This panel proposes to bring together scholars and practitioners for a multidisciplinary exploration of ‘potent substances’—the herbal, fungal, mineral, metal, and animal-based materia medica at the heart of Asian medicines. We aim to discuss issues
Acceptance-based interventions such as mindfulness-based stress reduction program and acceptance and commitment therapy are alternative therapies for cognitive behavioral therapy for treating chronic pain patients. To assess the effects of acceptance-based interventions on patients with chronic pain, we conducted a systematic review and meta-analysis of controlled and noncontrolled studies reporting effects on mental and physical health of pain patients. All studies were rated for quality. Primary outcome measures were pain intensity and depression. Secondary outcomes were anxiety, physical wellbeing, and quality of life. Twenty-two studies (9 randomized controlled studies, 5 clinical controlled studies [without randomization] and 8 noncontrolled studies) were included, totaling 1235 patients with chronic pain. An effect size on pain of 0.37 was found for the controlled studies. The effect on depression was 0.32. The quality of the studies was not found to moderate the effects of acceptance-based interventions. The results suggest that at present mindfulness-based stress reduction program and acceptance and commitment therapy are not superior to cognitive behavioral therapy but can be good alternatives. More high-quality studies are needed. It is recommended to focus on therapies that integrate mindfulness and behavioral therapy. Acceptance-based therapies have small to medium effects on physical and mental health in chronic pain patients. These effects are comparable to those of cognitive behavioral therapy.
As mindfulness-based cognitive therapy (MBCT) becomes an increasingly mainstream approach for recurrent depression, there is a growing need for practitioners who are able to teach MBCT. The requirements for being competent as a mindfulness-based teacher include personal meditation practice and at least a year of additional professional training. This study is the first to investigate the relationship between MBCT teacher competence and several key dimensions of MBCT treatment outcomes. Patients with recurrent depression in remission (N = 241) participated in a multi-centre trial of MBCT, provided by 15 teachers. Teacher competence was assessed using the Mindfulness-Based Interventions: Teaching Assessment Criteria (MBI:TAC) based on two to four randomly selected video-recorded sessions of each of the 15 teachers, evaluated by 16 trained assessors. Results showed that teacher competence was not significantly associated with adherence (number of MBCT sessions attended), possible mechanisms of change (rumination, cognitive reactivity, mindfulness, and self-compassion), or key outcomes (depressive symptoms at post treatment and depressive relapse/recurrence during the 15-month follow-up). Thus, findings from the current study indicate no robust effects of teacher competence, as measured by the MBI:TAC, on possible mediators and outcome variables in MBCT for recurrent depression. Possible explanations are the standardized delivery of MBCT, the strong emphasis on self-reliance within the MBCT learning process, the importance of participant-related factors, the difficulties in assessing teacher competence, the absence of main treatment effects in terms of reducing depressive symptoms, and the relatively small selection of videotapes. Further work is required to systematically investigate these explanations.
This doctoral dissertation forges and explores connections, flows and frictions between two seemingly unrelated manufacturers of Tibetan medicines: Men-Tsee-Khang, the Tibetan Medical and Astrological Institute in Dharamsala (Himachal Pradesh, India), and PADMA AG in Wetzikon (Zürich, Switzerland). Adopting a translocal, multispecies approach by positioning plant-medicines as the central actors in this ethnography, I trace how four plants - aru, ruta, tserngön and bongnak - become part of medicine in and between these two establishments of Sowa Rigpa of similar age and output volume, situated in highly diverse contexts at a stereotypical 'periphery' and 'core' of Western technoscience respectively. Inspired by Science and Technology Studies and by Pordié and Gaudillière's (2014a) 'reformulation regime' of industrial Ayurvedic proprietary products, I analyse the on-going material, technoscientific, and regulatory reformulations of Tibetan materia medica as they are actualised in contemporary recipes based on classical texts. In this thesis, I describe how both PADMA and Men-Tsee-Khang refer to Tibetan medical texts yet also rely on botanical taxonomy for plant identification. Both face the uncertainties of sourcing raw materials in bulk from growers and traders on the Indian market, skilfully mass-produce pills by means of machines for grinding, mixing, sieving and packaging, and depend on in-house laboratory analyses and each-other's expertise in the construction of hybrid 'qualities'. They are also forced to interact with technomedical conceptions of drug safety and toxicity, and with European medicine and food registration legislation to varying degrees. I argue that in performing this series of technoscientific reformulations, Tibetan medicines are becoming 'alternative pharmaceuticals': liminal, paradoxical yet politically subversive things oscillating betwixt and between tradition and modernity, orthodoxy and innovation, East and West. Men-Tsee-Khang and PADMA could thus be interpreted as two possible instantiations of a quasi-industrial techno-Sowa Rigpa, but only if one distinguishes 'Big' from 'Small Alternative' Pharma, and never without leaving crucial contradictions and identity politics behind.
Over the past century, the total material wealth of humanity has been enhanced. However, in the twenty-first century, we face scarcity in critical resources, the degradation of ecosystem services, and the erosion of the planet’s capability to absorb our wastes. Equity issues remain stubbornly difficult to solve. This situation is novel in its speed, its global scale and its threat to the resilience of the Earth System. The advent of the Anthropence, the time interval in which human activities now rival global geophysical processes, suggests that we need to fundamentally alter our relationship with the planet we inhabit. Many approaches could be adopted, ranging from geo-engineering solutions that purposefully manipulate parts of the Earth System to becoming active stewards of our own life support system. The Anthropocene is a reminder that the Holocene, during which complex human societies have developed, has been a stable, accommodating environment and is the only state of the Earth System that we know for sure can support contemporary society. The need to achieve effective planetary stewardship is urgent. As we go further into the Anthropocene, we risk driving the Earth System onto a trajectory toward more hostile states from which we cannot easily return.
The term Anthropocene, proposed and increasingly employed to denote the current interval of anthropogenic global environ- mental change, may be discussed on stratigraphic grounds. A case can be made for its consideration as a formal epoch in that, since the start of the Industrial Revolution, Earth has endured changes sufficient to leave a global stratigraphic signature dis- tinct from that of the Holocene or of previous Pleistocene inter- glacial phases, encompassing novel biotic, sedimentary, and geochemical change. These changes, although likely only in their initial phases, are sufficiently distinct and robustly estab- lished for suggestions of a Holocene-Anthropocene bound- ary in the recent historical past to be geologically reasonable. The boundary may be defined either via Global Stratigraphic Section and Point ("golden spike") locations or by adopting a numerical date. Formal adoption of this term in the near future will largely depend on its utility, particularly to earth scientists working on late Holocene successions. This datum, from the perspective of the far future, will most probably approximate a distinctive stratigraphic boundary.
Objective: This study aims to investigate the effect of an integrated intervention of art activities and Qigong exercise on the well-being of older adults in nursing homes in Indonesia. Method: We employed a randomized controlled trial with 4 specific groups, i.e. art, Qigong, integration of art and Qigong, and control group. A total of 267 participants aged 50 years or older were recruited from 9 nursing homes in Jakarta, Indonesia. The participants were randomly allocated to one of the four groups, attending two intervention sessions per week for eight weeks (16 sessions), lasting 90 minutes each. Measurements were administered at baseline (T0) and post-intervention (T1). The primary outcome was well-being (WHOQOL-Bref) and secondary outcomes were satisfaction with life (SWLS), depression (BDI-II), and health status (SF-36). Results: The art intervention had a significant positive effect on well-being, in particular in the domain of social relations. It also led to a decrease in depressive symptoms, as did the integration intervention. No significant effects were visible in the Qigong group nor in the integrated intervention compared to either art or Qigong alone. Conclusion: Interventions such as art programs and an integration of art and Qigong may give psychological benefits to older adults. Yet, results of the study need to be interpreted with caution and need to be replicated. A qualitative approach would be welcome to get an in-depth understanding of why art intervention is especially beneficial. (Trial registration: Clinicaltrials.gov NCT02957773, registered 28 September 2016).
Objective: To investigate whether observed interactions of mindfulness with the personality trait neuroticism extend to older adults and to aspects of psychological functioning other than depressive symptoms, and whether effects of mindfulness training in this population depend on levels of neuroticism.Method: We performed a secondary analysis of data from a randomized controlled trial of Mindfulness-Based Stress Reduction (MBSR) for community-dwelling older adults. We investigated whether neuroticism moderates associations of dispositional mindfulness with various aspects of psychological and physical functioning at baseline, as well as effects of MBSR on these outcomes.
Results: Significant two-way interactions showed that greater mindfulness was associated with fewer depressive symptoms and less negative affect at baseline in individuals with average or higher levels of neuroticism. In contrast, mindfulness was associated with greater positive affect and vitality and fewer physical symptoms regardless of the level of neuroticism. There were no effects of MBSR on these outcomes at any level of neuroticism.
Conclusion: Mindfulness may be more protective against psychological ill-being in older adults with higher levels of neuroticism, but conducive to positive psychological and physical well-being regardless of this personality trait. The potential moderating role of neuroticism should be further evaluated in studies of mindfulness-based interventions in older adults.
Objective: To investigate whether observed interactions of mindfulness with the personality trait neuroticism extend to older adults and to aspects of psychological functioning other than depressive symptoms, and whether effects of mindfulness training in this population depend on levels of neuroticism.Method: We performed a secondary analysis of data from a randomized controlled trial of Mindfulness-Based Stress Reduction (MBSR) for community-dwelling older adults. We investigated whether neuroticism moderates associations of dispositional mindfulness with various aspects of psychological and physical functioning at baseline, as well as effects of MBSR on these outcomes.
Results: Significant two-way interactions showed that greater mindfulness was associated with fewer depressive symptoms and less negative affect at baseline in individuals with average or higher levels of neuroticism. In contrast, mindfulness was associated with greater positive affect and vitality and fewer physical symptoms regardless of the level of neuroticism. There were no effects of MBSR on these outcomes at any level of neuroticism.
Conclusion: Mindfulness may be more protective against psychological ill-being in older adults with higher levels of neuroticism, but conducive to positive psychological and physical well-being regardless of this personality trait. The potential moderating role of neuroticism should be further evaluated in studies of mindfulness-based interventions in older adults.
Objective: To investigate whether observed interactions of mindfulness with the personality trait neuroticism extend to older adults and to aspects of psychological functioning other than depressive symptoms, and whether effects of mindfulness training in this population depend on levels of neuroticism.Method: We performed a secondary analysis of data from a randomized controlled trial of Mindfulness-Based Stress Reduction (MBSR) for community-dwelling older adults. We investigated whether neuroticism moderates associations of dispositional mindfulness with various aspects of psychological and physical functioning at baseline, as well as effects of MBSR on these outcomes.
Results: Significant two-way interactions showed that greater mindfulness was associated with fewer depressive symptoms and less negative affect at baseline in individuals with average or higher levels of neuroticism. In contrast, mindfulness was associated with greater positive affect and vitality and fewer physical symptoms regardless of the level of neuroticism. There were no effects of MBSR on these outcomes at any level of neuroticism.
Conclusion: Mindfulness may be more protective against psychological ill-being in older adults with higher levels of neuroticism, but conducive to positive psychological and physical well-being regardless of this personality trait. The potential moderating role of neuroticism should be further evaluated in studies of mindfulness-based interventions in older adults.
Reviewing the literature on autobiographical memory overgenerality, as measured by a cueing task like the Autobiographical Memory Test (AMT), gives a diffuse view of the moderating role of depression. This meta-analysis is an attempt to investigate the role of depression in the specificity of autobiographical memory, while accounting for the role of patient and task variables as possible moderators. Meta-analytic techniques are used to synthesize data from 14 studies on the recall of specific autobiographical memories in psychiatric and non-psychiatric samples. The results confirm the relationship between overgenerality and depression. The psychiatric patients are less specific than their non-clinical controls. It is not possible to establish that this result is solely due to a (co-morbid) diagnosis of depression. Self-reported depressed mood is also related to an impairment of autobiographical memory specificity. The way of presenting cues, audio taping responses and the maximum available amount of time to respond, are moderators of AMT performance.
The origin of altruism is a fundamental problem in evolution, and the maintenance of biodiversity is a fundamental problem in ecology. These two problems combine with the fundamental microbiological question of whether it is always advantageous for a unicellular organism to grow as fast as possible. The common basis for these three themes is a trade-off between growth rate and growth yield, which in turn is based on irreversible thermodynamics. The trade-off creates an evolutionary alternative between two strategies: high growth yield at low growth rate versus high growth rate at low growth yield. High growth yield at low growth rate is a case of an altruistic strategy because it increases the fitness of the group by using resources economically at the cost of decreased fitness, or growth rate, of the individual. The group-beneficial behaviour is advantageous in the long term, whereas the high growth rate strategy is advantageous in the short term. Coexistence of species requires differences between their niches, and niche space is typically divided into four ‘axes' (time, space, resources, predators). This neglects survival strategies based on cooperation, which extend the possibilities of coexistence, arguing for the inclusion of cooperation as the fifth ‘axis’. Here, individual-based model simulations show that spatial structure, as in, for example, biofilms, is necessary for the origin and maintenance of this ‘primitive’ altruistic strategy and that the common belief that growth rate but not yield decides the outcome of competition is based on chemostat models and experiments. This evolutionary perspective on life in biofilms can explain long-known biofilm characteristics, such as the structural organization into microcolonies, the often-observed lack of mixing among microcolonies, and the shedding of single cells, as promoting the origin and maintenance of the altruistic strategy. Whereas biofilms enrich altruists, enrichment cultures, microbiology's paradigm for isolating bacteria into pure culture, select for highest growth rate.
Wellbeing is a growing area of research, yet the question of how it should be defined remains unanswered. This multi-disciplinary review explores past attempts to define wellbeing and provides an overview of the main theoretical perspectives, from the work of Aristotle to the present day. The article argues that many attempts at expressing its nature have focused purely on dimensions of wellbeing, rather than on definition. Among these theoretical perspectives, we highlight the pertinence of dynamic equilibrium theory of wellbeing (Headey & Wearing, 1989), the effect of life challenges on homeostasis (Cummins, 2010) and the lifespan model of development (Hendry & Kloep, 2002). Consequently, we conclude that it would be appropriate for a new definition of wellbeing to centre on a state of equilibrium or balance that can be affected by life events or challenges. The article closes by proposing this new definition, which we believe to be simple, universal in application, optimistic and a basis for measurement. This definition conveys the multi-faceted nature of wellbeing and can help individuals and policy makers move forward in their understanding of this popular term.
Recently, there is a growing interest in meditation as an attentional and emotional regulatory strategy. To examine whether meditative practice is associated with successful emotion regulation, we examined the neurophysiological correlates of cognitive reappraisal in practitioners of a yogic meditative technique and controls. Participants were presented aversive pictures and were asked to cognitively change their appraisal of the affective meaning of the pictures by coming up with an alternative more positive interpretation of each picture. We found reduced magnitude of Event-Related Potentials (P300 and early time intervals of the late positive potential, LPP) following cognitive reappraisal of aversive pictures in both groups. However, in the yogic group, reduced magnitude was sustained during the later intervals of the LPP, while it subsided in the control group. Moreover, reduced amplitude of the late LPP correlated positively with experience of the technique. Results suggest a relation between yogic meditative practice and sustained attenuation of emotional response following emotion regulation. Increased positive affect and familiarity with cognitive emotion regulation in the yogic group may explain this effect. Whether this is a direct causal effect of the practice or can be attributed to characteristics of the participants that preexisted the training needs further examination in a randomized longitudinal study. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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This volume contains examples of how cognitive therapists working in varied settings with groups of adult clients have applied the cognitive model in their domain. Cognitive therapy has much broader application than the traditional area of depression; contributors illustrate the way they work by using extended case material, readers will hear the voices of the clients and empathise with both client and therapist as they seek to build a collaborative relationship. Areas discussed range from drug abuse and eating disorders to obsessive behaviour. Any therapist, however experienced, will learn from `listening in' on the cases presented and students will find it essential reading.
A recently published analysis by Lewis and Maslin (Lewis SL and Maslin MA (2015) Defining the Anthropocene. Nature 519: 171–180) has identified two new potential horizons for the Holocene−Anthropocene boundary: 1610 (associated with European colonization of the Americas), or 1964 (the peak of the excess radiocarbon signal arising from atom bomb tests). We discuss both of these novel suggestions, and consider that there is insufficient stratigraphic basis for the former, whereas placing the latter at the peak of the signal rather than at its inception does not follow normal stratigraphical practice. Wherever the boundary is eventually placed, it should be optimized to reflect stratigraphical evidence with the least possible ambiguity.
Perspectives of diverse constituencies need to be incorporated when developing conservation strategies. In Menri (Medicine Mountains) of the Eastern Himalayas, Tibetan doctors and professional botanists were interviewed about conservation of useful plants. We compare these two perspectives and find they differ significantly in conservation priorities (Wilcoxon Signed Ranks P < 0.05), both in how they prioritized, as well as the priorities themselves. Tibetan doctors first consider which plants are most important to their medical practice and, then secondarily, the conservation status of these plants. Additionally, perceptions of threatened medicinal plants differ among Tibetan doctors who received medical training in Lhasa, who were local trained, and who were self-taught. In contrast, professional botanists came to a consensus among themselves by first considering the conservation status of plants and then considering use. We conclude that, in order to effect community based conservation, opinions from both Tibetan doctors and professional botanists should be considered in establishing conservation priorities and sustainable conservation programs. Furthermore, we set our own research agenda based on combined perspectives.
Mount Kawa Karpo of the Menri ('Medicine Mountains' in Tibetan), in the eastern Himalayas, is one of the most sacred mountains to Tibetan Buddhists. Numerous sacred sites are found between 1900 and 4000 m, and at higher elevations the area as a whole is considered a sacred landscape. Religious beliefs may affect the ecology of these sacred areas, resulting in unique ecological characteristics of importance to conservation; recent studies have demonstrated that sacred areas can often play a major role in conservation. The goal of this study is to preliminarily analyze the vegetation of sacred areas in the Menri region using existing vegetation maps and a Geographical Information System (GIS) for remote assessment. Sacred sites are compared to random points in the landscape, in terms of: elevation, vegetation, and nearness to villages; species composition, diversity, and richness; and frequency of useful and endemic plant species. Detrended correspondence analysis (DCA) ordination reveals that sacred sites differ significantly in both useful species composition (p=0.034) and endemic species composition (p=0.045). Sacred sites are located at lower elevations, and closer to villages, than randomly selected, non-sacred sites (p< 0.0001), and have higher overall species richness (p=0.033) and diversity (p=0.042). In addition, the high-elevation (> 4000 m) areas of the mountain - a sacred landscape - are found to have significantly more endemics than low-elevation areas (p<0.0001). These findings represent an initial analysis of sacred sites and suggest that sacred sites in the Menri region may be ecologically and ethnobotanically unique.
Mount <i>Kawa Karpo</i> of the <i>Menri</i> ('Medicine Mountains' in Tibetan), in the eastern Himalayas, is one of the most sacred mountains to Tibetan Buddhists. Numerous sacred sites are found between 1900 and 4000 m, and at higher elevations the area as a whole is considered a sacred landscape. Religious beliefs may affect the ecology of these sacred areas, resulting in unique ecological characteristics of importance to conservation; recent studies have demonstrated that sacred areas can often play a major role in conservation. The goal of this study is to preliminarily analyze the vegetation of sacred areas in the <i>Menri</i> region using existing vegetation maps and a Geographical Information System (GIS) for remote assessment. Sacred sites are compared to random points in the landscape, in terms of: elevation, vegetation, and nearness to villages; species composition, diversity, and richness; and frequency of useful and endemic plant species. Detrended correspondence analysis (DCA) ordination reveals that sacred sites differ significantly in both useful species composition (<i>p</i>=0.034) and endemic species composition (<i>p</i>=0.045). Sacred sites are located at lower elevations, and closer to villages, than randomly selected, non-sacred sites (<i>p</i>< 0.0001), and have higher overall species richness (<i>p</i>=0.033) and diversity (<i>p</i>=0.042). In addition, the high-elevation (> 4000 m) areas of the mountain - a sacred landscape - are found to have significantly more endemics than low-elevation areas (<i>p</i><0.0001). These findings represent an initial analysis of sacred sites and suggest that sacred sites in the <i>Menri</i> region may be ecologically and ethnobotanically unique.
BACKGROUND:Mindfulness-based cognitive therapy (MBCT) and maintenance antidepressant medication (mADM) both reduce the risk of relapse in recurrent depression, but their combination has not been studied.
AIMS:
To investigate whether MBCT with discontinuation of mADM is non-inferior to MBCT+mADM.
METHOD:
A multicentre randomised controlled non-inferiority trial (ClinicalTrials.gov:NCT00928980). Adults with recurrent depression in remission, using mADM for 6 months or longer (n= 249), were randomly allocated to either discontinue (n= 128) or continue (n= 121) mADM after MBCT. The primary outcome was depressive relapse/recurrence within 15 months. A confidence interval approach with a margin of 25% was used to test non-inferiority. Key secondary outcomes were time to relapse/recurrence and depression severity.
RESULTS:
The difference in relapse/recurrence rates exceeded the non-inferiority margin and time to relapse/recurrence was significantly shorter after discontinuation of mADM. There were only minor differences in depression severity.
CONCLUSIONS:
Our findings suggest an increased risk of relapse/recurrence in patients withdrawing from mADM after MBCT.
During the past decade, Mindfulness-Based Cognitive Therapy (MBCT) aiming at relapse prevention in depression has been developed and empirically tested. All exercises taught during MBCT are based on the development of a heightened awareness of one's body. The important role of the body is also stressed in a recently emerging interdisciplinary field of research termed ‘embodiment.’ This research program focuses on the interactions between bodily, cognitive, and emotional processes. Based on the obvious role of the body in MBCT and on the theoretical and empirical evidence highlighting the role of the body in emotional processes, we argue that considering embodied processes might be a useful perspective for research on the etiology of depression and for mechanisms of action in MBCT.
The ‘Anthropocene’ is now being used as a conceptual frame by different communities and in a variety of contexts to understand the evolving human–environment relationship. However, as we argue in this paper, the notion of an Anthropos, or ‘humanity’, as global, unified ‘geological force’ threatens to mask the diversity and differences in the actual conditions and impacts of humankind, and does not do justice to the diversity of local and regional contexts. For this reason, we interpret in this article the notion of an Anthropocene in a more context-dependent, localized and social understanding. We do this through illustrating examples from four issue domains, selected for their variation in terms of spatial and temporal scale, systems of governance and functional interdependencies: nitrogen cycle distortion (in particular as it relates to food security); ocean acidification; urbanization; and wildfires. Based on this analysis, we systematically address the consequences of the lens of the Anthropocene for the governance of social-ecological systems, focusing on the multi-level, functional and sectoral organization of governance, and possible redefinitions of governance systems and policy domains. We conclude that the notion of the Anthropocene, once seen in light of social inequalities and regional differences, allows for novel analysis of issue-based problems in the context of a global understanding, in both academic and political terms. This makes it a useful concept to help leverage and (re-)focus our efforts in a more innovative and effective way to transition towards sustainability.
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