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.
Working memory (WM) comprises operations whose coordinated action contributes to our ability to maintain focus on goal-relevant information in the presence of distraction. The present study investigated the nature of distraction upon the neural correlates of WM maintenance operations by presenting task-irrelevant distracters during the interval between the memoranda and probes of a delayed-response WM task. The study used a region of interest (ROIs) approach to investigate the role of anterior (e.g., lateral and medial prefrontal cortex--PFC) and posterior (e.g., parietal and fusiform cortices) brain regions that have been previously associated with WM operations. Behavioral results showed that distracters that were confusable with the memorandum impaired WM performance, compared to either the presence of non-confusable distracters or to the absence of distracters. These different levels of distraction led to differences in the regional patterns of delay interval activity measured with event-related functional magnetic resonance imaging (fMRI). In the anterior ROIs, dorsolateral PFC activation was associated with WM encoding and maintenance, and in maintaining a preparatory state, and ventrolateral PFC activation was associated with the inhibition of distraction. In the posterior ROIs, activation of the posterior parietal and fusiform cortices was associated with WM and perceptual processing, respectively. These findings provide novel evidence concerning the neural systems mediating the cognitive and behavioral responses during distraction, and places frontal cortex at the top of the hierarchy of the neural systems responsible for cognitive control.
Yoga has demonstrated benefit in healthy individuals and those with various health conditions. There are, however, few systematic studies to support the development of yoga interventions for cancer patients. Restorative yoga (RY) is a gentle type of yoga that has been described as "active relaxation." The specific aims of this pilot study were to determine the feasibility of implementing an RY intervention as a supportive therapy for women diagnosed with ovarian or breast cancer and to measure changes in self-reported fatigue, psychological distress and well-being, and quality of life. Fifty-one women with ovarian (n = 37) or breast cancer (n = 14) with a mean age of 58.9 years enrolled in this study; the majority (61%) were actively undergoing cancer treatment at the time of enrollment. All study participants participated in 10 weekly 75-minute RY classes that combined physical postures, breathing, and deep relaxation. Study participants completed questionnaires at baseline, immediately postintervention, and 2 months postintervention. Significant improvements were seen for depression, negative affect, state anxiety, mental health, and overall quality of life. Fatigue decreased between baseline and postintervention follow-up. Health-related quality of life improved between baseline and the 2-month follow-up. Qualitative feedback from participants was predominantly positive; relaxation and shared group experience were two common themes.
<p>A review by Roy Andrew Miller of L. Kwanten, <em>The Timely Pearl, A 12th-Century Tangut Chinese Glossary, Volume 1., The Chinese Glosses</em>.</p>
Our objective was to review the current body of evidence supporting the efficacy of self-management programs in individuals with multiple sclerosis (MS) and other chronic neurological conditions. We reviewed published literature using standardized search terms; examined self-management interventions in a variety of chronic neurological disorders, including MS; and classified studies using the evidence classification established by the American Academy of Neurology. We reviewed 527 abstracts, of which 39 met our inclusion criteria for evaluation. Of the 39 studies, 3 provided class I evidence assessing the efficacy of self-management interventions: a randomized controlled trial of a telephone counseling program for health promotion in MS, a home-based exercise program for reducing falls in people with Parkinson disease, and the comparison of a fitness center program versus a home-based exercise program for people with traumatic brain injury. The remaining studies provided additional support for self-management interventions with a lesser degree of methodologic rigor (class II, class III, or class IV evidence). We concluded that self-management strategies are applicable to chronic neurological diseases, but a need exists for more rigorous studies in this area. We provide recommendations for future intervention study methodologies with a specific emphasis on MS care.
This timely, accessible reference and text addresses some of the most fundamental questions about human behavior, such as what causes racism and prejudice and why good people do bad things. Leading authorities present state-of-the-science theoretical and empirical work. Essential themes include the complex interaction of individual, societal, and situational factors underpinning good or evil behavior; the role of moral emotions, unconscious bias, and the self-concept; issues of responsibility and motivation; and how technology and globalization have enabled newer forms of threat and harm. New to This Edition *Many new authors; extensively revised with the latest theory and research. *Section on group perspectives, with chapters on bystanders to emergencies, remembering historical victimization, organizational dynamics, and globalization and terrorism. *Chapters on free will, conscious versus unconscious processes, media violence, dehumanization, genocide, and sexual violence. *Chapters on false moral superiority, compassionate goals in relationships, and moral emotions in incarcerated offenders"-- "This timely, accessible reference and text addresses some of the most fundamental questions about human behavior, such as what causes racism and prejudice and why good people do bad things. Leading authorities present state-of-the-science theoretical and empirical work. Essential themes include the complex interaction of individual, societal, and situational factors underpinning good or evil behavior; the role of moral emotions, unconscious bias, and the self-concept; issues of responsibility and motivation; and how technology and globalization have enabled newer forms of threat and harm. Key Words/Subject Areas: aggression, altruism, antisocial, evil, free will, good, guilt, heroism, human behavior, morality, prejudice, prosocial, racism, shame, social psychology, stereotyping, terrorism, values, violence Audience: Students and researchers in social psychology; also of interest to sociologists.
Stratigraphic boundaries are ideally defined by distinct lithological,geochemical, and palaeobiological signatures, to which a chronological
framework can be applied. We present a range of observations that
illustrate how the Holocene-Anthropocene transition meets these criteria
in its expression in sediments from remote arctic and alpine lakes,
removed from direct, catchment-scale, anthropogenic influences. In
glaciated lake basins, the retreat of glaciers commonly leads to
lithological successions from proglacial clastic sedimentation to
non-glacial organic deposition. Sediments from the majority of lakes
record marked depletions in the nitrogen stable isotopic composition of
sediment organic matter, reflecting anthropogenic influences on the
global nitrogen cycle. In all cases, siliceous microfossil assemblages
(diatoms and chrysophytes) change markedly and directionally, with
regional nuances. These stratigraphic fingerprints begin to appear in
the sediment record after AD 1850, but accelerate in pulses between AD
1950 and 1970 and again after AD 1980. Our review indicates that recent
environmental changes associated with humankind's dominance of key
global biogeochemical cycles are sufficiently pervasive to be imprinted
on the sediment record of remote lakes. Moreover, these changes are of
sufficient magnitude to conclude that the Holocene has effectively
ended, and that the concept of Anthropocene more aptly describes current
planetary dynamics. The synthesis of these observations pertains
directly to ongoing discussions concerning the eventual formalization of
a new stratigraphic boundary.
This book includes papers written by teachers and how they engage holistic education in their classrooms. The papers come from a course taught by Jack Miller at the Ontario Institute for Studies in Education at the University of Toronto entitled The Holistic Curriculum. This is a rich and diverse collection of papers showing how holistic education can be brought into public education despite the pressures of testing and other accountability measures. Although most of the teachers teach in public schools there are also examples from teachers working in private and post secondary settings. This book can inspire other teachers who are looking for ways to teach the whole person in a more connected manner.
This book includes papers written by teachers and how they engage holistic education in their classrooms. The papers come from a course taught by Jack Miller at the Ontario Institute for Studies in Education at the University of Toronto entitled The Holistic Curriculum. This is a rich and diverse collection of papers showing how holistic education can be brought into public education despite the pressures of testing and other accountability measures. Although most of the teachers teach in public schools there are also examples from teachers working in private and post secondary settings. This book can inspire other teachers who are looking for ways to teach the whole person in a more connected manner.
This is the first book to provide a comprehensive review of the burgeoning literature on theory of mind (TOM) after the preschool years and the first to integrate this literature with other approaches to the study of social understanding. By highlighting the relationship between early and later developments, the book provides readers with a greater understanding of what we know and what we still need to know about higher-order TOM. Although the focus is on development in typical populations, development in individuals with autism and in older adults is also explored to give readers a deeper understanding of possible problems in development.Examining the later developments of TOM gives readers a greater understanding of:
Developments that occur after the age of 5.
Individual differences in rate of development and atypical development and the effects of those differences.
The differences in rate of mastery which become more marked, and therefore more informative, with increased age.
What it means to have a “good theory of mind.”
The differences between first- and second- order theory of mind development in preschoolers, older children, adolescents, and adults.
The range of beliefs available to children at various ages, providing a fuller picture of what is meant by “understanding of belief.”
After the introduction, the literature on first-order developments during the preschool period is summarized to serve as a backdrop for understanding more advanced developments. Chapter 3 is devoted to the second-order false belief task. Chapters 4 and 5 introduce a variety of other measures for understanding higher-level forms of TOM thereby providing readers with greater insight into other cognitive and social developmental outcomes. Chapter 6 discusses the relation between children’s TOM abilities and other aspects of their development. Chapters 7 and 8 place the work in a historical context. First, the research on the development of social and mental worlds that predated the emergence of TOM is examined. Chapter 8 then provides a comparative treatment of the two literatures and how they complement one another.
Ideal as a supplement in graduate or advanced undergraduate courses in theory of mind, cognitive development, or social development taught in psychology and education. Veteran researchers will also appreciate this book‘s unique synthesis of this critical research.
A previous study of 22 medical patients with DSM-III-R-defined anxiety disorders showed clinically and statistically significant improvements in subjective and objective symptoms of anxiety and panic following an 8-week outpatient physician-referred group stress reduction intervention based on mindfulness meditation. Twenty subjects demonstrated significant reductions in Hamilton and Beck Anxiety and Depression scores postintervention and at 3-month follow-up. In this study, 3-year follow-up data were obtained and analyzed on 18 of the original 22 subjects to probe long-term effects. Repeated measures analysis showed maintenance of the gains obtained in the original study on the Hamilton [F(2,32) = 13.22; p < 0.001] and Beck [F(2,32) = 9.83; p < 0.001] anxiety scales as well as on their respective depression scales, on the Hamilton panic score, the number and severity of panic attacks, and on the Mobility Index-Accompanied and the Fear Survey. A 3-year follow-up comparison of this cohort with a larger group of subjects from the intervention who had met criteria for screening for the original study suggests generalizability of the results obtained with the smaller, more intensively studied cohort. Ongoing compliance with the meditation practice was also demonstrated in the majority of subjects at 3 years. We conclude that an intensive but time-limited group stress reduction intervention based on mindfulness meditation can have long-term beneficial effects in the treatment of people diagnosed with anxiety disorders.
Zotero Collections:
A previous study of 22 medical patients with DSM-III-R-defined anxiety disorders showed clinically and statistically significant improvements in subjective and objective symptoms of anxiety and panic following an 8-week outpatient physician-referred group stress reduction intervention based on mindfulness meditation. Twenty subjects demonstrated significant reductions in Hamilton and Beck Anxiety and Depression scores postintervention and at 3-month follow-up. In this study, 3-year follow-up data were obtained and analyzed on 18 of the original 22 subjects to probe long-term effects. Repeated measures analysis showed maintenance of the gains obtained in the original study on the Hamilton [F(2,32) = 13.22; p < 0.001] and Beck [F(2,32) = 9.83; p < 0.001] anxiety scales as well as on their respective depression scales, on the Hamilton panic score, the number and severity of panic attacks, and on the Mobility Index-Accompanied and the Fear Survey. A 3-year follow-up comparison of this cohort with a larger group of subjects from the intervention who had met criteria for screening for the original study suggests generalizability of the results obtained with the smaller, more intensively studied cohort. Ongoing compliance with the meditation practice was also demonstrated in the majority of subjects at 3 years. We conclude that an intensive but time-limited group stress reduction intervention based on mindfulness meditation can have long-term beneficial effects in the treatment of people diagnosed with anxiety disorders.
A previous study of 22 medical patients with DSM-III-R-defined anxiety disorders showed clinically and statistically significant improvements in subjective and objective symptoms of anxiety and panic following an 8-week outpatient physician-referred group stress reduction intervention based on mindfulness meditation. Twenty subjects demonstrated significant reductions in Hamilton and Beck Anxiety and Depression scores postintervention and at 3-month follow-up. In this study, 3-year follow-up data were obtained and analyzed on 18 of the original 22 subjects to probe long-term effects. Repeated measures analysis showed maintenance of the gains obtained in the original study on the Hamilton [F(2,32) = 13.22; p < 0.001] and Beck [F(2,32) = 9.83; p < 0.001] anxiety scales as well as on their respective depression scales, on the Hamilton panic score, the number and severity of panic attacks, and on the Mobility Index-Accompanied and the Fear Survey. A 3-year follow-up comparison of this cohort with a larger group of subjects from the intervention who had met criteria for screening for the original study suggests generalizability of the results obtained with the smaller, more intensively studied cohort. Ongoing compliance with the meditation practice was also demonstrated in the majority of subjects at 3 years. We conclude that an intensive but time-limited group stress reduction intervention based on mindfulness meditation can have long-term beneficial effects in the treatment of people diagnosed with anxiety disorders.
A previous study of 22 medical patients with DSM-III-R-defined anxiety disorders showed clinically and statistically significant improvements in subjective and objective symptoms of anxiety and panic following an 8-week outpatient physician-referred group stress reduction intervention based on mindfulness meditation. Twenty subjects demonstrated significant reductions in Hamilton and Beck Anxiety and Depression scores postintervention and at 3-month follow-up. In this study, 3-year follow-up data were obtained and analyzed on 18 of the original 22 subjects to probe long-term effects. Repeated measures analysis showed maintenance of the gains obtained in the original study on the Hamilton [F(2,32) = 13.22; p < 0.001] and Beck [F(2,32) = 9.83; p < 0.001] anxiety scales as well as on their respective depression scales, on the Hamilton panic score, the number and severity of panic attacks, and on the Mobility Index-Accompanied and the Fear Survey. A 3-year follow-up comparison of this cohort with a larger group of subjects from the intervention who had met criteria for screening for the original study suggests generalizability of the results obtained with the smaller, more intensively studied cohort. Ongoing compliance with the meditation practice was also demonstrated in the majority of subjects at 3 years. We conclude that an intensive but time-limited group stress reduction intervention based on mindfulness meditation can have long-term beneficial effects in the treatment of people diagnosed with anxiety disorders.
<p>A three year follow-up of 22 individuals suffering from DSM defined anxiety disorder who participated in a time-limited, physician-referred mindfulness meditation program showed maintenance of the significant stress and panic reduction that had previously been observed during an initial three month follow-up. Measures used were Hamilton and Beck Anxiety and Depression surveys. The results seem to indicate intense, time-limited mindfulness based interventions can be effective in the long term treatment of anxiety disorders. (Zach Rowinski 2005-03-04)</p>
Objective. To explore evidence for the traditional Tibetan medicine, Zhi Byed 11 (ZB11), for use as a uterotonic. Methods. The eleven ingredients in ZB11 were chemically analyzed by mass spectroscopy. A review was conducted of Western allopathic literature for scientific studies on ZB11's individual components. Literature from Tibetan and other traditional paradigms were reviewed. Results. Potential mechanisms of action for ZB11 as a uterotonic include laxative effects, a dose-dependant increase in smooth muscle tissue peristalsis that may also affect the uterus smooth muscle, and chemical components that are prostaglandin precursors and/or increase prostaglandin synthesis. A recent RCT demonstrated comparable efficacy to misoprostol in reducing severe postpartum hemorrhage (PPH) (>1000 mL) and greater effect than placebo. Historical and anecdotal evidence for ZB11 and its ingredients for childbirth provide further support. Discussion. ZB11 and its ingredients are candidates for potentially effective uterotonics, especially in low-resource settings. Further research is warranted to understand the mechanisms of action and synergy between ingredients.
Objective. To explore evidence for the traditional Tibetan medicine, Zhi Byed 11 (ZB11), for use as a uterotonic. Methods. The eleven ingredients in ZB11 were chemically analyzed by mass spectroscopy. A review was conducted of Western allopathic literature for scientific studies on ZB11's individual components. Literature from Tibetan and other traditional paradigms were reviewed. Results. Potential mechanisms of action for ZB11 as a uterotonic include laxative effects, a dose-dependant increase in smooth muscle tissue peristalsis that may also affect the uterus smooth muscle, and chemical components that are prostaglandin precursors and/or increase prostaglandin synthesis. A recent RCT demonstrated comparable efficacy to misoprostol in reducing severe postpartum hemorrhage (PPH) (>1000 mL) and greater effect than placebo. Historical and anecdotal evidence for ZB11 and its ingredients for childbirth provide further support. Discussion. ZB11 and its ingredients are candidates for potentially effective uterotonics, especially in low-resource settings. Further research is warranted to understand the mechanisms of action and synergy between ingredients.
Objective. To explore evidence for the traditional Tibetan medicine, Zhi Byed 11 (ZB11), for use as a uterotonic. Methods. The eleven ingredients in ZB11 were chemically analyzed by mass spectroscopy. A review was conducted of Western allopathic literature for scientific studies on ZB11’s individual components. Literature from Tibetan and other traditional paradigms were reviewed. Results. Potential mechanisms of action for ZB11 as a uterotonic include laxative effects, a dose-dependant increase in smooth muscle tissue peristalsis that may also affect the uterus smooth muscle, and chemical components that are prostaglandin precursors and/or increase prostaglandin synthesis. A recent RCT demonstrated comparable efficacy to misoprostol in reducing severe postpartum hemorrhage (PPH) (>1000 mL) and greater effect than placebo. Historical and anecdotal evidence for ZB11 and its ingredients for childbirth provide further support. Discussion. ZB11 and its ingredients are candidates for potentially effective uterotonics, especially in low-resource settings. Further research is warranted to understand the mechanisms of action and synergy between ingredients.
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