Objectives: Chronic low-back pain (CLBP) is burdensome and costly, and a common condition for which adults use integrative therapies. The effectiveness of multidisciplinary integrative approaches has not been well studied. The purpose of this observational study was to compare characteristics and outcomes of CLBP patients treated at the Osher Clinical Center (OCC) versus other clinics at Brigham and Women's Hospital. Design: Observational comparative effectiveness study. Setting: Tertiary care hospital. Subjects: Patients >= 21 years with 3+ months of CLBP or 6+ months of intermittent low-back pain. Intervention: All patients were observed for 12 months. OCC patients received care at the integrative clinic (7.3 visits on average over 13 weeks); non-OCC patients received usual care at other clinics of the same hospital. Outcome measures: Primary outcomes: change from baseline to 6 months in functional status (Roland Disability Questionnaire [RDQ]) and bothersomeness of pain (BOP). Secondary outcomes: change in RDQ and BOP at 3 and 12 months, percentages of patients with clinically meaningful (>= 30%) improvements. Results: One hundred fifty-six OCC and 153 non-OCC participants were enrolled; follow-up was 90.4 and 98.0%, respectively, at 12 months. There were substantial differences in baseline characteristics between groups. For RDQ, the adjusted mean group difference was nonsignificant at 6 months; for BOP, the differences were significant, but clinically small. At 12 months, the observed benefit on RDQ was significant and clinically meaningful; for BOP, there were significant, but clinically small differences. Percentages of patients with >= 30% improvements in RDQ were significantly greater in the OCC group only at 12 months, and both 6 and 12 months for BOP. Conclusions: Baseline characteristics can differ between those who select different sources of healthcare for CLBP. While benefits seen in the OCC versus non-OCC clinics were not large, further evaluation through randomized trials might be warranted to provide a more definitive evaluation.
Recent innovations in the treatment and prevention of depression that build on the foundation of cognitivebehavioral therapy represent promising directions for clinical practice and research. Specifically, behavioral activation and mindfulness-based cognitive therapy have been a recent focus of attention. Behavioral activation is a brief, structured approach to treating acute depression that seeks to alleviate depression by promoting an individual’s contact with sources of reward through increasing activation, improving problem solving, and decreasing avoidance and other barriers to activation. Mindfulness-based cognitive therapy is a brief group intervention that seeks to prevent depressive relapse by promoting mindful attention, acceptance, and skillful action to help individuals interrupt habitual cognitive and affective patterns associated with risk of relapse. Each approach is supported by at least two large-scale, randomized clinical trials; however, many important questions remain. We examine current research on both approaches by addressing the robustness of findings, the extension to novel populations, and the processes by which clinical benefit is achieved.
Objective: To update and expand The North American Menopause Society's evidence-based position on nonhormonal management of menopause-associated vasomotor symptoms (VMS), previously a portion of the position statement on the management of VMS. Methods: NAMS enlisted clinical and research experts in the field and a reference librarian to identify and review available evidence. Five different electronic search engines were used to cull relevant literature. Using the literature, experts created a document for final approval by the NAMS Board of Trustees. Results: Nonhormonal management of VMS is an important consideration when hormone therapy is not an option, either because of medical contraindications or a woman's personal choice. Nonhormonal therapies include lifestyle changes, mind-body techniques, dietary management and supplements, prescription therapies, and others. The costs, time, and effort involved as well as adverse effects, lack of long-term studies, and potential interactions with medications all need to be carefully weighed against potential effectiveness during decision making. Conclusions: Clinicians need to be well informed about the level of evidence available for the wide array of nonhormonal management options currently available to midlife women to help prevent underuse of effective therapies or use of inappropriate or ineffective therapies. Recommended: Cognitive-behavioral therapy and, to a lesser extent, clinical hypnosis have been shown to be effective in reducing VMS. Paroxetine salt is the only nonhormonal medication approved by the US Food and Drug Administration for the management of VMS, although other selective serotonin reuptake/norepinephrine reuptake inhibitors, gabapentinoids, and clonidine show evidence of efficacy. Recommend with caution: Some therapies that may be beneficial for alleviating VMS are weight loss, mindfulness-based stress reduction, the S-equol derivatives of soy isoflavones, and stellate ganglion block, but additional studies of these therapies are warranted. Do not recommend at this time: There are negative, insufficient, or inconclusive data suggesting the following should not be recommended as proven therapies for managing VMS: cooling techniques, avoidance of triggers, exercise, yoga, paced respiration, relaxation, over-the-counter supplements and herbal therapies, acupuncture, calibration of neural oscillations, and chiropractic interventions. Incorporating the available evidence into clinical practice will help ensure that women receive evidence-based recommendations along with appropriate cautions for appropriate and timely management of VMS.
The impact of the Internet across multiple aspects of modern society is clear. However, the influence that it may have on our brain structure and functioning remains a central topic of investigation. Here we draw on recent psychological, psychiatric and neuroimaging findings to examine several key hypotheses on how the Internet may be changing our cognition. Specifically, we explore how unique features of the online world may be influencing: a) attentional capacities, as the constantly evolving stream of online information encourages our divided attention across multiple media sources, at the expense of sustained concentration; b) memory processes, as this vast and ubiquitous source of online information begins to shift the way we retrieve, store, and even value knowledge; and c) social cognition, as the ability for online social settings to resemble and evoke real-world social processes creates a new interplay between the Internet and our social lives, including our self-concepts and self-esteem. Overall, the available evidence indicates that the Internet can produce both acute and sustained alterations in each of these areas of cognition, which may be reflected in changes in the brain. However, an emerging priority for future research is to determine the effects of extensive online media usage on cognitive development in youth, and examine how this may differ from cognitive outcomes and brain impact of uses of Internet in the elderly. We conclude by proposing how Internet research could be integrated into broader research settings to study how this unprecedented new facet of society can affect our cognition and the brain across the life course.
Mindfulness meditation training has been found to be helpful across a range of mental and physical health conditions. Research testing mindfulness-based interventions in the psychiatric rehabilitation context has been rare, however—possibly due to concerns about the potential for exacerbation of psychotic symptoms during meditation practice. Fifteen individuals diagnosed with schizophrenia spectrum disorders participated in a pilot study testing a mindfulness-based intervention to reduce anxiety. In this descriptive study of program evaluation interview responses, we examined the feedback participants had provided in face-to-face interviews to determine the degree to which individuals reported finding mindfulness training acceptable and helpful. Two raters systematically coded the data independently. The combined findings led to the identification of themes that surfaced most often overall and the context in which these themes had emerged. Outcomes mentioned most frequently by participants were relaxation, relief from psychological symptoms, cognitive changes, and focus on the present. These findings were consistent with extant literature identifying similar constructs as active ingredients of mindfulness-based interventions. Results suggested that mindfulness meditation training was acceptable to all participants; no one reported worsening of psychotic or other symptoms while meditating. We concluded that mindfulness meditation training should be further tested for its potential to be helpful in recovery from psychiatric disability.
Children today face increasingly high stress levels, impacting their well-being. Schools can play a crucial role in teaching social and emotional skills; therefore there is a need to identify effective interventions. This mixed-methods study of 124 elementary school students from three New Zealand schools aimed to (1) assess if children experienced improved well-being after an eight-week mindfulness program, and (2) understand their perceptions of the program. Participants completed these self-rated scales: the Mindful Awareness Attention Scale for Children and the Stirling Children’s Well-being Scale. Six children were interviewed about their perceptions and classroom teachers’ observations were reviewed. Quantitative data indicated a steady increase in students’ mindfulness, while well-being increased significantly but returned to baseline levels at three-month follow up. Changes in mindfulness were positively related to changes in well-being. The study results suggest the importance of offering mindfulness-based programs for potential improvements in students’ well-being.
Children today face increasingly high stress levels, impacting their well-being. Schools can play a crucial role in teaching social and emotional skills; therefore there is a need to identify effective interventions. This mixed-methods study of 124 elementary school students from three New Zealand schools aimed to (1) assess if children experienced improved well-being after an eight-week mindfulness program, and (2) understand their perceptions of the program. Participants completed these self-rated scales: the Mindful Awareness Attention Scale for Children and the Stirling Children’s Well-being Scale. Six children were interviewed about their perceptions and classroom teachers’ observations were reviewed. Quantitative data indicated a steady increase in students’ mindfulness, while well-being increased significantly but returned to baseline levels at three-month follow up. Changes in mindfulness were positively related to changes in well-being. The study results suggest the importance of offering mindfulness-based programs for potential improvements in students’ well-being.
Purpose/Objectives: To determine the feasibility of a standardized yoga intervention for survivors of non-small cell lung cancer (NSCLC) and, effects on sleep, mood, salivary cortisol levels, and quality of life (QOL).Design: This 14-week, one-group, repeated-measures study included a three-week preintervention phase, eight weeks of yoga classes (40 minutes once per week) and home practice, and a three-week postintervention phase. Follow-up occurred at three and six months poststudy.Setting: A community-based cancer support center in the midwestern United States.Sample: 7 adults who had completed initial treatment for stages I-IIIa NSCLC.Methods: A standardized yoga protocol was developed prior to the study by experts in the field. Breathing ease was monitored before, during, and after classes to assess feasibility of movement without compromising respiratory status while doing yoga. Data analysis included descriptive statistics, repeated-measures analysis of variance, and salivary cortisol analysis.Main Research Variables: Sleep quality, mood, salivary cortisol, and QOL were assessed using the Pittsburgh Sleep Quality Index, Profile of Mood States-Brief, a cortisol measurement, and the Medical Outcomes Survey SF-36®, respectively. Breathing ease was assessed using a dyspnea numeric rating scale as well as observation of participants.Findings: Participants with varying stages of disease and length of survivorship were able to perform yoga without respiratory distress. Class attendance exceeded 95%, and all practiced at home. Mood, sleep efficiency, and QOL significantly improved; salivary cortisol levels decreased over time.Conclusions: Yoga was feasible for NSCLC survivors without further compromising breathing with movement. Potential benefits were identified, supporting the need for future clinical trials with larger samples stratified by cancer stage, treatment, and length of survivorship.Implications for Nursing: Nurses and healthcare providers should consider yoga as a mind-body practice to manage stress, improve mood and sleep, and potentially enhance QOL for NSCLC survivors.
<p>BACKGROUND: Mindfulness means paying attention in the present moment, non-judgmentally, without commentary or decision-making. We report results of a pilot study designed to test the feasibility of using Mindfulness Based Stress Reduction (MBSR) (with minor modifications) as a smoking intervention. METHODS: MBSR instructors provided instructions in mindfulness in eight weekly group sessions. Subjects attempted smoking cessation during week seven without pharmacotherapy. Smoking abstinence was tested six weeks after the smoking quit day with carbon monoxide breath test and 7-day smoking calendars. Questionnaires were administered to evaluate changes in stress and affective distress. RESULTS: 18 subjects enrolled in the intervention with an average smoking history of 19.9 cigarettes per day for 26.4 years. At the 6-week post-quit visit, 10 of 18 subjects (56%) achieved biologically confirmed 7-day point-prevalent smoking abstinence. Compliance with meditation was positively associated with smoking abstinence and decreases in stress and affective distress. DISCUSSIONS and CONCLUSIONS The results of this study suggest that mindfulness training may show promise for smoking cessation and warrants additional study in a larger comparative trial.</p>
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This week we speak to popular education blogger Vicki A Davis of the Cool Cat Teacher blog about the nuance of language, our shared understanding of these terms, and how a current trend in early education - social-emotional learning - can be directly connected to STEM. Vicki asks those of us in preschools and K-12 to define how they will implement an SEL program and not just use these popular taglines without deploying it effectively.
Objective: Physical activity interventions have been shown to improve the health of people with schizophrenia, yet treatment dropout poses an important challenge in this population, and rates vary substantially across studies. We conducted a meta-analysis to investigate the prevalence and predictors of treatment dropout in physical activity interventions in people with schizophrenia. Method: We systematically searched major electronic databases from inception until August 2015. Randomized controlled trials of physical activity interventions in people with schizophrenia reporting dropout rates were included. Two independent authors conducted searches and extracted data. Random-effects meta-analysis and meta-regression analyses were conducted. Results: In 19 studies, 594 patients with schizophrenia assigned to exercise interventions were investigated (age=37.2 years, 67.5% male, range=37.5%-100%). Trim and fill adjusted treatment dropout rate was 26.7% [95% confidence interval (CI)=19.7%-35.0%], which is more than double than in nonactive control interventions (odds ratio=2.15, 95% CI=1.29-3.58, P=.003). In the multivariate regression, qualification of the professional delivering the intervention (beta=-1.06, 95% CI=-1.77 to - 0.35, P=.003) moderated treatment dropout rates, while continuous supervision of physical activity approached statistical significance (P=.05). Conclusions: Qualified professionals (e.g., physical therapists/ exercise physiologists) should prescribe supervised physical activity for people with schizophrenia to enhance adherence, improve psychiatric symptoms and reduce the onset and burden of cardiovascular disease. (C) 2016 Elsevier Inc. All rights reserved.
PURPOSE: A growing number of cancer survivors suffer high levels of distress, depression and stress, as well as sleep disturbance, pain and fatigue. Two different mind-body interventions helpful for treating these problems are Mindfulness-Based Cancer Recovery (MBCR) and Tai Chi/Qigong (TCQ). However, while both interventions show efficacy compared to usual care, they have never been evaluated in the same study or directly compared. This study will be the first to incorporate innovative design features including patient choice while evaluating two interventions to treat distressed cancer survivors. It will also allow for secondary analyses of which program best targets specific symptoms in particular groups of survivors, based on preferences and baseline characteristics.METHODS AND SIGNIFICANCE: The design is a preference-based multi-site randomized comparative effectiveness trial. Participants (N=600) with a preference for either MBCR or TCQ will receive their preferred intervention; while those without a preference will be randomized into either intervention. Further, within the preference and non-preference groups, participants will be randomized into immediate intervention or wait-list control. Total mood disturbance on the Profile of mood states (POMS) post-intervention is the primary outcome. Other measures taken pre- and post-intervention and at 6-month follow-up include quality of life, psychological functioning, cancer-related symptoms and physical functioning. Exploratory analyses investigate biomarkers (cortisol, cytokines, blood pressure/Heart Rate Variability, telomere length, gene expression), which may uncover potentially important effects on key biological regulatory and antineoplastic functions. Health economic measures will determine potential savings to the health system.
BACKGROUND: Yoga may be well suited for depressed and anxious pregnant women, given reported benefits of meditation and physical activity and pregnant women's preference for nonpharmacological treatments. METHODS: We randomly assigned 46 pregnant women with symptoms of depression and anxiety to an 8-week yoga intervention or treatment-as-usual (TAU) in order to examine feasibility and preliminary outcomes. RESULTS: Yoga was associated with high levels of credibility and satisfaction as an intervention for depression and anxiety during pregnancy. Participants in both conditions reported significant improvement in symptoms of depression and anxiety over time; and yoga was associated with significantly greater reduction in negative affect as compared to TAU (beta = -0.53, SE = 0.20, p = .011). CONCLUSION: Prenatal yoga was found to be a feasible and acceptable intervention and was associated with reductions in symptoms of anxiety and depression; however, prenatal yoga only significantly outperformed TAU on reduction of negative affect.
BACKGROUND: Yoga may be well suited for depressed and anxious pregnant women, given reported benefits of meditation and physical activity and pregnant women's preference for nonpharmacological treatments. METHODS: We randomly assigned 46 pregnant women with symptoms of depression and anxiety to an 8-week yoga intervention or treatment-as-usual (TAU) in order to examine feasibility and preliminary outcomes. RESULTS: Yoga was associated with high levels of credibility and satisfaction as an intervention for depression and anxiety during pregnancy. Participants in both conditions reported significant improvement in symptoms of depression and anxiety over time; and yoga was associated with significantly greater reduction in negative affect as compared to TAU (beta = -0.53, SE = 0.20, p = .011). CONCLUSION: Prenatal yoga was found to be a feasible and acceptable intervention and was associated with reductions in symptoms of anxiety and depression; however, prenatal yoga only significantly outperformed TAU on reduction of negative affect.
OBJECTIVE:The aim of this study was to assess whether an in-person mindfulness-based resilience training (MBRT) program or a smartphone-delivered resiliency-based intervention improved stress, well-being, and burnout in employees at a major tertiary health care institution.
METHODS:
Sixty participants were randomized to a 6-week MBRT, a resiliency-based smartphone intervention, or an active control group. Stress, well-being, and burnout were assessed at baseline, at program completion, and 3 months postintervention.
RESULTS:
Both the MBRT and the smartphone groups showed improvements in well-being, whereas only the MBRT group showed improvements in stress and emotional burnout over time. The control group did not demonstrate sustained improvement on any outcome.
CONCLUSION:
Findings suggest that brief, targeted interventions improve psychological outcomes and point to the need for larger scale studies comparing the individual and combined treatments that can inform development of tailored, effective, and low-cost programs for health care workers.
The 'helper's high' could help you live a longer, healthier life
Objective To investigate whether a sham device (a validated sham acupuncture needle) has a greater placebo effect than an inert pill in patients with persistent arm pain.
Design A single blind randomised controlled trial created from the two week placebo run-in periods for two nested trials that compared acupuncture and amitriptyline with their respective placebo controls. Comparison of participants who remained on placebo continued beyond the run-in period to the end of the study.
Setting Academic medical centre.
Participants 270 adults with arm pain due to repetitive use that had lasted at least three months despite treatment and who scored ≥3 on a 10 point pain scale.
Interventions Acupuncture with sham device twice a week for six weeks or placebo pill once a day for eight weeks.
Main outcomemeasures Arm pain measured on a 10 point pain scale. Secondary outcomes were symptoms measured by the Levine symptom severity scale, function measured by Pransky's upper extremity function scale, and grip strength.
Results Pain decreased during the two week placebo run-in period in both the sham device and placebo pill groups, but changes were not different between the groups (−0.14, 95% confidence interval −0.52 to 0.25, P = 0.49). Changes in severity scores for arm symptoms and grip strength were similar between groups, but arm function improved more in the placebo pill group (2.0, 0.06 to 3.92, P = 0.04). Longitudinal regression analyses that followed participants throughout the treatment period showed significantly greater downward slopes per week on the 10 point arm pain scale in the sham device group than in the placebo pill group (−0.33 (−0.40 to −0.26) v −0.15 (−0.21 to −0.09), P = 0.0001) and on the symptom severity scale (−0.07 (−0.09 to −0.05) v −0.05 (−0.06 to −0.03), P = 0.02). Differences were not significant, however, on the function scale or for grip strength. Reported adverse effects were different in the two groups.
Conclusions The sham device had greater effects than the placebo pill on self reported pain and severity of symptoms over the entire course of treatment but not during the two week placebo run in. Placebo effects seem to be malleable and depend on the behaviours embedded in medical rituals.
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PURPOSE: Worsening of schizophrenia symptoms is related to stress and anxiety. People with schizophrenia often experience difficulties in coping with stress and possess a limited repertoire of coping strategies. A randomised comparative trial was undertaken in patients with schizophrenia to evaluate changes in state anxiety, psychological stress and subjective well-being after single sessions of yoga and aerobic exercise compared with a control condition.METHOD: Forty participants performed a single 30-min yoga session, 20-min of aerobic exercise on a bicycle ergometre at self-selected intensity and a 20-min no exercise control condition in random order.
RESULTS: After single sessions of yoga and aerobic exercise individuals with schizophrenia or schizoaffective disorder showed significantly decreased state anxiety (p < 0.0001), decreased psychological stress (p < 0.0001) and increased subjective well-being (p < 0.0001) compared to a no exercise control condition. Effect sizes ranged from 0.82 for psychological stress after aerobic exercise to 1.01 for state anxiety after yoga. The magnitude of the changes did not differ significantly between yoga and aerobic exercise.
CONCLUSION: People with schizophrenia and physiotherapists can choose either yoga or aerobic exercise in reducing acute stress and anxiety taking into account the personal preference of each individual.
PURPOSE: Worsening of schizophrenia symptoms is related to stress and anxiety. People with schizophrenia often experience difficulties in coping with stress and possess a limited repertoire of coping strategies. A randomised comparative trial was undertaken in patients with schizophrenia to evaluate changes in state anxiety, psychological stress and subjective well-being after single sessions of yoga and aerobic exercise compared with a control condition.METHOD: Forty participants performed a single 30-min yoga session, 20-min of aerobic exercise on a bicycle ergometre at self-selected intensity and a 20-min no exercise control condition in random order.
RESULTS: After single sessions of yoga and aerobic exercise individuals with schizophrenia or schizoaffective disorder showed significantly decreased state anxiety (p < 0.0001), decreased psychological stress (p < 0.0001) and increased subjective well-being (p < 0.0001) compared to a no exercise control condition. Effect sizes ranged from 0.82 for psychological stress after aerobic exercise to 1.01 for state anxiety after yoga. The magnitude of the changes did not differ significantly between yoga and aerobic exercise.
CONCLUSION: People with schizophrenia and physiotherapists can choose either yoga or aerobic exercise in reducing acute stress and anxiety taking into account the personal preference of each individual.
OBJECTIVE:Mindfulness based relapse prevention (MBRP) has demonstrated efficacy in alleviating substance use, stress, and craving but how MBRP works for marginalized young adults has not been investigated. The current study used a novel rolling group format for MBRP as an additional intervention for young adults in residential treatment. We tested the hypothesis that MBRP (plus Treatment as usual (TAU)) would reduce stress, craving, and substance use among young adults in residential treatment relative to treatment-as-usual plus 12-step/self-help meetings (TAU only). Further, we examined whether reduced stress during treatment was a potential mechanism of change operating in MBRP.
METHOD:
Seventy-nine young adults (Mage = 25.3,SD = 2.7;35 % female) were randomly assigned to MBRP (n = 44) or TAU (n = 35). Follow-up assessments were conducted bi-monthly for self-reported measures of stress, craving, and substance use.
RESULTS:
At treatment completion young adults receiving MBRP had lower substance use (d = -0.58, [-0.91, -0.26]), craving (d = -0.58, [-1.0, -0.14]), and stress (d = -0.77 [-1.2, -0.30]) relative to TAU condition. Reduced stress during treatment partially mediated observed outcome differences between MBRP and TAU for substance use (βindirect = -0.45 [-0.79, -0.11]).
CONCLUSIONS:
Results suggest that MBRP is a useful and appropriate intervention for marginalized young adults. Further, our results suggest that the effects of MBRP on long-term substance use outcomes may be partially explained by reduced stress.
OBJECTIVE: To determine the feasibility of a randomized controlled trial of the effect of a tai chi program on quality of life and exercise capacity in patients with COPD.METHODS: We randomized 10 patients with moderate to severe COPD to 12 weeks of tai chi plus usual care (n = 5) or usual care alone (n = 5). The tai chi training consisted of a 1-hour class, twice weekly, that emphasized gentle movement, relaxation, meditation, and breathing techniques. Exploratory outcomes included disease-specific symptoms and quality-of-life, exercise capacity, pulmonary function tests, mood, and self-efficacy. We also conducted qualitative interviews to capture patient narratives regarding their experience with tai chi.
RESULTS: The patients were willing to be randomized. Among 4 of the 5 patients in the intervention group, adherence to the study protocol was excellent. The cohort's baseline mean ± SD age, percent-of-predicted FEV1, and ratio of FEV1 to forced vital capacity were 66 ± 6 y, 50 ± 12%, and 0.63 ± 0.14, respectively. At 12 weeks there was significant improvement in Chronic Respiratory Questionnaire score among the tai chi participants (1.4 ± 1.1), compared to the usual-care group (−0.1 ± 0.4) (P = .03). There were nonsignificant trends toward improvement in 6-min walk distance (55 ± 47 vs –13 ± 64 m, P = .09), Center for Epidemiologic Studies Depression Scale (−9.0 ± 9.1 vs −2.8 ± 4.3, P = .20), and University of California, San Diego Shortness of Breath score (−7.8 ± 3.5 vs −1.2 ± 11, P = .40). There were no significant changes in either group's peak oxygen uptake.
CONCLUSIONS: A randomized controlled trial of tai chi is feasible in patients with moderate to severe COPD. Tai chi exercise as an adjunct to standard care warrants further investigation. (ClinicalTrials.gov registration NCT01007903)
OBJECTIVE:This study sought to identify relationships between trait mindfulness, repressive, and suppressive emotional styles, and the relative importance of these traits in their association with self-reported psychological health among women with breast cancer.
METHOD:
Of the 277 women with breast cancer accrued in the study, 227 (81.9%) completed a set of questionnaires assessing personality traits, stress symptoms, and mood.
RESULTS:
High levels of mindfulness were associated with fewer stress-related symptoms and less mood disturbance, while high levels of suppression were associated with poorer self-reported health.
CONCLUSION:
Individuals' dispositional ways to manage negative emotions were associated with the experience of symptoms and aversive moods. Helping patients cultivate mindful insights and reduce deliberate emotional inhibition may be a useful focus for psycho-oncological interventions.
OBJECTIVES: This study aimed to compare the effects of true and sham acupuncture in relieving symptoms of irritable bowel syndrome (IBS).
METHODS: A total of 230 adult IBS patients (75% females, average age: 38.4 years) were randomly assigned to 3 weeks of true or sham acupuncture (6 treatments) after a 3-week "run-in" with sham acupuncture in an "augmented" or "limited" patient–practitioner interaction. A third arm of the study included a waitlist control group. The primary outcome was the IBS Global Improvement Scale (IBS-GIS) (range: 1–7); secondary outcomes included the IBS Symptom Severity Scale (IBS-SSS), the IBS Adequate Relief (IBS-AR), and the IBS Quality of Life (IBS-QOL).
RESULTS: Although there was no statistically significant difference between acupuncture and sham acupuncture on the IBS-GIS (41 vs. 32%, P=0.25), both groups improved significantly compared with the waitlist control group (37 vs. 4%, P=0.001). Similarly, small differences that were not statistically significant favored acupuncture over the other three outcomes: IBS-AR (59 vs. 57%, P=0.83), IBS-SSS (31 vs. 21%, P=0.18), and IBS-QOL (17 vs. 13%, P=0.56). Eliminating responders during the run-in period did not substantively change the results. Side effects were generally mild and only slightly greater in the acupuncture group.
CONCLUSIONS: This study did not find evidence to support the superiority of acupuncture compared with sham acupuncture in the treatment of IBS.
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This study evaluated the degree to which a range of social emotional learning skills--academic self-efficacy, academic motivation, social connections, importance of school, and managing psychological and emotional distress and academic stress--could be used as an indicator of future academic outcomes. Using a sample of 4,797 from a large urban school district, we found that high school students classified as performing in the lowest 25% of their grade reported lower social emotional skills than students classified in the top 25% of academic performers by the end of the 8th grade. Two variables, perceived importance of attending college and psychological and physical stress, accounted for nearly 26% of the variance in cumulative high school GPA after controlling for 9th-grade GPA. Finally, the results indicated that a combination of 5 social emotional learning subscales effectively discriminated between students making positive progress towards high school graduation and those identified as having dropped out of or failed more than 14% of their courses.
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