OBJECTIVES: Considerable morbidity persists among survivors of breast cancer (BC) including high levels of psychological stress, anxiety, depression, fear of recurrence, and physical symptoms including pain, fatigue, and sleep disturbances, and impaired quality of life. Effective interventions are needed during this difficult transitional period.METHODS: We conducted a randomized controlled trial of 84 female BC survivors (Stages 0-III) recruited from the H. Lee Moffitt Cancer and Research Institute. All subjects were within 18 months of treatment completion with surgery and adjuvant radiation and/or chemotherapy. Subjects were randomly assigned to a 6-week Mindfulness-Based Stress Reduction (MBSR) program designed to self-regulate arousal to stressful circumstances or symptoms (n=41) or to usual care (n=43). Outcome measures compared at 6 weeks by random assignment included validated measures of psychological status (depression, anxiety, perceived stress, fear of recurrence, optimism, social support) and psychological and physical subscales of quality of life (SF-36).
RESULTS: Compared with usual care, subjects assigned to MBSR(BC) had significantly lower (two-sided p<0.05) adjusted mean levels of depression (6.3 vs 9.6), anxiety (28.3 vs 33.0), and fear of recurrence (9.3 vs 11.6) at 6 weeks, along with higher energy (53.5 vs 49.2), physical functioning (50.1 vs 47.0), and physical role functioning (49.1 vs 42.8). In stratified analyses, subjects more compliant with MBSR tended to experience greater improvements in measures of energy and physical functioning.
CONCLUSIONS: Among BC survivors within 18 months of treatment completion, a 6-week MBSR(BC) program resulted in significant improvements in psychological status and quality of life compared with usual care.
Objectives: Considerable morbidity persists among survivors of breast cancer (BC) including high levels of psychological stress, anxiety, depression, fear of recurrence, and physical symptoms including pain, fatigue, and sleep disturbances, and impaired quality of life. Effective interventions are needed during this difficult transitional period.Methods: We conducted a randomized controlled trial of 84 female BC survivors (Stages 0–III) recruited from the H. Lee Moffitt Cancer and Research Institute. All subjects were within 18 months of treatment completion with surgery and adjuvant radiation and/or chemotherapy. Subjects were randomly assigned to a 6‐week Mindfulness‐Based Stress Reduction (MBSR) program designed to self‐regulate arousal to stressful circumstances or symptoms (n=41) or to usual care (n=43). Outcome measures compared at 6 weeks by random assignment included validated measures of psychological status (depression, anxiety, perceived stress, fear of recurrence, optimism, social support) and psychological and physical subscales of quality of life (SF‐36).
Results: Compared with usual care, subjects assigned to MBSR(BC) had significantly lower (two‐sided p<0.05) adjusted mean levels of depression (6.3 vs 9.6), anxiety (28.3 vs 33.0), and fear of recurrence (9.3 vs 11.6) at 6 weeks, along with higher energy (53.5 vs 49.2), physical functioning (50.1 vs 47.0), and physical role functioning (49.1 vs 42.8). In stratified analyses, subjects more compliant with MBSR tended to experience greater improvements in measures of energy and physical functioning.
Conclusions: Among BC survivors within 18 months of treatment completion, a 6‐week MBSR(BC) program resulted in significant improvements in psychological status and quality of life compared with usual care.
<p>Background : Although mindfulness meditation interventions have recently shown benefits for reducing stress in various populations, little is known about their relative efficacy compared with relaxation interventions. Purpose : This randomized controlled trial examines the effects of a 1-month mindfulness meditation versus somatic relaxation training as compared to a control group in 83 students (M age=25; 16 men and 67 women) reporting distress. Method : Psychological distress, positive states of mind, distractive and ruminative thoughts and behaviors, and spiritual experience were measured, while controlling for social desirability. Results : Hierarchical linear modeling reveals that both meditation and relaxation groups experienced significant decreases in distress as well as increases in positive mood states over time, compared with the control group (p<.05 in all cases). There were no significant differences between meditation and relaxation on distress and positive mood states over time. Effect sizes for distress were large for both meditation and relaxation (Cohen’s d=1.36 and .91, respectively), whereas the meditation group showed a larger effect size for positive states of mind than relaxation (Cohen’s d=.71 and .25, respectively). The meditation group also demonstrated significant pre-post decreases in both distractive and ruminative thoughts/behaviors compared with the control group (p<.04 in all cases; Cohen’s d=.57 for rumination and .25 for distraction for the meditation group), with mediation models suggesting that mindfulness meditation’s effects on reducing distress were partially mediated by reducing rumination. No significant effects were found for spiritual experience. Conclusions : The data suggest that compared with a no-treatment control, brief training in mindfulness meditation or somatic relaxation reduces distress and improves positive mood states. However, mindfulness meditation may be specific in its ability to reduce distractive and ruminative thoughts and behaviors, and this ability may provide a unique mechanism by which mindfulness meditation reduces distress.</p>
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BACKGROUND:Although mindfulness meditation interventions have recently shown benefits for reducing stress in various populations, little is known about their relative efficacy compared with relaxation interventions.
PURPOSE:
This randomized controlled trial examines the effects of a 1-month mindfulness meditation versus somatic relaxation training as compared to a control group in 83 students (M age = 25; 16 men and 67 women) reporting distress.
METHOD:
Psychological distress, positive states of mind, distractive and ruminative thoughts and behaviors, and spiritual experience were measured, while controlling for social desirability.
RESULTS:
Hierarchical linear modeling reveals that both meditation and relaxation groups experienced significant decreases in distress as well as increases in positive mood states over time, compared with the control group (p < .05 in all cases). There were no significant differences between meditation and relaxation on distress and positive mood states over time. Effect sizes for distress were large for both meditation and relaxation (Cohen's d = 1.36 and .91, respectively), whereas the meditation group showed a larger effect size for positive states of mind than relaxation (Cohen's d =.71 and .25, respectively). The meditation group also demonstrated significant pre-post decreases in both distractive and ruminative thoughts/behaviors compared with the control group (p < .04 in all cases; Cohen's d = .57 for rumination and .25 for distraction for the meditation group), with mediation models suggesting that mindfulness meditation's effects on reducing distress were partially mediated by reducing rumination. No significant effects were found for spiritual experience.
CONCLUSIONS:
The data suggest that compared with a no-treatment control, brief training in mindfulness meditation or somatic relaxation reduces distress and improves positive mood states. However, mindfulness meditation may be specific in its ability to reduce distractive and ruminative thoughts and behaviors, and this ability may provide a unique mechanism by which mindfulness meditation reduces distress.
BACKGROUND: Emotional distress is an increasing public health problem and Hatha yoga has been claimed to induce stress reduction and empowerment in practicing subjects. We aimed to evaluate potential effects of Iyengar Hatha yoga on perceived stress and associated psychological outcomes in mentally distressed women.MATERIAL/METHODS: A controlled prospective non-randomized study was conducted in 24 self-referred female subjects (mean age 37.9+/-7.3 years) who perceived themselves as emotionally distressed. Subjects were offered participation in one of two subsequential 3-months yoga programs. Group 1 (n=16) participated in the first class, group 2 (n=8) served as a waiting list control. During the yoga course, subjects attended two-weekly 90-min Iyengar yoga classes. Outcome was assessed on entry and after 3 months by Cohen Perceived Stress Scale, State-Trait Anxiety Inventory, Profile of Mood States, CESD-Depression Scale, Bf-S/Bf-S' Well-Being Scales, Freiburg Complaint List and ratings of physical well-being. Salivary cortisol levels were measured before and after an evening yoga class in a second sample.
RESULTS: Compared to waiting-list, women who participated in the yoga-training demonstrated pronounced and significant improvements in perceived stress (P<0.02), State and Trait Anxiety (P<0.02 and P<0.01, respectively), well-being (P<0.01), vigor (P<0.02), fatigue (P<0.02) and depression (P<0.05). Physical well-being also increased (P<0.01), and those subjects suffering from headache or back pain reported marked pain relief. Salivary cortisol decreased significantly after participation in a yoga class (P<0.05).
CONCLUSIONS: Women suffering from mental distress participating in a 3-month Iyengar yoga class show significant improvements on measures of stress and psychological outcomes. Further investigation of yoga with respect to prevention and treatment of stress-related disease and of underlying mechanism is warranted.
BACKGROUND: Emotional distress is an increasing public health problem and Hatha yoga has been claimed to induce stress reduction and empowerment in practicing subjects. We aimed to evaluate potential effects of Iyengar Hatha yoga on perceived stress and associated psychological outcomes in mentally distressed women.MATERIAL/METHODS: A controlled prospective non-randomized study was conducted in 24 self-referred female subjects (mean age 37.9+/-7.3 years) who perceived themselves as emotionally distressed. Subjects were offered participation in one of two subsequential 3-months yoga programs. Group 1 (n=16) participated in the first class, group 2 (n=8) served as a waiting list control. During the yoga course, subjects attended two-weekly 90-min Iyengar yoga classes. Outcome was assessed on entry and after 3 months by Cohen Perceived Stress Scale, State-Trait Anxiety Inventory, Profile of Mood States, CESD-Depression Scale, Bf-S/Bf-S' Well-Being Scales, Freiburg Complaint List and ratings of physical well-being. Salivary cortisol levels were measured before and after an evening yoga class in a second sample.
RESULTS: Compared to waiting-list, women who participated in the yoga-training demonstrated pronounced and significant improvements in perceived stress (P<0.02), State and Trait Anxiety (P<0.02 and P<0.01, respectively), well-being (P<0.01), vigor (P<0.02), fatigue (P<0.02) and depression (P<0.05). Physical well-being also increased (P<0.01), and those subjects suffering from headache or back pain reported marked pain relief. Salivary cortisol decreased significantly after participation in a yoga class (P<0.05).
CONCLUSIONS: Women suffering from mental distress participating in a 3-month Iyengar yoga class show significant improvements on measures of stress and psychological outcomes. Further investigation of yoga with respect to prevention and treatment of stress-related disease and of underlying mechanism is warranted.
High rates of child abuse and neglect occur in many families in which either or both parents abuse illicit drugs. This study reports on the results of a randomized controlled trial with families having a parent on methadone maintenance (N = 64), in which an intensive, home-based intervention, the Parents Under Pressure (PUP) program, was compared to standard care. A second brief intervention control group of families received a two-session parenting education intervention. The PUP intervention draws from the ecological model of child development by targeting multiple domains of family functioning including the psychological functioning of individuals in the family, parent–child relationships, and social contextual factors. Mindfulness skills were included to address parental affect regulation, a significant problem for this group of parents. At 3- and 6-month follow-up, PUP families showed significant reductions in problems across multiple domains of family functioning, including a reduction in child abuse potential, rigid parenting attitudes, and child behavior problems. Families in the brief intervention group showed a modest reduction in child abuse potential but no other changes in family function. There were no improvements found in the standard care group and some significant worsening was observed. Results are discussed in terms of their implications for improved treatment.
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Past research has shown that rumination, experiential avoidance and mindfulness are important cognitive emotion regulation strategies in the aetiology of depressive symptoms. There is still little knowledge of their relative importance as predictors of depressive symptomology in a longitudinal design. Participants from a student-sample (N=208) completed measures of depressive symptoms, rumination, experiential avoidance and mindfulness at two assessments separated by a 12-month period. Results showed that in combination only more trait mindfulness was associated with less depressive symptoms at follow-up, even when taken into account baseline-depressive symptoms. The results suggest that trait mindfulness may be a more robust protective factor than rumination and experiential avoidance in the development of depressive symptoms over one year.
Activist burnout, which causes activists to disengage from their activism, is a formidable barrier to the sustainability of social justice movements, including those focused on social justice in educational contexts. However, the cultures of these movements often disregard the importance of self-care, seeing it as self-indulgence, putting activists at even higher risks of burnout. In this study, one of the first to assess the impact of specific self-care strategies on activist burnout, data from interviews with 14 social justice education activists are analyzed in order to uncover how they used mindfulness practices such as yoga, tai-chi, and meditation to cope with burnout. The analysis revealed a variety of ways in which mindfulness mitigated their burnout experiences. It revealed, as well, a shared perception that, beyond helping to sustain their activism, mindfulness made them more effective activists.
What rational justification is there for conceiving of all living things as possessing inherent worth? In Respect for Nature, Paul Taylor draws on biology, moral philosophy, and environmental science to defend a biocentric environmental ethic in which all life has value. Without making claims for the moral rights of plants and animals, he offers a reasoned alternative to the prevailing anthropocentric view--that the natural environment and its wildlife are valued only as objects for human use or enjoyment. Respect for Nature provides both a full account of the biological conditions for life--human or otherwise--and a comprehensive view of the complex relationship between human beings and the whole of nature.This classic book remains a valuable resource for philosophers, biologists, and environmentalists alike--along with all those who care about the future of life on Earth. A new foreword by Dale Jamieson looks at how the original 1986 edition of Respect for Nature has shaped the study of environmental ethics, and shows why the work remains relevant to debates today.
This study investigates the psychological process involved when people with current distressing psychosis learned to respond mindfully to unpleasant psychotic sensations (voices, thoughts, and images). Sixteen participants were interviewed on completion of a mindfulness group program. Grounded theory methodology was used to generate a theory of the core psychological process using a systematically applied set of methods linking analysis with data collection. The theory inducted describes the experience of relating differently to psychosis through a three-stage process: centering in awareness of psychosis; allowing voices, thoughts, and images to come and go without reacting or struggle; and reclaiming power through acceptance of psychosis and the self. The conceptual and clinical applications of the theory and its limits are discussed.
The Anthropocene, just established as a particular geophysical state, challenges us to critically reconsider normative responsibility towards life, human and non-human, as the scale of potential global disruption becomes apparent. The characteristics it reveals, of our technically interlocked condition now with non-human nature, the problems of uncertainty and human exceptionalism suggest that currently influential positions, those of Hans Jonas and Michel Foucault, are both useful for understanding the political ontology of human life, but only offer partial perspectives towards better responsibility. A critical program of rereading Foucault’s genealogical account reveals the usefulness of a biopolitical perspective, but also its limitations, and the need to redevelop its framework to include non-human species in order then to appropriately confront the emerging crisis of the Anthropocene.
In the context of aging European conservation institutions rewilding has emerged as a popular and scientific expression of new directions in ecology and conservation management associated with the restoration of ecosystem function through reassembly of trophic levels involving the reintroduction of large mammals. It introduces a radical new natural archetype that evokes a positive environmentalism. The Oostvaardersplassen experiment in the Netherlands demonstrates the agency of rewilding for nature development and engaging diverse publics in debates on what is natural and the future of conservation policy. If conservation is to retain its cultural and policy visibility and influence in a 21st century multi‐cultural Europe, our conservation institutions and the natures we value must adapt. In this forum I frame rewilding as an asset for institutional adaptation that is being constrained by substantive institutional and societal resistance. I argue the need for strategic investment in a European network of experimental rewilding sites. These would bring rewilding into densely populated areas, develop the science and practice of ecosystem restoration, and promote public debate on nature conservation futures. The ‘Fitness check’ of European nature conservation legislation mandated in 2014 is a case of high politics. In this situation, compromise and negotiation is inevitable and the environmental lobby needs something to advocate as well as defend. A rewilding agenda could fulfil this need.
International research examining teacher stress and contextual factors, such as culture, government policies, professional autonomy, and school level factors, are reviewed in this chapter, as well as their impact on teachers’ occupational health. Research reviewed identifies important contextual and cultural factors impacting teacher stress and the occupational health factors of job satisfaction and workforce instability. While research examining teacher stress in different countries nation is robust, there is a dearth of research examining the role of culture within or between national borders. Further, while models of stress and occupational health are prevalent in existing research, theoretical models explaining the role of culture and other contextual factors in teacher stress are needed.
International research examining teacher stress and contextual factors, such as culture, government policies, professional autonomy, and school level factors, are reviewed in this chapter, as well as their impact on teachers’ occupational health. Research reviewed identifies important contextual and cultural factors impacting teacher stress and the occupational health factors of job satisfaction and workforce instability. While research examining teacher stress in different countries nation is robust, there is a dearth of research examining the role of culture within or between national borders. Further, while models of stress and occupational health are prevalent in existing research, theoretical models explaining the role of culture and other contextual factors in teacher stress are needed.
<p>This brief article investigates the authenticity of a letter attributed to Sakya Paṇḍita (<em>sa skya paN+Dita</em>). The letter, titled <em>Bu slob rnams la spring ba</em>, has been cited by several scholars as source material on early Mongol-Tibetan relations. However, Jackson points to several factors that bring the letters authenticity into doubt, including the absence of any reference to the letter until the 16th century. Further, there are several stylistic elements of the letter which are unique among Sakya's writings. (Ben Deitle 2006-02-02)</p>
<p>maher</p>
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The immediate outcomes of mindfulness meditation (MM) and loving-kindness meditation (LKM) on experimental measures of explicit and implicit self- and other-referential processing (SRP-ORP) have not been investigated previously. In this study, undergraduate students (n = 104) were randomized to a single-session practice of MM, LKM, or reading control and completed self-report measures of decentering and positive affect directed toward self and other. Participants also completed an experimental measure of valenced SRP-ORP. Practice of both meditations was associated with increased decentering and positive affect relative to reading control, although self-reported response to MM and LKM did not significantly differ. Following the meditation, whereas participants randomized to MM evidenced an expected self-positivity bias in positive affective response and reaction time during an experimental SRP-ORP task, participants randomized to LKM did not. LKM, as uniquely involving the intentional cultivation of positive emotion toward both self and other, may be associated with a relative normalization of the self-positivity bias. Individual differences in response to SRP-ORP were also examined as a function of traits related to mindfulness and loving-kindness, in addition to as a function of variability in experiential response to MM and LKM. Study limitations and future research directions are also discussed.
BackgroundSleep problems are a major risk factor for the emergence of depression in adolescence. The aim of this study was to test whether an intervention for improving sleep habits could prevent the emergence of depression, and improve well-being and cardiovascular indices amongst at-risk adolescents.
Methods/Design
A longitudinal randomised controlled trial (RCT) is being conducted across Victorian Secondary Schools in Melbourne, Australia. Adolescents (aged 12–17 years) were defined as at-risk for depression if they reported high levels of anxiety and sleep problems on in-school screening questionnaires and had no prior history of depression (assessed by clinical diagnostic interview). Eligible participants were randomised into either a sleep improvement intervention (based on cognitive behavioral and mindfulness principles) or an active control condition teaching study skills. Both programs consisted of seven 90 minute-long sessions over seven weeks. All participants were required to complete a battery of mood and sleep questionnaires, seven-days of actigraphy, and sleep diary entry at pre- and post-intervention. Participants also completed a cardiovascular assessment and two days of saliva collection at pre-intervention. Participants will repeat all assessments at two-year follow up (ongoing).
Discussion
This will be the first efficacy trial of a selective group-based sleep intervention for the prevention of depression in an adolescent community sample. If effective, the program could be disseminated in schools and greatly improve health outcomes for anxious adolescents.
BackgroundSleep problems are a major risk factor for the emergence of depression in adolescence. The aim of this study was to test whether an intervention for improving sleep habits could prevent the emergence of depression, and improve well-being and cardiovascular indices amongst at-risk adolescents.
Methods/Design
A longitudinal randomised controlled trial (RCT) is being conducted across Victorian Secondary Schools in Melbourne, Australia. Adolescents (aged 12–17 years) were defined as at-risk for depression if they reported high levels of anxiety and sleep problems on in-school screening questionnaires and had no prior history of depression (assessed by clinical diagnostic interview). Eligible participants were randomised into either a sleep improvement intervention (based on cognitive behavioral and mindfulness principles) or an active control condition teaching study skills. Both programs consisted of seven 90 minute-long sessions over seven weeks. All participants were required to complete a battery of mood and sleep questionnaires, seven-days of actigraphy, and sleep diary entry at pre- and post-intervention. Participants also completed a cardiovascular assessment and two days of saliva collection at pre-intervention. Participants will repeat all assessments at two-year follow up (ongoing).
Discussion
This will be the first efficacy trial of a selective group-based sleep intervention for the prevention of depression in an adolescent community sample. If effective, the program could be disseminated in schools and greatly improve health outcomes for anxious adolescents.
The Sherpa are a Tibetan-speaking people who moved into the valleys of eastern Nepal in the middle of the sixteenth century. They survived as traders transporting goods by Yak across the Himalayas, linking the markets of China to Nepal and India. This collection of 19 documents about the Sherpa covers a period from the 1950s to 1990s. The Sherpa environment, religion, and social change have received the most attention by these authors.
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