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
OBJECTIVE: To assess the effectiveness of conservative therapy in carpal tunnel syndrome. DATA SOURCES: A computer-aided search of MEDLINE and the Cochrane Collaboration was conducted for randomized controlled trials (RCTs) from January 1985 to May 2006. REVIEW METHODS: RCTs were included if: (1) the patients, with clinically and electrophysiologically confirmed carpal tunnel syndrome, had not previously undergone surgical release, (2) the efficacy of one or more conservative treatment options was evaluated, (3) the study was designed as a randomized controlled trial. Two reviewers independently selected the studies and performed data extraction using a standardized form. In order to assess the methodological quality, the criteria list of the Cochrane Back Review Group for systematic reviews was applied. The different treatment methods were grouped (local injections, oral therapies, physical therapies, therapeutic exercises and splints). RESULTS: Thirty-three RCTs were included in the review. The studies were analysed to determine the strength of the available evidence for the efficacy of the treatment. Our review shows that: (1) locally injected steroids produce a significant but temporary improvement, (2) vitamin B6 is ineffective, (3) steroids are better than non-steroidal anti-inflammatory drugs (NSAIDs) and diuretics, but they can produce side-effects, (4) ultrasound is effective while laser therapy shows variable results, (5) exercise therapy is not effective, (6) splints are effective, especially if used full-time. CONCLUSION: There is: (1) strong evidence (level 1) on efficacy of local and oral steroids; (2) moderate evidence (level 2) that vitamin B6 is ineffective and splints are effective and (3) limited or conflicting evidence (level 3) that NSAIDs, diuretics, yoga, laser and ultrasound are effective whereas exercise therapy and botulinum toxin B injection are ineffective.
INTRODUCTION:Recent research indicates that mindfulness-based interventions are effective for stress, maladaptive weight-related behaviors, and weight loss. Little is presently known about their applicability and effectiveness when delivered electronically, including through Web-based and mobile device media. The primary aims of this review were to identify what types of electronic mindfulness-based interventions have been undertaken for stress, maladaptive weight-related behaviors, and weight loss, and to assess their overall effectiveness.
METHODS:
A systematic search of PubMed (MEDLINE), Embase, CINAHL, and Web of Science databases was undertaken in June 2016.
RESULTS:
A total of 21 studies were identified that met inclusion criteria and were selected in the final review. Of these, 19 were mindfulness-based interventions for stress reduction. Two were Web-based mindful eating/intuitive eating interventions for weight. Only one electronic mindfulness-based study was identified that targeted both stress and maladaptive weight-related behaviors. Most electronic interventions were effective for stress reduction N = 14/19 (74%). There were insufficient electronic mindfulness-based interventions for weight to determine if they were effective or not. Additionally, no mobile mindfulness-based intervention was identified for weight or weight-related behaviors.
CONCLUSION:
Electronic mindfulness-based interventions through diverse media appear to be effective for stress reduction. More studies are needed that target weight and weight-related behaviors as well as studies that target both stress and weight. More randomized controlled trials (RCTs) that assess mobile mindfulness-based apps are needed as we only identified four app trials for stress. Mobile mindfulness-based interventions for weight and weight-related behaviors are a future area of research novelty.
Several factors may impede ethnoracial minority inclusion in Mindfulness- and Meditation-Based Intervention (MMBI) studies, such as healthcare disparities, historical underrepresentation in clinical research, and a conceptual perspective that emphasizes the universality of Buddhist teachings. This systematic review was performed with the aim of describing MMBI studies with a significant diversity focus, defined as involving minority inclusion in sample composition, cultural adaptations of interventions, and/or planned comparisons of outcomes for different ethnoracial groups. Studies were identified through PsycINFO and MEDLINE databases from 1990 to 2016 in the United States. We reviewed 12,265 citations to include 24 MMBI diversity-focused studies. Aside from Native Alaskans, all other major US ethnoracial minority groups were included in at least one study. Most of the studies (75%) were conducted with child and youth samples; the others included only women. Most (58%) included participants selected for a health or mental health condition, but none required specific diagnoses for study inclusion. The most commonly used MMBI was mindfulness-based stress reduction (29%), and only 12.5% of all studies used a culturally adapted intervention. Only one study reported planned ethnoracial comparisons of treatment outcomes. Cohen’s d effect sizes for single-sample studies ranged from 0.10 to 0.62 and for randomized controlled trials ranged from 0.02 to 0.99. Results from this systematic review highlight the dearth of diversity focus in MMBI research. Future work should include indicators of feasibility, acceptability, and safety; address underrepresentation of ethnoracial minorities, men, and participants with clinically or functionally significant symptoms; and investigate cultural adaptations to optimize treatment effectiveness.
PURPOSE: The purpose of this systematic review was to summarise the evidence from randomised controlled trials examining the effectiveness of physical therapy compared with care as usual or a wait-list condition on eating pathology and on physiological and psychological parameters in patients with anorexia and bulimia nervosa. METHOD: EMBASE, PsycINFO, PubMed, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database and The Cochrane Library were searched from their inception until February, 2013. Articles were eligible if they utilised a randomised controlled trial design, compared physical therapy with a placebo condition, control intervention, or standard care and included patients with anorexia and bulimia nervosa. The methodological quality was assessed with the Jadad scale. RESULTS: Eight randomised controlled trials involving 213 patients (age range: 16-36 years) met all selection criteria. Three of the 8 included studies were of strong methodological quality (Jadad score>/=3). Major methodological weaknesses were attrition and selection bias. The main results demonstrate that aerobic and resistance training result in significantly increased muscle strength, body mass index and body fat percentage in anorexia patients. In addition, aerobic exercise, yoga, massage and basic body awareness therapy significantly lowered scores of eating pathology and depressive symptoms in both anorexia and bulimia nervosa patients. No adverse effects were reported. CONCLUSIONS: The paucity and heterogeneity of available studies limits overall conclusions and highlights the need for further research. Implications for Rehabilitation Supervised physical therapy might increase weight in anorexia nervosa patients. Aerobic exercise, massage, basic body awareness therapy and yoga might reduce eating pathology in patients with anorexia and bulimia nervosa. Aerobic exercise, yoga and basic body awareness therapy might improve mental and physical quality of life in patients with an eating disorder.
PURPOSE: Since a distorted body experience and a sedentary lifestyle are central in the course of binge eating disorder (BED), physical therapy might be an interesting add-on treatment. The aim of this study was to systematically review randomised controlled trials (RCTs) evaluating physical therapy on binge eating and physical and mental health in BED patients. METHOD: EMBASE, PsycINFO, PubMed, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database and Cochrane Library were searched from their inception until 15 August 2012 for relevant RCTs comparing physical therapy with a placebo condition, control intervention or standard care. RESULTS: Three RCTs involving 211 female community patients (age range: 25-63 years) met all selection criteria. Review data demonstrate that aerobic and yoga exercises reduce the number of binges and the body mass index (BMI) of BED patients. Aerobic exercise also reduces depressive symptoms. Only combining cognitive behavioural therapy (CBT) with aerobic exercise and not CBT alone reduces BMI. Combining aerobic exercise with CBT is more effective in reducing depressive symptoms than CBT alone. CONCLUSIONS: The limited number of available studies and the heterogeneity of the interventions limit overall conclusions and highlight the need for further research. IMPLICATIONS FOR REHABILITATION: Because of severe co-morbid psychiatric and physical conditions, binge eating disorder is one of the most difficult psychiatric conditions to treat. Both yoga and aerobic exercise have shown promise in reducing binge eating pathology and weight. Combining aerobic exercise with cognitive behavioural therapy seems more effective in reducing depressive symptoms than cognitive behavioural therapy alone.
Psychoneuroimmunology-based interventions are used to attenuated disease progression and/or side effects of pharmacological treatment. This systematic review evaluates the different therapeutic and/or clinical psychoneuroimmunology-based interventions associated to both psychological, neuroendocrine and immunological variables. The review was conducted for all English, Portuguese and Spanish language articles published between 2005 and 2015. Independent investigators analyzed 42 studies concerning human psychoneuroimmunology-based interventions. Decreased levels of cortisol, epinephrine and norepinephrine (stress-related hormones) were associated to interventions like yoga, meditation, tai chi, acupuncture, mindfulness, religious/spiritual practices, cognitive behavior therapy, coping and physical exercises. Moreover, those interventions were also associated to reductions in inflammatory processes and levels of pro-inflammatory cytokines in cancer, HIV, depression, anxiety, wound healing, sleep disorder, cardiovascular diseases and fibromyalgia. Despite the associations between PNI variables and clinical/therapeutic interventions, only one study evidenced significant effects on a disease progression.
Refugees often experience significant psychological distress, but many do not receive necessary services. Among children and youth, most mental health services are provided by schools, so schools are an important service provider for young refugees. We conducted a systemic literature review to synthesize and evaluate the existing research on school-based interventions to improve mental health or social-emotional functioning of students who are refugees, asylum seekers, or immigrants with war trauma. Three types of school-based interventions were identified: cognitive behavioral therapy, creative expression, and multitiered or multimodal models. The review identified several interventions with positive effects, as well as multiple interventions that had null or negative effects. We address the implications of this body of intervention research for practice and research.
OBJECTIVE: To critically evaluate the rehabilitative effects of mindful exercises for poststroke patients. DATA SOURCES: Six databases (PubMed, Physiotherapy Evidence Database, Cochrane Library, Web of Science, Wanfang, Chinese National Knowledge Infrastructure) and reference lists of relevant articles were searched. STUDY SELECTION: Randomized controlled trials on the effects of mindful exercises on rehabilitative outcomes such as sensorimotor function, gait speed, leg strength, aerobic endurance, cognitive function, and overall motor function. DATA EXTRACTION: Two investigators independently screened eligible studies according to the eligible criteria, extracted data, and assessed risk of bias. DATA SYNTHESIS: A total of 20 studies that satisfied the eligibility criteria were finally included. The sum scores of 5-9 points in the adapted Physiotherapy Evidence Database scale indicates low-to-medium risk of bias. The study results of meta-analysis indicate that mindful exercise intervention was significantly associated with improved sensorimotor function on both lower limb (standardized mean difference=0.79; 95% confidence interval, 0.43-1.15; P<.001; I(2)=62.67%) and upper limb (standardized mean difference=0.7; 95% confidence interval, 0.39-1.01; P<.001; I(2)=32.36%). CONCLUSIONS: This review suggests that mindful exercises are effective in improving sensorimotor function of lower and upper limbs in poststroke patients. The effects on gait speed, leg strength, aerobic endurance, overall motor function, and other outcomes (eg, cognitive function, gait parameters) require further investigation for allowing evidence-based conclusions.
OBJECTIVE: Anxiety disorders are the most prevalent psychological disorders among children and youths. There is growing interest in intervention options for anxiety. Yoga is widely used in clinical, school, and community settings, but consolidated sources outlining its effectiveness in reducing anxiety are limited. METHOD: This systematic review examined the evidence base (1990-2014) for yoga interventions addressing anxiety among children and adolescents (ages 3-18 yr). RESULTS: We identified 2,147 references and found 80 articles that were eligible for full-text review. The final analysis included 16: 6 randomized controlled trials, 2 nonrandomized preintervention-postintervention control-group designs, 7 uncontrolled preintervention-postintervention studies, and 1 case study. CONCLUSION: Nearly all studies indicated reduced anxiety after a yoga intervention. However, because of the wide variety of study populations, limitations in some study designs, and variable outcome measures, further research is needed to enhance the ability to generalize and apply yoga to reduce anxiety.
OBJECTIVE: Anxiety disorders are the most prevalent psychological disorders among children and youths. There is growing interest in intervention options for anxiety. Yoga is widely used in clinical, school, and community settings, but consolidated sources outlining its effectiveness in reducing anxiety are limited.METHOD: This systematic review examined the evidence base (1990-2014) for yoga interventions addressing anxiety among children and adolescents (ages 3-18 yr).
RESULTS: We identified 2,147 references and found 80 articles that were eligible for full-text review. The final analysis included 16: 6 randomized controlled trials, 2 nonrandomized preintervention-postintervention control-group designs, 7 uncontrolled preintervention-postintervention studies, and 1 case study.
CONCLUSION: Nearly all studies indicated reduced anxiety after a yoga intervention. However, because of the wide variety of study populations, limitations in some study designs, and variable outcome measures, further research is needed to enhance the ability to generalize and apply yoga to reduce anxiety.
OBJECTIVE: Anxiety disorders are the most prevalent psychological disorders among children and youths. There is growing interest in intervention options for anxiety. Yoga is widely used in clinical, school, and community settings, but consolidated sources outlining its effectiveness in reducing anxiety are limited. METHOD: This systematic review examined the evidence base (1990-2014) for yoga interventions addressing anxiety among children and adolescents (ages 3-18 yr). RESULTS: We identified 2,147 references and found 80 articles that were eligible for full-text review. The final analysis included 16: 6 randomized controlled trials, 2 nonrandomized preintervention-postintervention control-group designs, 7 uncontrolled preintervention-postintervention studies, and 1 case study. CONCLUSION: Nearly all studies indicated reduced anxiety after a yoga intervention. However, because of the wide variety of study populations, limitations in some study designs, and variable outcome measures, further research is needed to enhance the ability to generalize and apply yoga to reduce anxiety.
Taban-Arshan extract decreased expression of T-lymphocyte activation markers, normalized T-cell-mediated immunity, and suppressed increased activity of natural killer receptors during culturing with lymphocytes of patients with atopic bronchial asthma. Taban-Arshan extract normalized activation processes in the B-cell immunity and stimulated expression of receptors of activation-induced apoptosis.
The chapters in this anthology present an encompassing perspective of how some Chinese martial art styles-and most significantly taijiquan-developed and evolved along with deep rooted traditions of spirituality and the quest for health and longevity. Much in this volume deals with Daoist theories and practices, particularly its influences ranging from human energetics and other physical exercises, to practical combative arts. Holcombe, Willmont, and Breslow's well-researched chapters dive deeply into the philosophical, spiritual, and physical traditions associated with Daoism. The search for immortality is shown to be of prime importance since it gave impetus to the belief that human beings can live healthier, longer, and happier lives. My own chapter presents a way of directly discovering taijiquan's philosophical principles through experiential involvement in the art itself. Henning's chapter gives an example in this tradition in the life of Ge Hong (284-363 CE). Known for his Daoist alchemical pursuits, Ge was also a military officer who provides valuable insights into Chinese martial arts practices. Dr. Wile explores the ways in which martial arts have been exposed to cultural construction and deconstruction. A Daoist connection has figured in political ideology, national identity, and commercial interest during the past 400 years of Chinese history. The text focuses on taichiquan as an important site of constructing Chinese-ness. From the early 20th century, the Chinese government often looked at Daoism as a form of superstition, and allowed temples to fall into disrepair. In the 21st century, as Hawthorne shows, there is a quest to rescue historic Daoist sites and study the tradition. In the final chapter, Greg Brodsky applies a five-element yoga model to the practice of taijiquan as a "quality assurance test." It offers opportunities for deepening, enriching, and enjoying taiga practice. In all, the chapters here offer insights for understanding how Chinese martial traditions...particularly taijiquan...developed and evolved within the framework of culture. The word taiji takes on different meanings according to time and place. This also resolves the ongoing arguments regarding taijiquan as a practical combat art verses a health regimen. As a proverb points out: "From the standpoint of the sun, day and night have no meaning."
Mindfulness training (MT) is a form of mental training in which individuals engage in exercises to cultivate an attentive, present centered, and non-reactive mental mode. The present study examines the putative benefits of MT in University students for whom mind wandering can interfere with learning and academic success. We tested the hypothesis that short-form MT (7 h over 7 weeks) contextualized for the challenges and concerns of University students may reduce mind wandering and improve working memory. Performance on the sustained attention to response task (SART) and two working memory tasks (operation span, delayed-recognition with distracters) was indexed in participants assigned to a waitlist control group or the MT course. Results demonstrated MT-related benefits in SART performance. Relative to the control group, MT participants had higher task accuracy and self-reported being more "on-task" after the 7-week training period. MT did not significantly benefit the operation span task or accuracy on the delayed-recognition task. Together these results suggest that while short-form MT did not bolster working memory task performance, it may help curb mind wandering and should, therefore, be further investigated for its use in academic contexts.
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Mindfulness training (MT) is a form of mental training in which individuals engage in exercises to cultivate an attentive, present centered, and non-reactive mental mode. The present study examines the putative benefits of MT in University students for whom mind wandering can interfere with learning and academic success. We tested the hypothesis that short-form MT (7 h over 7 weeks) contextualized for the challenges and concerns of University students may reduce mind wandering and improve working memory. Performance on the sustained attention to response task (SART) and two working memory tasks (operation span, delayed-recognition with distracters) was indexed in participants assigned to a waitlist control group or the MT course. Results demonstrated MT-related benefits in SART performance. Relative to the control group, MT participants had higher task accuracy and self-reported being more “on-task” after the 7-week training period. MT did not significantly benefit the operation span task or accuracy on the delayed-recognition task. Together these results suggest that while short-form MT did not bolster working memory task performance, it may help curb mind wandering and should, therefore, be further investigated for its use in academic contexts.
<p>A translation of a Bön (bon) Mother Tantra. The Tibetan title is <em>Bdud rtsi bum pa'i rgyud</em>, and it is found in the third volume of the <em>Collected tantras of Bon</em> (<em>Bka' 'gyur rgyud sde'i skor</em>). The translation is heavily annotated and the Tibetan text is reproduced at the end. (Ben Deitle 2006-02-02)</p>
ObjectivesMindfulness has the potential to prevent compassion fatigue and burnout in that the doctor who is self‐aware is more likely to engage in self‐care activities and to manage stress better. Moreover, well doctors are better equipped to foster wellness in their patients. Teaching mindfulness in medical school is gaining momentum; we examined the literature and related websites to determine the extent to which this work is carried out with medical students and residents.
Methods
A literature search revealed that 14 medical schools teach mindfulness to medical and dental students and residents.
Results
A wide range of formats are used in teaching mindfulness. These include simple lectures, 1‐day workshops and 8–10‐week programmes in mindfulness‐based stress reduction. Two medical schools stand out because they have integrated mindfulness into their curricula: the University of Rochester School of Medicine and Dentistry (USA) and Monash Medical School (Australia). Studies show that students who follow these programmes experience decreased psychological distress and an improved quality of life.
Conclusions
Although the evidence points to the usefulness of teaching mindful practices, various issues remain to be considered. When is it best to teach mindfulness in the trajectory of a doctor's career? What format works best, when and for whom? How can what is learned be maintained over time? Should mindfulness training be integrated into the medical school core curriculum?
<p>Preparation for the role of therapist can occur on both professional and personal levels. Research has found that therapists are at risk for occupationally related psychological problems. It follows that self-care may be a useful complement to the professional training of future therapists. The present study examined the effects of one approach to self-care, Mindfulness-Based Stress Reduction (MBSR), for therapists in training. Using a prospective, cohort-controlled design, the study found participants in the MBSR program reported significant declines in stress, negative affect, rumination, state and trait anxiety, and significant increases in positive affect and self-compassion. Further, MBSR participation was associated with increases in mindfulness, and this enhancement was related to several of the beneficial effects of MBSR participation. Discussion highlights the potential for future research addressing the mental health needs of therapists and therapist trainees.</p>
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Preparation for the role of therapist can occur on both professional and personal levels. Research has found that therapists are at risk for occupationally related psychological problems. It follows that self-care may be a useful complement to the professional training of future therapists. The present study examined the effects of one approach to self-care, Mindfulness-Based Stress Reduction (MBSR), for therapists in training. Using a prospective, cohort-controlled design, the study found participants in the MBSR program reported significant declines in stress, negative affect, rumination, state and trait anxiety, and significant increases in positive affect and self-compassion. Further, MBSR participation was associated with increases in mindfulness, and this enhancement was related to several of the beneficial effects of MBSR participation. Discussion highlights the potential for future research addressing the mental health needs of therapists and therapist trainees.
Preparation for the role of therapist can occur on both professional and personal levels. Research has found that therapists are at risk for occupationally related psychological problems. It follows that self-care may be a useful complement to the professional training of future therapists. The present study examined the effects of one approach to self-care, Mindfulness-Based Stress Reduction (MBSR), for therapists in training. Using a prospective, cohort-controlled design, the study found participants in the MBSR program reported significant declines in stress, negative affect, rumination, state and trait anxiety, and significant increases in positive affect and self-compassion. Further, MBSR participation was associated with increases in mindfulness, and this enhancement was related to several of the beneficial effects of MBSR participation. Discussion highlights the potential for future research addressing the mental health needs of therapists and therapist trainees.
Part critique of existing policy and practice, part call-to-action, Technology and Literacy in the Twenty-First Century explores the complex linkage between technology and literacy that has come to characterize American culture and its public educational system at the end of the twentieth century. To provide a specific case study of this complex cultural formation, award-winning educator Cynthia L. Selfe discusses the Technology Literacy Challenge, an official, federally sponsored literacy project begun in 1996 that has changed—at fundamentally important levels—the definition of literacy and the practices recognized as constituting literate behavior in America. Selfe tries to identify the effects of this new literacy agenda, focusing specifically on what she calls "serious and shameful" inequities it fosters in our culture and in the public education system: among them, the continuing presence of racism, poverty, and illiteracy. She describes how the national project to expand technological literacy came about, what effects it has yielded, why the American public has supported this project, and how teachers of English, language arts, and composition have contributed to this project, despite their best intentions. A primary goal of this study is to make teachers of English and composition increasingly aware of the new literacy agenda and to suggest how they might positively influence its shape and future direction, both in the classroom and in the community. This awareness is an integral part of educators' larger professional responsibility to understand the way in which our culture thinks about and values literacy. Perhaps even more important, argues Selfe, this awareness is part of teachers' ethical responsibility to understand how literacy and literacy instruction directly and continually affect the lived experiences of the individuals and families with whom teachers interact.
In the present study, we examined the stability of one measure of emotion, the emotion-modulated acoustic startle response, in an undergraduate sample. Using the acoustic startle paradigm on two different occasions, we measured stability of affective modulation of the startle response during and following the presentation of pictures selected to be of positive, negative, or neutral emotional valence. The two assessments were separated by 4 weeks. Two groups of subjects were compared: one group that viewed the same pictures at each assessment and a second group that viewed different pictures at the second assessment. We found that viewing different pictures at two assessments separated by 4 weeks yielded moderate stability of the emotion modulation of startle magnitude, whereas subjects who viewed the same pictures at both assessments showed poor stability. Furthermore, this difference was due to the stability of responses to high versus low arousal pictures, not to differences in valence.
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