Background/Aims: The typical physical therapist's workday involves teaching patients exercises to strengthen muscles. It is important for physical therapists to 'practice what they preach' by modelling good health behaviours in their own personal lives. The purpose of this study was to determine: i) whether strength training participation among physical therapists meets or exceeds commonly accepted standards for maintaining health; ii) how physical therapists participate in strength training. Methods: A Psychdata survey was developed and administered electronically to members (n=800) of the American Physical Therapy Association nationwide as part of a cross-sectional study design. A final sample of 153 surveys was collected and analysed in SPSS 15.0 for a 19% response rate. Frequency analysis was performed for all relevant survey items. Results: Approximately 67% of physical therapists regularly participate in traditional strength training that meets the American College of Sports Medicine exercise guidelines, and 55% regularly participate in alternative strength training, such as yoga and pilates, working all major muscle groups at moderate-to high-intensity at least two days per week. Conclusions: Most physical therapists appear to be good role models for engaging in strength training; more than half the physical therapists surveyed meet minimum guidelines for strength training whereas less than 20% of the general population meets the same minimum guidelines.
Objectives: Mind and Body Practice (MBP) use (e.g., chiropractic, acupuncture, meditation) among Emergency Department (ED) patients is largely unknown. We aimed to determine the period prevalence, nature of MBP use, and perceptions of MBP among adult ED patients. Design and Setting: We undertook a cross-sectional survey of a convenience sample of patients presenting to three EDs between February and June 2016. Subjects: Patients were eligible for inclusion if they were aged 18 years or more and had presented for medical treatment. Intervention: An anonymous, self-administered questionnaire, based upon a validated pediatric questionnaire, was completed by the patient, with assistance if required. Outcome measures: The primary outcome was the nature and 12 month period prevalence of MBP use. Secondary outcomes were variables associated with use and patient perceptions of MBP. Results: 674 patients were enrolled. In the previous 12 months, 500 (74.2%) patients had used at least one MBP. MBP users and nonusers did not differ in gender, ancestry, or chronic illness status (p>0.05). However, users were significantly younger and more likely to have private health insurance (p<0.001). A total of 2094 courses of 68 different MBP had been used including massage (75.0% of users), meditation (35.2%), chiropractic (32.6%), acupuncture (32.0%), and yoga (30.6%). Users were significantly more likely (p<0.01) to believe that MBP prevented illness, treated illness, were more effective than prescription medicines, assisted prescription medications, and were safe and provided a more holistic approach. Forty-one (6.1%) patients used MBP for their ED presenting complaint. However, only 14 (34.1%) advised their ED physician of this. Conclusion: The period prevalence of MBP use among ED patients is high. Knowledge of the MBP used for a patient's presenting complaint may better inform the ED physician when making management decisions.
Objective
To investigate the effect of mindfulness training on pain tolerance, psychological well-being, physiological activity, and the acquisition of mindfulness skills.
Methods
Forty-two asymptomatic University students participated in a randomized, single-blind, active control pilot study. Participants in the experimental condition were offered six (1-h) mindfulness sessions; control participants were offered two (1-h) Guided Visual Imagery sessions. Both groups were provided with practice CDs and encouraged to practice daily. Pre–post pain tolerance (cold pressor test), mood, blood pressure, pulse, and mindfulness skills were obtained.
Results
Pain tolerance significantly increased in the mindfulness condition only. There was a strong trend indicating that mindfulness skills increased in the mindfulness condition, but this was not related to improved pain tolerance. Diastolic blood pressure significantly decreased in both conditions.
Conclusion
Mindfulness training did increase pain tolerance, but this was not related to the acquisition of mindfulness skills.
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<p>The authors tested the approach/inhibition theory of power by examining teasing interactions between women and men in conditions in which either one was given elevated power or they were in an equal-power control condition. Consistent with hypotheses, high-power individuals behaved in a disinhibited fashion and were less accurate judges of their partner's emotion, whereas low-power individuals behaved in a more inhibited, indirect fashion and reported more self-conscious/anxiety-related emotion. Additional contrast analyses revealed only modest support for the claim that men would act in powerful fashion in the absence of explicit power differences, and that power-based differences were greatest when the man had power over the woman. Discussion focuses on different perspectives on the interaction between power and gender.</p>
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Major depressive disorder (MDD) is the leading cause of disability in the developed world, yet broadly effective treatments remain elusive. The primary aim of this pilot study was to investigate the efficacy of mindfulness-based cognitive therapy (MBCT) monotherapy, compared to sertraline monotherapy, for patients with acute MDD. This open-label, nonrandomized controlled trial examined a MBCT cohort (N = 23) recruited to match the gender, age, and depression severity of a depressed control group (N = 20) that completed 8 weeks of monotherapy with the antidepressant sertraline. The 17-item clinician-rated Hamilton Depression Severity Rating Scale (HAMD-17) was the primary outcome measure of depression to assess overall change after 8 weeks and rates of response and remission. The 16-item Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR16) was the secondary outcome measure to further assess depression severity. Both cohorts were demographically similar and showed significant improvement in depression ratings. No difference was found in the degree of change in HAMD-17 scores (t(34) = 1.42, p = 0.165) between groups. Secondary analysis showed statistically significant differences in mean scores of the QIDS-SR16 (t(32) = 4.39, p < 0.0001), with the MBCT group showing greater mean improvement. This study was limited by the small sample size and non-randomized, non-blinded design. Preliminary findings suggest that an 8-week course of MBCT monotherapy may be effective in treating MDD and is a viable alternative to antidepressant medication. Greater changes in the self-rated QIDS-SR16 for the MBCT cohort raise the possibility that patients derive additional subjective benefit from enhanced self-efficacy skills.
Major depressive disorder (MDD) is the leading cause of disability in the developed world, yet broadly effective treatments remain elusive. The primary aim of this pilot study was to investigate the efficacy of mindfulness-based cognitive therapy (MBCT) monotherapy, compared to sertraline monotherapy, for patients with acute MDD. This open-label, nonrandomized controlled trial examined a MBCT cohort (N = 23) recruited to match the gender, age, and depression severity of a depressed control group (N = 20) that completed 8 weeks of monotherapy with the antidepressant sertraline. The 17-item clinician-rated Hamilton Depression Severity Rating Scale (HAMD-17) was the primary outcome measure of depression to assess overall change after 8 weeks and rates of response and remission. The 16-item Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR16) was the secondary outcome measure to further assess depression severity. Both cohorts were demographically similar and showed significant improvement in depression ratings. No difference was found in the degree of change in HAMD-17 scores (t(34) = 1.42, p = 0.165) between groups. Secondary analysis showed statistically significant differences in mean scores of the QIDS-SR16 (t(32) = 4.39, p < 0.0001), with the MBCT group showing greater mean improvement. This study was limited by the small sample size and non-randomized, non-blinded design. Preliminary findings suggest that an 8-week course of MBCT monotherapy may be effective in treating MDD and is a viable alternative to antidepressant medication. Greater changes in the self-rated QIDS-SR16 for the MBCT cohort raise the possibility that patients derive additional subjective benefit from enhanced self-efficacy skills.
Major depressive disorder (MDD) is the leading cause of disability in the developed world, yet broadly effective treatments remain elusive. The primary aim of this pilot study was to investigate the efficacy of mindfulness-based cognitive therapy (MBCT) monotherapy, compared to sertraline monotherapy, for patients with acute MDD. This open-label, nonrandomized controlled trial examined a MBCT cohort (N = 23) recruited to match the gender, age, and depression severity of a depressed control group (N = 20) that completed 8 weeks of monotherapy with the antidepressant sertraline. The 17-item clinician-rated Hamilton Depression Severity Rating Scale (HAMD-17) was the primary outcome measure of depression to assess overall change after 8 weeks and rates of response and remission. The 16-item Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR16) was the secondary outcome measure to further assess depression severity. Both cohorts were demographically similar and showed significant improvement in depression ratings. No difference was found in the degree of change in HAMD-17 scores (t(34) = 1.42, p = 0.165) between groups. Secondary analysis showed statistically significant differences in mean scores of the QIDS-SR16 (t(32) = 4.39, p < 0.0001), with the MBCT group showing greater mean improvement. This study was limited by the small sample size and non-randomized, non-blinded design. Preliminary findings suggest that an 8-week course of MBCT monotherapy may be effective in treating MDD and is a viable alternative to antidepressant medication. Greater changes in the self-rated QIDS-SR16 for the MBCT cohort raise the possibility that patients derive additional subjective benefit from enhanced self-efficacy skills.
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The American Medical Association defines an "impaired physicain" as one who is unable to fulfill professional or personal responsibilities because of psychiatric illness, alcoholism, or drug dependency.1 Although this definition addresses only substance abuse and mental illness, medical problems that affect judgment and performance could compromise the ability to provide reasonable medical care, thus causing impairment. Likewise, issues surrounding clinical competency, such as medical knowledge, medical judgment, and clinical decision making, can compromise judgment and performance.
PURPOSE: A growing number of cancer survivors suffer high levels of distress, depression and stress, as well as sleep disturbance, pain and fatigue. Two different mind-body interventions helpful for treating these problems are Mindfulness-Based Cancer Recovery (MBCR) and Tai Chi/Qigong (TCQ). However, while both interventions show efficacy compared to usual care, they have never been evaluated in the same study or directly compared. This study will be the first to incorporate innovative design features including patient choice while evaluating two interventions to treat distressed cancer survivors. It will also allow for secondary analyses of which program best targets specific symptoms in particular groups of survivors, based on preferences and baseline characteristics.METHODS AND SIGNIFICANCE: The design is a preference-based multi-site randomized comparative effectiveness trial. Participants (N=600) with a preference for either MBCR or TCQ will receive their preferred intervention; while those without a preference will be randomized into either intervention. Further, within the preference and non-preference groups, participants will be randomized into immediate intervention or wait-list control. Total mood disturbance on the Profile of mood states (POMS) post-intervention is the primary outcome. Other measures taken pre- and post-intervention and at 6-month follow-up include quality of life, psychological functioning, cancer-related symptoms and physical functioning. Exploratory analyses investigate biomarkers (cortisol, cytokines, blood pressure/Heart Rate Variability, telomere length, gene expression), which may uncover potentially important effects on key biological regulatory and antineoplastic functions. Health economic measures will determine potential savings to the health system.
<p>BACKGROUND: Increasingly, researchers attend to both positive and negative aspects of mental health. Such distinctions call for clarification of whether psychological well-being and ill-being comprise opposite ends of a bipolar continuum, or are best construed as separate, independent dimensions of mental health. Biology can help resolve this query--bipolarity predicts 'mirrored' biological correlates (i.e. well-being and ill-being correlate similarly with biomarkers, but show opposite directional signs), whereas independence predicts 'distinct' biological correlates (i.e. well-being and ill-being have different biological signatures). METHODS: Multiple aspects of psychological well-being (eudaimonic, hedonic) and ill-being (depression, anxiety, anger) were assessed in a sample of aging women (n = 135, mean age = 74) on whom diverse neuroendocrine (salivary cortisol, epinephrine, norepinephrine, DHEA-S) and cardiovascular factors (weight, waist-hip ratio, systolic and diastolic blood pressure, HDL cholesterol, total/HDL cholesterol, glycosylated hemoglobin) were also measured. RESULTS: Measures of psychological well-being and ill-being were significantly linked with numerous biomarkers, with some associations being more strongly evident for respondents aged 75+. Outcomes for seven biomarkers supported the distinct hypothesis, while findings for only two biomarkers supported the mirrored hypothesis. CONCLUSION: This research adds to the growing literature on how psychological well-being and mental maladjustment are instantiated in biology. Population-based inquiries and challenge studies constitute important future directions.</p>
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Learning what others know, especially experts, is a crucial shortcut to understanding the world. Other people's actions and utterances are thus a powerful source of evidence. However, people do not simply copy others' choices or stated beliefs; rather, they infer what others believe and integrate these beliefs with their own. In this paper, we present a computational account of the inference and integration process that underpins learning from a combination of social and direct evidence. This account formalizes the learner's intuitive understanding of psychology-or theory of mind (ToM)-including attributes such as confidence, reliability, and knowledgeability. It then shows how ToM is the lens used to interpret another person's choices, weighing them against the learner's own direct evidence. To test this account, we develop an experimental paradigm that allows for graded manipulation of social and direct evidence, and for quantitative measurement of the learner's resulting beliefs. Four experiments test the predictions of the model, manipulating knowledgeability, confidence, and reliability of the social source. Learners' behavior is consistent with our quantitative and qualitative model predictions across all 4 experiments, demonstrating subtle interactions between evidence and the attributes of those learned from
This chapter proposes ecospirituality as the missing dimension in Education for Sustainability. The period 2005–2014 is the UNESCO Decade for Education for Sustainable Development, and the transdisciplinary field of Education for Sustainability (EfS) has the goal of fostering an environmental stewardship approach to life on Earth. But EfS rarely includes a spiritual dimension which has the potential to ground students’ experience in a recasting of the I-It to an I-Thou relationship with Nature. Extreme consumerism, burgeoning human population, and spiritual impoverishment have led to a radical disconnection of humans from Nature, and many young people fear the future, believing themselves to be powerless to change direction. While the exploitation of Nature has underpinnings in the Abrahamic religions which privilege the human over the rest of creation, in recognition of the convergence of cosmology, ecology, and spirituality through ecospirituality, religions are beginning to recast themselves to take account of the global ecological crisis. Thomas Berry (2000) describes this recasting as “moments of grace,” where humanity begins to understand its deep connection within the evolution of the universe and that human wellbeing is intimately entwined with the wellbeing of Earth’s ecosystems. Indeed humans would seem to be born with an empathetic orientation toward Nature. Thus, positive age-appropriate ecospiritual experiences are critical for developing concern for the environment, without which children may develop “ecophobia” (Sobel, 1999). The chapter concludes with a discussion of approaches and resources for ecospirituality education.
BackgroundA large proportion of mindfulness-based therapy trials report statistically significant results, even in the context of very low statistical power. The objective of the present study was to characterize the reporting of “positive” results in randomized controlled trials of mindfulness-based therapy. We also assessed mindfulness-based therapy trial registrations for indications of possible reporting bias and reviewed recent systematic reviews and meta-analyses to determine whether reporting biases were identified.
Methods
CINAHL, Cochrane CENTRAL, EMBASE, ISI, MEDLINE, PsycInfo, and SCOPUS databases were searched for randomized controlled trials of mindfulness-based therapy. The number of positive trials was described and compared to the number that might be expected if mindfulness-based therapy were similarly effective compared to individual therapy for depression. Trial registries were searched for mindfulness-based therapy registrations. CINAHL, Cochrane CENTRAL, EMBASE, ISI, MEDLINE, PsycInfo, and SCOPUS were also searched for mindfulness-based therapy systematic reviews and meta-analyses.
Results
108 (87%) of 124 published trials reported ≥1 positive outcome in the abstract, and 109 (88%) concluded that mindfulness-based therapy was effective, 1.6 times greater than the expected number of positive trials based on effect size d = 0.55 (expected number positive trials = 65.7). Of 21 trial registrations, 13 (62%) remained unpublished 30 months post-trial completion. No trial registrations adequately specified a single primary outcome measure with time of assessment. None of 36 systematic reviews and meta-analyses concluded that effect estimates were overestimated due to reporting biases.
Conclusions
The proportion of mindfulness-based therapy trials with statistically significant results may overstate what would occur in practice.
BackgroundA large proportion of mindfulness-based therapy trials report statistically significant results, even in the context of very low statistical power. The objective of the present study was to characterize the reporting of “positive” results in randomized controlled trials of mindfulness-based therapy. We also assessed mindfulness-based therapy trial registrations for indications of possible reporting bias and reviewed recent systematic reviews and meta-analyses to determine whether reporting biases were identified.
Methods
CINAHL, Cochrane CENTRAL, EMBASE, ISI, MEDLINE, PsycInfo, and SCOPUS databases were searched for randomized controlled trials of mindfulness-based therapy. The number of positive trials was described and compared to the number that might be expected if mindfulness-based therapy were similarly effective compared to individual therapy for depression. Trial registries were searched for mindfulness-based therapy registrations. CINAHL, Cochrane CENTRAL, EMBASE, ISI, MEDLINE, PsycInfo, and SCOPUS were also searched for mindfulness-based therapy systematic reviews and meta-analyses.
Results
108 (87%) of 124 published trials reported ≥1 positive outcome in the abstract, and 109 (88%) concluded that mindfulness-based therapy was effective, 1.6 times greater than the expected number of positive trials based on effect size d = 0.55 (expected number positive trials = 65.7). Of 21 trial registrations, 13 (62%) remained unpublished 30 months post-trial completion. No trial registrations adequately specified a single primary outcome measure with time of assessment. None of 36 systematic reviews and meta-analyses concluded that effect estimates were overestimated due to reporting biases.
Conclusions
The proportion of mindfulness-based therapy trials with statistically significant results may overstate what would occur in practice.
The purpose of this article is to synthesize the existing research on classwide social, emotional, and behavioral programs for kindergarten students. The researchers identified 26 studies in peer-reviewed journals and dissertation databases to review. Each study was examined and coded in terms of study characteristics, strength of evidence, and quality of evidence. The interventions represented in the studies were grouped into four categories: social-emotional learning, behavioral, coping skills, and other. The studies of behavioral interventions demonstrated the strongest effects on increasing prosocial behavior and decreasing antisocial behavior. These studies also included the highest quality of research. The social-emotional learning intervention studies consistently demonstrated weaker effects and lower quality research. The remaining categories included too few studies to draw meaningful conclusions. Implications for practice and future research regarding classwide kindergarten social, emotional, and behavioral interventions are discussed.
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