Purpose: To systematically review articles reporting on depression, anxiety, and burnout among U.S. and Canadian medical students.
Method: Medline and PubMed were searched to identify peer-reviewed English-language studies published between January 1980 and May 2005 reporting on depression, anxiety, and burnout among U.S. and Canadian medical students. Searches used combinations of the Medical Subject Heading terms medical student and depression, depressive disorder major, depressive disorder, professional burnout, mental health, depersonalization, distress, anxiety, or emotional exhaustion. Reference lists of retrieved articles were inspected to identify relevant additional articles. Demographic information, instruments used, prevalence data on student distress, and statistically significant associations were abstracted.
Results: The search identified 40 articles on medical student psychological distress (i.e., depression, anxiety, burnout, and related mental health problems) that met the authors' criteria. No studies of burnout among medical students were identified. The studies suggest a high prevalence of depression and anxiety among medical students, with levels of overall psychological distress consistently higher than in the general population and age-matched peers by the later years of training. Overall, the studies suggest psychological distress may be higher among female students. Limited data were available regarding the causes of student distress and its impact on academic performance, dropout rates, and professional development.
Conclusions: Medical school is a time of significant psychological distress for physicians-in-training. Currently available information is insufficient to draw firm conclusions on the causes and consequences of student distress. Large, prospective, multicenter studies are needed to identify personal and training-related features that influence depression, anxiety, and burnout among students and explore relationships between distress and competency.
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<p>Objective. To critically review the evidence on the effectiveness of complementary therapies for patients with RA. Randomized controlled trials, published in English up to May 2011, were identified using systematic searches of bibliographic databases and searching of reference lists. Information was extracted on outcomes and statistical significance in comparison with alternative treatments and reported side effects. The methodological quality of the identified studies was determined using the Jadad scoring system. All outcomes were considered but with a focus on patient global assessment and pain reporting. Eleven eligible trials were identified covering seven therapies. Three trials that compared acupuncture with sham acupuncture reported no significant difference in pain reduction between the groups but one out of two reported an improvement in patient global assessment. Except for reduction in physicianʼs global assessment of treatment and disease activity reported in one trial, no other comparative benefit of acupuncture was seen. There were two studies on meditation and one each on autogenic training, healing therapy, progressive muscle relaxation, static magnets and tai chi. None of these trials reported positive comparative effects on pain but some positive effects on patient global assessment were noted at individual time points in the healing therapy and magnet therapy studies. A small number of other outcomes showed comparative improvement in individual trials. There were no reports of major adverse events. The very limited evidence available indicates that for none of the practitioner-based complementary therapies considered here is there good evidence of efficacy or effectiveness in the management of RA</p>
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This book takes a bold new look at ways of exploring the nature, origins, and potentials of consciousness within the context of science and religion. It draws careful distinctions between four elements of the scientific tradition: science itself, scientific realism, scientific materialism, and scientism. Arguing that the metaphysical doctrine of scientific materialism has taken on the role of ersatz-religion for its adherents, it traces its development from its Greek and Judeo-Christian origins, focusing on the interrelation between the Protestant Reformation and the Scientific Revolution. It also looks at scientists' long term resistance to the firsthand study of consciousness and details the ways in which subjectivity has been deemed taboo within the scientific community. In conclusion, the book draws on William James's idea for a “science of religion” that would study the nature of religious and, in particular, contemplative experience.
The specific aim of this course is development of a university dance curriculum that will link post-modern dance with Tai Chi as it is understood and practiced by the masters of the discipline in China – both as a practice (i.e., as a set of physical movements known as “Tai Chi Chuan”) and as a spiritual discipline (i.e., “Tai Chi”) worthy of scholarly study. A central hypothesis of this course is that the teaching of Tai Chi Chuan in this country – both in academic and experiential contexts – has generally missed the essence of the actual Chinese discipline by concentrating more on the specific physical steps than on the deeper mental and spiritual principles from which it derives. A major goal of the course is to restore to the curriculum those important principles of employing certain meditation techniques that have not been taught here. The course will apply two central principles of Tai Chi in the context of dance: first, the goal of awareness, or softness, which is simply movement based on stillness; and second, the goal of relational physics, or the intention and orientation of the individual to the whole.
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<p>Explains the TCT-DP by discussing (a) the need for the TCT-DP, (b) the justification for and purpose of the test, (c) the meaning and limitations of the test construct, (d) design, (e) evaluation criteria, (f) the 1st results, and (g) prognostics. The TCT-DP testing sheet includes stimuli, in the form of figural elements or fragments, intentionally designed in an incomplete and irregular fashion to achieve maximum flexibility as an imperative for creativity. The TCT-DP allows potentially gifted students to interpret and to complete what they conceive to be significant for the development of a creative product.</p>
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<p>The purpose of this article is to show how meditation can be used to help a student to become an ethical person. Discursive and non-discursive meditation give the student an awareness of ethical issues and lead to the discovery and application of models of ethical conduct. In part one, the student is led through non-discursive meditation to discover him/her self as an ethical person. The student is also given the tools to explore ethical issues. Part two discusses a transition stage from non-discursive to discursive meditation. The student is led to use non-discursive meditation to construct an ethical value system and apply it to his/her own life. An art medium is especially helpful at this stage. Discursive meditation gives the chance for the student to compare who he/she is with what he/she should be. Part three discusses four elements in the construction of an ethical vision with discursive meditaton: First, a picture of reality; second, models of ethical rules; third, models of ethical conduct; fourth, current personal and social values. The conclusion contains a description of the ethical person.</p>
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<p>Few counseling programs directly address the importance of self-care in reducing stress and burnout in their curricula. A course entitled Mind/Body Medicine and the Art of Self-Care was created to address personal and professional growth opportunities through self-care and mindfulness practices (meditation, yoga, qigong, and conscious relaxation exercises). Three methods of evaluating this 15-week 3-credit mindfulness-based stress reduction (MBSR) course for counseling students indicated positive changes for students in learning how to manage stress and improve counseling practice. Students reported positive physical, emotional, mental, spiritual, and interpersonal changes and substantial effects on their counseling skills and therapeutic relationships. Information from a focus group, qualitative reports, and quantitative course evaluations were triangulated; all data signified positive student responses to the course, method of teaching, and course instructor. Most students reported intentions of integrating mindfulness practices into their future profession.</p>
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Mindfulness, or being fully present and attentive to the moment, not only improves the way doctors engage with patients but also mitigates the stresses of clinical practice.
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<p>Preparation for the role of therapist can occur on both professional and personal levels. Research has found that therapists are at risk for occupationally related psychological problems. It follows that self-care may be a useful complement to the professional training of future therapists. The present study examined the effects of one approach to self-care, Mindfulness-Based Stress Reduction (MBSR), for therapists in training. Using a prospective, cohort-controlled design, the study found participants in the MBSR program reported significant declines in stress, negative affect, rumination, state and trait anxiety, and significant increases in positive affect and self-compassion. Further, MBSR participation was associated with increases in mindfulness, and this enhancement was related to several of the beneficial effects of MBSR participation. Discussion highlights the potential for future research addressing the mental health needs of therapists and therapist trainees.</p>
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Following E. Goffman's (1967) face threat analysis of social interaction, it was hypothesized that the aggressive, playful content of teasing would vary according to social status and relational satisfaction, personality, role as teaser or target, and gender. These 4 hypotheses were tested in analyses of the teasing among fraternity members (Study 1) and romantic couples (Study 2). Consistent with a face threat analysis of teasing, low-status fraternity members and satisfied romantic partners teased in more prosocial ways, defined by reduced face threat and increased redressive action. Some findings indicate that disagreeable individuals teased in less prosocial ways, consistent with studies of bullying. Targets reported more negative emotion than teasers. Although female and male romantic partners teased each other in similar ways, women found being the target of teasing more aversive, consistent with previous speculation.
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We present a new tensor-based morphometric framework that quantifies cortical shape variations using a local area element. The local area element is computed from the Riemannian metric tensors, which are obtained from the smooth functional parametrization of a cortical mesh. For the smooth parametrization, we have developed a novel weighted spherical harmonic (SPHARM) representation, which generalizes the traditional SPHARM as a special case. For a specific choice of weights, the weighted-SPHARM is shown to be the least squares approximation to the solution of an isotropic heat diffusion on a unit sphere. The main aims of this paper are to present the weighted-SPHARM and to show how it can be used in the tensor-based morphometry. As an illustration, the methodology has been applied in the problem of detecting abnormal cortical regions in the group of high functioning autistic subjects.
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<p>Philosophers speak-or, rather, they respond to various forms of speaking that are handed to them. This book by one of our most distinguished philosophers focuses on the communicative aspect of philosophical thought. Peperzak's central focus is addressing: what distinguishes speaking or writing from rumination is their being directed by someone to someone. To be involved in philosophy is to be part of a tradition through which thinkers propose their findings to others, who respond by offering their own appropriations to their interlocutors.After a critical sketch of the conception of modern philosophy, Peperzak presents a succinct analysis of speaking, insisting on the radical distinction between speaking about and speaking to. He enlarges this analysis to history and tries to answer the question whether philosophy also implies a certain form of listening and responding to words of God. Since philosophical speech about persons can neither honor nor reveal their full truth, speaking and thinking about God is even more problematic. Meditation about the archaic Word cannot reach the Speaker unless it turns into prayer, or-as Descartes wrote-into a contemplation that makes the thinker consider, admire, and adore the beauty of God's immense light, as much as the eyesight of my blinded mind can tolerate."Thinking is a work of genuine and original scholarship which responds to the tradition of philosophical thinking with a critique of its language, style, focus, and scope.-Catriona Hanley, Loyola College, Maryland</p>
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<p>An English translation of an oral commentary by Deshung Rinpoche on Könchok Lhündrup's (Dkon mchog lhun grub) _The Beautiful Ornament of the Three Visions_ (Snang gsum mdzes rgyan), a guide to the practice of the Sakya (sa skya) preliminaries (sngon 'gro). (BJN)</p>
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<p>An English translation of a guide to the practice of the Sakya (sa skya) preliminaries (sngon 'gro). The Tibetan title is _Lam 'bras sngon 'gro'i khrid yig snang gsum mdzes rgyan_. (BJN)</p>
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Translated by Agurme Dorje. Edited by Graham Coleman with Thupten Jinpa. Introductory Commentary by His Holiness The Dalai Lama
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Two replication studies test in Canada a field theory of the effect of consciousness on social change. The exogenous variable is the number of participants in the largest North American group practice of the Transcendental Meditation and TM-Sidhi program, in Iowa. The first study indicated a significant reduction in violent deaths (homicide, suicide, and motor vehicle fatalities), using both time series intervention analysis and transfer function analysis methods, in weeks following change in the exogenous variable during the period 1983 to 1985. The second study, using time series intervention analysis, gave during and after intervention periods a significant improvement in quality of life on an index composed of the behavioral variables available on a monthly basis for Canada from 1972 to 1986 - homicide, suicide, motor vehicle fatalities, cigarette consumption, and workers' days lost due to strikes. Implications of the findings for theory and social policy are noted briefly.
The study of emotional signaling has focused almost exclusively on the face and voice. In 2 studies, the authors investigated whether people can identify emotions from the experience of being touched by a stranger on the arm (without seeing the touch). In the 3rd study, they investigated whether observers can identify emotions from watching someone being touched on the arm. Two kinds of evidence suggest that humans can communicate numerous emotions with touch. First, participants in the United States (Study 1) and Spain (Study 2) could decode anger, fear, disgust, love, gratitude, and sympathy via touch at much-better-than-chance levels. Second, fine-grained coding documented specific touch behaviors associated with different emotions. In Study 3, the authors provide evidence that participants can accurately decode distinct emotions by merely watching others communicate via touch. The findings are discussed in terms of their contributions to affective science and the evolution of altruism and cooperation.
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<p>In the present review of recent empirical research, the authors point to ways by which meditation may complement the traditional goals of the academy by helping to develop traditionally valued academic skills as well as help to build important emotional and interpersonal capacities that foster psychological well-being and the development of the whole person.</p>
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- Classical Buddhist Contemplation Practices,
- Practices Specific to Tibetan Buddhism,
- Literature Specific to Tibetan Buddhism,
- Contemplation by Tradition,
- Four Immeasurables (catvary apramanani, tsemé zhi),
- Avalokiteshvara (Chenrezik),
- Means of Accomplishment (sadana, druptap),
- Literature of Buddhist Contemplation,
- Practices of Buddhist Contemplation,
- Generation phase (utpattikrama, kyerim),
- Compassion Meditations,
- Deity yoga (devata-yoga, lhé nenjor),
- Buddhist Contemplation
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