The aim of this study was to explore the feasibility and effectiveness of mindful walking in nature as a possible means to maintain mindfulness skills after a mindfulness-based cognitive therapy (MBCT) or mindfulness-based stress reduction (MBSR) course. Mindful walking alongside the river Rhine took place for 1, 3, 6, or 10 days, with a control period of a similar number of days, 1 week before the mindful walking period. In 29 mindfulness participants, experience sampling method (ESM) was performed during the control and mindful walking period. Smartphones offered items on positive and negative affect and state mindfulness at random times during the day. Furthermore, self-report questionnaires were administered before and after the control and mindful walking period, assessing depression, anxiety, stress, brooding, and mindfulness skills. ESM data showed that walking resulted in a significant improvement of both mindfulness and positive affect, and that state mindfulness and positive affect prospectively enhanced each other in an upward spiral. The opposite pattern was observed with state mindfulness and negative affect, where increased state mindfulness predicted less negative affect. Exploratory questionnaire data indicated corresponding results, though non-significant due to the small sample size. This is the first time that ESM was used to assess interactions between state mindfulness and momentary affect during a mindfulness intervention of several consecutive days, showing an upward spiral effect. Mindful walking in nature may be an effective way to maintain mindfulness practice and further improve psychological functioning.
Mindfulness-based cognitive therapy (MBCT) teaches the patient to recognize a deteriorating mood with the goal of avoiding self-perpetuating patterns of ruminative, negative thoughts and thus depressive disorders. MBCT was initially conceived as an intervention to prevent relapse of major depression, but it has since been studied in patients with current episodes of depression. MBCT has been shown to nearly halve the risk of relapse in persons currently well with a history of at least 3 prior episodes of depression and is comparable to the use of an antidepressant in preventing recurrence. Although theoretical drawbacks exist to using MBCT in a currently depressed patient, randomized controlled data suggest it may be as effective in currently depressed patients as those in remission and similar in efficacy to cognitive-behavioral therapy.
BackgroundClinically significant psychological distress in pregnancy is common, with epidemiological research suggesting that between 15 and 25 % of pregnant women experience elevated symptoms of stress, anxiety, and depression. Untreated psychological distress in pregnancy is associated with poor obstetrical outcomes, changes in maternal physiology, elevated incidence of child physical and psychological disorders, and is predictive of maternal postpartum mood disorders. Despite the wide-ranging impact of antenatal psychological distress on mothers and their children, there is a gap in our knowledge about the most effective treatments that are available for psychological distress experienced in pregnancy. Additionally, no trials have focused on potential physiological changes that may occur as a result of receiving mindfulness training in pregnancy. The proposed trial will determine the effectiveness of an 8-week modified Mindfulness-based Cognitive Therapy (MBCT) intervention delivered during pregnancy.
Methods
A randomized controlled trial (RCT) design with repeated measures will be used to evaluate the effectiveness of MBCT to treat psychological distress in pregnancy. A sample of 60 consenting pregnant women aged 18 years and above will be enrolled and randomized to the experimental (MBCT) or control (treatment as usual) condition. Primary (e.g., symptoms of stress, depression, and anxiety), secondary (cortisol, blood pressure (BP), heart rate variability (HRV), and sleep) and other outcome data (e.g., psychological diagnoses) will be collected via a combination of laboratory visits and at-home assessments from both groups at baseline (T1), immediately following the intervention (T2), and at 3 months postpartum (T3). Descriptive statistics will be used to describe sample characteristics. Data will be analyzed using an intention-to-treat approach. Hierarchical linear models will be used to test intervention effects on primary and secondary outcomes.
Discussion
The trial is expected to improve knowledge about evidence-based treatments for psychological distress experienced in pregnancy and to evaluate the potential impact of mindfulness-based interventions on maternal physiology.
<p>This study was designed to test the hypothesis that mindfulness involves sustained attention, attention switching, inhibition of elaborative processing and non-directed attention. Healthy adults were tested before and after random assignment to an 8-week Mindfulness-Based Stress Reduction (MBSR) course (n = 39) or a wait-list control (n = 33). Testing included measures of sustained attention, attention switching, Stroop interference (as a measure of inhibition of elaborative processing), detection of objects in consistent or inconsistent scenes (as a measure of non-directed attention), as well as self-report measures of emotional well-being and mindfulness. Participation in the MBSR course was associated with significantly greater improvements in emotional well-being and mindfulness, but no improvements in attentional control relative to the control group. However, improvements in mindfulness after MBSR were correlated with improvements in object detection. We discuss the implications of these results as they relate to the role of attention in mindfulness. Copyright © 2007 John Wiley & Sons, Ltd.</p>
Zotero Collections:
This study was designed to test the hypothesis that mindfulness involves sustained attention, attention switching, inhibition of elaborative processing and non-directed attention. Healthy adults were tested before and after random assignment to an 8-weekMindfulness-Based Stress Reduction (MBSR) course (n = 39) or a wait-list control (n = 33). Testing included measures of sustained attention, attention switching, Stroop interference (as a measure of inhibition of laborative processing), detection of objects in consistent or inconsistent scenes (as a measure of non-directed attention), as well as self-report measures of emotional well-being and mindfulness. Participation in the MBSR course was associated with significantly greater improvements in emotional well-being and mindfulness, but no improvements in attentional control relative to the control group. However, improvements in mindfulness after
MBSR were correlated with improvements in object detection. We
discuss the implications of these results as they relate to the role of attention in mindfulness.
OBJECTIVE: The aim of this study was to investigate the potential of mindfulness-based stress reduction (MBSR) as a treatment for chronic primary insomnia.DESIGN: A randomized controlled trial was conducted.
SETTING: The study was conducted at a university health center.
PATIENTS: Thirty adults with primary chronic insomnia based on criteria of the Diagnostic and Statistical Manual of Mental Disorders, Text Revision, 4th Edition were randomized 2:1 to MBSR or pharmacotherapy (PCT).
INTERVENTIONS: Mindfulness-based stress reduction, a program of mindfulness meditation training consisting of eight weekly 2.5 hour classes and a daylong retreat, was provided, with ongoing home meditation practice expectations during three-month follow-up; PCT, consisting of three milligrams of eszopiclone (LUNESTA) nightly for eight weeks, followed by three months of use as needed. A 10-minute sleep hygiene presentation was included in both interventions.
MAIN OUTCOMES: The Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), sleep diaries, and wrist actigraphy were collected pretreatment, posttreatment (eight weeks), and at five months (self-reports only).
RESULTS: Between baseline and eight weeks, sleep onset latency (SOL) measured by actigraphy decreased 8.9 minutes in the MBSR arm (P < .05). Large, significant improvements were found on the ISI, PSQI, and diary-measured total sleep time, SOL, and sleep efficiency (P < .01, all) from baseline to five-month follow-up in the MBSR arm. Changes of comparable magnitude were found in the PCT arm. Twenty-seven of 30 patients completed their assigned treatment. This study provides initial evidence for the efficacy of MBSR as a viable treatment for chronic insomnia as measured by sleep diary, actigraphy, well-validated sleep scales, and measures of remission and clinical recovery.
OBJECTIVE: The aim of this study was to investigate the potential of mindfulness-based stress reduction (MBSR) as a treatment for chronic primary insomnia.DESIGN: A randomized controlled trial was conducted.
SETTING: The study was conducted at a university health center.
PATIENTS: Thirty adults with primary chronic insomnia based on criteria of the Diagnostic and Statistical Manual of Mental Disorders, Text Revision, 4th Edition were randomized 2:1 to MBSR or pharmacotherapy (PCT).
INTERVENTIONS: Mindfulness-based stress reduction, a program of mindfulness meditation training consisting of eight weekly 2.5 hour classes and a daylong retreat, was provided, with ongoing home meditation practice expectations during three-month follow-up; PCT, consisting of three milligrams of eszopiclone (LUNESTA) nightly for eight weeks, followed by three months of use as needed. A 10-minute sleep hygiene presentation was included in both interventions.
MAIN OUTCOMES: The Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), sleep diaries, and wrist actigraphy were collected pretreatment, posttreatment (eight weeks), and at five months (self-reports only).
RESULTS: Between baseline and eight weeks, sleep onset latency (SOL) measured by actigraphy decreased 8.9 minutes in the MBSR arm (P < .05). Large, significant improvements were found on the ISI, PSQI, and diary-measured total sleep time, SOL, and sleep efficiency (P < .01, all) from baseline to five-month follow-up in the MBSR arm. Changes of comparable magnitude were found in the PCT arm. Twenty-seven of 30 patients completed their assigned treatment. This study provides initial evidence for the efficacy of MBSR as a viable treatment for chronic insomnia as measured by sleep diary, actigraphy, well-validated sleep scales, and measures of remission and clinical recovery.
Listen to The Kindness Podcast episodes free, on demand. Chad McGehee works with the Center for Healthy Minds at the University of Wisconsin to teach mindfulness to people of all ages. He uses a teaching approach that incorporates findings from modern neuroscience and encourages kindness. His group’s groundbreaking research is being used across the country, from teachers to police officers to the producers of Sesame Street!For more on the Center for Healthy Minds go to centerhealthyminds.org. The easiest way to listen to podcasts on your iPhone, iPad, Android, PC, smart speaker – and even in your car. For free. Bonus and ad-free content available with Stitcher Premium.
Zotero Collections:
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.
Objective: To examine whether mindfulness-based cognitive therapy (MBCT) increases momentary positive emotions and the ability to make use of natural rewards in daily life. Method: Adults with a life-time history of depression and current residual depressive symptoms (mean age = 43.9 years, SD = 9.6; 75% female; all Caucasian) were randomized to MBCT (n = 64) or waitlist control (CONTROL; n = 66) in a parallel, open-label, randomized controlled trial. The Experience Sampling Method was used to measure momentary positive emotions as well as appraisal of pleasant activities in daily life during 6 days before and after the intervention. Residual depressive symptoms were measured using the 17-item Hamilton Depression Rating Scale (Hamilton, 1960). Results: MBCT compared to CONTROL was associated with significant increases in appraisals of positive emotion (b* = .39) and activity pleasantness (b* = .22) as well as enhanced ability to boost momentary positive emotions by engaging in pleasant activities (b* = .08; all ps < .005). Associations remained significant when corrected for reductions in depressive symptoms or for reductions in negative emotion, rumination, and worry. In the MBCT condition, increases in positive emotion variables were associated with reduction of residual depressive symptoms (all ps < .05). Conclusions: MBCT is associated with increased experience of momentary positive emotions as well as greater appreciation of, and enhanced responsiveness to, pleasant daily-life activities. These changes were unlikely to be pure epiphenomena of decreased depression and, given the role of positive emotions in resilience against depression, may contribute to the protective effects of MBCT against depressive relapse.
OBJECTIVE: To examine whether mindfulness-based cognitive therapy (MBCT) increases momentary positive emotions and the ability to make use of natural rewards in daily life.METHOD:
Adults with a life-time history of depression and current residual depressive symptoms (mean age = 43.9 years, SD = 9.6; 75% female; all Caucasian) were randomized to MBCT (n = 64) or waitlist control (CONTROL; n = 66) in a parallel, open-label, randomized controlled trial. The Experience Sampling Method was used to measure momentary positive emotions as well as appraisal of pleasant activities in daily life during 6 days before and after the intervention. Residual depressive symptoms were measured using the 17-item Hamilton Depression Rating Scale (Hamilton, 1960).
RESULTS:
MBCT compared to CONTROL was associated with significant increases in appraisals of positive emotion (b* = .39) and activity pleasantness (b* = .22) as well as enhanced ability to boost momentary positive emotions by engaging in pleasant activities (b* = .08; all ps < .005). Associations remained significant when corrected for reductions in depressive symptoms or for reductions in negative emotion, rumination, and worry. In the MBCT condition, increases in positive emotion variables were associated with reduction of residual depressive symptoms (all ps < .05).
CONCLUSIONS:
MBCT is associated with increased experience of momentary positive emotions as well as greater appreciation of, and enhanced responsiveness to, pleasant daily-life activities. These changes were unlikely to be pure epiphenomena of decreased depression and, given the role of positive emotions in resilience against depression, may contribute to the protective effects of MBCT against depressive relapse.
Recent theory suggests that positive psychological processes integral to health may be energized through the self-reinforcing dynamics of an upward spiral to counter emotion dysregulation.The present study examined positive emotion–cognition interactions among individuals in partial remission from depression who had been randomly assigned to treatment with mindfulness-based cognitive therapy (MBCT; n = 64) or a waitlist control condition (n = 66). We hypothesized that MBCT stimulates upward spirals by increasing positive affect and positive cognition. Experience sampling assessed changes in affect and cognition during 6 days before and after treatment, which were analyzed with a series of multilevel and autoregressive latent trajectory models. Findings suggest that MBCT was associated with significant increases in trait positive affect and momentary positive cognition, which were preserved through autoregressive and cross-lagged effects driven by global emotional tone. Findings suggest that daily positive affect and cognition are maintained by an upward spiral that might be promoted by mindfulness training. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Many unethical decisions stem from a lack of awareness. In this article, we consider how mindfulness, an individual's awareness of his or her present experience, impacts ethical decision making. In our first study, we demonstrate that compared to individuals low in mindfulness, individuals high in mindfulness report that they are more likely to act ethically, are more likely to value upholding ethical standards (self-importance of moral identity, SMI), and are more likely to use a principled approach to ethical decision making (formalism). In our second study, we test this relationship with a novel behavioral measure of unethical behavior: the carbonless anagram method (CAM). We find that of participants who cheated, compared to individuals low in mindfulness, individuals high in mindfulness cheated less. Taken together, our results demonstrate important connections between mindfulness and ethical decision making.
Zotero Collections:
ContextParanoia embodies altered representation of the social environment, fuelling altered feelings of social acceptance leading to further mistrust. Mindfulness-based cognitive therapy (MBCT) may relieve paranoia and reduce its impact on social acceptance.
Objective
To determine whether MBCT alters momentary feeling of paranoia and social acceptance in daily life.
Design
Randomized controlled trial of daily-life repeated measures (up to 120 per participant) before and after allocation to MBCT or waiting list control.
Participants
Volunteer sample of 130 eligible men and women with residual affective dysregulation after at least one episode of major depressive disorder.
Interventions
Eight weeks of MBCT in groups of 10–15 participants in addition to participants' usual treatment.
Outcome Measures
Daily-life ratings of paranoia and social acceptance. This manuscript concerns additional analyses of the original trial; hypotheses were developed after data collection (focus initially on depressive symptoms) but before data analysis.
Results
Sixty-six participants were assigned to the waiting list control group and 64 to the MBCT intervention group, of whom 66 and 61 respectively were included in the per-protocol analyses. Intention-to-treat analyses revealed a significant group by time interaction in the model of momentary paranoia (b = −.18, p<0.001, d = −0.35) and social acceptance (b = .26, p<0.001, d = 0.41). Paranoia levels in the intervention group were significantly reduced (b = −.11, p<0.001) and feelings of social acceptance significantly increased (b = .18, p<0.001), whereas in the Control condition a significant increase in paranoia (b = .07, p = 0.008) and a decrease in social acceptance was apparent (b = −.09, p = 0.013). The detrimental effect of paranoia on social acceptance was significantly reduced in the MBCT, but not the control group (group by time interaction: b = .12, p = 0.022).
Conclusions
MBCT confers a substantial benefit on subclinical paranoia and may interrupt the social processes that maintain and foster paranoia in individuals with residual affective dysregulation.
ContextParanoia embodies altered representation of the social environment, fuelling altered feelings of social acceptance leading to further mistrust. Mindfulness-based cognitive therapy (MBCT) may relieve paranoia and reduce its impact on social acceptance.
Objective
To determine whether MBCT alters momentary feeling of paranoia and social acceptance in daily life.
Design
Randomized controlled trial of daily-life repeated measures (up to 120 per participant) before and after allocation to MBCT or waiting list control.
Participants
Volunteer sample of 130 eligible men and women with residual affective dysregulation after at least one episode of major depressive disorder.
Interventions
Eight weeks of MBCT in groups of 10–15 participants in addition to participants' usual treatment.
Outcome Measures
Daily-life ratings of paranoia and social acceptance. This manuscript concerns additional analyses of the original trial; hypotheses were developed after data collection (focus initially on depressive symptoms) but before data analysis.
Results
Sixty-six participants were assigned to the waiting list control group and 64 to the MBCT intervention group, of whom 66 and 61 respectively were included in the per-protocol analyses. Intention-to-treat analyses revealed a significant group by time interaction in the model of momentary paranoia (b = −.18, p<0.001, d = −0.35) and social acceptance (b = .26, p<0.001, d = 0.41). Paranoia levels in the intervention group were significantly reduced (b = −.11, p<0.001) and feelings of social acceptance significantly increased (b = .18, p<0.001), whereas in the Control condition a significant increase in paranoia (b = .07, p = 0.008) and a decrease in social acceptance was apparent (b = −.09, p = 0.013). The detrimental effect of paranoia on social acceptance was significantly reduced in the MBCT, but not the control group (group by time interaction: b = .12, p = 0.022).
Conclusions
MBCT confers a substantial benefit on subclinical paranoia and may interrupt the social processes that maintain and foster paranoia in individuals with residual affective dysregulation.
Twenty‐six young participants, 18–25 years, with social phobia (SP) were randomly assigned to eight 2‐hour sessions of group mindfulness‐based cognitive therapy (MBCT) and twelve 2‐hour sessions of group cognitive‐behavioral therapy (CBT) in a crossover design with participants receiving treatments in reversed order. Outcome was assessed after treatments, and at 6‐ and 12‐month follow‐ups. MBCT achieved moderate‐high pre‐post effect sizes (d = 0.78 on a composite SP measure), not significantly different from, although numerical lower than those of CBT (d = 1.15). Participants in both groups further improved in the periods following their first and second treatment until 6‐months follow‐up (pre‐follow‐up ds = 1.42 and 1.62). Thus, MBCT might be a useful, low cost treatment for SP, although, probably, less efficacious than CBT.
Activation of the induced receptor for advanced glycation endproducts (RAGE) leads to initiation of NF-κB and MAP kinase signaling pathways resulting in propagation and perpetuation of inflammation. RAGE knock out animals are less susceptible to acute inflammation and carcinogen induced tumor development. We have reported that most forms of tumor cell death result in release of the RAGE ligand, HMGB1. We now report a novel role for RAGE in the tumor cell response to stress. Targeted knockdown of RAGE in the tumor cell, leads to increased apoptosis, diminished autophagy and decreased tumor cell survival . In contrast, overexpression of RAGE is associated with enhanced autophagy, diminished apoptosis and greater tumor cell viability. RAGE limits apoptosis through a p53 dependent mitochondrial pathway. Moreover, RAGE-sustained autophagy is associated with decreased phosphorylation of mTOR and increased Beclin-1/VPS34 autophagosome formation. These findings demonstrate that the inflammatory receptor RAGE plays a heretofore unrecognized role in the tumor cell response to stress. Furthermore, these studies establish a direct link between inflammatory mediators in the tumor microenvironment and resistance to programmed cell death. Our data suggest that targeted inhibition of RAGE or its ligands may serve as novel targets to enhance current cancer therapies.
Few Spanish language tools are available for assessing important social-emotional learning (SEL) skills. The present study presents evidence of the psychometric properties of a Spanish-language version of SELweb (SELweb-S), a web-based system for assessing children's ability to recognize others' emotions and perspectives, solve social problems, and engage in self-control. With a sample of 524 students in Grades K to 3, we examined the reliability and validity of SELweb-S. This study provided evidence that (a) individual assessment modules exhibited moderate to high internal consistency and moderate 6-month temporal stability, (b) composite assessment scores exhibited high reliability, (c) assessment module scores fit a theoretically coherent factor structure, and (d) performance on SELweb-S assessment modules was positively related to teacher-reported SEL skills. Findings are discussed in terms of the importance of direct assessments of SEL skills in languages other than English. In addition, we highlight the importance of abiding by rigorous recommendations in the literature for the translation and cultural adaptation of assessments. (PsycINFO Database Record
Few Spanish language tools are available for assessing important social-emotional learning (SEL) skills. The present study presents evidence of the psychometric properties of a Spanish-language version of SELweb (SELweb-S), a web-based system for assessing children's ability to recognize others' emotions and perspectives, solve social problems, and engage in self-control. With a sample of 524 students in Grades K to 3, we examined the reliability and validity of SELweb-S. This study provided evidence that (a) individual assessment modules exhibited moderate to high internal consistency and moderate 6-month temporal stability, (b) composite assessment scores exhibited high reliability, (c) assessment module scores fit a theoretically coherent factor structure, and (d) performance on SELweb-S assessment modules was positively related to teacher-reported SEL skills. Findings are discussed in terms of the importance of direct assessments of SEL skills in languages other than English. In addition, we highlight the importance of abiding by rigorous recommendations in the literature for the translation and cultural adaptation of assessments. (PsycINFO Database Record
In an era of top-down mandates and neoliberal reform policies, early career teachers must receive sustained social and emotional support as part of their regular professional development in order to navigate the murky waters of education that can sometimes feel disempowering and disillusioning. Teachers in high-poverty urban schools, who often deal with additional variables like student achievement gaps, disparate funding and high teacher turnover, among myriad other hurdles, are often highly impacted by these policies. This study examined the experiences of a group of early career teachers in an urban school district that participated in a mindfulness-based professional learning intervention. Findings show that participants not only experienced increased self-efficacy in assuaging personal and professional stressors, but also connected newly acquired strategies to the ways they supported the diverse students in their classrooms. Implications from this study suggest that learning about mindfulness-based strategies in an informal group setting can be beneficial for teachers, both personally and professionally, as they navigate the tensions of beginning their careers embedded in “the neoliberal program of reform”.
Social-emotional learning (SEL) skill includes the ability to encode, interpret, and reason about social and emotional information. In two related studies, we examined the relationship between children's SEL skill, their ability to regulate their own behavior, and the competence of their social interactions. Study 1 included 158 typically developing children ages 4 to 14 years. Study 2 included 126 clinic-referred children ages 5 to 17 years. Findings from both studies supported the conclusion that SEL skill includes three broad factors: awareness of nonverbal cues; the ability to interpret social meaning through theory of mind, empathy, and pragmatic language; and the ability to reason about social problems. Furthermore, the better children perform on measures of SEL skill and the more their parents and teachers report that children can regulate their behavior, the more competent their social interactions.
Meditation-based interventions such as mindfulness and yoga are commonly practiced in the general community to improve mental and physical health. Parents, teachers and healthcare providers are also increasingly using such interventions with children. This review examines the use of meditation-based interventions in the treatment of children with Attention-Deficit Hyperactivity Disorder (ADHD). Electronic databases searched included PsycINFO, Medline, CINAHL, and AMED. Inclusion criteria involved children (aged to 18 years) diagnosed with ADHD, delivery of a meditation-based intervention to children and/or parents, and publication in a peer-reviewed journal. Studies were identified and coded using standard criteria, risk of bias was assessed using Risk of Bias in Non-randomised Studies- of interventions (ROBINS-I), and effect sizes were calculated. A total of 16 studies were identified (8 that included children in treatment, and 8 that included combined parent-child treatment). Results indicated that risk of bias was high across studies. At this stage, no definitive conclusions can be offered regarding the utility of meditation-based interventions for children with ADHD and/or their parents, since the methodological quality of the studies reviewed is low. Future well designed research is needed to establish the efficacy of meditation-based interventions, including commonly used practices such as mindfulness, before recommendations can be made for children with ADHD and their families.
Pages |