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Objective:While mindfulness-based cognitive therapy (MBCT) has demonstrated efficacy in reducing depressive relapse/recurrence over 12–18 months, questions remain around effectiveness, longer-term outcomes, and suitability in combination with medication. The aim of this study was to investigate within a pragmatic study design the effectiveness of MBCT on depressive relapse/recurrence over 2 years of follow-up. Method: This was a prospective, multi-site, single-blind trial based in Melbourne and the regional city of Geelong, Australia. Non-depressed adults with a history of three or more episodes of depression were randomised to MBCT + depression relapse active monitoring (DRAM) (n=101) or control (DRAM alone) (n=102). Randomisation was stratified by medication (prescribed antidepressants and/or mood stabilisers: yes/no), site of usual care (primary or specialist), diagnosis (bipolar disorder: yes/no) and sex. Relapse/recurrence of major depression was assessed over 2 years using the Composite International Diagnostic Interview 2.1. Results: The average number of days with major depression was 65 for MBCT participants and 112 for controls, significant with repeated-measures ANOVA (F(1, 164)=4.56, p=0.03). Proportionally fewer MBCT participants relapsed in both year 1 and year 2 compared to controls (odds ratio 0.45, p<0.05). Kaplan-Meier survival analysis for time to first depressive episode was non-significant, although trends favouring the MBCT group were suggested. Subgroup analyses supported the effectiveness of MBCT for people receiving usual care in a specialist setting and for people taking antidepressant/mood stabiliser medication. Conclusions: This work in a pragmatic design with an active control condition supports the effectiveness of MBCT in something closer to implementation in routine practice than has been studied hitherto. As expected in this translational research design, observed effects were less strong than in some previous efficacy studies but appreciable and significant differences in outcome were detected. MBCT is most clearly demonstrated as effective for people receiving specialist care and seems to work well combined with antidepressants.

Objective:While mindfulness-based cognitive therapy is effective in reducing depressive relapse/recurrence, relatively little is known about its health economic properties. We describe the health economic properties of mindfulness-based cognitive therapy in relation to its impact on depressive relapse/recurrence over 2 years of follow-up. Method: Non-depressed adults with a history of three or more major depressive episodes were randomised to mindfulness-based cognitive therapy + depressive relapse active monitoring (n = 101) or control (depressive relapse active monitoring alone) (n = 102) and followed up for 2 years. Structured self-report instruments for service use and absenteeism provided cost data items for health economic analyses. Treatment utility, expressed as disability-adjusted life years, was calculated by adjusting the number of days an individual was depressed by the relevant International Classification of Diseases 12-month severity of depression disability weight from the Global Burden of Disease 2010. Intention-to-treat analysis assessed the incremental cost–utility ratios of the interventions across mental health care, all of health-care and whole-of-society perspectives. Per protocol and site of usual care subgroup analyses were also conducted. Probabilistic uncertainty analysis was completed using cost–utility acceptability curves. Results: Mindfulness-based cognitive therapy participants had significantly less major depressive episode days compared to controls, as supported by the differential distributions of major depressive episode days (modelled as Poisson, p < 0.001). Average major depressive episode days were consistently less in the mindfulness-based cognitive therapy group compared to controls, e.g., 31 and 55 days, respectively. From a whole-of-society perspective, analyses of patients receiving usual care from all sectors of the health-care system demonstrated dominance (reduced costs, demonstrable health gains). From a mental health-care perspective, the incremental gain per disability-adjusted life year for mindfulness-based cognitive therapy was AUD83,744 net benefit, with an overall annual cost saving of AUD143,511 for people in specialist care. Conclusion: Mindfulness-based cognitive therapy demonstrated very good health economic properties lending weight to the consideration of mindfulness-based cognitive therapy provision as a good buy within health-care delivery.

Mindfulness is associated with being less judgmental and with a reduction in feelings of anxiety. It is believed to increase non-judgmental cognitive processing and reduce negative associations as a consequence of automatic processing. We hypothesized that mindfulness is negatively correlated with prejudiced attitudes. In a series of five studies, with sample sizes ranging from 93 to 184, participants from Prolific, psychology research sites, or college completed measures online. We examined the relation of three mindfulness measures, the Mindful Attention Awareness Scale, the Cognitive and Affective Mindfulness Scale-Revised, and the Kentucky Inventory of Mindfulness Skills with three markers of prejudice: attitudes to outgroups, an affective thermometer scale, and social worldviews. The attitudinal instrument focused on stigmatized groups, such as newcomers, homeless persons, handicapped individuals, and Blacks. The affective thermometer measured feelings of warmth to individuals classified as dissident, derogated, or dangerous. The two social worldviews assessed were Social Dominance Orientation and Right-Wing Authoritarianism, both associated with prejudice. Few significant associations were found. The only significant associations found were between the Kentucky Inventory of Mindfulness Skills, Right-Wing Authoritarianism, and Social Dominance Orientation. These findings provide little support for the relation between trait mindfulness and attitudinal expressions of prejudice.

This article proposes that many Tibetan rituals are shaped by a language of creating, giving, and eating food. Drawing on a range of premodern texts and observation of a week-long Accomplishing Medicine (sman sgrub) ritual based on those texts, we explore ritualized food interactions from a narrative perspective. Through the creation, offering, and consumption of food, ritual participants, including Buddhas, deities, and other unseen beings, create and maintain variant identities and relationships with each other. Using a ritual tradition that crosses religious and medical domains in Tibet, we examine how food and eating honors, constructs, and maintains an appropriate and spatiotemporally situated community order with a gastronomic contract familiar to all participants.

Emergency doctor Bernard Fontanille travels to the village of Pokharato discover the secrets of traditional Tibetan medicine. He visits the school of brothers Tenzing and Gyasto Bista, the last guardians of amchi. Among twenty children ranging in age from 6 to 15, Fontanille discovers a well-structured institution: dormitories, a kitchen, classrooms, acupuncture rooms, laboratories, and a biomedical garden to harvest the basic ingredients for the various remedies.; Release Date: 2013; Run Time: 26; Target Audience: 9 & up

We examined the impact of relatively "green" or natural settings on attention-deficit/hyperactivity disorder (ADHD) symptoms across diverse subpopulations of children.

We examined the impact of relatively "green" or natural settings on attention-deficit/hyperactivity disorder (ADHD) symptoms across diverse subpopulations of children.

This book explores the cultural history of embryology in Tibet, in culture, religion, art and literature, and what this reveals about its medicine and religion. Filling a significant gap in the literature this is the first in-depth exploration of Tibetan…

Abstract This essay will consider the relationship between eating and maintaining health or curing illness, as seen in Tibetan pre-modern texts. In particular, it will focus on selected 'ritually' enhanced food practices that are aimed at treating illness and improving one's psycho-physical health and power. It begins with a look at practices that model hunger as an illness for both humans and non-humans, observing a resulting blurring of boundaries between food and medicine. The essay proposes continuity along a range of 'culinary' practices, focusing in particular on 'ritual cake' (gtor ma) offerings and 'nectar' (bdud rtsi) recipes involving creation of pills and healing foods. The essay posits a 'culinary aesthetics' of healing and personal enhancement and introduces speculation about Tibetan understandings of food as medicine that may shape our understanding of the relationship between medical and religious thinking and practice in Tibet.

This chapter examines different models of fetal growth in premodern religious and medical Tibetan embryological narratives, which describe causal forces such as karma, the natural elements, the energetic winds, and the wisdom of a Buddha. Embryology is presented as a means for Tibetan thinkers to define acceptable paradigms for change and growth and a theoretical model for addressing other issues of vital concern to Buddhists.

Tibetan medicine is recognized today as one of the world’s mostcomplex and sophisticated systems of medicine. Over the last 1300 years, Tibetan medical traditions have produced a vast corpus of literature analogous in complexity to the medical scholasticism of India, China, or Greece. Tibetan medical systems are practised widely today in the countries of Nepal, Bhutan, and Mongolia; in Tibetan populated areas of the People’s Republic of China; in parts of Russia (Kalmykia, Buryatia); and throughout India (Ladakh, Sikkim, and in Tibetan refugee settlements). The popularity and use of Tibetan medicine is growing in Europe, North America, and the Pacific Rim as well.

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