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BACKGROUND: Despite the apparent high placebo response rate in randomized placebo-controlled trials (RCT) of patients with irritable bowel syndrome (IBS), little is known about the variability and predictors of this response.
OBJECTIVES: To describe the magnitude of response in placebo arms of IBS clinical trials and to identify which factors predict the variability of the placebo response.
METHODS: We performed a meta-analysis of published, English language, RCT with 20 or more IBS patients who were treated for at least 2 weeks. This analysis is limited to studies that assessed global response (improvement in overall symptoms). The variables considered as potential placebo modifiers were study design, study duration, use of a run-in phase, Jadad score, entry criteria, number of office visits, number of office visits/study duration, use of diagnostic testing, gender, age and type of medication studied.
FINDINGS: Forty-five placebo-controlled RCTs met the inclusion criteria. The placebo response ranged from 16.0 to 71.4% with a population-weighted average of 40.2%, 95% CI (35.9-44.4). Significant associations with lower placebo response rates were fulfillment of the Rome criteria for study entry (P=0.049) and an increased number of office visits (P=0.026).
CONCLUSIONS: Placebo effects in IBS clinical trials measuring a global outcome are highly variable. Entry criteria and number of office visits are significant predictors of the placebo response. More stringent entry criteria and an increased number of office visits appear to independently decrease the placebo response.
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Publisher's description: This book teaches us how to fully connect with the visual richness of our ordinary, daily experience. Photography is not just a mechanical process; it requires learning how to see. As you develop your ability to look and see, you will open, more and more, to the natural inspiration of your surroundings. Filled with practical exercises, photographic assignments, and techniques for working with texture, light, and color, this book offers a system of training that draws on both Buddhist mindfulness practice and the insights of master photographers such as Alfred Stieglitz, Edward Weston, and Henri Cartier-Bresson.
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The ‘problem of other minds’ is central to sociological theory and of immediate importance to contemporary research on subjectivity and interiority. How do we cultivate and maintain an intersubjective space during silent, private, experiences? Drawing on Alfred Schutz’s phenomenology, this study challenges the common view which regards silence as an obstacle to social relations. The data consist of two years of participant observation of vipassana meditation practices in Israel and the United States. Vipassana meditation is conducted in complete silence, discouraging group sharing of meditation experiences, thus offering an extreme case of silence and privacy. The findings illustrate how, despite the absence of direct verbal communication, the practice of meditation still holds important intersubjective dimensions. I suggest that covert mechanisms of silent intersubjectivity play an important role in everyday social life and require further ethnographic attention.
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<p>BACKGROUND: Increasingly, researchers attend to both positive and negative aspects of mental health. Such distinctions call for clarification of whether psychological well-being and ill-being comprise opposite ends of a bipolar continuum, or are best construed as separate, independent dimensions of mental health. Biology can help resolve this query--bipolarity predicts 'mirrored' biological correlates (i.e. well-being and ill-being correlate similarly with biomarkers, but show opposite directional signs), whereas independence predicts 'distinct' biological correlates (i.e. well-being and ill-being have different biological signatures). METHODS: Multiple aspects of psychological well-being (eudaimonic, hedonic) and ill-being (depression, anxiety, anger) were assessed in a sample of aging women (n = 135, mean age = 74) on whom diverse neuroendocrine (salivary cortisol, epinephrine, norepinephrine, DHEA-S) and cardiovascular factors (weight, waist-hip ratio, systolic and diastolic blood pressure, HDL cholesterol, total/HDL cholesterol, glycosylated hemoglobin) were also measured. RESULTS: Measures of psychological well-being and ill-being were significantly linked with numerous biomarkers, with some associations being more strongly evident for respondents aged 75+. Outcomes for seven biomarkers supported the distinct hypothesis, while findings for only two biomarkers supported the mirrored hypothesis. CONCLUSION: This research adds to the growing literature on how psychological well-being and mental maladjustment are instantiated in biology. Population-based inquiries and challenge studies constitute important future directions.</p>
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This article assessed whether resting electroencephalographic (EEG) asymmetry in anterior regions of the brain can predict affective responses to emotion elicitors. Baseline EEG was recorded from 32 female adults, after which Ss viewed film clips preselected to elicit positive or negative affect. Resting alpha power asymmetry in the frontal region significantly predicted self-reported global negative affect in response to clips and predicted the difference between global positive and negative affect. Analyses of discrete emotions revealed a strong relation between frontal asymmetry and fear responses to films. Effects were independent of Ss mood ratings at the time at which baseline EEG was measured. Resting anterior asymmetry may be a state-independent index of the individual's predisposition to respond affectively.
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This study examined the interplay of social engagement, sleep quality, and plasma levels of interleukin-6 (IL-6) in a sample of aging women (n = 74, aged 61-90, M age = 73.4). Social engagement was assessed by questionnaire, sleep was assessed by using the NightCap in-home sleep monitoring system and the Pittsburgh Sleep Quality Index, and blood samples were obtained for analysis of plasma levels of IL-6. Regarding subjective assessment, poorer sleep (higher scores on the Pittsburgh Sleep Quality Index) was associated with lower positive social relations scores. Multivariate regression analyses showed that lower levels of plasma IL-6 were predicted by greater sleep efficiency (P < 0.001), measured objectively and by more positive social relations (P < 0.05). A significant interaction showed that women with the highest IL-6 levels were those with both poor sleep efficiency and poor social relations (P < 0.05). However, those with low sleep efficiency but compensating good relationships as well as women with poor relationships but compensating high sleep efficiency had IL-6 levels comparable to those with the protective influences of both good social ties and good sleep.
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OBJECTIVE: To test the hypothesis that socioeconomic status (SES) would be associated with sleep quality measured objectively, even after controlling for related covariates (health status, psychosocial characteristics). Epidemiological studies linking SES and sleep quality have traditionally relied on self-reported assessments of sleep.
METHODS: Ninety-four women, 61 to 90 years of age, participated in this study. SES was determined by pretax household income and years of education. Objective and subjective assessments of sleep quality were obtained using the NightCap sleep system and the Pittsburgh Sleep Quality Index (PSQI), respectively. Health status was determined by subjective health ratings and objective measures of recent and chronic illnesses. Depressive symptoms and neuroticism were quantified using the Center for Epidemiological Studies Depression Scale and the Neuroticism subscale of the NEO Personality Inventory, respectively.
RESULTS: Household income significantly predicted sleep latency and sleep efficiency even after adjusting for demographic factors, health status, and psychosocial characteristics. Income also predicted PSQI scores, although this association was significantly attenuated by inclusion of neuroticism in multivariate analyses. Education predicted both sleep latency and sleep efficiency, but the latter association was partially reduced after health status and psychosocial measures were included in analyses. Education predicted PSQI sleep efficiency component scores, but not global scores.
CONCLUSIONS: These results suggest that SES is robustly linked to both subjective and objective sleep quality, and that health status and psychosocial characteristics partially explain these associations.
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"The practice of contemplation is one of the great spiritual arts," writes Martin Laird in A Sunlit Absence. "Not a technique but a skill, it harnesses the winds of grace that lead us out into the liberating sea of silence." In this companion volume to his bestselling Into the Silent Land, Laird focuses on a quality often overlooked by books on Christian meditation: a vast and flowing spaciousness that embraces both silence and sound, and transcends all subject/object dualisms. Drawing on the wisdom of great contemplatives from St. Augustine and St. Teresa of Avila to St. Hesychios, Simone Weil, and many others, Laird shows how we can uncover the deeper levels of awareness that rest within us like buried treasure waiting to be found. The key insight of the book is that as our practice matures, so will our experience of life's ordeals, sorrows, and joys expand into generous, receptive maturity. We learn to see whatever difficulties we experience in meditation--boredom, lethargy, arrogance, depression, grief, anxiety--not as obstacles to be overcome but as opportunities to practice surrender to what is. With clarity and grace Laird shows how we can move away from identifying with our turbulent, ever-changing thoughts and emotions to the cultivation of a "sunlit absence"--the luminous awareness in which God's presence can most profoundly be felt. Addressed to both beginners and intermediates on the pathless path of still prayer, A Sunlit Absence offers wise guidance on the specifics of contemplative practice as well as an inspiring vision of the purpose of such practice and the central role it can play in our spiritual lives.
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