BackgroundDepression is often a chronic relapsing condition, with relapse rates of 50-80% in those who have been depressed before. This is particularly problematic for those who become suicidal when depressed since habitual recurrence of suicidal thoughts increases likelihood of further acute suicidal episodes. Therefore the question how to prevent relapse is of particular urgency in this group.
Methods/Design
This trial compares Mindfulness-Based Cognitive Therapy (MBCT), a novel form of treatment combining mindfulness meditation and cognitive therapy for depression, with both Cognitive Psycho-Education (CPE), an equally plausible cognitive treatment but without meditation, and treatment as usual (TAU). It will test whether MBCT reduces the risk of relapse in recurrently depressed patients and the incidence of suicidal symptoms in those with a history of suicidality who do relapse. It recruits participants, screens them by telephone for main inclusion and exclusion criteria and, if they are eligible, invites them to a pre-treatment session to assess eligibility in more detail. This trial allocates eligible participants at random between MBCT and TAU, CPE and TAU, and TAU alone in a ratio of 2:2:1, stratified by presence of suicidal ideation or behaviour and current anti-depressant use. We aim to recruit sufficient participants to allow for retention of 300 following attrition. We deliver both active treatments in groups meeting for two hours every week for eight weeks. We shall estimate effects on rates of relapse and suicidal symptoms over 12 months following treatment and assess clinical status immediately after treatment, and three, six, nine and twelve months thereafter.
Discussion
This will be the first trial of MBCT to investigate whether MCBT is effective in preventing relapse to depression when compared with a control psychological treatment of equal plausibility; and to explore the use of MBCT for the most severe recurrent depression - that in people who become suicidal when depressed.
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.
Many childhood and adolescent stress-related symptoms have a psychophysiological component that involves muscular tension and/or autonomic nervous system dysfunction. Examples of this include recurrent headache, chest pain, abdominal pain, syncope, and dizziness. After a careful medical and psychosocial evaluation, the clinician may identify many patients who are appropriate for the application of stress reduction techniques such as progressive muscular relaxation, meditation, biofeedback, and relaxation/mental imagery (self-hypnosis). This review describes these techniques and their application with selected children and adolescents.
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Different conceptual perspectives converge to predict that if individuals are stressed, an encounter with most unthreatening natural environments will have a stress reducing or restorative influence, whereas many urban environments will hamper recuperation. Hypotheses regarding emotional, attentional and physiological aspects of stress reducing influences of nature are derived from a psycho-evolutionary theory. To investigate these hypotheses, 120 subjects first viewed a stressful movie, and then were exposed to color/sound videotapes of one of six different natural and urban settings. Data concerning stress recovery during the environmental presentations were obtained from self-ratings of affective states and a battery of physiological measures: heart period, muscle tension, skin conductance and pulse transit time, a non-invasive measure that correlates with systolic blood pressure. Findings from the physiological and verbal measures converged to indicate that recovery was faster and more complete when subjects were exposed to natural rather than urban environments. The pattern of physiological findings raised the possibility that responses to nature had a salient parasympathetic nervous system component; however, there was no evidence of pronounced parasympathetic involvement in responses to the urban settings. There were directional differences in cardiac responses to the natural vs urban settings, suggesting that attention/intake was higher during the natural exposures. However, both the stressor film and the nature settings elicited high levels of involuntary or automatic attention, which contradicts the notion that restorative influences of nature stem from involuntary attention or fascination. Findings were consistent with the predictions of the psycho-evolutionary theory that restorative influences of nature involve a shift towards a more positively-toned emotional state, positive changes in physiological activity levels, and that these changes are accompanied by sustained attention/intake. Content differences in terms of natural vs human-made properties appeared decisive in accounting for the differences in recuperation and perceptual intake.
<p><em>Studies in Nepali History and Society</em> (SINHAS) aims to further understanding of cultural politics and social conditions in Nepal through a commitment to historical analysis, attention to Nepali scholarship, and a willingness to explore new terrain. The journal provides an interdisciplinary forum for original research with an emphasis is on work that i) opens up to scholarship areas of study that have not traditionally been part of "Nepal Studies" and ii) casts new light on familiar topics. Articles are either in English or Nepali.</p>
<p>SINHAS will be of value not only to scholars of Nepal, but also to development practitioners, and to other South Asianists who seek to understand the complex history of Nepali society. SINHAS encourages clear and jargon-free prose. Thus it will also be a useful source for travellers and others interested in Nepal who seek a more in-depth picture of Nepali society than that provided by guidebooks and travel literature.</p>
<p>Contents of SINHAS include: Research-based articles by academics, development workers and social activists; essays and fiction about Nepali history and social life by creative writers; multi-volume book review essays; "For a Scholarship of Nepal," an occasional forum for critical reflection on the state of Nepal scholarship; "Commentary," a forum for opinion pieces on subjects of contemporary concern in Nepal by authors with first-hand experience in the area under discussion; and reference bibliographies on topics of importance to Nepal Studies. (2006-01-10)</p>
A strong body of research indicates that evidence-based programs designed to promote social and emotional learning (SEL) can lead to positive developmental outcomes for children and youth. Although these evidence-based programs have demonstrated benefits for students, it is also well-established that programs must be implemented with quality and sustained to maximize positive outcomes. To support schools in implementing SEL that is integrated into all aspects of a school community, the CASEL School Guide implementation model was developed to guide school leadership teams in establishing a vision; selecting, implementing, and sustaining evidence-based programs; and integrating SEL schoolwide. The School Guide model is based on CASEL's School Theory of Action which includes planning, implementing, and monitoring schoolwide SEL. This paper describes findings about the feasibility and degree of implementation of this model as carried out by 14 school leadership teams who were supported by SEL coaches. The participating schools implemented an evidence-based SEL program as the foundation of their efforts to promote schoolwide SEL. Findings demonstrate the feasibility of implementing this model in urban schools that primarily serve students of color, as all teams successfully carried out the implementation model and demonstrated increased levels of capacity related to supporting schoolwide SEL.
A strong body of research indicates that evidence-based programs designed to promote social and emotional learning (SEL) can lead to positive developmental outcomes for children and youth. Although these evidence-based programs have demonstrated benefits for students, it is also well-established that programs must be implemented with quality and sustained to maximize positive outcomes. To support schools in implementing SEL that is integrated into all aspects of a school community, the CASEL School Guide implementation model was developed to guide school leadership teams in establishing a vision; selecting, implementing, and sustaining evidence-based programs; and integrating SEL schoolwide. The School Guide model is based on CASEL's School Theory of Action which includes planning, implementing, and monitoring schoolwide SEL. This paper describes findings about the feasibility and degree of implementation of this model as carried out by 14 school leadership teams who were supported by SEL coaches. The participating schools implemented an evidence-based SEL program as the foundation of their efforts to promote schoolwide SEL. Findings demonstrate the feasibility of implementing this model in urban schools that primarily serve students of color, as all teams successfully carried out the implementation model and demonstrated increased levels of capacity related to supporting schoolwide SEL.
<p>A trilingual online dictionary of Thangmi, Nepali and English which displays using Nepali characters. Approximately 2,000 entries and the first online deployment of a Nepali Unicode language database. (Mark Turin 2004-03-23)</p>
24 articles by scholars from nine different countries on languages spoken in the Himalayan regions of Nepal, India, Tibet and China. (Mark Turin 2004-03-23)
Comment éviter les rechutes dépressives grâce à un programme basé sur la pleine conscience. Un programme qui a fait ses preuves et ne cesse de prouver son efficacité sur le terrain!
Comment éviter les rechutes dépressives grâce à un programme basé sur la pleine conscience. Un programme qui a fait ses preuves et ne cesse de prouver son efficacité sur le terrain!
Comment éviter les rechutes dépressives grâce à un programme basé sur la pleine conscience. Un programme qui a fait ses preuves et ne cesse de prouver son efficacité sur le terrain!
<p>This article is based on the study of Thakali population in Nepal. It focuses on language and ethnicity among the Thakali. (Rajeev Ranjan Singh 2007-03-05)</p>
In this study, the authors both developed and validated a self-report mindfulness measure, the Toronto Mindfulness Scale (TMS). In Study 1, participants were individuals with and without meditation experience. Results showed good internal consistency and two factors, Curiosity and Decentering. Most of the expected relationships with other constructs were as expected. The TMS scores increased with increasing mindfulness meditation experience. In Study 2. criterion and incremental validity of the TMS were investigated on a group of individuals participating in 8-week mindfulness-based stress reduction programs. Results showed that TMS scores increased following treatment, and Decentering scores predicted improvements in clinical outcome. Thus, the TMS is a promising measure of the mindfulness state with good psychometric properties and predictive of treatment outcome. Keywords: Toronto Mindfulness Scale; self-report assessment: mindfulness; meditation; psychometric characteristics
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Mindfulness, as both a process and a practice, has received substantial research attention across a range of health conditions, including chronic pain. Previously proposed mechanisms underlying the potential health-related benefits of mindfulness and mindfulness-based interventions (MBIs) are based on a strong theoretical background. However, to date, an empirically grounded, integrated theoretical model of the mechanisms of MBIs within the context of chronic pain has yet to be proposed. This is a surprising gap in the literature given the exponential growth of studies reporting on the benefits of MBIs for heterogeneous chronic pain conditions. Moreover, given the importance of determining how, and for whom, psychological interventions for pain management are effective, it is imperative that this gap in the literature be addressed. The overarching aim of the current theoretical paper was to propose an initial integrated, theoretically driven, and empirically based model of the mechanisms of MBIs for chronic pain management. Theoretical and research implications of the model are discussed. The theoretical considerations proposed herein can be used to help organize and guide future research that will identify the mechanisms underlying the benefits of mindfulness-based treatments, and perhaps psychosocial treatments more broadly, for chronic pain management.
Mindfulness, as both a process and a practice, has received substantial research attention across a range of health conditions, including chronic pain. Previously proposed mechanisms underlying the potential health-related benefits of mindfulness and mindfulness-based interventions (MBIs) are based on a strong theoretical background. However, to date, an empirically grounded, integrated theoretical model of the mechanisms of MBIs within the context of chronic pain has yet to be proposed. This is a surprising gap in the literature given the exponential growth of studies reporting on the benefits of MBIs for heterogeneous chronic pain conditions. Moreover, given the importance of determining how, and for whom, psychological interventions for pain management are effective, it is imperative that this gap in the literature be addressed. The overarching aim of the current theoretical paper was to propose an initial integrated, theoretically driven, and empirically based model of the mechanisms of MBIs for chronic pain management. Theoretical and research implications of the model are discussed. The theoretical considerations proposed herein can be used to help organize and guide future research that will identify the mechanisms underlying the benefits of mindfulness-based treatments, and perhaps psychosocial treatments more broadly, for chronic pain management.
Several randomised controlled trials suggest that mindfulness-based approaches are helpful in preventing depressive relapse and recurrence, and the UK Government’s National Institute for Health and Clinical Excellence has recommended these interventions for use in the National Health Service. There are good grounds to suggest that mindfulness-based approaches are also helpful with anxiety disorders and a range of chronic physical health problems, and there is much clinical and research interest in applying mindfulness approaches to other populations and problems such as people with personality disorders, substance abuse, and eating disorders. We review the UK context for developments in mindfulness-based approaches and set out criteria for mindfulness teacher competence and training steps, as well as some of the challenges and future directions that can be anticipated in ensuring that evidence-based mindfulness approaches are available in health care and other settings.
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Several randomised controlled trials suggest that mindfulness-based approaches are helpful in preventing depressive relapse and recurrence, and the UK Government’s National Institute for Health and Clinical Excellence has recommended these interventions for use in the National Health Service. There are good grounds to suggest that mindfulness-based approaches are also helpful with anxiety disorders and a range of chronic physical health problems, and there is much clinical and research interest in applying mindfulness approaches to other populations and problems such as people with personality disorders, substance abuse, and eating disorders. We review the UK context for developments in mindfulness-based approaches and set out criteria for mindfulness teacher competence and training steps, as well as some of the challenges and future directions that can be anticipated in ensuring that evidence-based mindfulness approaches are available in health care and other settings.
Mindfulness has been suggested to be an important protective factor for emotional health. However, this effect might vary with regard to context. This study applied a novel statistical approach, quantile regression, in order to investigate the relation between trait mindfulness and residual depressive symptoms in individuals with a history of recurrent depression, while taking into account symptom severity and number of episodes as contextual factors. Rather than fitting to a single indicator of central tendency, quantile regression allows exploration of relations across the entire range of the response variable. Analysis of self-report data from 274 participants with a history of three or more previous episodes of depression showed that relatively higher levels of mindfulness were associated with relatively lower levels of residual depressive symptoms. This relationship was most pronounced near the upper end of the response distribution and moderated by the number of previous episodes of depression at the higher quantiles. The findings suggest that with lower levels of mindfulness, residual symptoms are less constrained and more likely to be influenced by other factors. Further, the limiting effect of mindfulness on residual symptoms is most salient in those with higher numbers of episodes.
The environmental movement has made huge progress over the last decades. Among others, it has raised awareness of challenges facing humanity, helped develop a critical mass of policies, and worked towards the implementation of many of these policies in collaboration with other stakeholders. Now, however, we are at a turning point in the history of the global environmental movement. In order to rise to challenges of the twenty-first century such as climate change and peak oil, it will not be possible to do business as usual; a step change will be needed. As IUCN celebrates its 60th anniversary, and marks six decades of global conservation achievement, it is also taking stock of the urgent challenges facing life on earth and reviewing its strategies. The key to future conservation action will lie in reconciling the needs of the environment with those of society in a manner that is equitable and just, and in promoting sustainable lifestyles and livelihoods as well as protecting endangered species and spaces. This document outlines IUCN’s Future of Sustainability initiative, the rationale for its implementation, and describes how the conservation movement can play new and decisive roles in the transition to sustainability.
This paper seeks to contribute to the debate around sustainability by proposing the need for an ecocentric stance to sustainability that reflexively embeds humans in—rather than detached from—nature. We argue that this requires a different way of thinking about our relationship with our world, necessitating a (re)engagement with the sociomaterial world in which we live. We develop the notion of ecocentrism by drawing on insights from sociomateriality studies, and show how radical-reflexivity enables us to appreciate our embeddedness and responsibility for sustainability by bringing attention to the interrelationship between values, actions and our social and material world. We examine the implications of an ecocentric radically reflexive approach to sustainability for management education.
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