Mobile applications (apps) to improve health are proliferating, but before healthcare providers or organizations can recommend an app to the patients they serve, they need to be confident the app will be user-friendly and helpful for the target disease or behavior. This paper summarizes seven strategies for evaluating and selecting health-related apps: (1) Review the scientific literature, (2) Search app clearinghouse websites, (3) Search app stores, (4) Review app descriptions, user ratings, and reviews, (5) Conduct a social media query within professional and, if available, patient networks, (6) Pilot the apps, and (7) Elicit feedback from patients. The paper concludes with an illustrative case example. Because of the enormous range of quality among apps, strategies for evaluating them will be necessary for adoption to occur in a way that aligns with core values in healthcare, such as the Hippocratic principles of nonmaleficence and beneficence.
Objective—This study explored the relationship of experiential avoidance (e.g., the tendency to avoid, suppress, or otherwise control internal experiences even when doing so causes behavioral harm) to alcohol use disorders and alcohol-related problems. Participants—Cross-sectional data was collected from 240 undergraduate college students in their first year in college between December 2009 and April 2010.Methods—Participants completed a diagnostic interview and online self-report survey.
Results—Students with a history of alcohol abuse or dependence had significantly higher levels of experiential avoidance relative to students with no alcohol use disorder diagnosis. A hierarchical linear regression analysis found that experiential avoidance significantly predicted alcohol-related problems, even after controlling for gender and psychological distress. Furthermore, experiential avoidance mediated the relationship of psychological distress to alcoholrelated problems.
Conclusions—These findings suggest experiential avoidance may play a role in problematic alcohol use among college students.
Applied Relaxation (AR), which involves noticing early signs of anxiety and responding with a relaxation response, is an empirically supported treatment for Generalized Anxiety Disorder (GAD). However, research on hypothesized mechanisms of AR (e.g., reduced muscle tension) has been mixed, making it likely that additional mechanisms are contributing to the efficacy of AR. Stemming from more recent conceptualizations of GAD, it is hypothesized that mindfulness, decentering, and acceptance may be potential mechanisms of change in AR. Outcome, mechanism data, and case descriptions from three individuals diagnosed with GAD who received 16 weeks of AR as part of a larger randomized controlled trial are presented to demonstrate the ways that AR may lead to clinical improvement through mindfulness, decentering, and acceptance.
<b>Abstract </b> Herbal medicinal materials have been used worldwide for centuries to maintain health and to treat disease. However, adulteration of herbal medicines remains a major concern of users and industry for reasons of safety and efficacy. Identification of herbal medicinal materials by DNA technology has been widely applied, started from the mid-1990s. In recent years, DNA barcoding of global plant species using four standard barcodes (<i>rbcL</i>, <i>matK</i>, <i>trnH</i>-<i>psbA</i> and ITS) has been a major focus in the fields of biodiversity and conservation. These DNA barcodes can also be used as reliable tools to facilitate the identification of herbal medicinal materials for the safe use of herbs, quality control, and forensic investigation. Many studies have applied these DNA barcodes for the identification of herbal medicinal species and their adulterants. The present article reviews efforts in the identification of herbal medicinal materials using the standard DNA barcodes and other DNA sequence-based markers.
A 34-year-old woman carrying a BRCAI gene and a significant family history was diagnosed with TIc, NI breast cancer. The tumor was estrogen receptor, progesterone receptor, and HER-2/Neu negative. The patient received dose-dense chemotherapy with Adriamycin and Cytoxan followed by Taxol, and left breast irradiation. Later, a bilateral S-GAP flap reconstruction with right prophylactic mastectomy and left mastectomy were performed. During her treatment, the patient had an integrative medicine consultation and was seen by a team of health care providers specializing in integrative therapies, including integrative nutrition, therapeutic massage, acupuncture, and yoga. Each modality contributed unique benefit in her care that led to a satisfactory outcome for the patient. A detailed discussion regarding her care from each modality is presented.The case elucidates the need for integrative approaches for cancer patients in a conventional medical setting.
OBJECTIVE:To better understand the role interpersonal problems play in response to two treatments for generalized anxiety disorder (GAD); an acceptance-based behavior therapy (ABBT) and applied relaxation (AR), and to examine how the development of mindfulness may be related to change in interpersonal problems over treatment and at follow-up.
METHOD:
Eighty-one individuals diagnosed with GAD (65.4% female, 80.2% identified as white, average age 32.92) were randomized to receive 16 sessions of either ABBT or AR. GAD severity, interpersonal problems, and mindfulness were measured at pre-treatment, post-treatment, 6-month follow-up, and 12-month follow-up.
RESULTS:
Mixed effect regression models did not reveal any significant effects of pre-treatment interpersonal problems on GAD severity over treatment. After controlling for post-treatment GAD severity, remaining post-treatment interpersonal problems predicted 6- but not 12-month GAD severity. Participants in both conditions experienced a large decrease in interpersonal problems over treatment. Increases in mindfulness over treatment and through follow-up were associated with decreases in interpersonal problems, even when accounting for reductions in overall GAD severity.
CONCLUSIONS:
Interpersonal problems may be an important target of treatment in GAD, even if pre-treatment interpersonal problems are not predictive of outcome. Developing mindfulness in individuals with GAD may help ameliorate interpersonal difficulties among this population.
The first aim of this study was to compare attention manipulation techniques deriving from metacognitive therapy (the Attention Training Technique; ATT) and mindfulness-based approaches (Mindfulness-Based Progressive Muscle Relaxation, MB-PMR) to a thought wandering control (TWC) condition, in terms of their impact on anxiety and four mechanisms: distancing, present-focused attention, uncontrollability and dangerousness, metacognitive beliefs, and cognitive flexibility (Stroop task). The second aim was to test indirect effects of the techniques on anxiety via the mechanism measures. High trait anxious participants (N = 81, Mage = 23.60, SDage = 7.66, 80% female) were randomized to receive ATT, MB-PMR, or the TWC condition. Measures of cognitive and somatic anxiety, distancing, present-focused attention, metacognitive beliefs, and cognitive flexibility were administered before or after the attention manipulation task. Compared to the TWC group, ATT and MB-PMR were associated with greater changes on cognitive (but not somatic) anxiety, present-focused attention, metacognitive beliefs, and uncorrected errors for threat-related words on the Stroop task. The pattern of means was similar for distancing, but this did not reach statistical significance, and Stroop speed increased equally for all conditions. Indirect effects models revealed significant effects of condition on state anxiety via distancing, metacognitive beliefs, and present-focused attention, but not via Stroop errors. ATT and MB-PMR were associated with changes on anxiety and the mechanism measures, suggesting that the mechanisms of change may be more similar than different across these techniques.
Zotero Collections:
Zotero Collections:
A wave of new developments has occurred in the behavioral and cognitive therapies that focuses on processes such as acceptance, mindfulness, attention, or values. In this review, we describe some of these developments and the data regarding them, focusing on information about components, moderators, mediators, and processes of change. These “third wave” methods all emphasize the context and function of psychological events more so than their validity, frequency, or form, and for these reasons we use the term “contextual cognitive behavioral therapy” to describe their characteristics. Both putative processes, and component and process evidence, indicate that they are focused on establishing a more open, aware, and active approach to living, and that their positive effects occur because of changes in these processes.
Zotero Collections:
<p>The objective of this review is to summarise the evidence for mindfulness and acceptance approaches in the treatment of adolescent depression. The article begins by summarising the outcomes of three broad approaches to the treatment of adolescent depression — primary prevention, pharmacotherapy, and psychotherapy — in order to advocate for advances in treatment. With regard to psychotherapy, we restrict this to comparisons of meta-analytic studies, in order to cover the breadth of the outcome literature. In the second half of this article, we introduce the reader to mindfulness and acceptance-based psychotherapy, with a particular focus on Acceptance and Commitment Therapy (ACT) and the applicability with adolescents. We provide an overview of the philosophical arguments that underlie this approach to psychotherapy and consider how each of these might contribute to treatment approaches for adolescents with depression.</p>
Zotero Collections:
ObjectiveTo examine whether an empirically and theoretically derived treatment combining mindfulness- and acceptance-based strategies with behavioral approaches would improve outcomes in GAD over an empirically-supported treatment.
Method
This trial randomized 81 individuals (65.4% female, 80.2% identified as White, average age 32.92) diagnosed with GAD to receive 16 sessions of either an Acceptance Based Behavior Therapy (ABBT) or Applied Relaxation (AR). Assessments at pre-treatment, post-treatment, and 6-month follow-up included the following primary outcome measures: GAD Clinician Severity Rating, Structured Interview Guide for the Hamilton Anxiety Rating Scale, Penn State Worry Questionnaire, Depression Anxiety Stress Scale, and the State Trait Anxiety Inventory. Secondary outcomes included the Beck Depression Inventory-II, Quality of Life Inventory, and number of comorbid diagnoses.
Results
Mixed Effect Regression Models showed significant large effects for Time for all primary outcome measures (d’s 1.36 to 1.61) but non-significant, small effects for Condition and Condition X Time (d’s 0.002 to 0.24), indicating clients in both treatments improved comparably over treatment. For secondary outcomes, Time was significant (d’s 0.74 to 1.38) but Condition and Condition X Time effects were not (d’s 0.11 to 0.31). No significant differences emerged over follow-up (d’s 0.02 to 0.16) indicating maintenance of gains. Between 63.3 and 80.0% of clients in ABBT and 60.6 and 78.8% of clients in AR experienced clinically significant change across 5 calculations of change at post-treatment and follow-up.
OBJECTIVE:To examine whether an empirically and theoretically derived treatment combining mindfulness- and acceptance-based strategies with behavioral approaches would improve outcomes in generalized anxiety disorder (GAD) over an empirically supported treatment.
METHOD:
This trial randomized 81 individuals (65.4% female, 80.2% identified as White, average age 32.92) diagnosed with GAD to receive 16 sessions of either an acceptance-based behavior therapy (ABBT) or applied relaxation (AR). Assessments at pretreatment, posttreatment, and 6-month follow-up included the following primary outcome measures: GAD clinician severity rating, Structured Interview Guide for the Hamilton Anxiety Rating Scale, Penn State Worry Questionnaire, Depression Anxiety Stress Scale, and the State-Trait Anxiety Inventory. Secondary outcomes included the Beck Depression Inventory-II, Quality of Life Inventory, and number of comorbid diagnoses.
RESULTS:
Mixed effect regression models showed significant, large effects for time for all primary outcome measures (ds = 1.27 to 1.61) but nonsignificant, small effects for condition and Condition × Time (ds = 0.002 to 0.20), indicating that clients in the 2 treatments improved comparably over treatment. For secondary outcomes, time was significant (ds = 0.74 to 1.38), but condition and Condition × Time effects were not (ds = 0.004 to 0.31). No significant differences emerged over follow-up (ds = 0.03 to 0.39), indicating maintenance of gains. Between 63.3 and 80.0% of clients in ABBT and 60.6 and 78.8% of clients in AR experienced clinically significant change across 5 calculations of change at posttreatment and follow-up.
CONCLUSION:
ABBT is a viable alternative for treating GAD. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
The present article interprets mindfulness from the point of view of the effects of language and cognition on human action. Relational Frame Theory is described to show how human suffering is created by entanglement with the cognitive networks made possible by language. Mindfulness can be understood as a collection of related processes that function to undermine the dominance of verbal networks, especially involving temporal and evaluative relations. These processes include acceptance, defusion, contact with the present moment, and the transcendent sense of self. Each of these components of mindfulness are targeted in Acceptance and Commitment Therapy, and there is some evidence that they underlie the therapeutic changes induced by this approach. The relation between the present approach to mindfulness and other approaches is discussed.
Identity is formed gradually as we mature through personal development within societal (and natural) context. As such, it is group informed but individually directed and is strongly influenced by our family, community, place and natural surroundings. Together, these interwoven aspects of our lives help us each to create an identity that is unique and that should be able to be sustained over time. However, because we live within collectives and places that have often become less sustainable of late, this has a corresponding effect on our identity. The interactive relationship between identity and sustainability is therefore integral to how we understand and then address issues that currently confront us all. To investigate this relationship, three aspects of identity are considered together: the significance of an ecocentric philosophy, personal development oriented to service and transformational leadership. Interweaving these related reflections goes beyond a more limited view of identity, providing new directions for sustainability. Copyright (c) 2010 John Wiley & Sons, Ltd and ERP Environment. [ABSTRACT FROM AUTHOR]; Copyright of Sustainable Development is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Since 1958 one of the most important and widely used texts on civilization in South Asia (now the nation-states of India, Pakstan, Bangladesh, Sri Lanka and Nepal), this classic is now extensively revised, with much new material added. Introductory essays explain the particular settings in which leading Indian thinkers have expressed their ideas about religious, social, political, and economic questions. Brief summaries precede each passage from their writings or sayings.Chapters address the opening of India to the West; Hindu and Muslim social and religious reform movements; the emergence of both moderate and extremist nationalisms; the thought of Mahatma Gandhi; public policies for independent India; Pakistan's formation as an Islamic state, and other topics.
BackgroundDepression is a common and distressing mental health problem that is responsible for significant individual disability and cost to society. Medication and psychological therapies are effective for treating depression and maintenance anti-depressants (m-ADM) can prevent relapse. However, individuals with depression often express a wish for psychological help that can help them recover from depression in the long-term. We need to develop psychological therapies that prevent depressive relapse/recurrence. A recently developed treatment, Mindfulness-based Cognitive Therapy (MBCT, see http://www.mbct.co.uk) shows potential as a brief group programme for people with recurring depression. In two studies it has been shown to halve the rates of depression recurring compared to usual care.
This trial asks the policy research question, is MBCT superior to m-ADM in terms of: a primary outcome of preventing depressive relapse/recurrence over 24 months; and, secondary outcomes of (a) depression free days, (b) residual depressive symptoms, (c) antidepressant (ADM) usage, (d) psychiatric and medical co-morbidity, (e) quality of life, and (f) cost effectiveness? An explanatory research question asks is an increase in mindfulness skills the key mechanism of change?
Methods/Design
The design is a single blind, parallel RCT examining MBCT vs. m-ADM with an embedded process study. To answer the main policy research question the proposed trial compares MBCT plus ADM-tapering with m-ADM for patients with recurrent depression. Four hundred and twenty patients with recurrent major depressive disorder in full or partial remission will be recruited through primary care. Depressive relapse/recurrence over two years is the primary outcome variable. The explanatory question will be addressed in two mutually informative ways: quantitative measurement of potential mediating variables pre/post-treatment and a qualitative study of service users' views and experiences.
Discussion
If the results of our exploratory trial are extended to this definitive trial, MBCT will be established as an alternative approach to maintenance anti-depressants for people with a history of recurrent depression. The process studies will provide evidence about the effective components which can be used to improve MBCT and inform theory as well as other therapeutic approaches.
Background: Mindfulness interventions are increasingly used as a part of integrated treatment in inflammatory bowel disease (IBD) but there are limited data and a lack of consensus regarding effectiveness. Objectives: We explored the efficacy of mindfulness interventions compared to treatment as usual (TAU), or other psychotherapeutic interventions, in treating physical and psychosocial symptoms associated with IBD. Methods: We conducted a systematic review and meta-analysis of relevant randomized controlled trials (RCTs). We included a broad range of mindfulness interventions including mindfulness-based interventions and yoga, with no restrictions on date of publication, participants' age, language or publication type. We searched the following electronic databases: MEDLINE, EMBASE, PsycINFO, CINAHL and WHO ICTRP database. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines in conducting the review. Results: We included eight studies in the meta-analysis. Mindfulness interventions showed a statistically significant effect on stress in both the short(SMD = -0.48; 95%CI:-0.97, 0.00; P =.05), and long term (SMD = -0.55; 95%CI:-0.78,-0.32; P <.00001), significant long term effects on depression (SMD =-0.36; 95%CI:-0.66, -0.07; P =.02) and quality of life (SMD = 0.38; 95%CI:0.08, 0.68; P =.01),and small but not statistically significant improvements in anxiety (SMD = -0.27; 95%CI:-0.65, 0.11; P =.16).Effects on physical outcomes were equivocal and not statistically significant. Conclusions: Mindfulness interventions are effective in reducing stress and depression and improving quality of life and anxiety, but do not lead to significant improvements in the physical symptoms of IBD. Further research involving IBD-tailored interventions and more rigorously designed trials is warranted.
Pages |