reward project basis

Dora and Fatih REWARD FOR LIFE ®

-REWARD IDEAS
-BENECEPTION (medial reward body-mind pathways ...BEN qi jing shen) > nociception (lateral reward BIAO) ((real ben = why ben -> biao))
-reward are instinctive NEEDS (genetical+epigenetical) to be accomplished
...since or a need is accomplished or ...it raises till convertion (dopa-beta-hydroxilase and habenula) to stress pathways
->reward are DUTIES for health of people and society
->rewards are RIGHTS for health and wellbeing

-REWARD STRATEGIES
1. diet
2. fitness
3. shen soul (mind)
4. love life
5. sleep
6. extra rewards

Dora and Fatih ..book 1: REWARD 7

http://ilmiolibro.kataweb.it/libro/medicina-e-salute/194027/reward7/

CAM and Reward for Wellness - International Journal of Complementary & Alternative Medicine - MedCrave

http://medcraveonline.com/IJCAM/IJCAM-01-00035.pdf

Volume 1 Issue 6- 2015

Nutritionist, Acupuncture fellow at AMAB, Italy

*Corresponding author: Dora Dragoni, Medical Doctor, Acupuncture Fellow (3rd/3 year), Personal Trainer, Mental Trainer, Nutrionist, AMAB, Italy, Tel: +39 338 5085731; Email: dora.dragoni@studio.unibo.it Received: October 21, 2015 | Published: October 26, 2015

Keywords: Reward; Wellness; Health; CAM; Stress; Acupuncture; Ayurveda; Diet; Nutrition; Fitness; Mental training; Epigenetic; Affective life; Lifestyle, Right to health; Prevention; Longevity

Abstract Review Article CAM strategies are at the same time ancient healing strategy systems, since ayurveda is 5000 years old and Traditional Chinese Medicine with acupuncture is 3000 years old, so they are proved to be effective and safe, …and they are also a new care approach, since occidental world still asks if they are really scientifical despite the evidence, the millennary effectiveness, the thousands of studies and researches, and the fact that people are using them more and more. CAM are called alternative in comparison to the official therapies systems, such as drugs and surgery. Antonovsky starting from 1979 underlines how, in a correct salutogenetic approach, to create health we should at first rule the lifestyle, manage a good diet (nutrition and physical activity), then proceed toward light caring treatments, passing then to acupuncture and such kind of medicine methods, and only in late stages recur to artificial molecules or even more.n It’s simple to understand that, as World Health Organization declares “health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” [1], so from that it derives this observation: relieving symptoms in some ways doesn’t correspond to creating wellness. Reaching a well-being global condition is an autonomous process that each person can live, thanks to therapists and all those who want to participate with an active and positive role into others lives. CAM are indeed lots of healing systems: Traditional Chinese Medicine (acupuncture, chinese fitotherapy, tui na massage, qi-gong, dietetic), ayurveda (yoga, mantra, use of spices and dietetic culture, therapeutical massages); but also integrated therapies, that are: diet, from the greek world δίαιτα that means lifestyle, particularly nutrition and physical activity, mindfullness and relaxation techniques (from mental training to any oriental zen form of meditation), and even simply understanding that affective life has a main role into our daily routine, becoming of course able to apply this need to our daily habits. The latest studies focus on reward system, the brain pathways and nuclei involved in the perception and feeling of positive signals and emotions, related to our main needs and istincts, such as food, sex, reproduction, parental behaviours. It is known that when medial paths prevale we have a good mood, positivity, wellness and pleasure perceptions. But in case of stress conditions dopamine is converted into cathecolamines and lateral ways are prevalent, with a global stressful mood and all the organic consequences that derive from that: Mayo Clinic on its site [2] publishes that stress is strictly related with all the most diffused diseases, such as cardiopathies, gastrointestinal dysfunctions (these two can also be called dysautonomias), allergies and autoimmune disorders, reumatologic diseases, headache/migraine, insomnia, and all the mood and sex dysfunctions. So it’s important to prevent stress, managing it creating wellness daily habits and situations. In this article I talk about the characteristics and functions of all main CAM (as I said: nutritional and fitness suggestions, acupuncture, ayurveda, mind relaxation tips, and affective life approaches), underlining their neuroscientific and global mechanisms of action: acting on reward system as well, they are able not only to relieve stress, symptoms and pain, but they also can improve in great ways our well-being global condition, and with the wellness feeling that derives from that: we are stronger (getting the so called “resilience”, the ability to overcome obstacles), able to face in the better and most positive ways our life, managing it how we want.

9) ARTICLE - "Stress & health: wellness for body and mind" [2015.04.01]

Stress & health: wellness for body and mind


KEY WORDS

wellness, stress, reward, acupuncture, psychotherapy

ABSTRACT

Well being means for sure to manage stress conditions. Understanding what is stress, and how to prevent, is the first point. Then we should improve our life styles: such as diet and physical activity. Of course how we feel is important too, our surroundings and the related emotions. Some advanced techniques can always help: for example, acupuncture and psychotherapy.

More and more scientific studies and wellness systems are examining the interactions between stress and well being, and are trying to understand and to find some ways of treatment to be and stay at our best.

But what is stress? Stress is a physiological response that our body has in order to overcome a problem. It can lead to maximal parameters in order to fight at best during a particular occasion.

Of course it has biological bases: his central regulations take place in hypotalamus. The hormone released for such response is the CRH, that provoques the production and secretion of another hormone, the ACTH, from the pituitary to all our body. From that we have the production of cortisol, secreted by adrenal glands.

The effects of stress are a lot: at first we have an increase of the blood pressure, and of glycemia. Furthermore a chronical stress condition leads to toxicity: due to the hyperglicemia, and determined by the catabolic inbalance this can have as consequence, and a cellular oxydation (resposible even of cancers).

Another consequence is that the ormonal equilibrium disbalances toward stress hormones and not of physiological ones: deriving from that, the mood symptoms and the sexual and social dissatisfaction.

It is common known that the immunitary system is damaged by stress molecules: it can become both hyperactive and then disregulated. Many diseases are spreading in these dacedes: autoimmune diseases particularly (type 1 diabetes, reumathoid arthritis, celiac disease). Flogistic alterations are also found in depression, so psicho-neuro-immuno-endocrinology is becoming one of the sciences helping us understanding how we are.

Some studies are explaining how headache is related to a raised amout of request to our brain (with till a 300% blood flux in brain), that cannot always face to such conditions from a metabolic point of view and the disbalance leads to molecular lacks: acting on opioids could help (as the acupuncture headache preventive treatment contributes to demonstrate).

Even Mayo Clinic has focused the attention on the correlation between stress and many common and diffused diseases, such as: headache, gastric symptoms, some chest and heart disfunctions (called also “dysautonomia”), the trend to get colds and flus, psychological disregulations, being often angry and dissatisfied, have an unsatisfactory affective and sexual life.

The point to pay attention is that, by regulating our mind and ways of living, we can manage stress conditions, preventing them and solving them as well.

Acting on the REWARD system (neural pathways), that counteracts stress, can be done at many practical levels:

•    DIET – many studies are done about sugar reduction or even deprivation: after 40 days rats see the first benefits in how they feel and behave with better blood parameters at first. We should avoid hypercalorical diets, and introduce always 1,5 liters of water at least; prefer vegetables and fruit, to guarantee the correct amount of fiber intake

•    SLEEP – a good regular sleep is one of the main elements to improve to reduce the stress amount. We always say that 7 hours of sleep are a good quantity, or even more

•    PHYSICAL ACTIVITY – doing a fitness training everyday for at least 45 minutes is good in inducing both relaxation and improvement of physical body shape (from which happiness). It is known that physical activity is good in the prevention of Alzheimer disease, and it acts both at a mental and somatic level

•    RELAXATION TECHNIQUES – we can distress our mind with yoga sessions or tai chi trainings. Even meditation, in every form, is useful to relax mind and soul. Mental training could help particular needs, such as those of sport persons, based on both relaxation and visualization

Of course we could also manage stress consequences in great ways:

•    ACUPUNCTURE – this very old system involves amazing theories developed through centuries in Asia (mainly in China, but also in Japan and Korea), and it is proved by the newest studies understanding how the stimulation of the opiate system, by needling specific cutaneous points, leads to a rebalancing of many molecules, particularly hormones and neurotransmitters

•    PSYCHOTHERAPY – if well done, and taking in consideration the whole person, it can help you find a good mind approach to life after a stressful period (particularly if there are even body symptoms, that can be a physical expression of a more general spiritual bad feeling). Helping your psyche and mind will bring you more happiness, a better social life and a satisfying sexual life: of course love and sex are the main keys to see life in the right way, they bring to the increase of many molecules, such as oxytocin, that are related to how we approach to other people, and they of course also act at body level, by reducing pain and inflammation, and on the whole by improving how we feel and we are.

www.mayoclinic.org

Maciocia, The foundations of chinese medicine

Dragoni D., Reward Pathway and Metabolism, Neuroscienze.net

4) ARTICLE - endocannabinoids [2011.10.15]

Endocannabinoids

SUBTITLE

The actions of endocannabinoids at a peripheral and central level

KEY WORDS

Endocannabinoids, liver disease, central nervous system,

metabolic syndrome, insulin-resistance

ABSTRACT

Endocannabinoids are found in the central nervous system and in the liver, and are involved in the control of different hepatic and metabolic functions. They play a role in hemodynamic alterations, in the control of fibrosis, and in the progression of NAFLD and NASH. They also regulate insulin-resistance, leptin-resistance, and metabolic syndrome. CB1 antagonists regulate hunger and weight, and reduce hepatic damage by stimulating tissue repair. CB2 agonists determine a reduced response to damage and a reduction of fibrosis in cirrhosis.

INTRODUCTION

The study of endocannabinoids has recently been able to correlate them with hepatic pathologies typical of major dysmetabolisms.

From a metabolic point of view their action takes place mainly at a peripheral level. The activation of CB1 is related with the progression of hepatic fibrosis typical of chronic liver damage, and contributes to portal hypertension and chirrotic cardiomiopathy. CB2 seems to be associated with anti-fibrogenic effects and the regulation of phlogosis in NAFLD, mainly in regulating ischemia-reperfusion damage.

Moreover endocannabinoids act on the central nervous system having as target its metabolism regulators.

The aim of this study is to obtain elements of physio-pathological logic that will permit the introduction of new agents for the treatment of chronic liver pathologies.

ENDOCANNABINOIDS

Endocannabinoids are bioactive lipids capable of linkage with cannabinoid receptors.

In order of discovery, they are:

- arachidonoil etanolamide, anandamide – AEA – discovered in 1992

- 2-arachidonoilglicerolo – 2AG – discovered in 1995

- 2-arachidonil-gliceril-ether – 2-AGE – a structural analogue of 2AG

- oleil-etanolamine – OEA

- virodamine

- N-arachidonoildopamine – NADA

- palmitoil-etanolamine – PEA

Endocannabinoids are not stored in vesicles, but rather synthesized ‘on demand’ starting from membrane phosphor-lipidic precursors. The biosynthesis begins with stimulus that triggers the depolarization of cell membrane. After synthesis they are immediately released from the cell and link cannabinoids receptors on nearby cells or on the same cell that produced them, and therefore with autocrine or paracrine action. Sometimes they behave as retrogradous messengers: they are synthesized in postsynaptic cells, and then go to activate CB1 receptors of the axons in presynaptic cells.

After exerting their action, the endocannabinoids are degraded or go through other processes such as: recaptation by passive diffusion through the membrane, hydrolysis, or the re-use of degraded products.

ENDOCANNABINOIDS AND METABOLISM

Endocannabinoids are expressed mainly in the liver, of which they regulate physiology, and of different physio-pathological grades typical of metabolic pathologies (already made and dating back to central mechanisms) ranging from the generic metabolic syndrome to more specific pictures of steatosis, NAFLD (non alcoholic fatty liver disease), NASH (non alcoholic steato-hepatitis), and situations of fibrosis-cirrhosis typical of advanced phases of liver injuries.

They are particularly present in different cells in association with different pathological conditions [1]:

- in hepatocyte we find

o CB1 – associated with CBP, primitive biliar cirrhosis, diet steatosis, and alcoholic steatosis

o CB2 – associated with CBP, regeneration, steatosis, and NASH

- in colangiocyte we find

o CB1 – associated with cirrhosis and portal hypertension

o CB2 – associated with CBP, and NAFLD

Endocannabinoids have the following functions [2]:

- they have an anti-stress function similar to endorphins, at both central and peripheral level

- they are produced in order to protect the organism thanks to an anti-oxidative action [3]

- they have an analgesic activity [4] [5] [6] [7] [8]

- they have a vaso-dilatory and hypotension action, with a physio-pathological role that must still be investigated further [9] [10] [11]

- they have a role in modulating immune system response [12] [13] [14]

- they regulate the cellular proliferation processes that lie at the basis of tumor growth [15]

- they are involved in steatosis pathogenesis [16]

- they are involved in obesity pathogenesis [16]

- they determine the progression from fibrosis to cirrhosis in the liver [16]

- they have a role in hyper-dynamic circulation syndrome [16]

- they are related to sodium retention and ascites formation

- they are up-regulated in hepato-carcinome

In further detail, other metabolic effects are receptor-specific [2]:

CB1

- insulin-resistance

- dislipidemia

- contribution to the onset of hepatic steatosis by excessively fat diets or by chronic alcoholism

- NAFLD promotion

- progression of hepatic fibrosis, with action of stellate cells

- condition of vasodilatation

- pathogenesis of portal hypertension

- pathogenesis of cirrhotic cardiomiopathy

by blocking CB1 (for example with rimonabant) which produces:

- prevention of steatosis

- slowdown of progression of fibrosis

- remission of cirrhotic cardiomiopathy

- reduction of portal hypertension

CB2

- anti-inflammatory effects

- anti-fibrogenetic effects

- regulation of hepatic inflammation during ischemia-reperfusion in NAFLD

in regard to their alterations at a serum level, the following have been found:

- a high level of OEA, PEA in cirrhosis [17]

- an expression of anandamide and 2-AG in hepatic ischemia-reperfusion damage [18]

Analyzing the variations in association with the pathologies permits the definition of:

- metabolic syndrome – CB1 is a mediator of the sensation of hunger, and CB1 antagonists have been hypothesized in obesity therapy such as rimonabant [19]: the loss of weight is due to reduced food absorption and reduced lipogenesis

- adiponectin – a CB1 blockade determines an increase in this adipokine, with positive effects on weight and metabolic syndrome [20]

- insulin-resistance – AM6545, CB1 antagonist, determines a reduction of insulin-resistance and leptin-resistance [19]; furthermore a CB1 block determines the captation of glucose thanks to insulinic stimulation, on the contrary activated CB1 triggers glucidic intolerance

- steatosis – CB1-/- deleted rats are resistant to alcohol steatosis

- ischemia-reperfusion damage – a CB1 blockade determines a reduction of both damage and endotoxiemia

- CBP – a hyper-regulation of the cannabinoid system has been seen in primitive biliar cirrhosis, mainly expressed in hepatocytes, in the cells of biliar epitelium, and in Kupffer cells; it has also been shown how proliferant colangiocytes constitute the “neuro-endocrine compartment” of the liver, able to secrete numerous substances among which endocannabinoids; the peripheral subministration of a selective CB1 agonist (HU210) reduces pruritus induced by histamine, and mitigates the excitation of cutaneous neural fibers (with the anti-nociceptive action related to opioids) [21]

- NASH – it has been viewed an hyper-expression of the CB2 receptor at the cytoplasmic level of hepatocytes, colangiocytes, and stellate cells [22]

- hepatic fibrosis – THC, tetraidrocannabinol, derived from marijuana is capable of linking CB1 and CB2 receptors, and is anti-fibrotic and hepatoprotector [23]

- cirrhosis – in cirrhosis there is an increase in CBs, which has mainly been viewed an increase in CB1 in perivascular nervous fibers of resistance mesenteric arteries [24]; haemodynamic alterations associated with CB1, that determines hypotension and endotoxic shock; in particular it has been shown that in this pathology there is a rise in CB1 in endothelial cells mainly in mesenteric arteries. Moreover an increase in CB1 at receptorial level is associated with cirrhotic cardiomiopathy. On the contrary CB2 seems to be a protector against cirrhosis, and this leads to the hypothesis of using certain agonists in treating this pathology

- portal hypertension – CB1 inhibition with SR141716A reduces hematic flux of mesenteric arteria and portal pressure

- hepatic encephalopathy – CB2 agonists (HU308) determine an improvement of cognitive function [1] and demonstrate themselves as having a positive effect on hepatic encephalopathy.

ENDOCANNABINOIDS AND THE CENTRAL NERVOUS SYSTEM

Endocannabinoids are neuromediators involved in neural webs deputized to controlling appetite, pain perception and body temperature regulation. They have also been found in the extra-pyramidal system.

The endocannabinoid system may be defined as a complex of neurotransmissions capable of regulating neuronal excitability.

CB1 distribution is mainly cerebral. The primary regions, in which cannabinoids appear are fundamentally the substantia nigra, globus pallidus, nucleus caudatus, and the putamen.

They have also been founded in the vagus nerve (X) branch comprehending enteric cholinergic neurons and enteric submucosa ganglia cells.

The discovery of endocannabinoids receptors in the brain has linked them to the control of movement, perception, and the alterations of learning and memory processes [25]; they seem to act with opioids in pain modulation [4] [5] [6] [7] [8]. They also regulate emotive states like pleasure and aggression [26] [27].

Correlations with circuitries that regulate vomit have also been found [28].

Furthermore involvements of endocannabinoids exist in the modulation of the spasticity associated with multiple sclerosis [29], while correlations with epilepsy have been underlined: endocannabinoids would act by modulating convulsive activity, with anti-convulsivant properties [30].

This series of consideration helps understand how the central nervous system is more and more considered as the key element in the regulation, prevention, and care of most major metabolic dysfunctions such as diabetes, NAFLD, or metabolic syndrome. It has often been demonstrated how therapies act also at central level and how forms of integrated therapies guarantee better success in treatment, such as in the case of behavior-cognitive psychotherapy, which is able to lead to metabolic re-balance with significant results. [31].

Given the function of CB1 in regulating hunger, the use of its antagonists has been hypothesized against obesity: in fact, it has been shown that rimonabant lead to a reduction in weight, even if associated with the onset of depression and anxiety. Agonists with metabolic effect but no effect on behavior would have the greatest potential [19].

CONCLUSIVE PERSPECTIVES

CB1 antagonists such as rimonabant (for two weeks) have determined, in models of cirrhosis, reduction in the formation of ascites and the reduction of hepatic fibrosis [32] in animals (rats); the same molecules are also involved in reducing hepatic damage, while appearing to favor tissue reparation [1].

This helps understand how endocannabinoids are revealing themselves more and more as essential target in the therapy of dysmetabolic pathologies like NAFLD, and of its advanced stage of cirrhosis, not only thanks to the peripheral action of these molecules but also due to their central re-balancing of mechanisms at the base of metabolic dysfunctions.

On the other hand we can hypothesize the use of CB2 agonists in treating hepatic cirrhosis, perhaps they would not be psychoactive: this thanks to findings that demonstrate reduced fibrosis and minor response to damage by CB2 agonist JWH-133 [33].

In light of their correlations with the central nervous system, more and more molecules capable of generating metabolic effects generally on obesity and on organ metabolic dysfunctions like NAFLD can be hypothesized, even if doubts arise in regard to which central functions are specifically controlled. It is certain however that a correct and metabolically-controlled lifestyle (thanks to diet and physical activity) with a more global interpretation of how metabolism is conceived, remains the basis for interaction with other forms of therapy.

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31. Moscatiello S, Di Luzio R, Bugianesi E, Suppini A, Hickman IJ, Di Domizio S, Dalle Grave R, Marchesini G (2011) Cognitive-behavioral treatment of nonalcoholic Fatty liver disease: a propensity score-adjusted observational study.Obesity (Silver Spring). Apr;19(4):763-70. Epub 2010 Oct 21.

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