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Several randomised controlled trials suggest that mindfulness-based approaches are helpful in preventing depressive relapse and recurrence, and the UK Government’s National Institute for Health and Clinical Excellence has recommended these interventions for use in the National Health Service. There are good grounds to suggest that mindfulness-based approaches are also helpful with anxiety disorders and a range of chronic physical health problems, and there is much clinical and research interest in applying mindfulness approaches to other populations and problems such as people with personality disorders, substance abuse, and eating disorders. We review the UK context for developments in mindfulness-based approaches and set out criteria for mindfulness teacher competence and training steps, as well as some of the challenges and future directions that can be anticipated in ensuring that evidence-based mindfulness approaches are available in health care and other settings.
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A humanistic and transpersonal approach to personal growth necessitates careful inquiry into the often pathological world of egoistic functioning—where the psyche is engaged in a continual, defensive, and ruminative effort to assert the uniqueness, power, and positivity of an independent symbolic self. This article describes narrative research, conducted at the beginning of several undergraduate courses in personality theory, in which students (n = 229) were encouraged to introspect into the process of objectifying and evaluating the self. After undergoing brief mindfulness training, individuals spent 1 week journaling about salient upward and downward social comparisons, with particular attention to those experiences that triggered strong feelings of inferiority and superiority. Prototypic journal passages are quoted to illustrate central findings. Participants expressed a remarkably intense array of self-evaluative episodes, particularly along the dimensions of physical appearance and intellect. Discussion focuses on the very high frequency of social comparisons reported, the cyclical nature of self-evaluation and its implications for persistent suffering, and the spontaneous experiences of insight into ego transcendence and deeper levels of self-awareness. This work advances the humanistic project by detailing a novel mechanism for facilitating self-realization in an educational context.

Reflective practice has been widely adopted as a successful method for developing nursing. The second edition of Transforming Nursing through Reflective Practice provides a wealth of new insights from practitioners actively involved in reflective practice in nursing research, education, clinical practice and practice development.This invaluable book enables nurses to continually evaluate their own practice in order to inform their approaches to reflection; critique, develop and monitor their professional practice; and thereby improve the quality of their patient care. There is a greater emphasis in the new edition on transforming practice, the research base for reflective practice and grounding the reflective process in clinical practice.* Examines the contribution of reflective practice to nursing* Enables nurses to continually develop their practice and improve patient care* Includes insights from many areas of clinical practice* Explores the role of reflection in clinical supervision and research studies* Examines the role of narrative and reflective dialogue in reflective practice

This study explores two conflictingmodels of how patients experience mind-bodytherapies; these models frame the design of aclinical trial examining the effects of qigong (a traditional Chinese movementtherapy) on the immune systems of former cancerpatients. Data consist of ethnographic researchand in-depth interviews conducted at the Bostonteaching hospital where the trial is to takeplace. These interviews, with biomedicalresearchers who designed the trial and with theqigong master responsible for the qigong arm of the trial, reveal twofundamentally different understandings of howqigong is experienced and how thatexperience may be beneficial. The biomedicalteam sees qigong as a non-specifictherapy which combines relaxation and exercise. The qigong master, on the other hand,sees qigong as using specific movementsand visualizations to direct mental attentionto specific areas of the body. Thus while thebiomedical team frames qigong as a“mind-body” practice, the qigong masterframes it as a “mind-in-body” practice. This research suggests that the biomedicalnotion that mind-body therapies work byeliciting mental relaxation is only one way ofthinking about how patients experiencemodalities like qigong: indeed,characterizations of mind-body therapies whichemphasize a mental sense of relaxation may bespecific to biomedicine and the cultures whichsurround it. More broadly, the paper arguesthat gaps in understanding between researchersand practitioners may be hindering scientificefforts to assess therapies like qigong.It concludes by proposing that clinical trialsof traditional and alternative therapies buildethnographic inquiry about practitionerexperience into the design process.
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This preliminary study examined whether the practice of mind–body techniques decreases symptoms of posttraumatic stress in adolescents. Posttraumatic Stress Reaction Index questionnaires were collected from 139 high school students in Kosovo who participated in a 6-week program that included meditation, biofeedback, drawings, autogenic training, guided imagery, genograms, movement, and breathing techniques. Three separate programs were held approximately 2 months apart. There was no control group. Posttraumatic stress scores significantly decreased after participation in the programs. These scores remained decreased in the 2 groups that participated in the follow-up study when compared to pretest measures. These data indicate that mind–body skills groups were effective in reducing posttraumatic stress symptoms in war-traumatized high school students.

<p>BACKGROUND: Many anecdotes and several uncontrolled case series have suggested that emotionally stressful events, and more specifically, anger, immediately precede and appear to trigger the onset of acute myocardial infarction. However, controlled studies to determine the relative risk of myocardial infarction after episodes of anger have not been reported. METHODS AND RESULTS: We interviewed 1623 patients (501 women) an average of 4 days after myocardial infarction. The interview identified the time, place, and quality of myocardial infarction pain and other symptoms, the estimated usual frequency of anger during the previous year, and the intensity and timing of anger and other potentially triggering factors during the 26 hours before the onset of myocardial infarction. Anger was assessed by the onset anger scale, a single-item, seven-level, self-report scale, and the state anger subscale of the State-Trait Personality Inventory. Occurrence of anger in the 2 hours preceding the onset of myocardial infarction was compared with its expected frequency using two types of self-matched control data based on the case-crossover study design. The onset anger scale identified 39 patients with episodes of anger in the 2 hours before the onset of myocardial infarction. The relative risk of myocardial infarction in the 2 hours after an episode of anger was 2.3 (95% confidence interval, 1.7 to 3.2). The state anger subscale corroborated these findings with a relative risk of 1.9 (95% confidence interval, 1.3 to 2.7). Regular users of aspirin had a significantly lower relative risk (1.4; 95% confidence interval, 0.8 to 2.6) than nonusers (2.9; 95% confidence interval, 2.0 to 4.1) (P&lt;.05). CONCLUSIONS: Episodes of anger are capable of triggering the onset of acute myocardial infarction, but aspirin may reduce this risk. A better understanding of the manner in which external events trigger the onset of acute cardiovascular events may lead to innovative preventive strategies aimed at severing the link between these external stressors and their pathological consequences.</p>
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In this article, I argue that educators can utilize mindfulness practices to enhance the efficacy of anti-oppressive pedagogy. The philosophies of Wittgenstein and Nagarjuna provide a holistic human ontology and show that learning affects students at all levels: mind, body, emotion, and spirit. My analysis of the phenomenology of thinking reveals the modes of relationship to ideation. I have proposed mindfulness practice as a proven technique to address the non-cognitive forms of attachment to ideation that may remain in force despite the most thorough-going intellectual change. /// Dans cet article, l'auteure fait valoir que les enseignants peuvent utiliser des pratiques attentionnées pour augmenter l'efficacité de la pédagogie libertaire. Les philosophies de Wittgenstein et de Nagarjuna permettent une ontologie humaine holistique et démontrent que l'apprentissage affecte les étudiants sur tous les plans: l'intelligence, le corps, les émotions et l'esprit. Les analyses de la phénoménologie de la pensée révèlent les types de relation à l'idéation. La pratique attentionnée est proposée comme une technique qui a fait ses preuves pour traiter les formes d'attachement hors du champ cognitif à l'idéation qui demeure active malgré le plus profond changement intellectuel.

OBJECTIVES: Affective neuroscience research that investigates core symptoms of pediatric bipolar disorder (PBD) may be effective in differentiating PBD phenotypes. The current study used affect-modulated startle to examine potential differences in reactivity to emotional stimuli (reward and punishment) in narrow and broad phenotype PBD and controls. METHODS: Thirty children meeting DSM-IV bipolar disorder criteria (i.e. narrow phenotype PBD with defined manic episodes with elevated/expansive mood), 19 children meeting criteria for severe mood dysregulation (i.e. broad phenotype with chronic irritability, hyper-reactivity, and hyperarousal), and 19 controls completed a lottery startle paradigm involving reward (money) and punishment (loud noise). Startle probes were presented during anticipation of the emotional stimulus, immediately following the presentation of the stimulus, or during return to baseline following the stimulus. RESULTS: By self-report, patients and controls found the putative punishment to be preferable to the neutral condition. In the reward condition, patient samples reported greater arousal than did controls, but no between-group differences were found on the magnitude of startle response during the reward, punishment, or neutral conditions. CONCLUSIONS: The failure to find differences in affect-modulated startle between control children and those with narrow or broad PBD phenotypes speaks to the methodological challenges associated with studying reward mechanisms in PBD. Alternative paradigms that focus on different aspects of reward mechanisms are discussed.
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Muscle electrical activity, or "electromyogenic" (EMG) artifact, poses a serious threat to the validity of electroencephalography (EEG) investigations in the frequency domain. EMG is sensitive to a variety of psychological processes and can mask genuine effects or masquerade as legitimate neurogenic effects across the scalp in frequencies at least as low as the alpha band (8-13 Hz). Although several techniques for correcting myogenic activity have been described, most are subjected to only limited validation attempts. Attempts to gauge the impact of EMG correction on intracerebral source models (source "localization" analyses) are rarer still. Accordingly, we assessed the sensitivity and specificity of one prominent correction tool, independent component analysis (ICA), on the scalp and in the source-space using high-resolution EEG. Data were collected from 17 participants while neurogenic and myogenic activity was independently varied. Several protocols for classifying and discarding components classified as myogenic and non-myogenic artifact (e.g., ocular) were systematically assessed, leading to the exclusion of one-third to as much as three-quarters of the variance in the EEG. Some, but not all, of these protocols showed adequate performance on the scalp. Indeed, performance was superior to previously validated regression-based techniques. Nevertheless, ICA-based EMG correction exhibited low validity in the intracerebral source-space, likely owing to incomplete separation of neurogenic from myogenic sources. Taken with prior work, this indicates that EMG artifact can substantially distort estimates of intracerebral spectral activity. Neither regression- nor ICA-based EMG correction techniques provide complete safeguards against such distortions. In light of these results, several practical suggestions and recommendations are made for intelligently using ICA to minimize EMG and other common artifacts.
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Meditation is approached as a technique for the activation of religious experience. Various theories used in psychology to explain the cognitive changes brought about by meditation are briefly reviewed. Of these, the role-theory of Sundén fits best the structure and function of various meditation methods in religious history. A small scale laboratory experiment is reported, designed for the purpose of testing the predictive validity of role-theory. The results make it possible to specify the theory's contribution and limitation.

BACKGROUND: Patterns of temporal variation of cardiac arrests may be important for understanding mechanisms leading to the onset of acute cardiovascular disorders. Previous studies have reported diurnal variation of the onset of cardiac arrests, with high incidence in the morning and in the evening, lack of daily variation during the week, and some seasonal variation. METHODS AND RESULTS: We explored weekly and yearly (seasonal) temporal variation in 6603 out-of-hospital cardiac arrests attended by the Seattle Fire Department. We observed daily variation that peaks on Monday and seasonal variation that peaks in the winter. CONCLUSIONS: Cardiac arrests do not occur randomly during the week or year but follow certain periodic patterns. These patterns are probably associated with patterns of activities.
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<p>BACKGROUND Seasonal and circadian variations in the occurrence of myocardial infarction and sudden cardiac death have been documented, suggesting that triggering factors may play a role in the causation of cardiac events. However, there are only sparse and conflicting data on the weekly distribution of the disorders. METHODS AND RESULTS To determine the weekly variation of acute myocardial infarction and sudden cardiac death, 5596 consecutive patients (71% men; age, 63 +/- 1 years) were analyzed in a regionally defined population (n = 330,000; age, 25 to 74 years) monitored from 1985 to 1990. The exact time of onset of symptoms was used to determine the day of the event. Patients with myocardial infarction (n = 2636) demonstrated a significant weekly variation (P &lt; .01) with a peak on Monday, whereas patients with sudden cardiac death (n = 2960) were evenly distributed throughout the week. A similar weekly pattern was observed in subgroups of patients with myocardial infarction defined with respect to age, sex, cardiac risk factors, prior cardiac medication, and infarct characteristics. The working population demonstrated a weekly variation of myocardial infarction as opposed to the nonworking population, with a 33% increase in relative risk of disease onset on Monday (P &lt; .05) and a trough on Sunday compared with the expected number of cases, if homogeneity was assumed. CONCLUSIONS The onset of acute myocardial infarction demonstrates a peak on Monday primarily in the working population. If this finding is confirmed in other communities, it may aid in identifying acute triggering events of myocardial infarction and perhaps in improving prevention of the disease. (Copyright © 1994 by American Heart Association)</p>
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We present a novel weighted Fourier series (WFS) representation for cortical surfaces. The WFS representation is a data smoothing technique that provides the explicit smooth functional estimation of unknown cortical boundary as a linear combination of basis functions. The basic properties of the representation are investigated in connection with a self-adjoint partial differential equation and the traditional spherical harmonic (SPHARM) representation. To reduce steep computational requirements, a new iterative residual fitting (IRF) algorithm is developed. Its computational and numerical implementation issues are discussed in detail. The computer codes are also available at http://www.stat.wisc.edu/-mchung/softwares/weighted.SPHARM/weighted-SPHARM.html. As an illustration, the WFS is applied i n quantifying the amount ofgray matter in a group of high functioning autistic subjects. Within the WFS framework, cortical thickness and gray matter density are computed and compared.
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<p>This article opens by noting that positive emotions do not fit existing models of emotions. Consequently, a new model is advanced to describe the form and function of a subset of positive emotions, including joy, interest, contentment, and love. This new model posits that these positive emotions serve to broaden an individual's momentary thought-action repertoire, which in turn has the effect of building that individual's physical, intellectual, and social resources. Empirical evidence to support this broaden-and-build model of positive emotions is reviewed, and implications for emotion regulation and health promotion are discussed.</p>

At the turn of the twentieth century, the mind-cure movement emphasized the healing power of positive emotions and beliefs. William James defended mind-cure during the Massachusetts legislature's debates on licensing physicians in 1894 and 1898. In The Varieties of Religious Experience (1902) he used the movement's therapeutic claims to illustrate the typically American, practical turn of the "religion of healthy-mindedness." Varieties sympathetically surveys mind-cure literature, but also criticizes healthy-minded religion for its limited range and refusal to confront tragedy and radical evil. Many of today's mind/body therapies continue the mind-cure tradition and retain the limitations that James noted.

Stephen Cope asked 25 yoga and meditation teachers to share their "tales from the path"--their thoughts on how the long-term practice of yoga and meditation has changed their lives. The result is a unique collection of stories offering insight and inspiration for everyone seeking a more satisfying life.

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