Favorite Table | PrintPruritus at a GlancePruritus is the predominant symptom of skin disease. May originate in the skin or nervous system.Clinical classification of itch includes:pruritus on diseased (inflamed) skinpruritus on nondiseased (noninflamed) skinpruritus presenting with severe chronic secondary scratch lesionsChronic itch consists of multidimensional phenomena including sensory, emotional, and cognitive components.Central and peripheral mediators in humans include histamine, proteinases, opiates, substance P, nerve growth factor, interleukins, and prostaglandins.Treatment should address the multifactorial nature of pruritus including central pathways and peripheral mediators.
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http://ayuryog.org/event/conference-medicine-and-yoga-south-and-inner-asia-body-cultivation-therapeutic-intervention Vienna, August 1-3, 2017 Co-hosted by the Dept. of South Asian, Tibet and Buddhist Studies, University of Vienna and the Institute
In his provocative essay “Slow Knowledge,” David Orr outlines the countervailing assumptions of what he calls “the culture of fast knowledge.” Among these are the widely shared, though rarely examined, beliefs that “only that which can be measured is true knowledge; the more knowledge we have, the better; there are no significant distinctions between information and knowledge; and wisdom is an undefinable, hence unimportant category.”1 If all this were true, it would follow that computers are fast overtaking humans as the next intelligent species. Or, to put it differently, the two species have been colluding for some time to produce smarter machines and dumber people, as we humans abdicate more and more of our mental tasks. Moreover, when it comes time to weigh values—to ask not how quickly or efficiently some task can be done, but whether it ought to be done at all—we are strangely disinclined to challenge digital fatalism, which has become the default logic of late capitalism. Whenever a new digital option appears, we assume that if it can be done and someone somewhere is doing it, then it should be done and we ought to do it too. So even the local hardware store has to be on Facebook so customers can “like” it, and the AAR needs a Twitter account to send weekly tweets. We seldom pause to ask questions about means and ends, unintended consequences, or the sheer mindless clutter of our lives—let alone the implications of this or that new app for our descendants down to the seventh generation, or the enlightenment of all sentient beings. Surface obliterates depth; instant stimulation trumps mature reflection; short-term profit overrules the long-range good.
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This article emerges from a workshop titled “Producing Efficacious Medicine: Quality, Potency, Lineage, and Critically Endangered Knowledge,” held in Kathmandu, Nepal, in December 2011. An experiment in collaborative event ethnography (CEE), this
Research on mindfulness indicates that it is associated with improved mental health, but the use of multiple different definitions of mindfulness prevents a clear understanding of the construct. In particular, the boundaries between different conceptualizations of mindfulness and emotion regulation are unclear. Furthermore, the mechanisms by which any of these conceptualizations of mindfulness might influence mental health are not well-understood. The two studies presented here addressed these questions using correlational, self-report data from a non-clinical sample of undergraduate students. The first study used a combination of exploratory and confirmatory factor analyses to better understand the factor structure of mindfulness and emotion regulation measures. Results indicated that these measures assess heterogeneous and overlapping constructs, and may be most accurately thought of as measuring four factors: present-centered attention, acceptance of experience, clarity about one’s internal experience, and the ability to manage negative emotions. A path analysis supported the hypothesis that mindfulness (defined by a two-factor construct including present-centered attention and acceptance of experience) contributed to clarity about one’s experience, which improved the ability to manage negative emotions. The second study developed these findings by exploring the mediating roles of clarity about one’s internal life, the ability to manage negative emotions, non-attachment (or the extent to which one’s happiness is independent of specific outcomes and events), and rumination in the relationship between mindfulness and two aspects of mental health, psychological distress and flourishing mental health. Results confirmed the importance of these mediators in the relationship between mindfulness and mental health.
Research on mindfulness indicates that it is associated with improved mental health, but the use of multiple different definitions of mindfulness prevents a clear understanding of the construct. In particular, the boundaries between different conceptualizations of mindfulness and emotion regulation are unclear. Furthermore, the mechanisms by which any of these conceptualizations of mindfulness might influence mental health are not well-understood. The two studies presented here addressed these questions using correlational, self-report data from a non-clinical sample of undergraduate students. The first study used a combination of exploratory and confirmatory factor analyses to better understand the factor structure of mindfulness and emotion regulation measures. Results indicated that these measures assess heterogeneous and overlapping constructs, and may be most accurately thought of as measuring four factors: present-centered attention, acceptance of experience, clarity about one’s internal experience, and the ability to manage negative emotions. A path analysis supported the hypothesis that mindfulness (defined by a two-factor construct including present-centered attention and acceptance of experience) contributed to clarity about one’s experience, which improved the ability to manage negative emotions. The second study developed these findings by exploring the mediating roles of clarity about one’s internal life, the ability to manage negative emotions, non-attachment (or the extent to which one’s happiness is independent of specific outcomes and events), and rumination in the relationship between mindfulness and two aspects of mental health, psychological distress and flourishing mental health. Results confirmed the importance of these mediators in the relationship between mindfulness and mental health.
Background: Workplace stress can affect job satisfaction, increase staff turnover and hospital costs, and reduce quality of patient care. Highly resilient nurses adapt to stress and use a variety of skills to cope effectively.Objective: To gain data on a mindfulness-based cognitive therapy resilience intervention for intensive care unit nurses to see if the intervention program would be feasible and acceptable.
Methods: Focus-group interviews were conducted by videoconference with critical care nurses who were members of the American Association of Critical-Care Nurses. The interview questions assessed the feasibility and acceptability of a mindfulness-based cognitive therapy program to reduce burnout syndrome in intensive care unit nurses.
Results: Thirty-three nurses participated in 11 focus groups. Respondents identified potential barriers to program adherence, incentives for adherence, preferred qualifications of instructors, and intensive care unit-specific issues to be addressed.
Conclusions: The mindfulness-based cognitive therapy pilot intervention was modified to incorporate thematic categories that the focus groups reported as relevant to intensive care unit nurses. Institutions that wish to design a resilience program for intensive care unit nurses to reduce burnout syndrome need an understanding of the barriers and concerns relevant to their local intensive care unit nurses.
Background: Workplace stress can affect job satisfaction, increase staff turnover and hospital costs, and reduce quality of patient care. Highly resilient nurses adapt to stress and use a variety of skills to cope effectively.Objective: To gain data on a mindfulness-based cognitive therapy resilience intervention for intensive care unit nurses to see if the intervention program would be feasible and acceptable.
Methods: Focus-group interviews were conducted by videoconference with critical care nurses who were members of the American Association of Critical-Care Nurses. The interview questions assessed the feasibility and acceptability of a mindfulness-based cognitive therapy program to reduce burnout syndrome in intensive care unit nurses.
Results: Thirty-three nurses participated in 11 focus groups. Respondents identified potential barriers to program adherence, incentives for adherence, preferred qualifications of instructors, and intensive care unit-specific issues to be addressed.
Conclusions: The mindfulness-based cognitive therapy pilot intervention was modified to incorporate thematic categories that the focus groups reported as relevant to intensive care unit nurses. Institutions that wish to design a resilience program for intensive care unit nurses to reduce burnout syndrome need an understanding of the barriers and concerns relevant to their local intensive care unit nurses.
Research Findings: In the past 20 years school districts have increasingly adopted classroom-based social and emotional development programs. The dissemination of these programs, however, has surpassed our understanding of and ability to assess factors that influence program implementation. The present study responded to this gap by developing a questionnaire that focuses on teacher perceptions of implementation support and teacher attitudes about social-emotional learning and by assessing its psychometric properties. One hundred forty-five Baltimore City Head Start preschool teachers completed the questionnaire. Factor analyses suggested 6 underlying constructs, which we termed administrative support, training, competence, program effectiveness, time constraints, and academic priority. Several of these scales predicted teacher reports of program implementation. Practice or Policy: The questionnaire holds significant promise as a tool for assessing readiness and barriers to social and emotional program implementation. (Contains 2 tables and 1 footnote.)
Transforming growth factor β1 (TGF-β1) is an important modulator of skin morphogenesis and cutaneous wound repair. To gain insight into the mechanisms of TGF-β1 action in the skin, we used the differential display RT-PCR technique to identify genes that are regulated by this factor in cultured human keratinocytes. We obtained several partial cDNA clones. One of them was identical to the 3'-end of p11, the small and regulatory subunit of the calpactin I complex [(annexin II)2(p11)2]. RNase protection and northern blot analysis revealed specific regulation of expression of both subunits of this heterotetrameric protein (p11 and annexin II) by TGF-β1 as well as by other growth factors, although the time course and degree of induction or suppression were different for each gene. Furthermore, we analyzed p11 and annexin II expression in normal and wounded skin. Both p11 and annexin II mRNAs were found in the dermal and epidermal compartments of normal human skin. Immunohistochemical studies demonstrated the presence of p11 at equally high levels in all layers of normal epidermis and in the hyper-proliferative epithelium at the wound edge. By contrast, annex, in II expression was high in the basal layer of normal epidermis but low in the suprabasal layers and in the hyper-proliferative epithelium at the wound edge, suggesting a differentiation-specific regulation of this calpaetin I subunit. The differential expression and regulation of p11 and annexin II subunits in keratinocytes suggest the existence of different ratios of monomeric versus p11-complexed annexin II that might be associated with different cellular functions.
Discriminatory experiences are not only momentarily distressing, but can also increase risk for lasting physical and psychological problems. Specifically, significantly higher rates of depression and depressive symptoms are reported among people who are frequently the target of prejudice. Given the gravity of this problem, this research focuses on an individual difference, trait mindfulness, as a protective factor in the association between discrimination and depressive symptoms. In a community sample of 605 individuals, trait mindfulness dampens the relationship between perceived discrimination and depressive symptoms. Additionally, mindfulness provides benefits above and beyond those of positive emotions. Trait mindfulness may thus operate as a protective individual difference for targets of discrimination.
Discriminatory experiences are not only momentarily distressing, but can also increase risk for lasting physical and psychological problems. Specifically, significantly higher rates of depression and depressive symptoms are reported among people who are frequently the target of prejudice. Given the gravity of this problem, this research focuses on an individual difference, trait mindfulness, as a protective factor in the association between discrimination and depressive symptoms. In a community sample of 605 individuals, trait mindfulness dampens the relationship between perceived discrimination and depressive symptoms. Additionally, mindfulness provides benefits above and beyond those of positive emotions. Trait mindfulness may thus operate as a protective individual difference for targets of discrimination.
An introduction to the journal is presented in which the editor discusses articles within the issue on topics related to the processing of mercury in an ayurvedic medicine, listing of traditional medicines and medicinal use of processed mercury.
Editorial of the Special Issue: Mercury in Ayurveda and Tibetan Medicine 2013 vol. 8.1, Leiden: Brill Academic Publishers
<p>The Editor's introduction to <em>Soundings in Tibetan civilization: proceedings of the 1982 seminar of the International Association of Tibetan Studies</em> (Mark Premo-Hopkins 2004-02-12)</p>
BACKGROUND:Individuals with a history of recurrent depression have a high risk of repeated depressive relapse/recurrence. Maintenance antidepressant medication (m-ADM) for at least 2 years is the current recommended treatment, but many individuals are interested in alternatives to m-ADM. Mindfulness-based cognitive therapy (MBCT) has been shown to reduce the risk of relapse/recurrence compared with usual care but has not yet been compared with m-ADM in a definitive trial.
OBJECTIVES:
To establish whether MBCT with support to taper and/or discontinue antidepressant medication (MBCT-TS) is superior to and more cost-effective than an approach of m-ADM in a primary care setting for patients with a history of recurrent depression followed up over a 2-year period in terms of preventing depressive relapse/recurrence. Secondary aims examined MBCT's acceptability and mechanism of action.
DESIGN:
Single-blind, parallel, individual randomised controlled trial.
SETTING:
UK general practices.
PARTICIPANTS:
Adult patients with a diagnosis of recurrent depression and who were taking m-ADM.
INTERVENTIONS:
Participants were randomised to MBCT-TS or m-ADM with stratification by centre and symptomatic status. Outcome data were collected blind to treatment allocation and the primary analysis was based on the principle of intention to treat. Process studies using quantitative and qualitative methods examined MBCT's acceptability and mechanism of action.
MAIN OUTCOMES MEASURES:
The primary outcome measure was time to relapse/recurrence of depression. At each follow-up the following secondary outcomes were recorded: number of depression-free days, residual depressive symptoms, quality of life, health-related quality of life and psychiatric and medical comorbidities.
RESULTS:
In total, 212 patients were randomised to MBCT-TS and 212 to m-ADM. The primary analysis did not find any evidence that MBCT-TS was superior to m-ADM in terms of the primary outcome of time to depressive relapse/recurrence over 24 months [hazard ratio (HR) 0.89, 95% confidence interval (CI) 0.67 to 1.18] or for any of the secondary outcomes. Cost-effectiveness analysis did not support the hypothesis that MBCT-TS is more cost-effective than m-ADM in terms of either relapse/recurrence or quality-adjusted life-years. In planned subgroup analyses, a significant interaction was found between treatment group and reported childhood abuse (HR 1.89, 95% CI 1.06 to 3.38), with delayed time to relapse/recurrence for MBCT-TS participants with a more abusive childhood compared with those with a less abusive history. Although changes in mindfulness were specific to MBCT (and not m-ADM), they did not predict outcome in terms of relapse/recurrence at 24 months. In terms of acceptability, the qualitative analyses suggest that many people have views about (dis)/continuing their ADM, which can serve as a facilitator or a barrier to taking part in a trial that requires either continuation for 2 years or discontinuation.
CONCLUSIONS:
There is no support for the hypothesis that MBCT-TS is superior to m-ADM in preventing depressive relapse/recurrence among individuals at risk for depressive relapse/recurrence. Both treatments appear to confer protection against relapse/recurrence. There is an indication that MBCT may be most indicated for individuals at greatest risk of relapse/recurrence. It is important to characterise those most at risk and carefully establish if and why MBCT may be most indicated for this group.
BACKGROUND:Individuals with a history of recurrent depression have a high risk of repeated depressive relapse/recurrence. Maintenance antidepressant medication (m-ADM) for at least 2 years is the current recommended treatment, but many individuals are interested in alternatives to m-ADM. Mindfulness-based cognitive therapy (MBCT) has been shown to reduce the risk of relapse/recurrence compared with usual care but has not yet been compared with m-ADM in a definitive trial.
OBJECTIVES:
To establish whether MBCT with support to taper and/or discontinue antidepressant medication (MBCT-TS) is superior to and more cost-effective than an approach of m-ADM in a primary care setting for patients with a history of recurrent depression followed up over a 2-year period in terms of preventing depressive relapse/recurrence. Secondary aims examined MBCT's acceptability and mechanism of action.
DESIGN:
Single-blind, parallel, individual randomised controlled trial.
SETTING:
UK general practices.
PARTICIPANTS:
Adult patients with a diagnosis of recurrent depression and who were taking m-ADM.
INTERVENTIONS:
Participants were randomised to MBCT-TS or m-ADM with stratification by centre and symptomatic status. Outcome data were collected blind to treatment allocation and the primary analysis was based on the principle of intention to treat. Process studies using quantitative and qualitative methods examined MBCT's acceptability and mechanism of action.
MAIN OUTCOMES MEASURES:
The primary outcome measure was time to relapse/recurrence of depression. At each follow-up the following secondary outcomes were recorded: number of depression-free days, residual depressive symptoms, quality of life, health-related quality of life and psychiatric and medical comorbidities.
RESULTS:
In total, 212 patients were randomised to MBCT-TS and 212 to m-ADM. The primary analysis did not find any evidence that MBCT-TS was superior to m-ADM in terms of the primary outcome of time to depressive relapse/recurrence over 24 months [hazard ratio (HR) 0.89, 95% confidence interval (CI) 0.67 to 1.18] or for any of the secondary outcomes. Cost-effectiveness analysis did not support the hypothesis that MBCT-TS is more cost-effective than m-ADM in terms of either relapse/recurrence or quality-adjusted life-years. In planned subgroup analyses, a significant interaction was found between treatment group and reported childhood abuse (HR 1.89, 95% CI 1.06 to 3.38), with delayed time to relapse/recurrence for MBCT-TS participants with a more abusive childhood compared with those with a less abusive history. Although changes in mindfulness were specific to MBCT (and not m-ADM), they did not predict outcome in terms of relapse/recurrence at 24 months. In terms of acceptability, the qualitative analyses suggest that many people have views about (dis)/continuing their ADM, which can serve as a facilitator or a barrier to taking part in a trial that requires either continuation for 2 years or discontinuation.
CONCLUSIONS:
There is no support for the hypothesis that MBCT-TS is superior to m-ADM in preventing depressive relapse/recurrence among individuals at risk for depressive relapse/recurrence. Both treatments appear to confer protection against relapse/recurrence. There is an indication that MBCT may be most indicated for individuals at greatest risk of relapse/recurrence. It is important to characterise those most at risk and carefully establish if and why MBCT may be most indicated for this group.
TRIAL REGISTRATION:
Current Controlled Trials ISRCTN26666654.
FUNDING:
This project was funded by the NIHR Health Technology Assessment programme and the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula and will be published in full in Health Technology Assessment; Vol. 19, No. 73. See the NIHR Journals Library website for further project information.
ObjectiveWe examined whether prenatal mindfulness training was associated with lower depressive symptoms through 18‐months postpartum compared to treatment as usual (TAU).
Method
A controlled, quasi‐experimental trial compared prenatal mindfulness training (MMT) to TAU. We collected depressive symptom data at post‐intervention, 6‐, and 18‐months postpartum. Latent profile analysis identified depressive symptom profiles, and multinomial logistic regression examined whether treatment condition predicted profile.
Results
Three depressive symptom severity profiles emerged: none/minimal, mild, and moderate. Adjusting for relevant covariates, MMT participants were less likely than TAU participants to be in the moderate profile than the none/minimal profile (OR = 0.13, 95% CI = 0.03‐0.54, p = .005).
Conclusions
Prenatal mindfulness training may have benefits for depressive symptoms during the transition to parenthood.
Gerke, B. 2007.Engaging the subtle body: Re-approaching bla rituals in the Himalayas. In Soundings in Tibetan Medicine. Anthropological and Historical Perspectives. PIATS 2003: Tibetan Studies: Proceedings of the 10th Seminar of the International Association for Tibetan Studies, Oxford 2003, edited by M. Schrempf. Leiden, Boston: Brill, 191-212.
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