This pilot study explores feasibility and outcomes of a newly developed mindfulness-based cognitive attitude training program for health care personnel. The program was designed as an intervention to reduce the negative effects of stress on health care personnel, on both a personal and professional level, as well as to encourage personal well-being and improved management of the caregiver-patient relationship. The study group (n = 52) consisted of individuals from various categories of caregivers within a primary care setting. The study includes pre- and postintervention assessments and a 3-month follow-up assessment of levels of mindfulness (Mindfulness Attention Awareness Scale), quality of life (the WHO-5 Well-Being Questionnaire), and perceived stress (two VAS scales). As a group, course participants demonstrated significant positive changes reflected in all assessment scales after completing the course. These positive changes persisted at a 3-month follow-up assessment. The study results indicate the feasibility of this program and a need for continued research with a more powerful study design, possibly supplemented with a qualitative survey.
<p>This position paper advocates for early childhood teachers and parents to regularly use of mindfulness practices themselves and with very young children. An understanding of 'mindfulness' is important because it can provide ways to support children during their sensitive years and sow seeds of kindness, tolerance and peace in our fast paced, competitive, consumerist culture. In addition, in times of trauma, mindfulness techniques offer teachers and parents ways to calm themselves and the children close to them. The value of using mindfulness techniques with children and for demonstrating mindfulness as adults is well supported by research (McCown, Reibel and Micozzi, 2010; Saltzman and Goldin, 2008).</p>
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This paper examined the facilitators and barriers to implementation of mindfulness training (MT) across seven secondary/high schools using a qualitative case study design. Schools varied in level of implementation. Within schools, head teachers, members of school senior leadership teams, and staff members involved in the implementation of MT were interviewed individually. In addition, focus groups were conducted with other members of school staff to capture a broad range of views and perspectives. Across the case studies, several key themes emerged, which suggested four cornerstones to successful implementation of MT in schools. These were: people, specifically the need for committed individuals to champion the approach within their schools, with the support of members of the senior leadership teams; resources, both time and financial resources required for training and delivery of MT; journey, reflecting the fact that implementation takes time, and may be a non-linear process with stops and starts; and finally perceptions, highlighting the importance of members of the school community sharing an understanding what MT is and why it is being introduced in each school context. Similarities and differences between the current findings and those of research on implementation of other forms of school mental health promotion programs, and implementation of MT in healthcare settings, are discussed.
<p><strong>Creator's Description:</strong> This article traces the changes and transformations of Tibetan dance that have occurred since 1950, looking at how agents of change ranging from small groups of Tibetans to the Chinese state create, negotiate and represent different kinds of Tibetan modernities through reconstructions and reconfigurations of Tibetan dance, examining how dance is modernized, the kinds of modernity represented, and the social and political power dynamics involved. In particular, the article looks at the repercussions on dance of the recent state-sponsored economic development of Tibet that has resulted in the formation of new urban middle classes but also a dramatic growth in disparity. It also examines the impact on dance culture of the growth of heterogeneous communities in the increasingly mobile population of contemporary Tibet. The article further addresses the issue of globalization, which sees new layers being added to the social and cultural hierarchies of twenty-first century Tibet.</p>
Matsutake is the most valuable mushroom in the world—and a weed that grows in human-disturbed forests across the northern hemisphere. Through its ability to nurture trees, matsutake helps forests to grow in daunting places. It is also an edible delicacy in Japan, where it sometimes commands astronomical prices. In all its contradictions, matsutake offers insights into areas far beyond just mushrooms and addresses a crucial question: what manages to live in the ruins we have made? A tale of diversity within our damaged landscapes, The Mushroom at the End of the World follows one of the strangest commodity chains of our times to explore the unexpected corners of capitalism. Here, we witness the varied and peculiar worlds of matsutake commerce: the worlds of Japanese gourmets, capitalist traders, Hmong jungle fighters, industrial forests, Yi Chinese goat herders, Finnish nature guides, and more. These companions also lead us into fungal ecologies and forest histories to better understand the promise of cohabitation in a time of massive human destruction.By investigating one of the world's most sought-after fungi, The Mushroom at the End of the World presents an original examination into the relation between capitalist destruction and collaborative survival within multispecies landscapes, the prerequisite for continuing life on earth.
Matsutake is the most valuable mushroom in the world—and a weed that grows in human-disturbed forests across the northern hemisphere. Through its ability to nurture trees, matsutake helps forests to grow in daunting places. It is also an edible delicacy in Japan, where it sometimes commands astronomical prices. In all its contradictions, matsutake offers insights into areas far beyond just mushrooms and addresses a crucial question: what manages to live in the ruins we have made? A tale of diversity within our damaged landscapes, The Mushroom at the End of the World follows one of the strangest commodity chains of our times to explore the unexpected corners of capitalism. Here, we witness the varied and peculiar worlds of matsutake commerce: the worlds of Japanese gourmets, capitalist traders, Hmong jungle fighters, industrial forests, Yi Chinese goat herders, Finnish nature guides, and more. These companions also lead us into fungal ecologies and forest histories to better understand the promise of cohabitation in a time of massive human destruction.By investigating one of the world's most sought-after fungi, The Mushroom at the End of the World presents an original examination into the relation between capitalist destruction and collaborative survival within multispecies landscapes, the prerequisite for continuing life on earth.
ObjectivesThe aim of this review is to examine the literature related to the sources of stress, coping mechanisms and interventions to support undergraduate nursing and midwifery students to cope with stress during their undergraduate education.
Design
Integrative literature review.
Data Sources
The databases CINAHL, PubMed and PsycINFO were searched for articles published between 2010 and 2016. Search terms in various combinations were used for example; student nurse, student midwife, undergraduate, stress, coping and interventions.
Review Methods
An integrative review based on Whittemore and Knafl's approach was used to conduct the review.
Results
The search generated 25 articles that met the inclusion criteria. The key sources of stress emanated from clinical, academic and financial issues but predominantly from the clinical environment. Students used a variety of coping strategies, both adaptive and maladaptive. These appear to be influenced by their past and present circumstances such as, their needs, what was at stake and their options for coping. Interventions for student nurses/midwives to cope with stress were varied and in the early stages of development. Mindfulness showed some promising positive results. Interventions focussed on the individual level excluding the wider social context or organisation level.
Conclusions
Stress is pervasive in all aspects of undergraduate nursing and midwifery education. Nursing and midwifery educators need to be aware of this impact and provide appropriate support to students in both the clinical and academic environments. Further research is needed to capture the experience of stress from the students' perspective as well as the barriers and facilitators to supporting students from the preceptors'/mentors' perspectives. Finally, more intervention studies are needed to identify and compare what interventions are effective in supporting students to cope with stress during their undergraduate education.
Introduction. Cancer diagnosis and treatment are often associated with physical and psychosocial impairments. Many cancer patients request complementary and alternative therapies such as mind-body medicine. Concept. The department of internal and integrative medicine at the Essen-Mitte Clinics offer a mind-body medicine day care clinic for cancer patients that is based on the Mindfulness-Based Stress Reduction Program and the mind-body medicine cancer program of the Harvard Mind/Body Medical Institute. The program encompasses mindfulness training, yoga, mindful exercise, nutrition, naturopathic self-help strategies, and cognitive restructuring. Cases. Two patients who had participated in the day care clinic program are presented here. One patient presented with anxiety and depression after recently diagnosed breast cancer and the other with psychological impairments as a result of multiple nevi excision after malignant melanoma surgery. Both patients improved in terms of anxiety and further psychological symptoms. Conclusions. The Essen-Mitte Clinics mind-body medicine day care clinic appears to alleviate psychological consequences of cancer and its treatment. Further studies and randomized controlled trials are necessary to confirm these results.
Introduction. Cancer diagnosis and treatment are often associated with physical and psychosocial impairments. Many cancer patients request complementary and alternative therapies such as mind-body medicine. Concept. The department of internal and integrative medicine at the Essen-Mitte Clinics offer a mind-body medicine day care clinic for cancer patients that is based on the Mindfulness-Based Stress Reduction Program and the mind-body medicine cancer program of the Harvard Mind/Body Medical Institute. The program encompasses mindfulness training, yoga, mindful exercise, nutrition, naturopathic self-help strategies, and cognitive restructuring. Cases. Two patients who had participated in the day care clinic program are presented here. One patient presented with anxiety and depression after recently diagnosed breast cancer and the other with psychological impairments as a result of multiple nevi excision after malignant melanoma surgery. Both patients improved in terms of anxiety and further psychological symptoms. Conclusions. The Essen-Mitte Clinics mind-body medicine day care clinic appears to alleviate psychological consequences of cancer and its treatment. Further studies and randomized controlled trials are necessary to confirm these results.
Have fun with yoga! These 20 animal positions will get kids moving.Yoga can help keep kids healthy and calm--and these 20 positions, inspired by the animal world, make the practice fun, too! Developed in collaboration with the AIYB (Associazione Italiana di Yoga per Bambini), this book features colorful, appealing posters of every pose that parents can use to decorate their child's room. Even the youngest yogi can master the positions, thanks to the charming explanations and step-by-step instructions, as well as Anna Lang's funny illustrations.
Study Design. Multicentered randomized controlled trial with quality of life and resource use data collected. Objective. The objective of this study was to evaluate the cost-effectiveness of yoga intervention plus usual care compared with usual care alone for chronic or recurrent low back pain. Summary of Background Data. Yoga has been shown as an effective intervention for treating chronic or recurrent low back pain. However, there is little evidence on its cost-effectiveness. The data are extracted from a pragmatic, multicentered, randomized controlled trial that has been conducted to evaluate the effectiveness and cost-effectiveness of a 12-week progressive program of yoga plus usual care in patients with chronic or recurrent low back pain. Methods. With this trial data, a cost-effectiveness analysis during the time period of 12 months from both perspectives of the UK National Health Service and the societal is presented. Main outcome measure is an incremental cost per quality-adjusted life-year (QALY). Results. From the perspective of the UK National Health Service, yoga intervention yields an incremental cost-effectiveness ratio of 13,606 pound per QALY. Given a willingness to pay for an additional QALY of 20,000 pound, the probability of yoga intervention being cost-effective is 72%. From the perspective of the society, yoga intervention is a dominant treatment compared with usual care alone. This result is surrounded by fewer uncertainties-the probability of yoga being cost-effective reaches 95% at a willingness to pay for an additional QALY of 20,000 pound. Sensitive analyses suggest the same results that yoga intervention is likely to be cost-effective in both perspectives. Conclusion. On the basis of this trial, 12 weekly group classes of specialized yoga are likely to be a cost-effective intervention for treating patients with chronic or recurrent low back pain.
Background: Yoga seems to be an effective means to cope with a variety of internal medicine conditions. While characteristics of yoga users have been investigated in the general population, little is known about predictors of yoga use and barriers to yoga use in internal medicine patients. The aim of this cross-sectional analysis was to identify sociodemographic, clinical, and psychological predictors of yoga use among internal medicine patients. Methods: A cross-sectional analysis was conducted among all patients being referred to a Department of Internal and Integrative Medicine during a 3-year period. It was assessed whether patients had ever used yoga for their primary medical complaint, the perceived benefit, and the perceived harm of yoga practice. Potential predictors of yoga use including sociodemographic characteristics, health behavior, internal medicine diagnosis, general health status, mental health, satisfaction with health, and health locus of control were assessed; and associations with yoga use were tested using multiple logistic regression analysis. Odds ratios (OR) with 95% confidence intervals (CI) were calculated for significant predictors. Results: Of 2486 participants, 303 (12.19%) reported having used yoga for their primary medical complaint. Of those, 184 (60.73%) reported benefits and 12 (3.96%) reported harms due to yoga practice. Compared to yoga non-users, yoga users were more likely to be 50-64 years old (OR = 1.45; 95%CI = 1.05-2.01; P = 0.025); female (OR = 2.45; 95%CI = 1.45-4.02; P < 0.001); and college graduates (OR = 1.61; 95%CI = 1.14-2.27; P = 0.007); and less likely to currently smoke (OR = 0.61; 95%CI = 0.39-0.96; P = 0.031). Manifest anxiety (OR = 1.47; 95%CI = 1.06-2.04; P = 0.020); and high internal health locus of control (OR = 1.92; 95%CI = 1.38-2.67; P < 0.001) were positively associated with yoga use, while high external-fatalistic health locus of control (OR = 0.66; 95%CI = 0.47-0.92; P = 0.014) was negatively associated with yoga use. Conclusion: Yoga was used for their primary medical complaint by 12.19% of an internal integrative medicine patient population and was commonly perceived as beneficial. Yoga use was not associated with the patients' specific diagnosis but with sociodemographic factors, mental health, and health locus of control. To improve adherence to yoga practice, it should be considered that male, younger, and anxious patients and those with low internal health locus of control might be less intrinsically motivated to start yoga.
The present study, which takes place in a high-poverty section of a large urban area of the northeastern United States, is based upon the prosocial classroom theoretical model that emphasizes the significance of teachers' social and emotional competence (SEC) and well-being in the development and maintenance of supportive teacher-student relationships, effective classroom management, and social and emotional learning (SEL) program effectiveness. These factors, as well as teachers' classroom management and instructional skills contribute to creating a classroom climate that is conducive to learning and that promotes positive developmental behavioral and academic outcomes among students. Cultivating Awareness and Resilience in Education (CARE) is a mindfulness-based professional development program designed to reduce stress, promote SEC and improve teachers' performance and classroom learning environments. From 8 elementary schools the authors recruited and consented 55 teachers (90.2% female, mean age = 39.41). They had relatively low attrition (7.2%) which was largely balanced across treatment and control conditions, resulting in a diverse sample of 51 teachers (53% white). All were regular lead teachers working in a self-contained classroom setting. The results reported here are from an IES-funded 4-year efficacy and replication study of CARE. The data are from the teacher self-report collected from the first year cohort of the cluster randomized controlled trial. After the teachers completed self-reports they were randomly assigned within schools to receive the CARE intervention or to a wait-list control group. After the treatment group received the CARE program, the same self-report battery was administered to both groups. A figure is appended.
Objective: A cross-sectional survey of quality of life of people attending a self-development course involving psychophysiological mind-body medicine (MBM) activities. Design: A questionnaire study using a health-related quality of life (HRQoL) instrument, the SWED-QUAL, with 13 subscales scored 0-100, and questions about utilisation of alternative and standard health care, medication and sick leave. Setting: A training centre for MBM, established 15 years ago. Study group: One hundred and seven eligible course attendants (response rate 88%, age 20-70 years) during the year 2000 assessed their HRQoL just before entering the course. Attendance was self-initiated, without referral. The results on HRQoL were compared with those of control subjects from the general Swedish population. Results: Six of the thirteen HRQoL subscales were strongly and significantly reduced (p < 0.0001) in the study group: Negative affectivity, Role limitation due to emotional health, Positive affectivity, Cognitive functioning, Family functioning and Marital functioning. Long-term sick leave (>6 months) was three times as frequent in the study group as in the general population. Use of psychotropic medication was slightly increased compared to the general population, at least among the younger male participants. The education level was high, health care utilisation was average and body functioning was good. Conclusions: This group of well-educated men and women gave their emotional health an unexpectedly low rating, on a par with that given by people with chronic diseases.
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The study examined the efficacy of a school-based mindfulness intervention on mental health and emotion regulation outcomes among adolescents in a wait-list controlled trial. The study also explored mediators and moderators of intervention effects. A total of 145 predominantly ethnic minority (Asian and Latino) 9th grade students with elevated mood symptoms were randomized to receive a 12-week mindfulness intervention at the start of the academic year, or in the second semester of the year. Students completed measures of emotion regulation and mental health symptoms at baseline, post-intervention, and 3-month follow-up. Intent-to-treat analyses revealed significant treatment effects of the mindfulness intervention for internalizing symptoms and perceived stress at post-treatment. Pooled pre-to-post treatment analyses of the entire sample revealed a small effect size for attention problems, medium for internalizing and externalizing problems, and large for perceived stress. We also found a small effect size for cognitive reappraisal, medium for expressive suppression, emotional processing, emotional expression, and rumination and large for avoidance fusion. Mediation analyses showed that treatment effects on internalizing symptoms and perceived stress were mediated by reductions in expressive suppression and rumination. Moderation analyses revealed that treatment effects were larger among youth with more severe problems at baseline for internalizing problems, externalizing problems, and perceived stress. However, for attention problems, students with lower severity at baseline appeared to have larger treatment gains. The study provided evidence that mindfulness intervention was beneficial for low-income ethnic minority youth in reducing perceived stress and internalizing problems, and improving emotion regulation outcomes. Furthermore, mindfulness training was associated with reduced mental health symptoms via improvements in emotion regulation.
BACKGROUND:Although suicide ranks 10th as a cause of death in the United States, and 1st among active military personnel, there are surprisingly few evidence-based therapies addressing suicidality, and development of new treatments is limited. This paper describes a clinical trial testing a novel therapy for reducing suicide risk in military veterans. The intervention, Mindfulness-Based Cognitive Therapy for Preventing Suicide Behavior (MBCT-S), is a 10-week group intervention adapted from an existing treatment for depression (Mindfulness-Based Cognitive Therapy - MBCT). MBCT-S incorporates the Safety Planning Intervention, which is currently implemented throughout the Veterans Health Administration (VHA) for veterans at high suicide risk.
METHODS:
MBCT-S is being tested in a VHA setting using an intention-to-treat, two-group randomized trial design in which 164 high suicide risk veterans are randomized to either VHA Treatment As Usual (TAU; n=82) or TAU+MBCT-S (n=82). Our primary outcome measure, suicide-related event, defined to include suicide preparatory behaviors, self-harm behavior with suicidal or indeterminate intent, suicide-related hospitalizations and Emergency Department (ED) visits, will be measured through five assessments administered by blinded assessors between baseline and 12months post-baseline. We will measure suicide attempts and suicide deaths as a secondary outcome, because of their anticipated low incidence during the study period. Secondary outcomes also include severity of suicidal ideation, hopelessness and depression.
SIGNIFICANCE:
This study has the potential to significantly enhance the quality and efficiency of VHA care for veterans at suicide risk and to substantially improve the quality of life for veterans and their families.
Epidermal growth factor (EGF) and inflammatory markers have been associated with various neuro-psychiatric disorders. However, their role in mild to moderate depression and anxiety patients treated with mindfulness-based group therapy (mindfulness) or cognitive behavioral therapy (CBT) is not known. In this study we analyzed plasma levels of interleukin (IL)-6, IL-8, high sensitivity C-reactive protein (hsCRP) and EGF before (baseline) and after treatment (8 weeks) and investigated their role in response to both arms of the treatment. To cover variety of mental symptoms, treatment response was analyzed by four scales, the Montgomery–Åsberg depression rating scale (MADRS), Hospital anxiety and depression scale- Depression (HADS-D) and anxiety (HADS-A) and patients health questionnaire-9.EGF levels were significantly decreased after both mindfulness and CBT and were associated with treatment response on all scales independent of the use of tranquilizers and antidepressant treatment. Moreover, baseline EGF levels were significantly associated only with baseline scores of anxiety scale. Levels of inflammatory markers analyzed in this study, were not significantly associated with treatment response on any scale. Our findings suggest that improvement in symptoms of depression and anxiety after both mindfulness and CBT is associated with changes in EGF levels but not with the inflammatory markers.
Identifying and protecting “keystone structures” is essential to maintain biodiversity in an increasingly human-dominated world. Sacred forests, i.e. natural areas protected by local people for cultural or religious regions, may be keystone structures for forest birds in the Greater Himalayas, but there is limited understanding of their use by bird communities. We surveyed birds and their habitat in and adjacent to six Tibetan sacred forests in northwest Yunnan China, a biodiversity hotspot. Our goal was to understand the ecological and conservation role of these remnant forest patches for forest birds. We found that sacred forests supported a different bird community than the surrounding matrix, and had higher bird species richness at plot, patch, and landscape scales. While we encountered a homogeneous matrix bird community outside the scared forests, the sacred forests themselves exhibited high heterogeneity, and supported at least two distinct bird communities. While bird community composition was primarily driven by the vegetation vertical structure, plots with the largest-diameter trees and native bamboo groves had the highest bird diversity, indicating that protecting forest ecosystems with old-growth characteristics is important for Himalayan forest birds. Finally, we found an increased bird use of the sacred forests and their edges during 2010, a severe drought year in Yunnan, indicating that sacred forests may serve as refuges during extreme weather years. Our results strongly indicate that sacred forests represent an important opportunity for Himalayan bird conservation because they protect a variety of habitat niches and increase bird diversity at multiple spatial scales.
Objective To investigate whether a sham device (a validated sham acupuncture needle) has a greater placebo effect than an inert pill in patients with persistent arm pain.
Design A single blind randomised controlled trial created from the two week placebo run-in periods for two nested trials that compared acupuncture and amitriptyline with their respective placebo controls. Comparison of participants who remained on placebo continued beyond the run-in period to the end of the study.
Setting Academic medical centre.
Participants 270 adults with arm pain due to repetitive use that had lasted at least three months despite treatment and who scored ≥3 on a 10 point pain scale.
Interventions Acupuncture with sham device twice a week for six weeks or placebo pill once a day for eight weeks.
Main outcomemeasures Arm pain measured on a 10 point pain scale. Secondary outcomes were symptoms measured by the Levine symptom severity scale, function measured by Pransky's upper extremity function scale, and grip strength.
Results Pain decreased during the two week placebo run-in period in both the sham device and placebo pill groups, but changes were not different between the groups (−0.14, 95% confidence interval −0.52 to 0.25, P = 0.49). Changes in severity scores for arm symptoms and grip strength were similar between groups, but arm function improved more in the placebo pill group (2.0, 0.06 to 3.92, P = 0.04). Longitudinal regression analyses that followed participants throughout the treatment period showed significantly greater downward slopes per week on the 10 point arm pain scale in the sham device group than in the placebo pill group (−0.33 (−0.40 to −0.26) v −0.15 (−0.21 to −0.09), P = 0.0001) and on the symptom severity scale (−0.07 (−0.09 to −0.05) v −0.05 (−0.06 to −0.03), P = 0.02). Differences were not significant, however, on the function scale or for grip strength. Reported adverse effects were different in the two groups.
Conclusions The sham device had greater effects than the placebo pill on self reported pain and severity of symptoms over the entire course of treatment but not during the two week placebo run in. Placebo effects seem to be malleable and depend on the behaviours embedded in medical rituals.
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Core deficits in autism spectrum disorder (ASD) center around social communication and behavior. For those with ASD, these deficits complicate the task of learning how to cope with and manage complex social emotional issues. Although individuals with ASD may receive sufficient academic and basic behavioral support in school settings, supports for dealing with complex social emotional issues are more difficult to access, even though these issues significantly impact student learning. When addressing these challenging social- and emotional-based issues, school and professional personnel need more specific instructional skill sets and resources to effectively and compassionately support students with ASD. In this article, we address three challenging areas of social emotional development that are commonly experienced by individuals with ASD: Anxiety, social isolation, and grief. We briefly explore the existing research on these three topics, identify evidence-based practices and learning strategies to support social emotional learning in individuals with ASD, and include descriptive lists of practical resources that address anxiety, social isolation, and grief.
A broad array of transdiagnostic psychological treatments for depressive and anxiety disorders have been evaluated, but existing reviews of this literature are restricted to face-to-face cognitive behavioural therapy (CBT) protocols. The current meta-analysis focused on studies evaluating clinician-guided internet/computerised or face-to-face manualised transdiagnostic treatments, to examine their effects on anxiety, depression and quality of life (QOL). Results from 50 studies showed that transdiagnostic treatments are efficacious, with large overall mean uncontrolled effects (pre- to post-treatment) for anxiety and depression (gs = .85 and .91 respectively), and medium for QOL (g = .69). Uncontrolled effect sizes were stable at follow-up. Results from 24 RCTs that met inclusion criteria showed that transdiagnostic treatments outperformed control conditions on all outcome measures (controlled ESs: gs = .65, .80, and .46 for anxiety, depression and QOL respectively), with the smallest differences found compared to treatment-as-usual (TAU) control conditions. RCT quality was generally poor, and heterogeneity was high. Examination of the high heterogeneity revealed that CBT protocols were more effective than mindfulness/acceptance protocols for anxiety (uncontrolled ESs: gs = .88 and .61 respectively), but not depression. Treatment delivery format influenced outcomes for anxiety (uncontrolled ESs: group: g = .70, individual: g = .97, computer/internet: g = .96) and depression (uncontrolled ESs: group: g = .89, individual: g = .86, computer/internet: g = .96). Preliminary evidence from 4 comparisons with disorder-specific treatments suggests that transdiagnostic treatments are as effective for reducing anxiety, and may be superior for reducing depression. These findings show that transdiagnostic psychological treatments are efficacious, but higher quality research studies are needed to explore the sources of heterogeneity amongst treatment effects.
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