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Mindfulness‐based stress reduction (MBSR) has grown in popularity over the last two decades, showing efficacy for a variety of health issues. In the current study, we examined the effects of an MBSR intervention on pain, positive states of mind, stress, and mindfulness self‐efficacy. These measures were collected before and following an 8‐week intervention. Post‐intervention levels of stress were significantly lower than pre‐intervention levels, while mindfulness self‐efficacy and positive states of mind were at significantly higher levels. The findings underscore the potential for stress management, awareness and attention training, and positive states of mind using MBSR.
Human influences on the planet's atmosphere, hydrosphere and biosphere are of such magnitude as to justify naming a new geological epoch, the Anthropocene. Different starting dates and phases have been proposed for this epoch, depending on the criteria used. Recent advances in microbial genomics and ecology show that human perturbations to microbial populations correspond closely to the proposed phases of the Anthropocene: the ‘paleoanthropocene’ which began with the rise of agriculture; the industrial revolution, from the late 1700s; and the ‘Great Acceleration’ from the 1950s to the present day. As the Anthropocene unfolds, environmental instability will trigger episodes of directional natural selection in microbial populations, adding to contemporary effects that already include changes to the human microbiome; intense selection for antimicrobial resistance; alterations to microbial carbon and nitrogen cycles; accelerated dispersal of microorganisms and disease agents; and selection for altered pH and temperature tolerance. Microbial evolution is currently keeping pace with the environmental changes wrought by humanity. It remains to be seen whether organisms with longer generation times, smaller populations and larger sizes can do the same.
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As behavioral and cognitive psychotherapy traditions increasingly incorporate mindfulness concepts and practices, it is important to notice changes occurring in the cross-cultural translation of the ideas and practices from their Buddhist origins. The current study explored this issue utilizing a qualitative research method to collect data from seven “information-rich” participants. These participants were psychotherapists with long-term mindfulness practices; all integrating mindfulness into their psychotherapy work. They had, on average, 31 years of mindfulness meditation practice as a component of a larger spiritual practice. Participants were interviewed about their mindfulness practices, their therapeutic work, and their perspectives on how mindfulness in their spirituality-based meditation practices differs from and informs their psychotherapy work. A review of findings is presented as well as in-depth exploration of a selected meta-theme; participants all, at times, demonstrated a non-dualistic worldview and discussed the ideas of relative and ultimate reality. These views affected their use of language and contributed to the presence of dialectical and paradoxical responses. These concepts are important to consider as the development of therapist training in mindfulness-based treatment delivery evolves.
The authors asked breast cancer (BC) patients to participate in 1 of 3 mind-body interventions (cognitive-behavioral therapy (CBT), yoga, or self-hypnosis) to explore their feasibility, ease of compliance, and impact on the participants' distress, quality of life (QoL), sleep, and mental adjustment. Ninety-nine patients completed an intervention (CBT: n = 10; yoga: n = 21; and self-hypnosis: n = 68). Results showed high feasibility and high compliance. After the interventions, there was no significant effect in the CBT group but significant positive effects on distress in the yoga and self-hypnosis groups, and, also, on QoL, sleep, and mental adjustment in the self-hypnosis group. In conclusion, mind-body interventions can decrease distress in BC patients, but RCTs are needed to confirm these findings.
BackgroundMindfulness-based interventions have shown to improve depression and anxiety symptoms as well as quality of life in patients with inflammatory bowel disease (IBD). However, little is known about the experiences of this group of patients participating in mindfulness interventions. This paper sets out to explore the perspectives of patients with IBD recruited to a pilot randomised controlled trial (RCT) of mindfulness-based cognitive therapy (MBCT) about the intervention.
Methods
In a qualitative study nested within a parallel two-arm pilot RCT of mindfulness-based cognitive therapy for patients with IBD, two focus group interviews (using the same schedule) and a free text postal survey were conducted. Data from both were analysed using thematic analysis. Data and investigator triangulation was performed to enhance confidence in the ensuing findings.
Forty-four patients with IBD were recruited to the pilot RCT from gastroenterology outpatient clinics from two Scottish NHS boards. Eighteen of these patients (ten from mindfulness intervention and eight from control group) also completed a postal survey and participated in two focus groups after completing post intervention assessments.
Results
The major themes that emerged from the data were the following: perceived benefits of MBCT for IBD, barriers to attending MBCT and expectations about MBCT. Participants identified MBCT as a therapeutic, educational and an inclusive process as key benefits of the intervention. Key barriers included time and travel constraints.
Conclusions
This qualitative study has demonstrated the acceptability of MBCT in a group of patients with IBD. Participants saw MBCT as a therapeutic and educational initiative that transformed their relationship with the illness. The inclusive process and shared experience of MBCT alleviated the sense of social isolation commonly associated with IBD. However, time commitment and travel were recognised as a barrier to MBCT which could potentially influence the degree of therapeutic gain from MBCT for some participants.
Research Findings: This study examined processes of change associated with the positive preschool and kindergarten outcomes of children who received the Head Start REDI (REsearch-based, Developmentally Informed) intervention compared to usual practice Head Start. Using data from a large-scale randomized controlled trial ("N" = 356 children, 42% African American or Latino, all from low-income families), this study tests the logic model that improving preschool social-emotional skills (e.g., emotion understanding, social problem solving, and positive social behavior) as well as language/emergent literacy skills will promote cross-domain academic and behavioral adjustment after children transition into kindergarten. Validating this logic model, the present study finds that intervention effects on 3 important kindergarten outcomes (e.g., reading achievement, learning engagement, and positive social behavior) were mediated by preschool gains in the proximal social-emotional and language/emergent literacy skills targeted by the REDI intervention. It is important to note that preschool gains in social-emotional skills made unique contributions to kindergarten outcomes in reading achievement and learning engagement, even after we accounted for concurrent preschool gains in vocabulary and emergent literacy skills. Practice or Policy: These findings highlight the importance of fostering at-risk children's social-emotional skills during preschool as a means of promoting school readiness.
INTRODUCTION:Stress and burnout are highly prevalent among medical doctors, and are associated with negative consequences for doctors, patients, and organizations. The purpose of the current study was to examine the effectiveness of a mindfulness training intervention in reducing stress and burnout among medical practitioners, by means of a Randomised Controlled Trial design.
METHODS:
Participants were 44 intern doctors completing an emergency department rotation in a major Australian hospital. Participants were randomly assigned to either an active control (one hour extra break per week) or the 10-week mindfulness training intervention. Measures of stress and burnout were taken pre-, mid- and post intervention.
RESULTS:
Participants undergoing the 10-week mindfulness training program reported greater improvements in stress and burnout relative to participants in the control condition. Significant reduction in stress and burnout was observed for participants in the mindfulness condition. No such reductions were observed for participants in the control condition.
CONCLUSIONS:
Mindfulness interventions may provide medical practitioners with skills to effectively manage stress and burnout, thereby reducing their experience of these symptoms. It is likely that doctors would benefit from the inclusion of such a training program as a part of their general medical education.
"While living the pressured, fast-moving life of a photojournalist in Paris, the author learns of an enigmatic character named Sonam, a Tibetan medicine man or Amchi. Intrigued, she inquires as to where she might find this extraordinary man, and she is told to go to Ladakh and 'turn right over the mountain...' Right Over the Mountain is the captivating story of the journey and the amazing events that follow, as Gill Marais and her Indian companion, Nazir, travel through the mountains of Tibet. Sonam takes them out on his rounds, and together they witness miraculous examples of healing - even a woman who removes kidney stones without the use of surgery! This is an extraordinary and highly readable story, combining the best elements of an absorbing travel adventure with an account of one woman's spiritual search. Gill Marais offers a unique study of Tibetan medicine and folk beliefs. Above all, it is a lively and enthralling picture of a valuable and vanishing culture" -- Back cover.
Few studies have examined changes of diurnal cortisol profiles prospectively, in relation to non-pharmacological interventions such as mindfulness-based cognitive therapy (MBCT). Fifty-six patients remitted from recurrent depression (≥3 episodes) were included in an 8-week randomized controlled trial comparing MBCT plus treatment as usual (TAU) with TAU for depression relapse prophylaxis. Saliva samples (0, 15, 30, 45, 60 min post-awakening, 3 PM, 8 PM) were collected on six occasions (pre- and post-intervention, 3-, 6-, 9-, 12-month follow-up). Cortisol awakening response (CAR), average day exposure (AUCday) and diurnal slope were analyzed with mixed effects models (248 profiles, 1-6 per patient). MBCT (n = 28) and TAU groups (n = 28) did not significantly differ with respect to baseline variables. Intra-individual variability exceeded inter-individual variability for the CAR (62.2% vs. 32.5%), AUC(day) (30.9% vs. 23.6%) and diurnal slope (51.0% vs. 34.2%). No time, group and time by group effect was observed for the CAR and diurnal slope. A significant time effect (p = 0.003) was detected for AUCday, which was explained by seasonal variations (p = 0.012). Later wake-up was associated with lower CAR (-11.7% per 1-hour later awakening, p < 0.001) and lower AUCday (-4.5%, p = 0.014). Longer depression history was associated with dampened CAR (-15.2% per 10-year longer illness, p = 0.003) and lower AUCday (-8.8%, p = 0.011). Unchanged cortisol secretion patterns following participation in MBCT should be interpreted with regard to large unexplained variability, similar relapse rates in both groups and study limitations. Further research is needed to address the scar hypothesis of diminished HPA activity with a longer, chronic course of depression.
BackgroundInflammatory bowel disease (IBD) is a chronic condition with an unpredictable disease course. Rates of anxiety and depression among IBD patients in relapse (active disease symptoms) as well as in remission are higher than in the general population. Previous studies suggest that the prolonged effect of pain, anxiety, distress and depression have a detrimental effect on patients’quality of life (QoL). Poor QoL in itself is associated with further symptom relapse. Mindfulness based cognitive therapy (MBCT) is a psychological group intervention that has the potential to improve QoL. When used in other chronic conditions, it demonstrated reduced negative effect from pain and psychological factors at completion of an 8-week MBCT course. The effect of MBCT has never been researched in IBD. The aim of this study is to obtain the information required to design a full scale randomised controlled trial (RCT) that will examine the effectiveness of MBCT in improving quality of life for IBD patients.
Methods/Design
This is an exploratory RCT with embedded process evaluation. Forty IBD patients will be recruited from NHS outpatient gastroenterology clinics and will be randomised to either a MBCT (intervention) group or to a wait-list (control) group. All participants will undergo 16 h of structured group training over an 8-week period, with the control group starting 6 months later than the intervention group. Primary outcomes are recruitment, completion/retention rates and adherence and adaptation to the MBCT manual for IBD patients. The secondary outcome is to assess the feasibility of collecting reliable and valid data on proposed outcome measures such as quality of life, anxiety, depression, disease activity and mindful awareness. The process evaluation will use a survey and focus groups to assess the acceptability of the intervention and trial procedures for IBD patients.
Discussion
The outcomes of this study will help define the barriers, uptake and perceived benefits of MBCT program for IBD patients. This information will enable the design of a full-scale study assessing the effect of MBCT on quality of life for IBD patients.