Mindfulness-based interventions (MBIs) improve depression symptoms after traumatic brain injury (TBI), with medium to large effect sizes. The goal of this study was to determine the clinical significance of individual changes in depression symptoms by examining data from three studies. Three criteria were used to assess the clinical significance of pre- to post-treatment change in Beck Depression Inventory-II (BDI-II) scores: (1) reliable change to account for measurement error, (2) five-point change to detect minimally important clinical differences, and (3) severity change to measure the severity of depression symptoms. The number of participants who met all three of these criteria (i.e., the three-criterion standard) was calculated for (a) all MBI participants across the three studies (N = 90) and for (b) only participants who completed the randomized controlled trial (study 3). According to the three-criterion standard, 50 % of TBI participants had BDI-II scores that clinically improved (45/90) and none had scores that deteriorated. When this standard was applied to study 3, more participants in the treatment group (20/38) had improved scores compared to controls (13/38). The majority of all participants also showed clinically improved BDI-II scores according to each of the separate criteria: reliable change (64/90), five-point change (49/90), and severity change (51/90). We suggest that (a) the three-criterion standard be considered the gold standard for assessing treatment-related change in depression symptoms, and (b) reporting the clinical significance of individual change may be more informative to clinicians when assessing the impact of MBIs on clients with TBI compared to findings based exclusively on group averages.
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.
Children with a cancer diagnosis experience symptom distress, including anxiety, because of the disease and its treatment. Parents experience stress and anxiety because of the uncertainty of the disease as well as the suffering of their children. Yoga is a complementary intervention that has physiological and psychological benefits in healthy children and healthy and chronically ill adults. On an inpatient hematology/oncology unit, 11 children aged 6 to 12 years, 5 adolescents aged 13 to 18 years, and 33 parents participated in a single yoga session tailored to the needs and abilities of the patients and parents. Sense of well-being pre- and postclass was measured with the Spielberger State Anxiety Scale. Children had normal anxiety scores preclass that did not change. Adolescents and parents experienced significant decreases in anxiety scores, and all cohorts gave positive feedback about the experience. The authors conclude that yoga is a feasible intervention for this population and is beneficial to adolescents and parents.
Zotero Collections:
Children with a cancer diagnosis experience symptom distress, including anxiety, because of the disease and its treatment. Parents experience stress and anxiety because of the uncertainty of the disease as well as the suffering of their children. Yoga is a complementary intervention that has physiological and psychological benefits in healthy children and healthy and chronically ill adults. On an inpatient hematology/oncology unit, 11 children aged 6 to 12 years, 5 adolescents aged 13 to 18 years, and 33 parents participated in a single yoga session tailored to the needs and abilities of the patients and parents. Sense of well-being pre- and postclass was measured with the Spielberger State Anxiety Scale. Children had normal anxiety scores preclass that did not change. Adolescents and parents experienced significant decreases in anxiety scores, and all cohorts gave positive feedback about the experience. The authors conclude that yoga is a feasible intervention for this population and is beneficial to adolescents and parents.
PURPOSE: The purpose of this paper is to describe the health benefits reported by breast cancer survivors following an 8-week yoga intervention.DESIGN: This phenomenological study employed three focus groups with six breast cancer survivors each (n = 18) following the yoga intervention.
SETTING: The focus groups and yoga classes were conducted in a large hospital in a midsized town in the Midwest.
SUBJECTS: Eighteen female breast cancer survivors who were at least 9 months posttreatment participated in the focus groups following the 8-week yoga intervention.
INTERVENTION: An 8-week yoga intervention designed specifically for this population was led by a yoga therapist.
MEASURES: A semistructured interview guide was utilized to guide each focus group.
ANALYSIS: Interpretative phenomenological analysis methods were employed to explore breast cancer survivors' experiences after participating in an 8-week yoga intervention.
RESULTS: The findings revealed that the women in the study found health promoting benefits in the areas of physical health and healing, mental health and healing, and social health and healing.
CONCLUSIONS: Yoga may be an important tool in the healing process for breast cancer survivors.
<p>In this meta-analysis, we give a comprehensive overview of the effects of meditation on psychological variables that can be extracted from empirical studies, concentrating on the effects of meditation on nonclinical groups of adult meditators. Mostly because of methodological problems, almost ¾ of an initially identified 595 studies had to be excluded. Most studies appear to have been conducted without sufficient theoretical background. To put the results into perspective, we briefly summarize the major theoretical approaches from both East and West. The 163 studies that allowed the calculation of effect sizes exhibited medium average effects ( = .28 for all studies and = .27 for the n = 125 studies from reviewed journals), which cannot be explained by mere relaxation or cognitive restructuring effects. In general, results were strongest (medium to large) for changes in emotionality and relationship issues, less strong (about medium) for measures of attention, and weakest (small to medium) for more cognitive measures. However, specific findings varied across different approaches to meditation (transcendental meditation, mindfulness meditation, and other meditation techniques). Surprisingly, meditation experience only partially covaried with long-term impact on the variables examined. In general, the dependent variables used cover only some of the content areas about which predictions can be made from already existing theories about meditation; still, such predictions lack precision at present. We conclude that to arrive at a comprehensive understanding of why and how meditation works, emphasis should be placed on the development of more precise theories and measurement devices.</p>
Zotero Collections:
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.
Today on Cause Talk Radio, Megan and Joe talk to William MacAskill, associate professor at Oxford University and author of a great new book: Doing Good Better. Will is one of the cofounders and leading voices of Effective Altruism, which he calls “Generosity for Nerds.”
ObjectivesSuicide is a leading cause of death in the USA. Although factors elevating long‐term risk for suicide are known and include bipolar disorder, signs of imminent suicide risk are difficult to study and not well specified. Acute risk determinations must be made to determine the appropriate level of care to safeguard patients. To increase safety among at‐risk patients in the short term and to decrease risk over time, psychosocial interventions to prevent suicide have been developed and tested in acute care and outpatient settings.
Methods
A narrative review of studies of imminent risk factors for suicide, suicide risk decision‐making, and psychosocial suicide prevention interventions was conducted.
Results
Although some long‐term risk factors of suicide have been established, accurate identification of individuals at imminent risk for suicide is difficult. Therefore, prevention efforts targeting individuals at high suicide behavior risk discharging from acute care settings tend to be generic and focus on psychoeducation and supportive follow‐up contact. Data regarding the effectiveness of brief interventions (i.e., those not requiring more than one individualized treatment session) are mixed, showing better outcomes in the shorter term and when the incidence of suicidal behavior or ideation is the outcome. With respect to longer‐term suicide prevention interventions (i.e., those with a minimum of ten sessions), Dialectical Behavior Therapy has the largest evidence base.
Conclusions
To improve suicide prevention efforts, more rigorous study of imminent risk factors and psychosocial interventions is needed. Adaptations specific to individuals with bipolar disorder are possible and needed.
Objective: To systematically evaluate the safety, feasibility, and effect of exercise among women with stage II+ breast cancer. Data Sources: CINAHL, Cochrane, Ebscohost, MEDLINE, Pubmed, ProQuest Health and Medical Complete, ProQuest Nursing and Allied Health Source, Science Direct and SPORTDiscus were searched for articles published before March 1, 2017. Study Selection: Randomized, controlled, exercise trials involving at least 50% of women diagnosed with stage II+ breast cancer were included. Data Extraction: Risk of bias was assessed and adverse event severity was classified using the Common Terminology Criteria. Feasibility was evaluated by computing median (range) recruitment, withdrawal, and adherence rates. Meta-analyses were performed to evaluate exercise safety and effects on health outcomes only. The influence of intervention characteristics (mode, supervision, duration and timing) on exercise outcomes were also explored. Data Synthesis: There were no differences in adverse events between exercise and usual care (risk difference: <0.01 ([95% CI: -0.01, 0.01], P=0.38). Median recruitment rate was 56% (1%-96%), withdrawal rate was 10% (0%-41%) and adherence rate was 82% (44%-99%). Safety and feasibility outcomes were similar, irrespective of exercise mode, supervision, duration, or timing. Effects of exercise for quality of life, fitness, fatigue, strength, anxiety, depression, body mass index and waist circumference compared with usual care were significant (standardized mean difference range: 0.17-0.77, P<0.05). Conclusion: The findings support the safety, feasibility, and effects of exercise for those with stage II+ breast cancer, suggesting that national and international exercise guidelines appear generalizable to women with local, regional, and distant breast cancer. (C) 2018 by the American Congress of Rehabilitation Medicine
The use of Yoga and other complementary healthcare interventions for both clinical and non-clinical populations has increased substantially in recent years. In this context, we describe the implementation of Hatha Yoga in the Mindfulness-Based Stress Reduction (MBSR) program of Kabat-Zinn and colleagues. This is embedded in a more general consideration of Yoga’s place in complementary healthcare. In providing this overview, we comment on the nature and quality of current research on Yoga, summarize current physiological and psychological explanations of its effects, and discuss practical issues related to teacher training and experience.
Zotero Collections:
Recently I came across a blog post about how to teach yoga and mindfulness to children with hearing loss. Since I've worked at a school for the deaf for a number of years I was interested to discover what insights the author might add. Miss Megan of Learning Lotuses joins us for this episode to chat about yoga for children with hearing loss. She'll share insights on what to expect as an instructor and how to navigate some potential hurdles. We'll discuss sensory processing and sensory fatigue, the effective use of FM systems, tips for gesturing (no sign language skills needed), and so much more.
Pages |