-room/q-a-detail/q-a-coronaviruses#:%7E:text=symptoms">dry cough</a>. So it’s difficult to imagine why controlled coughing would help when you’re coughing so much anyway.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/can-coronavirus-spread-through-food-can-anti-inflammatories-like-ibuprofen-make-it-worse-coronavirus-claims-checked-by-experts-133911">Can coronavirus spread through food? Can anti-inflammatories like ibuprofen make it worse? Coronavirus claims checked by experts</a>
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</em>
</p>
<hr>
<h2>Is there any harm in trying?</h2>
<p>There is a very real risk that unintentionally this technique would actually spread the virus. </p>
<p>When we cough we produce a lot of droplets of mucus from the <a href="https://academic.oup.com/cid/article/46/1/93/338992">lungs</a> that are spread as a spray.
My research <a href="https://iopscience.iop.org/article/10.1088/1752-7155/10/4/046002">has also shown</a> breathing out forcefully is enough to propel viruses from the lungs this way.</p>
<p>Either way large sprays of viruses could infect other people. </p>
<p>In hospital, this risk is minimised by having specialised negative pressure rooms that remove the contaminated air. Patients wear masks to capture the sprays and clinical staff wear personal protective equipment, including masks and face shields. There are also strict infection control measures, such as limits on visitors and hand washing. Yet the risks of transmission remain high.</p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/no-5g-radiation-doesnt-cause-or-spread-the-coronavirus-saying-it-does-is-destructive-135695">No, 5G radiation doesn't cause or spread the coronavirus. Saying it does is destructive</a>
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</em>
</p>
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<p>But if you practise controlled coughing at home or on the bus, it’s easy to see how you could inadvertently spread the virus.</p>
<p>And of course, the technique doesn’t kill the virus or cure anyone.</p>
<h2>So what are we to make of all this?</h2>
<p>So why did JK Rowling endorse this technique? In essence, it’s because she believed it helped her, and thought it would help others.</p>
<p>However, her tweet says she <a href="https://twitter.com/jk_rowling/status/1247121896082157568">hadn’t been tested</a> for COVID-19, so it’s not certain she had the infection. And she may or may not have benefited from the technique. Perhaps her symptoms may have improved by themselves anyway. It’s hard to know.</p>
<p>My advice is to seek medical advice if you suspect you have the coronavirus rather than rely on testimonials, however well meaning. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/coronavirus-how-long-does-it-take-to-get-sick-how-infectious-is-it-will-you-always-have-a-fever-covid-19-basics-explained-132963">Coronavirus: how long does it take to get sick? How infectious is it? Will you always have a fever? COVID-19 basics explained</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/135935/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Brian Oliver receives funding from the NHMRC and the ARC.
Brian Oliver is the co-director of the Respiratory, Sleep, Environmental and Occupational Health Clinical Academic group of Maridulu Budyari Gumal, the Sydney Partnership for Health, Education, Research and Enterprise (SPHERE), A NHMRC AHRTC. He is also president of the NSW branch of the thoracic society of Australia and New Zealand. </span></em></p>
Controlled coughing can help people with cystic fibrosis, under supervision and in hospital. But when done at home, it could help spread the coronavirus.
Brian Oliver, Research Leader in Respiratory cellular and molecular biology at the Woolcock Institute of Medical Research and Professor, Faculty of Science, University of Technology Sydney
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/135590
2020-04-06T12:08:01Z
2020-04-06T12:08:01Z
The CDC now recommends wearing a mask in some cases – a physician explains why and when to wear one
<figure><img src="https://images.theconversation.com/files/325419/original/file-20200404-74235-h877qq.jpg?ixlib=rb-1.1.0&rect=0%2C13%2C1280%2C705&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The change in CDC guidance comes in response to new research on how the new coronavirus can spread.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/flu-h1n1-swine-contagious-person-sneezing-40246747"> Peter Denovo/Shutterstock.com</a></span></figcaption></figure><p>The <a href="https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html">Centers for Disease Control and Prevention</a> has changed its policy and is now advising everyone, whether or not they have symptoms of COVID-19, to cover their face with a mask or cloth covering whenever social distancing is difficult to maintain. To be clear, the CDC is not saying you should wear a mask wherever you go, but rather in places where people congregate, including grocery stores and public transportation and ride-shares. </p>
<p>The shift in recommendations reflects <a href="https://www.nap.edu/read/25769/chapter/1">growing evidence</a> that COVID-19 can be transmitted by a person’s exhalations and normal speech but also the fact that people are not effectively covering their sneezes and coughs.</p>
<h2>The stealth virus</h2>
<p>COVID-19’s middle name should be “stealth.” People can be shedding virus for <a href="https://www.cidrap.umn.edu/news-perspective/2020/04/symptom-spread-may-complicate-covid-19-containment">one to three days</a> before showing any symptoms – including no coughing, sneezing or fever – in what’s called “presymptomatic transmission.” A <a href="https://www.cdc.gov/mmwr/volumes/69/wr/mm6914e1.htm">Singapore study</a> suggests that 10% of infections are attributable to presymptomatic spread. </p>
<p>A study of the 3,711 passengers and crew on the <a href="https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.10.2000180">Diamond Princess</a> cruise ship indicates that close to 1 in 5 COVID-19 carriers never develop symptoms. Some these people transmit the virus through “asymptomatic transmission.” The proportion of infected people that never develop symptoms could be more like <a href="https://www.nature.com/articles/d41586-020-00822-x">one-third</a> for the general population that is younger and healthier than typical cruise takers. </p>
<p>The virus’s ability to spread so easily from one person to the next is why people are being asked to <a href="https://theconversation.com/video-why-social-distancing-is-one-of-the-best-tools-we-have-to-fight-the-coronavirus-134742">physically distance</a> themselves from one another. But people still have to go out to get essentials at places where people gather. </p>
<p>If a person is not coughing or sneezing, how are they spreading the virus? One way is by contact. The virus lives on the mucous membranes in the throat and nose. With people touching their faces every <a href="https://www.ajicjournal.org/article/S0196-6553(14)01281-4/fulltext">two-and-a-half minutes,</a> on average it’s easy to see how the virus gets on our hands, and then we can spread it to commonly used surfaces like door knobs, a plastic handle in the subway or someone else’s hand. <a href="https://www.nejm.org/doi/full/10.1056/NEJMc2004973">Steel and plastic</a> surfaces can harbor live virus for three days.</p>
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<iframe width="440" height="260" src="https://www.youtube.com/embed/piCWFgwysu0?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Wearing a mask can help protect others if you sneeze or cough in public. Growing evidence indicates that it can also protect the wearer from airborne virus particles.</span></figcaption>
</figure>
<p>The other manner of spread is by asymptomatic infected people simply <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2843947/?report=reader">breathing</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6984704/">talking</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6382806/">yelling</a> or <a href="https://www.latimes.com/world-nation/story/2020-03-29/coronavirus-choir-outbreak">singing</a>. These activities <a href="https://www.cdc.gov/niosh/topics/aerosols/pdfs/Aerosol_101.pdf">aerosolize virus</a>, creating airborne virus particles – also called droplet nuclei – that are so tiny they can float around in the air for <a href="https://www.nejm.org/doi/full/10.1056/NEJMc2004973">three hours</a>. Coughing and sneezing produce larger water and virus-borne <a href="https://www.ncbi.nlm.nih.gov/books/NBK143281/">droplets</a>, as well as producing <a href="https://jamanetwork.com/journals/jama/fullarticle/2763852">aerosolized virus</a>. </p>
<p>Common medical devices, like nebulizer machines for people with asthma and CPAP machines for those with sleep apnea, can aerosolize virus. But the concentration of aerosolized virus will be small in a large well-ventilated space and practically absent outdoors. Infectious aerosolized virus becomes more of a concern in a place like a small, poorly ventilated room. Places like a patient’s bedroom in their home, some nursing home rooms and a classroom would all be concerning to me as a <a href="https://www.bumc.bu.edu/busm/profile/thomas-perls/">physician</a>. Hospital rooms are generally better ventilated.</p>
<p>Another key determinant of getting infected is the amount of time you are exposed – so your risk is much less with five minutes versus 30 or more minutes of exposure. People think about the danger of radiation exposure in very much the same way – how close you are to the source, the concentration of exposure and the amount of time you are exposed. </p>
<h2>DIY and surgical masks may protect you and others</h2>
<p>The purpose of all of us wearing face coverings or surgical masks anywhere people congregate is first and foremost to protect others if we sneeze or cough. These coverings will stop much of the large droplets that could otherwise reach people as far away as 18 feet away. Just-published <a href="https://www.nature.com/articles/s41591-020-0843-2">research</a> indicates that surgical masks can also decrease the amount of aerosolized virus the people produce by breathing and talking. </p>
<p>A big question is: Can these DIY or <a href="https://www.osha.gov/Publications/respirators-vs-surgicalmasks-factsheet.html">surgical masks</a> also protect the wearer? The same research <a href="https://www.nature.com/articles/s41591-020-0843-2">study</a> shows these masks impede aerosolized virus being expelled out by the user so presumably they can decrease breathing in the virus as well. But they aren’t foolproof. These coverings don’t fit the face tightly, so aerosolized virus and larger droplets can be sucked in through the gaps between the face and the mask when we take a breath. </p>
<p>Additionally, some of the viral particles are so small that they can be inhaled through the cloth or paper that’s used to make these masks. People should not be lulled into a false sense of security in thinking that these types of masks will protect them from airborne, aerosolized virus especially in poorly ventilated spaces frequented by others. The best thing to do is to either avoid such spaces or be in them for as short a period of time as possible.</p>
<h2>The bottom line</h2>
<p>The chance of catching COVID-19 from a person walking by outdoors is extremely small. Wearing face coverings is recommended and requested for when you are indoors, including mass transit and ride-shares, with other people. </p>
<p>Anywhere you go, maintain <a href="https://qz.com/1830347/social-distancing-isnt-the-right-language-for-what-covid-19-asks-of-us/">physical distancing</a> of at least 6 feet with no bodily contact. If someone nearby sneezes or coughs and they aren’t wearing a mask, get at least 20 feet away, quickly. When you do go out on an errand, wear a face covering and get your business done as fast as you can. </p>
<p>You don’t need a N-95 mask if you wear a face covering when you go out in a public indoor place or ride mass transit and practice good physical distancing. Health care workers have to care for their COVID-19 patients within very close distances for prolonged periods of time. If they don’t have a N-95 mask, the risk goes way up for them. If you have a N-95 mask, please donate it to your local hospital or first responder.</p>
<p>[<em>You need to understand the coronavirus pandemic, and we can help.</em> <a href="https://theconversation.com/us/newsletters?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=upper-coronavirus-help">Read our newsletter</a>.]</p><img src="https://counter.theconversation.com/content/135590/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Thomas Perls does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
The CDC now recommends that everyone wear a face covering when they go into a public place. But there’s confusion about why and if this protects the wearer, people around them or both.
Thomas Perls, Professor of Medicine, Boston University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/129903
2020-01-15T03:00:36Z
2020-01-15T03:00:36Z
I’m struggling to breathe with all the bushfire smoke – could I have undiagnosed asthma?
<p>As bushfire smoke continues to pollute the air of large parts of Australia’s eastern states, some people have experienced throat irritation, coughing and breathing difficulties. </p>
<p>Health authorities <a href="https://thenewdaily.com.au/news/state/vic/2020/01/06/smoke-melbourne-health-warnings/">have also warned</a> more severe symptoms such as chest tightness and wheezing may emerge in people who have underlying asthma and in people who haven’t yet been diagnosed. </p>
<p>Wheezing is a high-pitched whistling sound when you breathe, caused by muscle spasm or inflammation in narrowed airways.</p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/bushfire-smoke-is-everywhere-in-our-cities-heres-exactly-what-you-are-inhaling-129772">Bushfire smoke is everywhere in our cities. Here's exactly what you are inhaling</a>
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<h2>Normal response to bushfire smoke</h2>
<p>Respiratory symptoms can occur in otherwise healthy people in response to bushfire air pollution. This is due to large and small particulates in fire smoke irritating the the thin lining of the respiratory tract, called the mucous membrane. </p>
<p>These particles tend to cause increased secretions, inflammation and irritation of the eyes nose and throat, even in people who have no history of lung disease. </p>
<h2>Why it’s important to know your asthma profile</h2>
<p>Asthma is an inflammatory disease which causes narrowing of the airways. Symptoms and flare-ups or attacks can occur after exposure to a wide range of triggers. </p>
<p>If the airway inflammation isn’t treated, it can progress to more significant and permanent airway narrowing that results in persistent breathlessness and loss of lung function. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/310104/original/file-20200114-151848-1s0cpzt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/310104/original/file-20200114-151848-1s0cpzt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/310104/original/file-20200114-151848-1s0cpzt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/310104/original/file-20200114-151848-1s0cpzt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/310104/original/file-20200114-151848-1s0cpzt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/310104/original/file-20200114-151848-1s0cpzt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/310104/original/file-20200114-151848-1s0cpzt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">If left untreated, asthma can cause permanent damage.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/unhealthy-older-man-leaning-on-couch-1569052099">Fizkes/Shutterstock</a></span>
</figcaption>
</figure>
<p>If you have asthma, it’s most important to know the severity, how to control it, and how to identify and promptly treat an attack.</p>
<h2>What might signal undiagnosed asthma?</h2>
<p>People with asthma can experience severe attacks or flare-ups when exposed to bushfire smoke, or persistent respiratory symptoms that don’t settle promptly after their smoke exposure ends. </p>
<p>Symptoms that suggest the possibility of asthma include chest tightness and wheezing in response to exposure to irritants such as smoke, dusts, aerosol sprays and fumes, or in response to allergic triggers such as pollens, cat and dog fur, house dust, and mouldy atmospheres. </p>
<p>Asthma can also manifest as a cough. </p>
<p>Many people with asthma have a <a href="https://theconversation.com/whats-the-link-between-hay-fever-and-asthma-and-how-are-they-treated-64740">history of hayfever</a>, often provoked by pollens, house dust, cat and dog fur, and moulds. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/whats-the-link-between-hay-fever-and-asthma-and-how-are-they-treated-64740">What's the link between hay fever and asthma, and how are they treated?</a>
</strong>
</em>
</p>
<hr>
<p>People with a <a href="https://www.ncbi.nlm.nih.gov/pubmed/12568822">family history of asthma</a> are at greater risk of developing the disease, as are those with a history of <a href="https://www.rch.org.au/kidsinfo/fact_sheets/Asthma/">wheezing illness in childhood</a> caused by viral respiratory infections. In fact, viruses that cause the common cold are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5524340/">frequent triggers</a> of asthma attacks. </p>
<p>Some people with asthma may experience symptoms predominantly when they exercise. In such cases, chest tightness and wheezing typically occurs while exercising but often intensifies over a few minutes after stopping.</p>
<h2>What to do if you’re unsure</h2>
<p>If you experience symptoms of asthma from the bushfire smoke, see your GP.</p>
<p>To assess whether you have asthma, your doctor will undertake a breathing assessment called called a spirometry test. This requires you to blow into a mouthpiece to assess how much air you can blow out and how quickly you can expel the air. </p>
<figure>
<iframe src="https://player.vimeo.com/video/179264612" width="500" height="281" frameborder="0" webkitallowfullscreen="" mozallowfullscreen="" allowfullscreen=""></iframe>
<figcaption><span class="caption">Here’s how a spirometry test works. <em>National Asthma Council Australia</em></span></figcaption>
</figure>
<p>The doctor will also determine whether there is airway narrowing which improves after taking a bronchodilator – a reliever medication such as Ventolin. </p>
<p>It’s not OK to just take asthma medicines, gain some benefit and conclude you have the condition. Many respiratory symptoms can easily be mistaken for asthma, particularly when they occur in association with viral respiratory infection.</p>
<h2>How is asthma treated?</h2>
<p>Many people believe their asthma is being treated if they use their blue reliever inhaler as needed. </p>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/310097/original/file-20200114-93792-7ycd11.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/310097/original/file-20200114-93792-7ycd11.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=900&fit=crop&dpr=1 600w, https://images.theconversation.com/files/310097/original/file-20200114-93792-7ycd11.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=900&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/310097/original/file-20200114-93792-7ycd11.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=900&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/310097/original/file-20200114-93792-7ycd11.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1131&fit=crop&dpr=1 754w, https://images.theconversation.com/files/310097/original/file-20200114-93792-7ycd11.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1131&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/310097/original/file-20200114-93792-7ycd11.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1131&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Asthma relievers aren’t meant for daily use.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/asthma-treatment-woman-167917484">Image Point Fr/Shutterstock</a></span>
</figcaption>
</figure>
<p>But relievers don’t address the underlying airway inflammation, even though they relieve the symptoms. They should never be used as a daily medication for asthma.</p>
<p>Asthma treatment requires an anti-inflammatory medication, usually an inhaled corticosteroid taken regularly. These medications control the underlying inflammatory process and prevent symptoms and attacks. </p>
<p>Anti-inflammatory treatments are effective in maintaining asthma control day by day so that even with smoke and air pollution exposure, symptoms and attacks are less likely to occur. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/we-know-bushfire-smoke-affects-our-health-but-the-long-term-consequences-are-hazy-129451">We know bushfire smoke affects our health, but the long-term consequences are hazy</a>
</strong>
</em>
</p>
<hr>
<p>People with asthma should have a written action plan which identifies symptoms that typically occur during asthma flare-ups and enables patients to increase their medications appropriately. </p>
<p>Finally, because asthma is a chronic inflammatory condition it requires monitoring and regular review. In these reviews, your doctor will check your lung function and ensure you’re taking the right medication and that your action plan is up to date.</p><img src="https://counter.theconversation.com/content/129903/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>n the last 5 years, Christine Jenkins has received funding for research from the National Health and Medical Research Council, Asthma Australia, UNSW Sydney, GlaxoSmithKline and the Rebecca Cooper Foundation.</span></em></p>
Bushfire smoke is making it difficult for some people to breathe. Those with asthma are at particular risk, but not everyone with the condition has been diagnosed. Here’s what to look out for.
Christine Jenkins, Professor, Respiratory Medicine, UNSW Sydney and Uni of Sydney; Head, Respiratory Group, George Institute for Global Health
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/127674
2020-01-10T13:44:36Z
2020-01-10T13:44:36Z
Why we are hard-wired to worry, and what we can do to calm down
<figure><img src="https://images.theconversation.com/files/309151/original/file-20200108-107214-1hizipg.jpg?ixlib=rb-1.1.0&rect=77%2C242%2C7161%2C4616&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The everyday stressors of life can lead to worrisome thoughts. </span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/sadness-company-agent-woman-finding-working-659365795">PR Image Factory</a></span></figcaption></figure><p>A new year brings both hopes and anxieties. We want things to be better for ourselves and the people we love, but worry that they won’t be, and imagine some of the things that might stand in the way. More broadly, we might worry about who’s going to win the election, or even if our world will survive.</p>
<p>As it turns out, humans are wired to worry. Our brains are continually imagining futures that will meet our needs and things that could stand in the way of them. And sometimes any of those needs may be in conflict with each other. </p>
<p>Worry is when that vital planning gets the better of us and occupies our attention to no good effect. Tension, sleepless nights, preoccupation and distraction around those very people we care for, worry’s effects are endless. There are ways to tame it, however.</p>
<p>As a <a href="https://profiles.umassmed.edu/display/133176">professor of medicine and population and quantitative health sciences</a>, I’ve researched and taught mind-body principles to both physicians and patients. I’ve found that there are many methods of quieting the mind and that most of them draw on just a few straightforward principles. Understanding those can help in creatively practicing the techniques in your everyday life.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/309156/original/file-20200108-107243-116piyu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/309156/original/file-20200108-107243-116piyu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/309156/original/file-20200108-107243-116piyu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/309156/original/file-20200108-107243-116piyu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/309156/original/file-20200108-107243-116piyu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/309156/original/file-20200108-107243-116piyu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/309156/original/file-20200108-107243-116piyu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">It’s easier to be in the happier present moment when we are busy. When our minds have nothing to focus on, however, they tend toward worries and concerns.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/happy-beautiful-family-dancing-on-beach-150533825">altanaka/Shutterstock.com</a></span>
</figcaption>
</figure>
<h2>Our brains sabotage the happier present moment</h2>
<p>We’ve all experienced moments of flow, times when our attention is just effortlessly absorbed in what we are doing. And studies carried out in real time confirm an <a href="https://doi.org/doi:%2010.1126/science.1192439">increase in happiness </a> when people can focus attention on what they are doing, rather than when their minds are wandering. It may seem odd then that we leave our minds to wander for something like <a href="https://doi.org/doi:%2010.1126/science.1192439">half the day, despite the happiness cost</a>.</p>
<p>The reason can be found in the activity of linked brain regions, such as the default mode network, that <a href="https://doi.org/10.1016/j.neuroimage.2017.07.001">become active when our attention is not occupied with a task</a>. These systems function in the background of consciousness, envisaging futures compatible with our needs and desires and <a href="https://doi.org/10.1007/s00221-016-4729-y">planning how those might be brought about</a>. </p>
<p>Human brains have evolved to do this automatically; planning for scarcity and other threats is important to ensure survival. But there’s a downside: anxiety. Studies have shown that some people <a href="https://doi.org/doi:%2010.1126/science.1250830">prefer electric shocks</a> to being left alone with their thoughts. Sound familiar?</p>
<p>Our background thinking is essential to operating in the world. It is sometimes the <a href="https://doi.org/10.1080/10400419.2018.1411423">origin of our most creative images</a>. We suffer from its unease when, unnoticed, it takes over the mental store. </p>
<p>Mindfulness, the practice of observing our mind’s activity, affords both real-time insight into this default feature of the mental operating system and a <a href="https://doi.org/10.1177/1529100618821893">capacity to self-regulate it</a>.</p>
<p>That is confirmed by studies showing increased attention regulation, working memory, and awareness of mind wandering that develop after only <a href="https://doi.org/10.1177/0956797612459659">a couple of weeks of mindfulness training</a>. Imaging studies, similarly, show that this kind of training reduces default mode activity and enriches neural connections that facilitate <a href="https://doi.org/10.1093/scan/nsr087">attentional and emotional self-regulation</a>.</p>
<h2>Evolution prioritizes survival over happiness</h2>
<p>This default to planning is <a href="https://doi.org/10.1146/annurev-psych-010814-015331">part of our evolutionary history</a>. Its value is evident in the effortless persistence and universality with which it occurs. Mind-body programs like yoga and mindfulness are indicative of the yearning many people have to be in the happier present moment. </p>
<p>How we use our attention is <a href="https://doi.org/10.1207/s15327965pli0701_1">central to our emotional well-being</a>, and many mind-body programs are based on training our minds to be more skillful in this way. </p>
<p>Mindfulness training, for example, asks students to direct their attention to the sensations of breathing. And while that may seem easy, the mind resists, tenaciously. So, despite repeated resolve, a person finds that, within seconds, attention has effortlessly defaulted to planning daydreams. </p>
<p>Just <a href="https://doi.org/10.3389/fpsyg.2018.00798">recognizing this feature is progress</a>.</p>
<p>In those moments when you do manage to notice these thoughts with some detachment, <a href="https://doi.org/10.1146/annurev-psych-010814-015331">their dogged concern with past and future</a> becomes clear. And planning’s semi-vigilant (“What could go wrong here?”) orientation also becomes clear. </p>
<p>We begin to notice that this hoping, comparing and regretting is often concerned with family and friends, job and money – themes of relationship, status and power that are central to the survival of tribal primates. All set against the background knowledge of our passing. </p>
<h2>Our bodies take notice</h2>
<p>Traditional meditation teachings attribute our <a href="https://doi.org/10.1093/med:psych/9780199688906.003.0004">everyday unease to the bodily tightening</a> that naturally accompanies the possibility of <a href="https://doi.org/10.3389/fpsyg.2013.00524">loss, failure and unfulfilled dreams embedded within this narrative</a>. It’s a tension that is often unnoticed in the midst of managing everyday demands, but its background discomfort sends us looking for relief in something more pleasant like a snack, a screen, a drink or a drug.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/309159/original/file-20200108-107219-1ecrvkj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/309159/original/file-20200108-107219-1ecrvkj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=507&fit=crop&dpr=1 600w, https://images.theconversation.com/files/309159/original/file-20200108-107219-1ecrvkj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=507&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/309159/original/file-20200108-107219-1ecrvkj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=507&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/309159/original/file-20200108-107219-1ecrvkj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=637&fit=crop&dpr=1 754w, https://images.theconversation.com/files/309159/original/file-20200108-107219-1ecrvkj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=637&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/309159/original/file-20200108-107219-1ecrvkj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=637&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The unnoticed default mode in our minds may compel us to seek comfort in a drink, a snack or TV – or all three.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/man-drinks-beer-chips-front-tv-1401069929">BERMIX STUDIOS/Shutterstock.com</a></span>
</figcaption>
</figure>
<p>Mindfulness makes us more <a href="https://doi.org/10.1177/0956797612459659">aware of these preoccupations</a> and reorients attention to the senses. These, by their nature, are oriented to the present – hence the almost clichéd “being in the moment” idiom. </p>
<p>So, when you notice yourself tense and preoccupied with anxious thoughts, try shifting your attention to the sensations of your breathing, wherever you notice it in your body. Bodily tension naturally dissipates with the shift in focus, and a feeling of greater calm follows. Don’t expect attention to stay there; it won’t. Just notice that attention goes back to worries, and gently return it to breathing. </p>
<p>Try it for just a couple of minutes.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/309160/original/file-20200108-107224-1h3cp00.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/309160/original/file-20200108-107224-1h3cp00.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=390&fit=crop&dpr=1 600w, https://images.theconversation.com/files/309160/original/file-20200108-107224-1h3cp00.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=390&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/309160/original/file-20200108-107224-1h3cp00.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=390&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/309160/original/file-20200108-107224-1h3cp00.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=491&fit=crop&dpr=1 754w, https://images.theconversation.com/files/309160/original/file-20200108-107224-1h3cp00.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=491&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/309160/original/file-20200108-107224-1h3cp00.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=491&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Just focusing on how your breath is moving can shift your brain state – and you can even do it at work.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/african-american-man-relaxing-after-work-1044298753">fizkes/Shutterstock.com</a></span>
</figcaption>
</figure>
<h2>Other mind-body programs use similar principles</h2>
<p>It would be nearly impossible to design studies comparing all the techniques that cultivate mindfulness. But my more than four decades experience as a practitioner, clinician and researcher of several popular mind-body programs suggests that most techniques use similar principles to recover the present moment. </p>
<p>Yoga and tai chi, for example, direct attention to the flow of sensations accompanying the sequence of movements. In contrast, systems such as cognitive therapy, <a href="https://doi.org/10.1080/17439760.2015.1025418">self-compassion</a>, prayer and visualization counter the ambient narrative’s unsettling tone with more reassuring thoughts and images.</p>
<p>Just a little practice makes this universal mental tendency, and your ability to shift it, more apparent in the midst of activities. The reduced arousal that results means that <a href="https://doi.org/10.1016/j.psychres.2017.01.006">stress-related hormones dissipate,</a> allowing feel-good ones like serotonin and dopamine to be restored in the brain as the happier here and now becomes woven into the fabric of everyday life.</p>
<p>[ <em><a href="https://theconversation.com/us/newsletters?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=expertise">Expertise in your inbox. Sign up for The Conversation’s newsletter and get a digest of academic takes on today’s news, every day.</a></em> ]</p><img src="https://counter.theconversation.com/content/127674/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>James Carmody receives funding from the National Institutes of Health</span></em></p>
Are you a worry wart? Not to worry. Turns out you were born that way, to some degree. Humans have a default mode in their brains that lead them to worry, but there are many ways to switch gears.
James Carmody, Professor of Medicine and Population Health Sciences, UMass Chan Medical School
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/128072
2019-12-04T16:30:31Z
2019-12-04T16:30:31Z
How controlled breathing helps elite athletes – and you can benefit from it too
<figure><img src="https://images.theconversation.com/files/305176/original/file-20191204-70122-avhp8n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">shutterstock</span> </figcaption></figure><p>Professional sport is full of stories of elite athletes “choking” emotionally and mentally under the pressure of competition. One famous example is golfer Greg Norman, who was <a href="https://www.golf-monthly.co.uk/tour/us-masters/augusta-blog/greg-normans-1996-us-masters-collapse-63932">leading the 1994 US Masters</a> by six strokes at the beginning of the final round, but then lost by five strokes to Nick Faldo. And England football teams are well known for their <a href="https://news.sky.com/story/why-do-england-always-lose-at-penalties-11425022">struggles in penalty shoot outs</a>. </p>
<p>But the occasion I remember most vividly was watching the late, great Jana Novotna facing Steffi Graf in the <a href="https://www.reuters.com/article/us-tennis-novotna-appreciation/novotna-a-true-winner-was-famed-for-a-sporting-choke-idUSKBN1DK1LX">1993 Wimbledon final</a>. Having dominated the match, and leading the final set 4-1, Novotna served a double fault. After this simple error, Novotna’s match fell apart, and she ended up quickly losing the set 6-4. It was as if someone had flipped a switch, turning her from elite professional into nervous club player.</p>
<p>Many of us who have played a sport can sympathise with the phenomenon of choking. And as a sports psychologist, I am interested in what happens mentally during those crucial moments before catastrophic drops in performance. Understanding the processes and factors involved could allow us to develop ways to help athletes avoid choking, or regain control after it takes hold. </p>
<p>Researchers <a href="https://www.sciencedirect.com/science/article/pii/S1469029208000770">have shown</a> how performance anxiety can be split into a mental (“cognitive”) component, represented by worry (“I am worried that I may not perform as well as I can”) and self-focused attention (“I am conscious of every movement I make”), and a physiological anxiety represented by arousal (fast heart rate) and tension (feeling on edge). </p>
<p>The ability to respond positively to anxiety reflects the level of control the athlete feels they have over a given situation, and their own response (“I believe I have the resources to meet this challenge”). This perception of control is important, because it reflects whether athletes see the situation as a threat or a challenge, which ultimately might <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3677799/">change the way they perform</a>.</p>
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<p>Many anxiety interventions focus on ways in which we can control our physiology to ensure that athletes keep a “cool head”. The simplest of all relaxation strategies is slow diaphragmatic breathing, similar to that used in meditation and yoga. We <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5709795/">now know</a> that breathing in this way can have a number of benefits. </p>
<p>The most obvious benefit is the immediate effect upon our physiology. If you feel yourself becoming stressed, you will notice how your heart rate increases and your breathing becomes more shallow and sporadic. Concentrating on your breathing and aiming to slow it down will reduce your heart rate and make you feel more calm and in control.</p>
<p>This type of breathing allows us to “hijack” the body’s natural blood pressure <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5709795/">regulation system</a> and to increase our heart rate variability (HRV). HRV is the varying interval in our heart rate, where an increase is reflective of a greater capacity to deal with stress. </p>
<p>This is because our heart is required to adapt appropriately and quickly to environmental demands (from a state of rest to a “fight” response, say), in order to drive other physiological systems such as the delivery of oxygen to the muscles. If your heart can go from slow to fast and back again quickly, you are more adaptable to the demands you may face, moment by moment.</p>
<h2>Breathe to win</h2>
<p>In <a href="https://www.ncbi.nlm.nih.gov/pubmed/26782084">our work</a> with elite athletes, we use a technique called HRV biofeedback. For this, we ask athletes to pace their breathing at around six breaths per minute, while providing visual feedback of the effect this has on the heart. </p>
<p>This breathing rate automatically results in a synchronisation between breathing and heart rate, such that our heart rate increases on inhaling, and decreases on exhaling. This coherence, technically known as “respiratory sinus arrhythmia”, naturally increases heart rate variability, while decreasing blood pressure and lowering our average heart rate. </p>
<p>Our aim in using HRV biofeedback is to teach athletes to control their breathing without a visual guide. Then, when they feel under pressure, they have a go-to intervention which helps them return to their ideal performance state. It also allows them to focus on what is important in the environment and in their mind – positive, logical, helpful and controllable thinking. </p>
<p>Our athletes have found this technique helpful, both preparing for, and <a href="https://www.tandfonline.com/doi/10.1080/21520704.2017.1287797">during competition</a>, and we are beginning to use it in very specific contexts such as the “taper” period in elite swimming. The taper period is the final training phase (two to three weeks) before an important competition such as the Olympics, where athletes reduce the volume of training they are doing. This a period of emotional turmoil for swimmers – and we are looking at how we can address this with HRV biofeedback.</p>
<p>But the benefits of HRV biofeedback are not reserved for elite athletes. Modern life is stressful for everyone, with many sources of hassle at work and home. <a href="https://www.ncbi.nlm.nih.gov/pubmed/19534616">Evidence indicates</a> that adopting a regular, long-term schedule of breathing practice at around six breaths per minute for 10 minutes every day could help improve the body’s ability to manage stress. </p>
<p>Simple breathing pacer apps on smartphones, or cheap heart rate monitors, can be used to practice becoming more aware of your breathing, and controlling your heart rate. In times of pressure and amid the stresses of modern life, anyone can breathe to win.</p><img src="https://counter.theconversation.com/content/128072/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>David Shearer has received funding from Sport Wales, KESS2 (Knowledge Economy Skills Scholarships), and A4B (European Regional Development Funding)</span></em></p>
Responding to pressure with your respiratory system.
David Shearer, Professor of Elite Performance Psychology, University of South Wales
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/116659
2019-05-20T23:37:01Z
2019-05-20T23:37:01Z
Curious Kids: why do we sigh?
<figure><img src="https://images.theconversation.com/files/273726/original/file-20190510-183112-1xps3qb.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C1022%2C680&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Take a deep breath. </span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/shenghunglin/290865741/in/photolist-auFpSs-rGLfz-Z6Rodu-985vyV-cbYPrs-XZBHM-8YSiz3-9tVrFA-auFpmE-auFr2E-dJRksQ-55p8mx-2ghqu4-Vxt1rY-4Xe5hv-egq75V-auD14k-azf3CD-atTr69-6xXy4F-eqkje-VW69eP-4ZXYi4-auCKjr-ehQVJz-7fixad-5zKkpu-atTtLY-7Uf1Ny-bQ2nUg-9Mr7fd-auFS4J-5zKzSU-7P9pDt-9BGdS9-bKfRW4-35F8dY-auFshb-4DCpFU-e8Mjx6-aF9HA-9Mofmv-6nLLMV-23tGLsB-a1zhAq-bKfTce-9Mr62f-pjZMgC-bmU8zv-9Moqyc">Flickr/Shenghung Lin</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p><em><a href="https://theconversation.com/au/topics/curious-kids-36782">Curious Kids</a> is a series for children. If you have a question you’d like an expert to answer, send it to curiouskids@theconversation.edu.au You might also like the podcast <a href="http://www.abc.net.au/kidslisten/imagine-this/">Imagine This</a>, a co-production between ABC KIDS listen and The Conversation, based on Curious Kids.</em> </p>
<hr>
<blockquote>
<p><strong>Why do we sigh? – Sophie, aged 4, East St Kilda, Melbourne.</strong></p>
</blockquote>
<hr>
<p>Dear Sophie,</p>
<p>Thanks for your lovely and excellent question about sighing. </p>
<p>Since you asked a question about sighing, it is probably safe to say that you already know something about breathing. But, for the benefit of everyone else (who might not be an expert like you or me) I am going to talk a little bit about breathing first. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/curious-kids-what-is-brain-freeze-112774">Curious Kids: what is brain freeze?</a>
</strong>
</em>
</p>
<hr>
<h2>The tiny sacks of life</h2>
<p>You have two lungs that you use to breathe. Each lung is a stretchy sack, kind of like a balloon, but not empty like a balloon. Inside your lungs are <a href="https://www.atsjournals.org/doi/full/10.1164/rccm.200308-1107OC">millions and millions and millions</a> of tiny sacks called <em>alveoli</em>. These tiny sacks called alveoli are very important.</p>
<p>To keep living, we need a gas called oxygen to be moved out of the air and into our blood. And that’s not all! We need another gas called carbon dioxide to be moved in the opposite direction: from out of your blood and into the air. </p>
<p>For these two things to happen, the air and your blood need to be brought very, very close together. This is exactly what happens in the tiny sacks called alveoli that fill your lungs. This is just as well! If you don’t get oxygen in and carbon dioxide out, you will die, which is bad. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/273728/original/file-20190510-183103-19bttzt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/273728/original/file-20190510-183103-19bttzt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/273728/original/file-20190510-183103-19bttzt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=457&fit=crop&dpr=1 600w, https://images.theconversation.com/files/273728/original/file-20190510-183103-19bttzt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=457&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/273728/original/file-20190510-183103-19bttzt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=457&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/273728/original/file-20190510-183103-19bttzt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=574&fit=crop&dpr=1 754w, https://images.theconversation.com/files/273728/original/file-20190510-183103-19bttzt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=574&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/273728/original/file-20190510-183103-19bttzt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=574&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Your lungs are not empty. They are full of alveoli.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<p>When you breathe in, the tiny sacks called alveoli (seriously, your lungs are full of ‘em) get filled with air. At the same time, blood (pumped by your heart) flows around the sides of the tiny sacks. </p>
<p>This brings the air and the blood very close together and so allows the gases to move in the right direction (oxygen in, carbon dioxide out). </p>
<p>Moving these gases is essential <em>for survival</em>, which means that breathing is essential for survival, which means the tiny sacks called alveoli are very, very essential for survival indeed.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/curious-kids-what-is-a-headache-is-it-our-brain-hurting-112951">Curious Kids: what is a headache? Is it our brain hurting?</a>
</strong>
</em>
</p>
<hr>
<h2>Back to sighing</h2>
<p>Here’s the thing about the tiny sacks called alveoli: you have so many of them that, actually, you don’t need to use them all at once. When you are sitting quietly, you can get move enough gas by using just <em>some</em> of them. </p>
<p>This is all fine and well, but if you are sitting quietly for a long while, these tiny unused sacks stay unused. And when a sack stays unused for a long time, it tends to collapse in on itself. When the tiny sacks called alveoli that fill your lungs collapse, they can’t be used to move gas in or out of your blood any more, which is bad.</p>
<p>Fortunately, there is a solution: the sigh. A sigh is breath that is <em>deeper</em> than usual, so sighs fill your lungs with more air than a normal breath would. </p>
<p>This means that any tiny sacks (called alveoli) that are not being used get filled up with lovely air when you sigh. This stops them from collapsing and averts the danger! Hooray!</p>
<p>Most of the time, your brain takes care of breathing for you and, fortunately, <a href="http://www.sciencedirect.com/science/article/pii/B9780444632746000060">it takes care of sighing for you too</a>. This means that you don’t need to worry about <em>remembering</em> to sigh.</p>
<p>If you need to worry about remembering anything, Sophie, it’s that you should never stop asking this sort of lovely question. Congratulations: you are now an expert on breathing <em>and</em> sighing.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/curious-kids-how-much-does-a-brain-weigh-112000">Curious Kids: how much does a brain weigh?</a>
</strong>
</em>
</p>
<hr>
<p><em>Hello, curious kids! Have you got a question you’d like an expert to answer? Ask an adult to send your question to curiouskids@theconversation.edu.au.</em> </p>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/168011/original/file-20170505-21620-huq4lj.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/168011/original/file-20170505-21620-huq4lj.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=376&fit=crop&dpr=1 600w, https://images.theconversation.com/files/168011/original/file-20170505-21620-huq4lj.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=376&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/168011/original/file-20170505-21620-huq4lj.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=376&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/168011/original/file-20170505-21620-huq4lj.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=472&fit=crop&dpr=1 754w, https://images.theconversation.com/files/168011/original/file-20170505-21620-huq4lj.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=472&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/168011/original/file-20170505-21620-huq4lj.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=472&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
<span class="attribution"><a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<p><em>Please tell us your name, age and which city you live in. We won’t be able to answer every question but we will do our best.</em></p><img src="https://counter.theconversation.com/content/116659/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>David Farmer receives is employed on a grant awarded by the National Health and Medical Research Council. </span></em></p>
A sigh is the brain’s way of stopping the tiny sacks in your lung from collapsing.
David Farmer, Researcher, The University of Melbourne
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/97046
2018-06-25T13:40:47Z
2018-06-25T13:40:47Z
What happens to your body when you’re stressed – and how breathing can help
<figure><img src="https://images.theconversation.com/files/221548/original/file-20180604-175425-je9dwo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Stress can make us superhuman but it's also our kryptonite.</span> <span class="attribution"><span class="source">shutterstock</span></span></figcaption></figure><p>Stress is great. It makes us faster, stronger, more agile and our brains have better recall and flexibility. That’s why people are willing to put themselves in <a href="https://theconversation.com/how-to-build-a-mentally-healthy-workplace-step-by-step-65826">stressful work situations</a> or engage in <a href="https://theconversation.com/adrenaline-zen-what-normal-people-can-learn-from-extreme-sports-72944">extreme sports</a>. </p>
<p>The problem is that uncontrolled, stress can leave us frozen to the spot and unable to think – something all too familiar for people having to speak in public or students sitting in the exam hall.</p>
<p>Stress developed because it gives an <a href="http://www.nhm.ac.uk/discover/human-evolution.html">evolutionary advantage</a>. For early man, and with predators everywhere, food could be scarce and diseases prevalent. By understanding what is happening inside our bodies and why, we can learn to control stress and use it our advantage.</p>
<h2>Your body, when stressed</h2>
<p>When you’re feeling stressed, it’s a sign that your body is going into emergency mode. The turbo button is pressed, the engine of your body has roared into overdrive and you become superhuman. This means becoming ultra vigilant, able to react quickly and increase memory recall, and to remember every aspect of what you are seeing, hearing and feeling. It is this increased attention to detail that gives us the <a href="https://www.livescience.com/2117-time-slow-emergencies.html">feeling of time standing still</a>, during a car crash for instance. </p>
<p>Inside the body, a complex cascade of hormones is triggered by the release of a hormone called <a href="http://www.yourhormones.info/hormones/corticotrophin-releasing-hormone/">CRH</a> (corticotropin releasing hormone), by a small part of the brain known as the <a href="https://www.healthline.com/human-body-maps/hypothalamus">hypothalamus</a>. This results in an increase in breathing, blood pressure and heart rate, to help pump blood and oxygen <a href="https://www.bhf.org.uk/heart-health/how-a-healthy-heart-works">around the body more effectively</a>.</p>
<p>At the same time the liver breaks down more <a href="https://theconversation.com/liver-molecule-linked-to-diabetes-1876">glycogen</a>, a high energy storage substance similar to the starch in plants. It is made in the body by combining glucose (sugar) molecules – and breaking it down again produces the glucose that our bodies actually use for energy.</p>
<p>Blood is moved from other areas of your body to <a href="http://www.apa.org/helpcenter/stress-body.aspx">support the muscles</a> – which show increased strength and endurance. Your immune system switches up a gear and your blood prepares itself to clot – in case you’re injured. Your brain also starts working much better – fed by the glucose and oxygen being pumped around your body. </p>
<h2>What about burnout?</h2>
<p>Like a powerful engine, when we’re stressed we burn hot, but if we do it for too long, <a href="https://theconversation.com/five-ways-to-deal-with-burnout-using-lessons-from-elite-sport-81522">we burn out</a>. In the short term, physiological changes, including increased blood pressure, higher levels of glucose in our blood and decreased appetite, are important adaptations, which normally cause little damage to the body. But <a href="http://www.apa.org/helpcenter/understanding-chronic-stress.aspx">chronic stress</a> can result in a suppressed immune system, diabetes, heart attacks, strokes and a range of other conditions.</p>
<p>Our bodies do their best to only use these stress adaptations when they are most needed – maximising the benefit and minimising the potential for damage. But despite this, the body tends towards stress, given its potential <a href="https://hbr.org/2016/08/how-to-use-stress-to-your-advantage">advantage in our survival</a>.</p>
<h2>Breathing to control stress</h2>
<p>One of the simplest things you can do to relieve stress is to breathe – something we all know how to do. The presence of breathing techniques in both <a href="https://breathmeditation.org/the-buddhist-tradition-of-breath-meditation">traditional meditation techniques</a> and modern relaxation methods reflects the importance of taking deep breaths. The immediate impact of doing this can be seen in the reduced production of one of the stress hormones, noradrenaline. Levels of cortisol, another stress hormone, will also start to reduce.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/221550/original/file-20180604-175411-azlawu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/221550/original/file-20180604-175411-azlawu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=445&fit=crop&dpr=1 600w, https://images.theconversation.com/files/221550/original/file-20180604-175411-azlawu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=445&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/221550/original/file-20180604-175411-azlawu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=445&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/221550/original/file-20180604-175411-azlawu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=559&fit=crop&dpr=1 754w, https://images.theconversation.com/files/221550/original/file-20180604-175411-azlawu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=559&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/221550/original/file-20180604-175411-azlawu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=559&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Knowing how to calm yourself when things get too much, is an important skill.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<p><a href="http://science.sciencemag.org/content/355/6332/1411">Research</a> by scientists in the Howard Hughes Medical Institute, at Stanford University, have now identified that these changes are linked to a group of nerves in our brains called the “pre-Bötzinger complex”, which regulates our breathing. The scientists found that changes in the expression of certain genes in these nerves – which are physically connected to critical areas in the brain associated with relaxation, attention, excitement and panic – can calm an individual. The clear implication being that changes in breathing directly affect stress levels.</p>
<p>Modern meditation techniques are epitomised in the concept of <a href="https://www.nhs.uk/conditions/stress-anxiety-depression/mindfulness/">mindfulness</a>, which brings together these breathing techniques and the idea of “living in the moment”, putting concerns for the past and future into context. Psychologically, this helps to reduce the level of anticipation associated with unnecessary forward planning and concerns, while physically reducing important stress hormones.</p>
<p>By learning simple coping strategies, understanding what makes us stressed, keeping stress at manageable levels through breathing techniques, and taking regular breaks from it, we can begin to learn to use stress to our advantage, rather than letting it control us.</p><img src="https://counter.theconversation.com/content/97046/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michael Porter does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
Deep breathing is one of the simplest ways to deal with stress.
Michael Porter, Lecturer in Molecular Genetics, University of Central Lancashire
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/96276
2018-05-22T19:40:03Z
2018-05-22T19:40:03Z
Curious Kids: How does an echidna breathe when digging through solid earth?
<p><em>This is an article from <a href="https://theconversation.com/au/topics/curious-kids-36782">Curious Kids</a>, a series for children. The Conversation is asking kids to send in questions they’d like an expert to answer. All questions are welcome – serious, weird or wacky!</em> </p>
<hr>
<blockquote>
<p><strong>How does an echidna manage to breathe when digging through solid earth? – Isabella, age 8, Cowes, Phillip Island.</strong></p>
</blockquote>
<hr>
<p>Thank you, Isabella, for your great question. </p>
<p>When it comes to breathing, a digging mammal faces some big problems. It has to be able to physically move its chest to inflate its lungs. It also has to be able to get enough oxygen and find a way to get rid of the carbon dioxide it breathes out.</p>
<p>The good news is that echidnas are well adapted to solving these problems.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/the-secret-life-of-echidnas-reveals-a-world-class-digger-vital-to-our-ecosystems-67298">The secret life of echidnas reveals a world-class digger vital to our ecosystems</a>
</strong>
</em>
</p>
<hr>
<p>When breathing in and out, they use their muscular diaphragm (a muscle between their chest and abdomen) as well as the muscles between their ribs. These muscles are strong enough to push air in and out, even when they are buried under the top layer of soil and leaf litter.</p>
<p>When they dig down, they loosen the soil around their body. It gets so loose, it doesn’t actually stop their chest from moving in and out, so they can still breathe. When they dig deeper, they form a burrow which has self-supporting walls and roof and so the echidna has enough room to be able to breathe and move.</p>
<h2>Getting enough oxygen</h2>
<p>A bigger problem is getting enough oxygen, and getting rid of enough carbon dioxide when burrowed underground.</p>
<p>Like all mammals, echindas need to breathe in oxygen from the air, and when they breathe out they expel carbon dioxide as a toxic waste product. Having too much carbon dioxide around (from your out-breath) can be a real problem. </p>
<p>Gases such as oxygen and carbon dioxide move through soil more easily than most people think. As long as echidnas do not burrow into very wet soil, just enough fresh air can usually get in and the carbon dioxide from their out-breath can get out.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/curious-kids-i-would-like-to-know-why-man-lions-have-manes-and-lady-lions-dont-96525">Curious Kids: 'I would like to know why man lions have manes and lady lions don't'</a>
</strong>
</em>
</p>
<hr>
<p>Echidnas also have a few special tricks. When they are buried, <a href="https://europepmc.org/abstract/med/16481582">they move the front part of their bodies</a> a lot to flush the gases through the soil. They make these flushing movements more often if they are buried in really thick soil, or when they are digging really hard and need more oxygen.</p>
<p>Echidnas have very low body temperatures and, like many other burrowing animals, a low metabolic rate (metabolic rate means how fast they use up energy; when you have a high metabolic rate, you use up oxygen faster). Compared with other mammals of a similar size, they <a href="https://www.ncbi.nlm.nih.gov/pubmed/27153127">don’t use as much oxygen</a> or make as much carbon dioxide. This means that the oxygen that is available isn’t used up very quickly, and <a href="https://espace.library.uq.edu.au/view/UQ:383440">carbon dioxide doesn’t build up to dangerous levels</a>.</p>
<p>Finally, echidnas can survive low levels of oxygen. Echidnas in low-oxygen environments breathe more, but they don’t reduce their energy use like most other mammals; they can maintain their normal levels of metabolism. Echidna blood is especially good at holding and transporting oxygen.</p>
<hr>
<p><em>Hello, curious kids! Have you got a question you’d like an expert to answer? Ask an adult to send your question to us. They can:</em></p>
<p><em>* Email your question to curiouskids@theconversation.edu.au
<br>
* Tell us on <a href="https://twitter.com/ConversationEDU">Twitter</a></em></p>
<figure class="align-left ">
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<span class="attribution"><a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
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<p class="fine-print"><em><span>Christine Cooper receives funding from the Australian Research Council.
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Echidnas can survive quite low levels of oxygen.
Christine Cooper, Senior Lecturer, Department of Environment and Agriculture, Curtin University
Licensed as Creative Commons – attribution, no derivatives.