AYUSH, an acronym for Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa-Rigpa and Homeopathy represents the alternative systems of medicine recognized by the Government of India. Understanding the patterns of utilization of AYUSH care has been important for various reasons including an increased focus on its mainstreaming and integration with biomedicine-based health care system. Based on a nationally representative health survey 2014, we present an analysis to understand utilization of AYUSH care across socioeconomic and demographic groups in India. Overall, 6.9% of all patients seeking outpatient care in the reference period of last two weeks have used AYUSH services without any significant differentials across rural and urban India. Importantly, public health facilities play a key role in provisioning of AYUSH care in rural areas with higher utilization in Chhattisgarh, Kerala and West Bengal. Use of AYUSH among middle-income households is lower when compared with poorer and richer households. We also find that low-income households display a greater tendency for AYUSH self-medication. AYUSH care utilization is higher among patients with chronic diseases and also for treating skin-related and musculo-skeletal ailments. Although the overall share of AYUSH prescription drugs in total medical expenditure is only about 6% but the average expenditure for drugs on AYUSH and allopathy did not differ hugely. The discussion compares our estimates and findings with other studies and also highlights major policy issues around mainstreaming of AYUSH care.
AYUSH, an acronym for Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa-Rigpa and Homeopathy represents the alternative systems of medicine recognized by the Government of India. Understanding the patterns of utilization of AYUSH care has been important for various reasons including an increased focus on its mainstreaming and integration with biomedicine-based health care system. Based on a nationally representative health survey 2014, we present an analysis to understand utilization of AYUSH care across socioeconomic and demographic groups in India. Overall, 6.9% of all patients seeking outpatient care in the reference period of last two weeks have used AYUSH services without any significant differentials across rural and urban India. Importantly, public health facilities play a key role in provisioning of AYUSH care in rural areas with higher utilization in Chhattisgarh, Kerala and West Bengal. Use of AYUSH among middle-income households is lower when compared with poorer and richer households. We also find that low-income households display a greater tendency for AYUSH self-medication. AYUSH care utilization is higher among patients with chronic diseases and also for treating skin-related and musculo-skeletal ailments. Although the overall share of AYUSH prescription drugs in total medical expenditure is only about 6% but the average expenditure for drugs on AYUSH and allopathy did not differ hugely. The discussion compares our estimates and findings with other studies and also highlights major policy issues around mainstreaming of AYUSH care.
William MacAskill makes a clever plea to those young graduates who want to improve the lives of others: Want to change the world for the better? Here's the case for working in finance, rather than for a charity.
There has been an explosion of interest in mindfulness-based programs (MBPs) such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy. This is demonstrated in increased research, implementation of MBPs in healthcare, educational, criminal justice and workplace settings, and in mainstream interest. For the sustainable development of the field there is a need to articulate a definition of what an MBP is and what it is not. This paper provides a framework to define the essential characteristics of the family of MBPs originating from the parent program MBSR, and the processes which inform adaptations of MBPs for different populations or contexts. The framework addresses the essential characteristics of the program and of teacher. MBPs: are informed by theories and practices that draw from a confluence of contemplative traditions, science, and the major disciplines of medicine, psychology and education; underpinned by a model of human experience which addresses the causes of human distress and the pathways to relieving it; develop a new relationship with experience characterized by present moment focus, decentering and an approach orientation; catalyze the development of qualities such as joy, compassion, wisdom, equanimity and greater attentional, emotional and behavioral self-regulation, and engage participants in a sustained intensive training in mindfulness meditation practice, in an experiential inquiry-based learning process and in exercises to develop understanding. The paper's aim is to support clarity, which will in turn support the systematic development of MBP research, and the integrity of the field during the process of implementation in the mainstream.
There has been an explosion of interest in mindfulness-based programs (MBPs) such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy. This is demonstrated in increased research, implementation of MBPs in healthcare, educational, criminal justice and workplace settings, and in mainstream interest. For the sustainable development of the field there is a need to articulate a definition of what an MBP is and what it is not. This paper provides a framework to define the essential characteristics of the family of MBPs originating from the parent program MBSR, and the processes which inform adaptations of MBPs for different populations or contexts. The framework addresses the essential characteristics of the program and of teacher. MBPs: are informed by theories and practices that draw from a confluence of contemplative traditions, science, and the major disciplines of medicine, psychology and education; underpinned by a model of human experience which addresses the causes of human distress and the pathways to relieving it; develop a new relationship with experience characterized by present moment focus, decentering and an approach orientation; catalyze the development of qualities such as joy, compassion, wisdom, equanimity and greater attentional, emotional and behavioral self-regulation, and engage participants in a sustained intensive training in mindfulness meditation practice, in an experiential inquiry-based learning process and in exercises to develop understanding. The paper's aim is to support clarity, which will in turn support the systematic development of MBP research, and the integrity of the field during the process of implementation in the mainstream.
There has been an explosion of interest in mindfulness-based programs (MBPs) such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy. This is demonstrated in increased research, implementation of MBPs in healthcare, educational, criminal justice and workplace settings, and in mainstream interest. For the sustainable development of the field there is a need to articulate a definition of what an MBP is and what it is not. This paper provides a framework to define the essential characteristics of the family of MBPs originating from the parent program MBSR, and the processes which inform adaptations of MBPs for different populations or contexts. The framework addresses the essential characteristics of the program and of teacher. MBPs: are informed by theories and practices that draw from a confluence of contemplative traditions, science, and the major disciplines of medicine, psychology and education; underpinned by a model of human experience which addresses the causes of human distress and the pathways to relieving it; develop a new relationship with experience characterized by present moment focus, decentering and an approach orientation; catalyze the development of qualities such as joy, compassion, wisdom, equanimity and greater attentional, emotional and behavioral self-regulation, and engage participants in a sustained intensive training in mindfulness meditation practice, in an experiential inquiry-based learning process and in exercises to develop understanding. The paper's aim is to support clarity, which will in turn support the systematic development of MBP research, and the integrity of the field during the process of implementation in the mainstream.
Mindfulness-based interventions, in particular, mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT), have been implemented and disseminated globally, and their efficacy is supported by evidence from several recent meta-analyses. As MBSR and MBCT are being integrated into the mainstream of society, including the fields of medicine, health care, education and leadership, there is an increasing need to educate and train professionals to teach and deliver these approaches and interventions. However, as capacity needs increase, the central risk is that the quality and integrity of mindfulness-based interventions could be lost if prospective teachers are not adequately trained to deliver such interventions. To help minimise this risk, we argue that the education and training of future MBSR and MBCT teachers need to be carried out through structured and systematic training pathways that are founded in mindfulness practice and study and closely examined and attended to by senior teachers with many years of contemplative practice and teaching experience. Indeed, prominent people in the field argue that the ongoing formation of mindfulness-based teachers is critical to maintaining and protecting the quality and integrity of MBSR and MBCT. Committed to translating and integrating mindfulness into a twenty-first century context and lexicon—while honouring the universal essence and deep roots of mindfulness practice arising out of classical Buddhist meditation practices—modern scientific research has been conducted, education and professional training standards have been proposed and tools for assessment of mindfulness-based teaching competencies have been developed and applied, all in service of this implementation, dissemination and capacity building process.
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We evaluate the boundary of the Anthropocene geological time interval as an epoch, since it is useful to have a consistent temporal definition for this increasingly used unit, whether the presently informal term is eventually formalized or not. Of the three main levels suggested – an ‘early Anthropocene’ level some thousands of years ago; the beginning of the Industrial Revolution at ∼1800 CE (Common Era); and the ‘Great Acceleration’ of the mid-twentieth century – current evidence suggests that the last of these has the most pronounced and globally synchronous signal. A boundary at this time need not have a Global Boundary Stratotype Section and Point (GSSP or ‘golden spike’) but can be defined by a Global Standard Stratigraphic Age (GSSA), i.e. a point in time of the human calendar. We propose an appropriate boundary level here to be the time of the world's first nuclear bomb explosion, on July 16th 1945 at Alamogordo, New Mexico; additional bombs were detonated at the average rate of one every 9.6 days until 1988 with attendant worldwide fallout easily identifiable in the chemostratigraphic record. Hence, Anthropocene deposits would be those that may include the globally distributed primary artificial radionuclide signal, while also being recognized using a wide range of other stratigraphic criteria. This suggestion for the Holocene–Anthropocene boundary may ultimately be superseded, as the Anthropocene is only in its early phases, but it should remain practical and effective for use by at least the current generation of scientists.
Since 2009, the Working Group on the ‘Anthropocene’ (or, commonly, AWG for Anthropocene Working Group), has been critically analysing the case for formalization of this proposed but still informal geological time unit. The study to date has mainly involved establishing the overall nature of the Anthropocene as a potential chronostratigraphic/geochronologic unit, and exploring the stratigraphic proxies, including several that are novel in geology, that might be applied to its characterization and definition. A preliminary summary of evidence and interim recommendations was presented by the Working Group at the 35th International Geological Congress in Cape Town, South Africa, in August 2016, together with results of voting by members of the AWG indicating the current balance of opinion on major questions surrounding the Anthropocene. The majority opinion within the AWG holds the Anthropocene to be stratigraphically real, and recommends formalization at epoch/series rank based on a mid-20th century boundary. Work is proceeding towards a formal proposal based upon selection of an appropriate Global boundary Stratotype Section and Point (GSSP), as well as auxiliary stratotypes. Among the array of proxies that might be used as a primary marker, anthropogenic radionuclides associated with nuclear arms testing are the most promising; potential secondary markers include plastic, carbon isotope patterns and industrial fly ash. All these proxies have excellent global or near-global correlation potential in a wide variety of sedimentary bodies, both marine and non-marine.
We have developed a low dose Mindfulness-Based Intervention (MBI-ld) that reduces the time committed to meetings and formal mindfulness practice, while conducting the sessions during the workday. This reduced the barriers commonly mentioned for non-participation in mindfulness programs. In a controlled randomized trial we studied university faculty and staff (n=186) who were found to have an elevated CRP level,>3.0 mg/ml, and who either had, or were at risk for cardiovascular disease. This study was designed to evaluate if MBI-ld could produce a greater decrease in CRP, IL-6 and cortisol than an active control group receiving a lifestyle education program when measured at the end of the 2 month interventions. We found that MBI-ld significantly enhanced mindfulness by 2-months and it was maintained for up to a year when compared to the education control. No significant changes were noted between interventions in cortisol, IL-6 levels or self-reported measures of perceived stress, depression and sleep quality at 2-months. Although not statistically significant (p=.08), the CRP level at 2-months was one mg/ml lower in the MBI-ld group than in the education control group, a change which may have clinical significance (Ridker et al., 2000; Wassel et al., 2010). A larger MBI-ld effect on CRP (as compared to control) occurred among participants who had a baseline BMI <30 (-2.67 mg/ml) than for those with BMI >30 (-0.18 mg/ml). We conclude that MBI-ld should be more fully investigated as a low-cost self-directed complementary strategy for decreasing inflammation, and it seems most promising for non-obese subjects.
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The World Peace Diet, now translated and published worldwide in 16 languages, connects many dots–culturally, historically, nutritionally, ecologically, psychologically, and spiritually–to reveal how our routine exploitation of animals for food and other products boomerangs in countless ways, affecting both our outer world and the inner landscape of our daily experience. A more conscious way of living is beckoning, and the World Peace Diet approach blends mindfulness with kindness and respect for each other and all expressions of life, creating a practical foundation for harmony and freedom for ourselves and our world.
AIMS AND OBJECTIVES: To describe the experiences of women taking part in a yoga intervention trial for breast cancer-related lymphoedema.BACKGROUND: Around 20% of women will experience lymphoedema as a consequence of treatment for breast cancer. Specialist lymphoedema clearing, along with self-management, remains the mainstay of therapy. Yoga, an increasingly popular complementary therapeutic practice, may provide another tool to augment self-management.
DESIGN: A qualitative, descriptive design.
METHODS: Interviews were conducted with 15 women with stage one breast cancer-related lymphoedema who had completed an 8-week yoga intervention trial. The intervention consisted of a weekly teacher-led 1.5-hr yoga class and a daily home practice using a 45-min DVD. Interviews were audio-taped and transcribed. These data were then analysed using an iterative-thematic approach.
RESULTS: Participants reported improved well-being, increased awareness of their physical body as well as improved physical, mental and social functioning. They gained from being part of the yoga group that also provided a forum for them to share their experiences. Nine women felt empowered to describe their yoga participation as a transformative journey through illness.
CONCLUSION: When safe to do so, the holistic practice of yoga may augment and provide additional benefit to current self-management and treatment practices for women with breast cancer-related lymphoedema.
RELEVANCE TO CLINICAL PRACTICE: Patients with breast cancer-related lymphoedema may seek advice and guidance from nurses and other healthcare professionals on a range of complementary therapies to help relieve symptoms and promote recovery. Patients who choose to augment their treatment of breast cancer-related lymphoedema by practicing yoga should be carefully assessed, be taught an appropriate technique by a qualified yoga teacher/therapist and its impact monitored by their yoga teacher/therapist, breast care nurse, lymphoedema therapist or treating clinician.
Background: Tobacco smoking remains the leading preventable cause of death among American women. Aerobic exercise has shown promise as an aid to smoking cessation because it improves affect and reduces nicotine withdrawal symptoms. Studies outside the realm of smoking cessation have shown that yoga practice also reduces perceived stress and negative affect. Methods: This pilot study examines the feasibility and initial efficacy of yoga as a complementary therapy for smoking cessation. Fifty-five women were given 8-week group-based cognitive behavioral therapy for smoking cessation and were randomized to a twice-weekly program of Vinyasa yoga or a general health and wellness program (contact control). The primary outcome measure was 7-day point prevalence abstinence at the end of treatment validated by saliva cotinine testing. Longitudinal analyses were also conducted to examine the effect of intervention on smoking cessation at 3- and 6-month follow-up. We examined the effects of the intervention on potential mediating variables (e. g., confidence in quitting smoking, self-efficacy), as well as measures of depressive symptoms, anxiety, and perceived health (SF-36). Results: At end of treatment, women in the yoga group had a greater 7-day point-prevalence abstinence rate than controls (odds ratio [OR], 4.56; 95% CI, 1.1-18.6). Abstinence remained higher among yoga participants through the six month assessment (OR, 1.54; 95% CI, 0.34-6.92), although differences were no longer statistically significant. Women participating in the yoga program also showed reduced anxiety and improvements in perceived health and well-being when compared with controls. Conclusions: Yoga may be an efficacious complementary therapy for smoking cessation among women.
Purpose To evaluate yoga's impact on inflammation, mood, and fatigue. Patients and Methods A randomized controlled 3-month trial was conducted with two post-treatment assessments of 200 breast cancer survivors assigned to either 12 weeks of 90-minute twice per week hatha yoga classes or a wait-list control. The main outcome measures were lipopolysaccharide-stimulated production of proinflammatory cytokines interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-), and interleukin-1 (IL-1), and scores on the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF), the vitality scale from the Medical Outcomes Study 36-item Short Form (SF-36), and the Center for Epidemiological Studies-Depression (CES-D) scale. Results Immediately post-treatment, fatigue was not lower (P > .05) but vitality was higher (P = .01) in the yoga group compared with the control group. At 3 months post-treatment, fatigue was lower in the yoga group (P = .002), vitality was higher (P = .01), and IL-6 (P = .027), TNF- (P = .027), and IL-1 (P = .037) were lower for yoga participants compared with the control group. Groups did not differ on depression at either time (P > .2). Planned secondary analyses showed that the frequency of yoga practice had stronger associations with fatigue at both post-treatment visits (P = .019; P < .001), as well as vitality (P = .016; P = .0045), but not depression (P > .05) than simple group assignment; more frequent practice produced larger changes. At 3 months post-treatment, increasing yoga practice also led to a decrease in IL-6 (P = .01) and IL-1 (P = .03) production but not in TNF- production (P > .05). Conclusion Chronic inflammation may fuel declines in physical function leading to frailty and disability. If yoga dampens or limits both fatigue and inflammation, then regular practice could have substantial health benefits.
Purpose To evaluate yoga's impact on inflammation, mood, and fatigue. Patients and Methods A randomized controlled 3-month trial was conducted with two post-treatment assessments of 200 breast cancer survivors assigned to either 12 weeks of 90-minute twice per week hatha yoga classes or a wait-list control. The main outcome measures were lipopolysaccharide-stimulated production of proinflammatory cytokines interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-), and interleukin-1 (IL-1), and scores on the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF), the vitality scale from the Medical Outcomes Study 36-item Short Form (SF-36), and the Center for Epidemiological Studies-Depression (CES-D) scale. Results Immediately post-treatment, fatigue was not lower (P > .05) but vitality was higher (P = .01) in the yoga group compared with the control group. At 3 months post-treatment, fatigue was lower in the yoga group (P = .002), vitality was higher (P = .01), and IL-6 (P = .027), TNF- (P = .027), and IL-1 (P = .037) were lower for yoga participants compared with the control group. Groups did not differ on depression at either time (P > .2). Planned secondary analyses showed that the frequency of yoga practice had stronger associations with fatigue at both post-treatment visits (P = .019; P < .001), as well as vitality (P = .016; P = .0045), but not depression (P > .05) than simple group assignment; more frequent practice produced larger changes. At 3 months post-treatment, increasing yoga practice also led to a decrease in IL-6 (P = .01) and IL-1 (P = .03) production but not in TNF- production (P > .05). Conclusion Chronic inflammation may fuel declines in physical function leading to frailty and disability. If yoga dampens or limits both fatigue and inflammation, then regular practice could have substantial health benefits.
BACKGROUND: Secondary arm lymphoedema continues to affect at least 20% of women after treatment for breast cancer requiring lifelong professional treatment and self-management. The holistic practice of yoga may offer benefits as an adjunct self-management option. The aim of this small pilot trial was to gain preliminary data to determine the effect of yoga on women with stage one breast cancer-related lymphoedema (BCRL). This paper reports the results for the primary and secondary outcomes. METHODS: Participants were randomised, after baseline testing, to receive either an 8-week yoga intervention (n = 15), consisting of a weekly 90-minute teacher-led class and a 40-minute daily session delivered by DVD, or to a usual care wait-listed control group (n = 13). Primary outcome measures were: arm volume of lymphoedema measured by circumference and extra-cellular fluid measured by bioimpedance spectroscopy. Secondary outcome measures were: tissue induration measured by tonometry; levels of sensations, pain, fatigue, and their limiting effects all measured by a visual analogue scale (VAS) and quality of life based on the Lymphoedema Quality of Life Tool (LYMQOL). Measurements were conducted at baseline, week 8 (post-intervention) and week 12 (four weeks after cessation of the intervention). RESULTS: At week 8, the intervention group had a greater decrease in tissue induration of the affected upper arm compared to the control group (p = 0.050), as well as a greater reduction in the symptom sub-scale for QOL (p = 0.038). There was no difference in arm volume of lymphoedema or extra-cellular fluid between groups at week 8; however, at week 12, arm volume increased more for the intervention group than the control group (p = 0.032). CONCLUSIONS: An 8-week yoga intervention reduced tissue induration of the affected upper arm and decreased the QOL sub-scale of symptoms. Arm volume of lymphoedema and extra-cellular fluid did not increase. These benefits did not last on cessation of the intervention when arm volume of lymphoedema increased. Further research trials with a longer duration, higher levels of lymphoedema and larger numbers are warranted before definitive conclusions can be made.
Yoga therapy is a mind-body intervention that can be an important solution in the treatment of anxiety. Yoga therapy alleviates the hyperarousal of the sympathetic nervous system (SNS) and the hypervigilance of the hypothalamic-pituitary-adrenal (HPA) axis that occurs in anxiety. Yoga therapy activates the parasympathetic branch of the nervous system, replacing SNS overdrive, or the flight-or-fight response, with the relaxation response and balancing the nervous system. Yoga therapy increases positive coping skills and builds self-esteem without harmful side effects. The results of this case study have demonstrated the clinical efficacy of yoga therapy in the treatment of anxiety and panic disorder (PD) in an adolescent female. Treatment consisted of 4 wks of individual sessions (60-min session/wk) and 6 wks of group sessions (90-min session/wk) with daily home practice. The results of the case study are significant because growing numbers of youth in the United States are presenting with anxiety and seeking nonpharmacological options.
Yoga therapy is a mind-body intervention that can be an important solution in the treatment of anxiety. Yoga therapy alleviates the hyperarousal of the sympathetic nervous system (SNS) and the hypervigilance of the hypothalamic-pituitary-adrenal (HPA) axis that occurs in anxiety. Yoga therapy activates the parasympathetic branch of the nervous system, replacing SNS overdrive, or the flight-or-fight response, with the relaxation response and balancing the nervous system. Yoga therapy increases positive coping skills and builds self-esteem without harmful side effects. The results of this case study have demonstrated the clinical efficacy of yoga therapy in the treatment of anxiety and panic disorder (PD) in an adolescent female. Treatment consisted of 4 wks of individual sessions (60-min session/wk) and 6 wks of group sessions (90-min session/wk) with daily home practice. The results of the case study are significant because growing numbers of youth in the United States are presenting with anxiety and seeking nonpharmacological options.
<p>An online bibliography of sources on Yogācāra Buddhism. Only lists 9 works, several bibliographies themselves.</p>
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