Trigger points associated with myofascial and visceral pains often lie within the areas of referred pain but many are located at a distance from them. Furthermore, brief, intense stimulation of trigger points frequently produces prolonged relief of pain. These properties of trigger points--their widespread distribution and the pain relief produced by stimulating them--resemble those of acupuncture points for the relief of pain. The purpose of this study was to determine the correlation between trigger points and acupuncture points for pain on the basis of two criteria: spatial distribution and the associated pain pattern. A remarkably high degree (71%) of correspondence was found. This close correlation suggests that trigger points and acupuncture points for pain, though discovered independently and labeled differently, represent the same phenomenon and can be explained in terms of the same underlying neural mechanisms. The mechanisms that play a role in the genesis of trigger points and possible underlying neural processes are discussed.
The functional behavior of slowly adapting cutaneous mechanoreceptors under combined thermal-mechanical stimulation was investigated by single-unit recordings from the lumbar dorsal roots of the cat. Increased sensitivity to bimodal stimulation was observed in 24 of the 28 units studied, employing stimulus-response functional behavior as the basis for judgment. Low-threshold receptors generally did not exhibit increased spontaneous firing as accompaniment to heightened sensitivity, while such enhanced basal activity was usually observed in moderate-threshold units in addition to increased reactivity. Information theory calculations performed on these stimulus-response data revealed that 15 of the 24 "heat-sensitive" receptors were additionally characterized by an enhanced ability to transmit neural information under bimodal stimulation. These results were interpreted as supporting pattern theories of pain as opposed to the concept of receptor specificity. No contradiction was observed, however, between the present results and those of other investigators. The present conclusions derive from new criteria for thermal reactivity based upon innovative stimulus conditions.
Elisabeth Fox traces the origins and development of the International Baccalaureate program as an outgrowth of continuing curriculum innovation in international schools. She describes its rapid expansion in North America, where many school systems are attracted by its challenging academic curriculum. Worldwide university recognition of the program is steadily increasing. Fox concludes by considering the prospects for future development, with particular emphasis on attempts to move the Baccalaureate beyond its Euro-centric origins.
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