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Importance Concerns exist about the current quality of undergraduate medical education and its effect on students’ well-being.Objective To identify best practices for undergraduate medical education learning environment interventions that are associated with improved emotional well-being of students. Data Sources Learning environment interventions were identified by searching the biomedical electronic databases Ovid MEDLINE, EMBASE, the Cochrane Library, and ERIC from database inception dates to October 2016. Studies examined any intervention designed to promote medical students’ emotional well-being in the setting of a US academic medical school, with an outcome defined as students’ reports of well-being as assessed by surveys, semistructured interviews, or other quantitative methods. Data Extraction and Synthesis Two investigators independently reviewed abstracts and full-text articles. Data were extracted into tables to summarize results. Study quality was assessed by the Medical Education Research Study Quality Instrument (MERQSI), which has a possible range of 5 to 18; higher scores indicate higher design and methods quality and a score of 14 or higher indicates a high-quality study. Findings Twenty-eight articles including at least 8224 participants met eligibility criteria. Study designs included single-group cross-sectional or posttest only (n = 10), single-group pretest/posttest (n = 2), nonrandomized 2-group (n = 13), and randomized clinical trial (n = 3); 89.2% were conducted at a single site, and the mean MERSQI score for all studies was 10.3 (SD, 2.11; range, 5-13). Studies encompassed a variety of interventions, including those focused on pass/fail grading systems (n = 3; mean MERSQI score, 12.0), mental health programs (n = 4; mean MERSQI score, 11.9), mind-body skills programs (n = 7; mean MERSQI score, 11.3), curriculum structure (n = 3; mean MERSQI score, 9.5), multicomponent program reform (n = 5; mean MERSQI score, 9.4), wellness programs (n = 4; mean MERSQI score, 9.0), and advising/mentoring programs (n = 3; mean MERSQI score, 8.2). Conclusions and Relevance In this systematic review, limited evidence suggested that some specific learning environment interventions were associated with improved emotional well-being among medical students. However, the overall quality of the evidence was low, highlighting the need for high-quality medical education research.

<p>Mindfulness has been associated with better psychological and physical health; although, the mechanisms of these benefits are poorly understood. We explored the role of mindfulness in stress-health pathways among undergraduates at a large public university. Participants reported on demographic and academic variables and completed data collection at two time points during the academic semester, approximately one month apart. At each collection, measures of mindfulness, perceived stress, and psychological well-being were gathered. Students provided two days of home-based saliva collection for assessment of cortisol. Mean scores were computed for each of the measures, over the two assessments. Hierarchical multiple regressions adjusting for GPA, hours of paid employment per week, minority status, and living situation explored the impact of mindfulness in our stress-health model. Students with higher dispositional mindfulness reported significantly less perceived stress and had lower overall mean diurnal cortisol. Mindfulness was associated with greater psychological well-being. Exploratory analyses suggested that future research should explore the potential mediating or moderating relationships between mindfulness, perceived stress, and cortisol. Findings suggest that mindfulness may help attenuate both psychological and physiological stress responses to college stress.</p>

Pairing full-length scholarly essays with shorter pieces drawn from scholarly blogs and conference presentations, as well as commissioned interviews and position statements, Debates in the Digital Humanities 2016 reveals a dynamic view of a field in negotiation with its identity, methods, and reach. Pieces in the book explore how DH can and must change in response to social justice movements and events like #Ferguson; how DH alters and is altered by community college classrooms; and how scholars applying DH approaches to feminist studies, queer studies, and black studies might reframe the commitments of DH analysts. Numerous contributors examine the movement of interdisciplinary DH work into areas such as history, art history, and archaeology, and a special forum on large-scale text mining brings together position statements on a fast-growing area of DH research. In the multivalent aspects of its arguments, progressing across a range of platforms and environments, Debates in the Digital Humanities 2016 offers a vision of DH as an expanded field's new possibilities, differently structured.

Background: This study examined the feasibility, safety and efficacy of an 8-week Relaxation Response (RR)-based group. Methods: Twenty-two depressed Chinese American immigrants were recruited. Outcomes measures were response and remission rates, the Hamilton Rating Scale for Depression, Clinical Global Impressions Scale, Quality of Life Enjoyment and Satisfaction Questionnaire, and the Multidimensional Scale of Perceived Social Support Scale. Results: Participants (N = 22) were 82% female, mean age was 53 (±12). After intervention, completers (N = 15) showed a 40% response rate and a 27% remission rate, and statistically significant improvement in most outcome measures. Discussion: The RR-based group is feasible and safe in treating Chinese American immigrants with depression.

Research questionWhat are the qualitative insights and perspectives about the implementation of a mindfulness and yoga-based program from elementary youth and teachers? Context A mindfulness and yoga-based curriculum was implemented in 15 schools. The curriculum was taught to students during a physical education or dance class by instructors who were within each school and received training on the curriculum. Sample selection Volunteer focus group elementary students who participated for one year and teachers who did not implement the program were qualitatively interviewed, by three trained University researchers. Data collection Nine focus groups were completed within three different elementary schools. Six focus groups were completed with 3rd and 5th grade students. Three focus groups were conducted with teachers within each school which received the program, excluding instructors. Analysis Focus group data were coded and a thematic analysis was completed among the 40 students and 23 teachers. Interpretation and main results Teachers had varying degrees of involvement with the program and communication emerged as a critical theme for buy-in as communication represents the underpinnings of creating and retaining stakeholders. Most students talked about perceived improvements in focus, emotional regulation, flexibility, breathing, and school work. A common theme to describe benefits of the program emerged with the idea of “increased focus”. Conceptually, it may be that increasing mindfulness increases “focus” thus increasing positive outcomes. More research is needed to understand if “focus” may serve as a mediating variable on emotional regulation, cognitive improvements, and other health outcomes.

RESEARCH QUESTION: What are the qualitative insights and perspectives about the implementation of a mindfulness and yoga-based program from elementary youth and teachers?CONTEXT: A mindfulness and yoga-based curriculum was implemented in 15 schools. The curriculum was taught to students during a physical education or dance class by instructors who were within each school and received training on the curriculum. SAMPLE SELECTION: Volunteer focus group elementary students who participated for one year and teachers who did not implement the program were qualitatively interviewed, by three trained University researchers. DATA COLLECTION: Nine focus groups were completed within three different elementary schools. Six focus groups were completed with 3rd and 5th grade students. Three focus groups were conducted with teachers within each school which received the program, excluding instructors. ANALYSIS: Focus group data were coded and a thematic analysis was completed among the 40 students and 23 teachers. INTERPRETATION AND MAIN RESULTS: Teachers had varying degrees of involvement with the program and communication emerged as a critical theme for buy-in as communication represents the underpinnings of creating and retaining stakeholders. Most students talked about perceived improvements in focus, emotional regulation, flexibility, breathing, and school work. A common theme to describe benefits of the program emerged with the idea of "increased focus". Conceptually, it may be that increasing mindfulness increases "focus" thus increasing positive outcomes. More research is needed to understand if "focus" may serve as a mediating variable on emotional regulation, cognitive improvements, and other health outcomes.

This study examined an experiential avoidance conceptualization of depressive rumination in 3 ways: 1) associations among questionnaire measures of rumination, experiential avoidance, and fear of emotions; 2) performance on a dichotic listening task that highlights preferences for nondepressive material; and 3) psychophysiological reactivity in an avoidance paradigm modeled after the one used by Borkovec and colleagues (1993) in their examination of worry. One hundred and thirty eight undergraduates completed questionnaire measures and participated in a clinical interview to diagnose current and past episodes of depression. Of those, 100 were randomly assigned to a rumination or relaxation induction condition and participated in a dichotic listening task, rumination/relaxation induction, and depression induction. Questionnaire measures confirmed a relationship between rumination status and avoidance; however, no significant effects were found in the dichotic listening task. Psychophysiological measures indicated no difference in physiological response to a depression induction among high ruminators (HR). However, low ruminators (LR) in the relaxation condition exhibited a larger IBI response than LR in the rumination condition. Overall, these results provide partial support for an avoidance conceptualization of depressive rumination. Implications of these findings are discussed.

BackgroundNon-suicidal self-injury (NSSI) is a transdiagnostic behaviour that can be difficult to treat; to date no evidence based treatment for NSSI exists. Mindfulness Based Cognitive Therapy (MBCT) specifically targets the mechanisms thought to initiate and maintain NSSI, and thus appears a viable treatment option. The aims of the current study are to test the ability of MBCT to reduce the frequency and medical severity of NSSI, and explore the mechanisms by which MBCT exerts its effect. Methods/Design We will conduct a parallel group randomised controlled trial of Mindfulness Based Cognitive Therapy (MBCT) versus Supportive Therapy (ST) in young people aged 18–25 years. Computerised block randomisation will be used to allocate participants to groups. All participants will meet the proposed DSM-5 criteria for NSSI (i.e. five episodes in the last twelve months). Participants will be excluded if they: 1) are currently receiving psychological treatment, 2) have attempted suicide in the previous 12 months, 3) exhibit acute psychosis, 4) have a diagnosis of borderline personality disorder, or 5) have prior experience of MBCT. Our primary outcome is the frequency and medical severity of NSSI. As secondary outcomes we will assess changes in rumination, mindfulness, emotion regulation, distress tolerance, stress, and attentional bias, and test these as mechanisms of change. Discussion This is the first randomised controlled trial to test the efficacy of MBCT in reducing NSSI. Evidence of the efficacy of MBCT for self-injury will allow provision of a brief intervention for self-injury that can be implemented as a stand-alone treatment or integrated with existing treatments for psychiatric disorders.

OBJECTIVE: A Mental Health Task Force (MHTF) was implemented in 2016 by a collegiate-based emergency medical services (CBEMS) organization to (1) improve mental health emergency response and to (2) address concerns for the mental health of CBEMS providers.PARTICIPANTS: Skidmore College EMS is a Basic Life Support First Response service staffed by volunteer undergraduate students. METHODS: In coordination with faculty and staff, students in the MHTF developed trainings, peer support structures, community events, policies, and informational resources. RESULTS: Sixteen students joined the MHTF within 1 year. Over 35 Skidmore College EMS members received training on mental health emergency response, peer-support, and self-care. Debriefing programs, mindfulness-based events, shift-length limitations, and access to informational resources promoted the mental health of Skidmore College EMS members. CONCLUSIONS: Implementing an MHTF is an innovative, student-led approach to coupling education on emergency response with programming that supports the mental health of CBEMS providers.

Family homelessness is associated with adverse outcomes in mothers and their young children. Evidence‐based programs are needed to support the socioemotional needs of these families. The purpose of this qualitative study was to explore the perceived benefits of participating in a mindfulness program in mother–child dyads receiving services at a therapeutic nursery serving homeless children under the age of 3 years. A convenience sample of 17 predominantly African American mothers participated in in‐depth qualitative interviews. Four themes were derived from the data regarding the perceived benefits of the mindfulness program: “me” time, maternal self‐regulation, dyadic connectedness, and child well‐being. Results demonstrate the perceived benefits of mindfulness on the parent–child relationship and have important implications for families at an increased risk of adverse outcomes. Because homelessness and residential instability confer considerable risk for young children, interventions to support effective parenting are critical.

In a complicated world, an outside-the-blackboard movement to hone students' social and emotional skills is gaining steam.

Purpose: Children of parents with bipolar disorder are at an increased risk of developing mood disorders compared to children without bipolar parents. Early signs of bipolar disorder include symptoms of anxiety, depression, and inattention. Pharmacological interventions for treating these symptoms are often poorly tolerated and may accelerate the onset of manic symptoms. Mindfulness-Based Cognitive Therapy-Child (MBCT-C), an evidence-based manualized 12-week group intervention, has been shown to effectively treat mood and anxiety disorders in children/adolescents. However, there has been no examination of MBCT-C for youth at high risk for bipolar disorder. We examined the effects of MBCT-C on outcomes among youth with anxiety disorders and a familial risk for bipolar disorder.Methods: Participants were 10 children/adolescents (Mage=13.17, SD=1.93; 80% girls; 40% White/African-American) who met DSM-IV criteria for an anxiety disorder (i.e., generalized anxiety disorder, separation anxiety disorder, panic disorder or social phobia) and had at least one parent with bipolar I disorder. A within-subjects, pre-post design was used to examine changes in anxiety, mindfulness, and emotion regulation associated with participation in MBCT-C. Results: Significant decreases were seen in both child-rated (Mpre=18.5 vs. Mpost=4.7, t=10.8, p<.01) and clinician-rated anxiety symptoms (Mpre=11.1 vs. Mpost=4.3, t=6.1, p<.01). Additionally, reductions in clinician-rated anxiety symptoms were significantly correlated with improvements in mindfulness (r=−.69, p<.05) and emotion regulation (r=−.82, p<.05). No significant changes were seen pre-post intervention in depressive symptoms, mania symptoms, mindfulness, or emotion regulation - though all changes were in the expected direction. Conclusion: Findings support the preliminary efficacy of MBCT-C in reducing anxiety among youth at risk for bipolar disorder, and suggest that changes in anxiety symptoms may be associated with changes in mindfulness and emotion regulation processes. Further research utilizing an active control group, larger sample size, and objective markers is warranted.

This manuscript explores how one teacher educator worked to facilitate preservice teachers' (PSTs) learning across field- and university-based settings. Using socio-cultural learning theory as a lens, the analysis draws on case study data gathered for two PSTs from the same teacher education program (TEP), who experienced proximal, but considerably different student teaching placements in urban schools. Findings articulate the teacher educator's repertoire of moves as she worked to mediate PSTs' development as equity-minded, reflective practitioners. By examining the learner-centered and contextually sensitive aspects of teacher educator mediation, this manuscript challenges notions of "best practices" in teacher education and adds nuance to discussions about "rich" clinical experiences.

<p>The first systematic and detailed overview of modern Tibetan literature, which has burgeoned only in the last thirty years. This comprehensive collection brings together fourteen pioneering scholars in the nascent field of Tibetan literary studies, including authors who are active in the Tibetan literary world itself. These scholars examine the literary output of Tibetan authors writing in Tibetan, Chinese, and English, both in Tibet and in the Tibetan diaspora.</p>

A review of behavioral and neurobiological data on mood and mood regulation as they pertain to an understanding of mood disorders is presented. Four approaches are considered: 1) behavioral and cognitive; 2) neurobiological; 3) computational; and 4) developmental. Within each of these four sections, we summarize the current status of the field and present our vision for the future, including particular challenges and opportunities. We conclude with a series of specific recommendations for National Institute of Mental Health priorities. Recommendations are presented for the behavioral domain, the neural domain, the domain of behavioral-neural interaction, for training, and for dissemination. It is in the domain of behavioral-neural interaction, in particular, that new research is required that brings together traditions that have developed relatively independently. Training interdisciplinary clinical scientists who meaningfully draw upon both behavioral and neuroscientific literatures and methods is critically required for the realization of these goals.
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Objective: We sought to evaluate the neurophysiology of mindfulness-based cognitive therapy for children (MBCT-C) in youth with generalized, social, and/or separation anxiety disorder who were at risk for developing bipolar disorder.Methods: Nine youth (mean age: 13 ± 2 years) with a generalized, social, and/or separation anxiety disorder and a parent with bipolar disorder completed functional magnetic resonance imaging (fMRI) while performing a continuous processing task with emotional and neutral distractors (CPT-END) prior to and following 12 weeks of MBCT-C. Results: MBCT-C was associated with increases in activation of the bilateral insula, lentiform nucleus, and thalamus, as well as the left anterior cingulate while viewing emotional stimuli during the CPT-END, and decreases in anxiety were correlated with change in activation in the bilateral insula and anterior cingulate during the viewing of emotional stimuli (p < 0.05, uncorrected; p < 0.005 corrected; cluster size, 37 voxels). Conclusions: MBCT-C treatment in anxious youth with a familial history of bipolar disorder is associated with increased activation of brain structures that subserve interoception and the processing of internal stimuli—functions that are ostensibly improved by this treatment.

Objective(1) Evaluate feasibility and acceptability of a mindfulness-based group in adolescent girls at-risk for type 2 diabetes (T2D) with depressive symptoms, and (2) compare efficacy of a mindfulness-based versus cognitive-behavioral group for decreasing depressive symptoms and improving insulin resistance. Design and setting Parallel-group, randomized controlled pilot trial conducted at a university. Participants Thirty-three girls 12–17y with overweight/obesity, family history of diabetes, and elevated depressive symptoms were randomized to a six-week mindfulness-based (n = 17) or cognitive-behavioral program (n = 16). Interventions Both interventions included six, one-hour weekly group sessions. The mindfulness-based program included guided mindfulness awareness practices. The cognitive-behavioral program involved cognitive restructuring and behavioral activation. Main outcome measures Adolescents were evaluated at baseline, post-intervention, and six-months. Feasibility/acceptability were measured by attendance and program ratings. Depressive symptoms were assessed by validated survey. Insulin resistance was determined from fasting insulin and glucose, and dual energy x-ray absorptiometry was used to assess body composition. Results Most adolescents attended ≥80% sessions (mindfulness: 92% versus cognitive-behavioral: 87%, p = 1.00). Acceptability ratings were strong. At post-treatment and six-months, adolescents in the mindfulness condition had greater decreases in depressive symptoms than adolescents in the cognitive-behavioral condition (ps < .05). Compared to the cognitive-behavioral condition, adolescents in the mindfulness-based intervention also had greater decreases in insulin resistance and fasting insulin at post-treatment, adjusting for fat mass and other covariates (ps < .05). Conclusions A mindfulness-based intervention shows feasibility and acceptability in girls at-risk for T2D with depressive symptoms. Compared to a cognitive-behavioral program, after the intervention, adolescents who received mindfulness showed greater reductions in depressive symptoms and better insulin resistance.

OBJECTIVE: To examine the feasibility and initial efficacy of 2 abbreviated dialectical behavior therapy (DBT) skills training groups: emotion regulation skills only and emotion regulation with mindfulness skills.PARTICIPANTS: Participants were 24 undergraduates (aged 18-29) with significant emotion dysregulation who participated between February and May of 2010, 2011, and 2012. METHODS: Participants participated in 2-hour weekly group sessions for 8 weeks and completed outcome measures at baseline, midtreatment, posttreatment, and 4-week follow-up. RESULTS: Participants in both conditions made significant gains, with large effect sizes, across measures of emotion regulation, affect, skills use, and functioning. There were no differences between the 2 groups, suggesting no additive benefit of mindfulness skills. CONCLUSIONS: This pilot study provides support for the acceptability and efficacy of abbreviated DBT skills training in colleges, given significant improvements, positive feedback, and low attrition. Impediments to feasibility included recruitment difficulties, particularly due to scheduling constraints.

Randomized controlled trials have demonstrated that mindfulness-based cognitive therapy (MBCT) is efficacious in reducing residual depressive symptoms and preventing future depressive episodes (Kuyken et al., 2016). One potential treatment effect of MBCT may be improvement of positive affect (PA), due to improved awareness of daily positive events (Geschwind et al., 2011). Considering social anxiety disorder (SAD) is characterized by diminished PA (Brown et al., 1998; Kashdan, 2007), we sought to determine whether MBCT would reduce social anxiety symptoms, and whether this reduction would be associated with improvement of PA deficits. Adults (N = 22) who met criteria for varied anxiety disorders participated in a small, open-label trial of an 8-week manualized MBCT intervention. Most participants presented with either a diagnosis (primary, secondary, or tertiary) of generalized anxiety disorder (GAD) (N = 15) and/or SAD (N = 14) prior to treatment, with eight individuals meeting diagnostic criteria for both GAD and SAD. We hypothesized participants would demonstrate improvements in social anxiety symptoms, which would be predicted by improvements in PA, not reductions in negative affect (NA). Results of several hierarchical linear regression analyses (completed in both full and disorder-specific samples) indicated that improvements in PA but not reductions in NA predicted social anxiety improvement. This effect was not observed for symptoms of worry, which were instead predicted by decreased NA for individuals diagnosed with GAD and both decreased NA and increased PA in the entire sample. Results suggest that MBCT may be efficacious in mitigating social anxiety symptoms, and this therapeutic effect may be linked to improvements in PA. However, further work is necessary considering the small, heterogeneous sample, uncontrolled study design, and exploratory nature of the study.

BackgroundAdjunctive psychological interventions for bipolar disorder have demonstrated better efficacy in preventing or delaying relapse and improving outcomes compared with pharmacotherapy alone. Aims To evaluate the efficacy of psychological interventions for bipolar disorder in low- and middle-income countries. Method A systematic review was conducted using PubMed, PsycINFO, Medline, EMBASE, Cochrane database for systematic review, Cochrane central register of controlled trials, Latin America and Caribbean Center on Health Science Literature and African Journals Online databases with no restriction of language or year of publication. Methodological heterogeneity of studies precluded meta-analysis. Results A total of 18 adjunctive studies were identified: psychoeducation (n = 14), family intervention (n = 1), group cognitive–behavioural therapy (CBT) (n = 2) and group mindfulness-based cognitive therapy (MBCT) (n = 1). In total, 16 of the 18 studies were from upper-middle-income countries and none from low-income countries. All used mental health specialists or experienced therapists to deliver the intervention. Most of the studies have moderately high risk of bias. Psychoeducation improved treatment adherence, knowledge of and attitudes towards bipolar disorder and quality of life, and led to decreased relapse rates and hospital admissions. Family psychoeducation prevented relapse, decreased hospital admissions and improved medication adherence. CBT reduced both depressive and manic symptoms. MBCT reduced emotional dysregulation. Conclusions Adjunctive psychological interventions alongside pharmacotherapy appear to improve the clinical outcome and quality of life of people with bipolar disorder in middle-income countries. Further studies are required to investigate contextual adaptation and the role of non-specialists in the provision of psychological interventions to ensure scalability and the efficacy of these interventions in low-income country settings.

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.

Depression has been associated with dysfunctional executive functions and abnormal activity within the anterior cingulate cortex (ACC), a region critically involved in action regulation. Prior research invites the possibility that executive deficits in depression may arise from abnormal responses to negative feedback or errors, but the underlying neural substrates remain unknown. We hypothesized that abnormal reactions to error would be associated with dysfunctional rostral ACC activity, a region previously implicated in error detection and evaluation of the emotional significance of events. To test this hypothesis, subjects with low and high Beck Depression Inventory (BDI) scores performed an Eriksen Flanker task. To assess whether tonic activity within the rostral ACC predicted post-error adjustments, 128-channel resting EEG data were collected before the task and analyzed with low-resolution electromagnetic tomography (LORETA) using a region-of-interest approach. High BDI subjects were uniquely characterized by significantly lower accuracy after incorrect than correct trials. Mirroring the behavioral findings, high BDI subjects had significantly reduced pretask gamma (36.5-44 Hz) current density within the affective (rostral; BA24, BA25, BA32) but not cognitive (dorsal; BA24', BA32') ACC subdivision. For low, but not high, BDI subjects pretask gamma within the affective ACC subdivision predicted post-error adjustments even after controlling for activity within the cognitive ACC subdivision. Abnormal responses to errors may thus arise due to lower activity within regions subserving affective and/or motivational responses to salient cues. Because rostral ACC regions have been implicated in treatment response in depression, our findings provide initial insight into putative mechanisms fostering treatment response.
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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.

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