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The orientation of this volume and the Longevity and Optimal Health: Integrating Eastern and Western Perspectives conference is that there is abundant evidence in the scientific and medical literatures that the diligent practice of certain yoga-meditational regimens can lead to a spectrum of health enhancements, ranging from modest to profound, and that these can be investigated in a scientifically rigorous fashion. This overview will summarize these possibilities regarding improved human longevity, regeneration, and protection of health and serve to introduce the perspectives of conference participants from all of the traditions represented.

The orientation of this volume and the Longevity and Optimal Health: Integrating Eastern and Western Perspectives conference is that there is abundant evidence in the scientific and medical literatures that the diligent practice of certain yoga-meditational regimens can lead to a spectrum of health enhancements, ranging from modest to profound, and that these can be investigated in a scientifically rigorous fashion. This overview will summarize these possibilities regarding improved human longevity, regeneration, and protection of health and serve to introduce the perspectives of conference participants from all of the traditions represented.

The orientation of this volume and the Longevity and Optimal Health: Integrating Eastern and Western Perspectives conference is that there is abundant evidence in the scientific and medical literatures that the diligent practice of certain yoga-meditational regimens can lead to a spectrum of health enhancements, ranging from modest to profound, and that these can be investigated in a scientifically rigorous fashion. This overview will summarize these possibilities regarding improved human longevity, regeneration, and protection of health and serve to introduce the perspectives of conference participants from all of the traditions represented.

The objective of this study was to determine the bone mineral density (BMD) of cervical vertebrae and correlate with the lumbar spine. Fifty-seven young adult healthy male volunteers, ranging from 18 to 41 years of age, underwent quantitative computed tomography (QCT) scanning of C2-T1 and L2-L4 vertebrae. To account for correlations, repeated measures techniques were used to compare data as a function of spinal level and region. Linear regression methods were used (+/-95% CI) to compare data as a function of spinal level and region. The mean age and body height were 25.0 +/- 5.8 years and 181.0 +/- 7.6 cm. BMD decreased from the rostral to caudal direction along the spinal column. Grouped data indicated that the neck is the densest followed by the first thoracic vertebra and low back with mean BMD of 256.0 +/- 48.1, 194.3 +/- 44.2, and 172.2 +/- 28.4 mg/cm(3), respectively; differences were statistically significant. While BMD did not vary significantly between the three lumbar bodies, neck vertebrae demonstrated significant trends. The matrix of correlation coefficients between BMD and spinal level indicated that the relationship is strong in the lumbar (r = 0.92-0.96) and cervical (r = 0.73-0.92) spines. Data from the present study show that the trabecular bony architecture of the neck is significantly different from the low back. These quantitative BMD data from a controlled young adult healthy human male volunteer population may be valuable in establishing normative data specifically for the neck. From a trabecular bone density perspective, these results indicate that lumbar vertebrae cannot act as the best surrogates for neck vertebrae. Significant variations in densities among neck vertebrae, unlike the low back counterpart, may underscore the need to treat these bones as different structures.

Traditional medical systems, like those preserved in Asia, pose a challenge because they involve theories and practices that strike many conventionally trained physicians and researchers as incomprehensible, even nonsensical. Should modern medicine continue to dismiss these systems as unscientific, therefore worthy of debunking rather than serious study; view them as sources of alternatives, possibly effective but hidden in a matrix of prescientific custom and belief; or do they represent something like a complementary science of medicine? We make the latter argument using the example of Indo-Tibetan medicine. Indo-Tibetan medicine is based on analytic models and methods that are rationally defined, internally coherent, and make testable predictions, therefore meeting current definitions of "science." The possibility of multiple, complementary sciences is a consequence of certain findings in physics that have led to a view of science as a set of tools-instruments of social activity that depend on learned agreement in aims and methods-rather than as a monolith of absolute objective truth. Implications of this pluralistic view of science for medical research and practice are discussed.

India and China face the same challenge of having too few trained psychiatric personnel to manage effectively the substantial burden of mental illness within their population. At the same time, both countries have many practitioners of traditional, complementary, and alternative medicine who are a potential resource for delivery of mental health care. In our paper, part of The Lancet and Lancet Psychiatry's Series about the China-India Mental Health Alliance, we describe and compare types of traditional, complementary, and alternative medicine in India and China. Further, we provide a systematic overview of evidence assessing the effectiveness of these alternative approaches for mental illness and discuss challenges in research. We suggest how practitioners of traditional, complementary, and alternative medicine and mental health professionals might forge collaborative relationships to provide more accessible, affordable, and acceptable mental health care in India and China. A substantial proportion of individuals with mental illness use traditional, complementary, and alternative medicine, either exclusively or with biomedicine, for reasons ranging from faith and cultural congruence to accessibility, cost, and belief that these approaches are safe. Systematic reviews of the effectiveness of traditional, complementary, and alternative medicine find several approaches to be promising for treatment of mental illness, but most clinical trials included in these systematic reviews have methodological limitations. Contemporary methods to establish efficacy and safety-typically through randomised controlled trials-need to be complemented by other means. The community of practice built on collaborative relationships between practitioners of traditional, complementary, and alternative medicine and providers of mental health care holds promise in bridging the treatment gap in mental health care in India and China.

Objectives: The objective of this study was to assess the association of trait mindfulness and stress in an urban convenience sample of homeless adults (N = 210). Methods: Associations between trait mindfulness and stress (general perceived stress and chronic urban stress) were assessed using linear regression analyses. Results: Higher trait mindfulness was significantly associated with lower perceived stress (p < .001) and urban stress (p < .001) after adjusting for age, sex, race, marital status, education, income, employment status, and homelessness factors. Conclusions: Higher trait mindfulness may serve as a protective factor against stress among homeless individuals. Future studies should examine the utility of mindfulness-based interventions in improving the health of homeless adults through stress reduction.

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.

Administered to 15 experienced transcendental meditators and 21 novices A. W. Bendig's (1956) modified version of the Taylor Manifest Anxiety Scale, Rotter's Internal-External Control Scale, and the Personal Orientation Inventory (POI) of self-actualization. As predicted, experienced meditators were significantly less anxious and more internally controlled than beginners. Likewise, experienced meditators were significantly higher (i.e., more self-actualized) on 7 POI subscales. Results are discussed in terms of the psychological health implications of Transcendental Meditation and its potential therapeutic applications

Students who practiced Transcendental Meditation (TM) from four university and college campuses were individually matched on seven variables with students from the general population of the same campuses (N # 23 matches). Results of a questionnaire designed to tap six social psychological attitudes indicated significant differences between these groups on five attitudes, with meditating students indicating more positive attitudes. In addition, matched meditating students (N # 6 matches) were compared on the variables of exposure to the TM philosophy and length of time meditating. Results on the exposure dimension found no significant difference between those with high or low exposure on the measured attitudes. Results on the length dimension found long term meditators with significantly more positive attitudes than short term meditators.

The effects of the Transcendental Meditation program in a maximum security prison were studied via cross-validation design. Each of two experiments involved the pre- and postmeasurement of a treatment and a control group with a 14-week treatment interval. All subjects were administered the Eysenck Personality Inventory, the State-Trait Anxiety Inventory, the Buss-Durkee Hostility Inventory, and a survey of sleep patterns and smoking habits. Parallel significant differences between the Transcendental Meditation and control groups across all the inventories were found via MANCOVAs, indicating reduction in anxiety, neuroticism, hostility, and insomnia as a function of the treatment.

PURPOSE We undertook a randomized controlled trial to assess the efficacy of group-based behavioral activation with mindfulness (BAM) for treating subthreshold depression in primary care in Hong Kong.METHODS We recruited adult patients aged 18 years or older with subthreshold depression from public primary care clinics and randomly assigned them to a BAM intervention group or a usual care group. The BAM group was provided with eight 2-hour weekly BAM sessions by trained allied health care workers. Patients in the usual care group received usual medical care with no additional psychological interventions. The primary outcome was depressive symptoms measured by the Beck Depression Inventory-II at 12 months. Secondary outcomes included incidence of major depressive disorder at 12 months. We assessed quality of life, activity and circumstances change, functional impairment, and anxiety at baseline, end of intervention, 5 months, and 12 months. RESULTS We randomly allocated 115 patients to the BAM intervention and 116 patients to usual care. At 12 months, compared with usual care peers, BAM patients had a slightly more favorable change in levels of depressive symptoms on the Beck Depression Inventory-II (between-group mean difference in score = −3.85; 95% CI, −6.36 to −1.34; Cohen d = −0.46, 95% CI, −0.76 to −0.16). Incidence of major depressive disorder was lower with BAM (10.8% vs 26.8%, P = .01), whereas groups did not differ significantly on other secondary outcomes at 12 months. CONCLUSIONS Group BAM appears to be efficacious for decreasing depressive symptoms and reducing the incidence of major depression among patients with subthreshold depression in primary care, although generalizability of our findings may be limited.

BACKGROUND: Hatha yoga may be helpful for alleviating depression symptoms. The purpose of this analysis is to determine whether treatment program preference, credibility, or expectancy predict engagement in depression interventions (yoga or a control class) or depression symptom severity over time. METHODS: This is a secondary analysis of a randomized controlled trial (RCT) of hatha yoga vs. a health education control group for treatment of depression. Depressed participants (n=122) attended up to 20 classes over a period of 10 weeks, and then completed additional assessments after 3 and 6 months. We assessed treatment preference prior to randomization, and treatment credibility and expectancy after participants attended their first class. Treatment "concordance" indicated that treatment preference matched assigned treatment. RESULTS: Treatment credibility, expectancy, and concordance were not associated with treatment engagement. Treatment expectancy moderated the association between treatment group and depression. Depression severity over time differed by expectancy level for the yoga group but not for the health education group. Controlling for baseline depression, participants in the yoga group with an average or high expectancy for improvement showed lower depression symptoms across the acute intervention and follow-up period than those with a low expectancy for improvement. There was a trend for a similar pattern for credibility. Concordance was not associated with treatment outcome. LIMITATIONS: This is a secondary, post-hoc analysis and should be considered hypothesis-generating. CONCLUSIONS: Results suggest that expectancy improves the likelihood of success only for a intervention thought to actively target depression (yoga) and not a control intervention.

Fatigue is a common symptom in multiple sclerosis (MS). As fatigue includes a variety of aspects, its treatment is best approached in a multidisciplinary fashion that includes nonpharmacological interventions and medications. In individuals with mild fatigue non-pharmacological treatment including yoga, aerobic exercises, cooling therapy and energy conservation techniques might be considered. Several pharmacological treatments for patients with significant fatigue have proved to be effective. Among these agents, amantadine and aminopyridines are the most frequently used. More recently also aspirin and carnitine have been used to treat MS fatigue but they need to be confirmed in larger studies.

Objective: To examine whether metacognitive psychological skills, acquired in mindfulness-based cognitive therapy (MBCT), are also present in patients receiving medication treatments for prevention of depressive relapse and whether these skills mediate MBCT's effectiveness. Method: This study, embedded within a randomized efficacy trial of MBCT, was the first to examine changes in mindfulness and decentering during 6–8 months of antidepressant treatment and then during an 18-month maintenance phase in which patients discontinued medication and received MBCT, continued on antidepressants, or were switched to a placebo. In total, 84 patients (mean age = 44 years, 58% female) were randomized to 1 of these 3 prevention conditions. In addition to symptom variables, changes in mindfulness, rumination, and decentering were assessed during the phases of the study. Results: Pharmacological treatment of acute depression was associated with reductions in scores for rumination and increased wider experiences. During the maintenance phase, only patients receiving MBCT showed significant increases in the ability to monitor and observe thoughts and feelings as measured by the Wider Experiences (p < .01) and Decentering (p < .01) subscales of the Experiences Questionnaire and by the Toronto Mindfulness Scale. In addition, changes in Wider Experiences (p < .05) and Curiosity (p < .01) predicted lower Hamilton Rating Scale for Depression scores at 6-month follow-up. Conclusions: An increased capacity for decentering and curiosity may be fostered during MBCT and may underlie its effectiveness. With practice, patients can learn to counter habitual avoidance tendencies and to regulate dysphoric affect in ways that support recovery.

OBJECTIVE: This report presents national estimates of the use of complementary health approaches among adults in the United States across three time points. Trends in the use of selected complementary health approaches are compared for 2002, 2007, and 2012, and differences by selected demographic characteristics are also examined. METHODS: Combined data from 88,962 adults aged 18 and over collected as part of the 2002, 2007, and 2012 National Health Interview Survey were analyzed for this report. Sample data were weighted to produce national estimates that are representative of the civilian noninstitutionalized U.S. adult population. Differences between percentages were evaluated using two-sided significance tests at the 0.05 level. RESULTS: Although the use of individual approaches varied across the three time points, nonvitamin, nonmineral dietary supplements remained the most popular complementary health approach used. The use of yoga, tai chi, and qi gong increased linearly across the three time points; among these three approaches, yoga accounted for approximately 80% of the prevalence. The use of any complementary health approach also differed by selected sociodemographic characteristics. The most notable observed differences in use were by age and Hispanic or Latino origin and race.

Students experienced a mindfulness program designed to enhance their selfregulation in prekindergarten and kindergarten. At the end of the 1st year of the program, these students showed improvements in teacher-reported executive function skills, specifically related to working memory and planning and organizing, whereas students in a business as usual control group showed a decline in these areas. No difference between the groups’ receptive vocabulary was found in prekindergarten. At the end of kindergarten, the mindfulness group had higher vocabulary and reading scores than the business as usual group. Practice or Policy: These findings suggest that mindfulness practices may be a promising technique that teachers can use in early childhood settings to enhance preschoolers’ executive functioning, with academic benefits emerging in the kindergarten year.

This study contributes to ongoing scholarship at the nexus of translational research, education reform, and the developmental and prevention sciences. It reports 2-year experimental impacts of a universal, integrated school-based intervention in social-emotional learning and literacy development on children's social-emotional, behavioral, and academic functioning. The study employed a school-randomized, experimental design with 1,184 children in 18 elementary schools. Children in the intervention schools showed improvements across several domains: self-reports of hostile attributional bias, aggressive interpersonal negotiation strategies, and depression, and teacher reports of attention skills, and aggressive and socially competent behavior. In addition, there were effects of the intervention on children's math and reading achievement for those identified by teachers at baseline at highest behavioral risk. These findings are interpreted in light of developmental cascades theory and lend support to the value of universal, integrated interventions in the elementary school period for promoting children's social-emotional and academic skills.

This article presents findings from a year-long multilevel comparative case study exploring the characteristics of effective urban high schools. We developed a comprehensive framework from the school effectiveness research that guided our data collection and analysis at the four high schools. Using value-added methodology, we identified two higher and two lower performing high schools in Broward County, Florida. We found that the two higher performing high schools in the study had strong and deliberate structures, programs, and practices that attended to both students' academic and social learning needs, something we call "Personalization for Academic and Social Emotional Learning". Because of the study's inductive focus on effectiveness, we follow our findings with a discussion of theories and prior research that substantiate the importance of schools' attention to the connection between students' academic and social emotional learning needs in high schools.

This paper seeks to contribute to the debate around sustainability by proposing the need for an ecocentric stance to sustainability that reflexively embeds humans in—rather than detached from—nature. We argue that this requires a different way of thinking about our relationship with our world, necessitating a (re)engagement with the sociomaterial world in which we live. We develop the notion of ecocentrism by drawing on insights from sociomateriality studies, and show how radical-reflexivity enables us to appreciate our embeddedness and responsibility for sustainability by bringing attention to the interrelationship between values, actions and our social and material world. We examine the implications of an ecocentric radically reflexive approach to sustainability for management education.

OBJECTIVE: Nearly 38% of U.S. adults use complementary and alternative medicine approaches to manage physical conditions (e.g., chronic pain, arthritis, cancer, heart disease, and high blood pressure) and psychological or emotional health concerns (e.g., post-traumatic stress disorder, anxiety, and depression). Research evidence has accumulated for yoga as an effective treatment approach for these conditions. Further, yoga has increased in popularity among healthcare providers and the general population. Given these trends, this study explored perceptions about yoga as a viable complementary treatment to which health professions students would refer patients. PARTICIPANTS: More than 1500 students enrolled in health professions programs at a Pacific Northwest school were enrolled; data were obtained from 478 respondents. DESIGN: The study assessed willingness to refer patients to yoga as a complementary and alternative medicine for 27 symptoms (identified in the literature as having evidence for yoga's utility), which were subsequently grouped into skeletal, physical, and psychological on the basis of factor analysis. Responses were assessed using a mixed-model analysis of variance with health profession and yoga practitioner as between-subjects variables and symptoms as a within-subjects factor. RESULTS: In descending order of likelihood to refer patients to yoga were students in occupational therapy, physician assistant program, psychology, physical therapy, pharmacy, dental hygiene, speech and audiology, and optometry. All groups perceived yoga's greatest utility for skeletal symptoms, followed by psychological and physical symptoms. Findings also revealed a significant positive relationship between level of personal yoga practice and willingness to refer patients to yoga. CONCLUSIONS: Although students expressed some openness to referring patients to yoga, ratings of appropriateness were not accurately aligned with extant evidence base. Personal experience seemed to be a salient factor for accepting yoga as a referral target. These findings suggest the importance of developing strategies to make health professionals more aware of the merits of yoga, regardless of whether they themselves are yoga practitioners.

Anxiety may begin at the moment a person is diagnosed with cancer and may fluctuate throughout the cancer trajectory as physical illness improves or declines. The purpose of this article is to present current evidence for nurses to implement interventions to reduce anxiety in patients who have cancer. The PubMed and CINAHL (R) databases were searched to identify relevant citations addressing interventions that treat or prevent anxiety symptoms in patients with cancer. Based on available evidence, the interventions addressed herein are categorized according to the Putting Evidence Into Practice (PEP (R)) rating schema. Interventions include pharmacologic and nonpharmacologic approaches to care, and meet criteria for three PEP categories: likely to be effective, effectiveness not established (the largest category of results), or effectiveness unlikely.

Vagal tone (VT), an index of autonomic flexibility, is linked to social and psychological well-being. We posit that the association between VT and well-being reflects an “upward spiral” in which autonomic flexibility, represented by VT, facilitates capitalizing on social and emotional opportunities and the resulting opportunistic gains, in turn, lead to higher VT. Community-dwelling adults were asked to monitor and report their positive emotions and the degree to which they felt socially connected each day for 9 weeks. VT was measured at the beginning and end of the 9-week period. Adults who possessed higher initial levels of VT increased in connectedness and positive emotions more rapidly than others. Furthermore, increases in connectedness and positive emotions predicted increases in VT, independent of initial VT level. This evidence is consistent with an “upward spiral” relationship of reciprocal causality, in which VT and psychosocial well-being reciprocally and prospectively predict one another.


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