SMILE

SMILE – Stress Medicine Education Integrated LEarning (in English)

SMILE focuses on providing individuals with biopsychosocial based services at our SMILE centers or on the web (centers are planned to be available for services after June 1). As we see health promotion, stress prevention and rehabilitation of stress related dysfunctions as mainly an educational and knowledge implementation matter SET focuses on providing needed tools – our code name is “man as a health creator” – including biofeedback for different interests groups. Our SET center will be opened during the spring, actually reopened while we have been working with this concept since late 1980-ties but within a non-profit organization. What is special with the Stress Medicine Concept is the way to use science and clinical perspective together while using biopsychosocial medicine as a platform for assessment and interventions where interventions are based on “man as a health creator”, which means individuals are educated to become an active, sufficient competent coworker for using, carry out and, in cooperation with the clinical provider, tailor needed strategies. ASPIRE is our tools for knowledge and its implementation. Below is described the components of the intervention package. ASPIRE – assisted by different kind of (bio)feedback is suggested tools for promoting and sustained health as well as for rehabilitation – to be learned and implemented according to individuals requirement and “style”

  • Adequate, biological breathing behaviors. Clinically we can identify destructive breathing with measurement of exhalation CO2. Using biofeedback assisted breathing training chemical balance can be re-established. How we breathe is crucial for biological functioning and biological functioning influence breathing behaviors. Our breathing behaviors is closely connected with both our autonomic nervous systems and cardiovascular systems as well as basic chemistry, This means that individuals way to breathe has both short termed and long termed consequences for health development and how we manage stress. We provide crucial knowledge as well as an easy way to used this knowledge and develop an own breathing strategy.
  • Slow motion (O2-balanced). Exercise is important for all of us but for those suffering from severe biopsychosocial stress slow motion is effective to normalize metabolic dysfunctions, which is common for such complex disorders. There are different ways to adjust exercise to individual prerequisites and we present an easy way to find out how to “tailor” and connect with the other tools.
    Peaceful, problem solving thought/images. The way we think, consciously or not (e.g. silent, automatic thoughts, images) is decisive for effective, health promoting coping in life. A number of easy as well as more complex approaches can be learned and integrated. Biofeedback is also included here for learning to integrate cognitive-behavioral-physiological systems. Very important when there are severe dysfunctions and related symptoms/problems. In biofeedback it is important to use appropriate strategies and modalities. This can mainly be provided via internet. About cognitive behavioral strategies: There are easy to learn effective strategies which can be integrated with the tools below. If not enough Cognitive Behavioral Therapy (CBT) is recommended where we advise certified CBT-psychologists.
  • Intake of required food/liquid. Recent knowledge development within nutrition can be regarded as a revolution which knowledge used in a careful way can be of outmost importance for most diseases. Thanks to much recent work in molecular biology we now understand how crucial it is how we eat. Many approaches are presented at the internet but mostly that basic actual knowledge is now well covered here. This is what we work hard for and thereby to present useful knowledge to prepare for our eating.
  • Relatedness and communications. The way we communicate and related is mostly a result of our social heritage which, if not constructive, can be developed using different kind of social strategies
  • Ecological caring relates to the importance to consider our way of improving in relations to our environment based on evolutionary aspects of the earth and living species.

The above are individually tailored using easy used strategies/approaches. They need to be considered both nomothetic (Evidence Based Behavioral Medicine, EBBM, validation) & ideographic (Individual biological evidence, IBE, validation (Evolution and Health – presentation by Bo von Scheele) considerations, where IBE is for clinical use and EBBM for normative use. Patient education focus on what is relevant related to observed and identified dysfunctions. What dysfunctions are identified, possible reasons for the dysfunction and how normalization can be done?   Before individuals use the ASPIRE tools we advise a point of departure in terms ofScreeningor Stressogram (Psychophysiological stress profiling) which can be done in several ways (more info will come here)   How to know if education and training (interventions) function? We use Individual Biological Evidence where we follow changes in important parameters where changes are predicted a priory and which also have biological significance. A prerequisite is to identify dysfunctions with psychophysiological measurement/test/protocols and from obtained data do the predictions. Here function symptoms also as outcome measures but sometimes there is a delay related to a number of factors, e.g. operational conditioning that maintain symptoms although dysfunction generating the symptoms is normalized. Mostly problems/symptoms are both psychological and physiological and changes are often not well paralleled. This is one of a number of reasons that a biopsychosocial platform needs while also the social side cannot be neglected. After– if the Screening or Stressogram is repeated after the education and training conclusions can be made about the general effect – increasing the IBE. If a base line period is done before start, that is, two base line screenings or stressogram, this increase the information about what causes what. More information how the above will be made available will be provided here after July 15 External social, ecological factors & internal psychophysiological factors may generate health as well as illnesses expressed as symptoms/problems/… But they are not always as early visible as we want. Early identification facilitates fast, effective normalization. Dysfunctions (independent variables) identified during psychophysiological tests directly or indirectly related to cardiovascular-, metabolic -, autonomic nervous systems diseases are mostly treatable with biopsychosocial medicine strategies.

Factors known to influence development of life style related diseases

Factors known to influence development of life style related diseases

* Refer to Stig Bengmark´s work Independent variable means what causes changes. What promotes diseases needs to be decreased and what prevent increased. To study intervention in only one the “factors” above at group level is not clinically meaningful. Of clinical significance is that patients find their own tailored application which is a challenge for both health care providers and the particular individual patient. Interventions are extracted from the above and repeated psychophysiological measurements are conducted by both patients and health care providers, which validate predicted changes during the process and thereby also identifying when cut-off is reached. This is called Individual Biological Evidence (IBE). IBE is also important as a motivator for extensive patient actions. Follow-ups confirm stabilization of obtained results – habits changed and stabilized! In sum Basics for biopsychosocial based stress medicine workProblem identification with biopsychosocial assessment

  • Observe and identify factors what promote and prevent/get rid of the problems as well as promote them
  • Use the information above for developing an intervention plan and do a priori predictions in crucial parameters
  • Carry out the plan while (also patient is) doing repeated measurement and, if needed, modify according to feedback
  • Document the process and report (clinical and to patient)

OICTOOLS – Observe, Identify & Change Tools for Health Creators Development of interactive psychophysiological medicine communication systems based on complex systems analysis including artificial intelligence treatment of data for effective performance, health promotion, stress prevention and rehabilitation of life styles- and society related diseases. OICTOOLS is a prototype system contenting sensors, data transmission, Artificial intelligence (AI)-based complex systems analysis of data which interactively communicated, which can be adapted to different applications and individually tailored. OICTOOLS can be used in private as well as in cooperation with health care systems. Aim: OICTOOLS is developed for observation, identification and modification, when needed, of crucial psychophysiological systems as autonomic nervous system (ANS) and its interactions with other systems, be it physiological and/or psychological. ANS is direct or indirect involved in most life styles and society related dysfunctions. Other systems of relevance are metabolic and cardiovascular systems. Background: There are a number of more or less well scientific grounded physiological measurement systems on the international market but no one yet which can be used by individuals as health creator tools where individuals learn basics about biopsychosocial medicine and learn how they can tailor effective processes themselves or in cooperation with health care systems as partners. The basis for development of this system is practical, functional integration of many disciplines and competences on a biopsychosocial medicine platform, which we have used clinically for many years manually. So – we do have extensive experiences as well as use of actual present knowledge but as the field is under develop theoretically, methodologically and practically as well as more empirical studies are needed to be done, we are open for cooperation with companies with related interest focuses – see more below. As the system above has some very unique parts it will not be described in details. PICTOOLS integrate competences from electronics, medicine, psychology, psychophysiology, education, computer science, artificial intelligence competences. The project is developed in cooperation with Mälardalen University (where I also am professor 20% of full time), especially concerning AI but there is much research within biopsychosocial medicine needed and therefore we are interested also cooperation in terms of doctoral students within computer science, psychophysiology and medicine, (please contact bo.vonscheele@stressmedicin.se in this matter). We are open for discussions of cooperation related to Systems development

  • Improvement of different kind of sensors of relevance
  • Improvement of wireless data transmission
  • Improvement of Interactive communications
  • Further improved efficacy in tests, biofeedback and adjunctive interventions
  • Individual and normative biological evaluations at highest scientific level

Different applications(design and tailoring of the prototype)

  • PTSD (post traumatic stress syndrome)
  • Burnouts
  • Other kind of different kind of stress related problems
  • Different kind of performance hand in hand with health
  • Health promotion
  • Product marketing and production

Contact: info@stressmedicin.se – info@stressmedicine.se Project director Bo von Schéele, Ph D in Psychology, Stress Medicine AB Professor in Medical Engineering, Mälardalen University

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