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Lymphedema affects 3-58% of survivors of breast cancer and can result in upper extremity impairments. Exercise can be beneficial in managing lymphedema. Yoga practice has been minimally studied for its effects on breast cancer related lymphedema (BCRL). The purpose of this study was to determine the effect of yoga on arm volume, quality of life (QOL), self-reported arm function, and hand grip strength in women with BCRL. Six women with BCRL participated in modified Hatha yoga 3x/week for 8 weeks. Compression sleeves were worn during yoga sessions. Arm volume, QOL, self-reported arm function, and hand grip strength were measured at baseline, half-way, and at the conclusion of yoga practice. Arm volume significantly decreased from baseline (2423.3 ml +/- 597.2) to final measures (2370.8 ml +/- 577.2) (p = .02). No significant changes in QOL (p = .12), self-reported arm function (p = .34), or hand grip strength (p = .26) were found. Yoga may be beneficial in the management of lymphedema.
The impact of living with metastatic breast cancer (MBC) is considerable and psychosocial support can be beneficial. Mindfulness-based stress reduction (MBSR) can help self-management of anxiety, depression, quality of life (QoL), and fatigue and has been evaluated in early-stage breast cancer but not MBC. This study investigated the acceptability and feasibility of providing MBSR for women with MBC and of introducing MBSR into a National Health Service (NHS) setting. A mixed methods convergent design was used. Eligible women with MBC, an Eastern Cooperative Oncology Group (ECOG) score of 0 to 2, stable disease, and life expectancy of at least 6 months were invited to attend (by their oncologist) an 8-week MBSR course. Qualitative interviews with patients, a focus group, and interview with NHS staff were held to explore acceptability and feasibility of MBSR. Questionnaires at baseline, during (weeks 4, 8), and after (weeks 16, 24) the course measured fatigue, anxiety and depression, mindfulness, disease-specific QoL, and generic preference based QoL. Of 100 women approached, 20 joined the study. One woman dropped out prior to the intervention due to illness progression. Nineteen women took part in 3 MBSR courses. Recruitment to 2 of the 3 courses was slow. Commitment to 8 weeks was a reason for non-participation, and proved challenging to participants during the course. Participants found the course acceptable and reported many cumulative and ongoing benefits. These included feeling less reactive to emotional distress and more accepting of the disruption to life that occurs with living with MBC. There was high attendance, completion of course sessions, adherence to home practice, excellent follow-up rates, and high questionnaire return rates. MBSR was acceptable to MBC patients, who perceived benefits such as improved anxiety and QoL; but the MBSR course requires a considerable time commitment. There is scope to tailor the intervention so that it is less intensive.
The inclusion of social and emotional learning (SEL) in schools is becoming a pertinent topic in the field of education. Teachers and administrators are recognizing a need to support students' social and emotional growth alongside their academics. Young adolescents in grades 6 -- 8 are in a developmental stage during which the acquisition of interpersonal and intrapersonal skills could be particularly beneficial and supportive to their ability to lead healthy lives. In this project-based thesis, the author based her research on the question; how are North Carolina (NC) public schools supporting the social and emotional development of their middle school students? This question was formulated in order to support the project of this thesis, the creation of a development plan for a public charter middle school in NC that focuses on social and emotional learning. The research method utilized in this study was grounded theory as developed by Barney Glaser and Anselm Strauss (1967). Data was collected through a survey sent to public middle schools across NC and through interviews conducted with school administrators. Constant comparative analysis was the process through which all of the data was analyzed. Results of this research found that 80% of the surveyed schools implement SEL programming and the majority of those schools believe SEL to positively affect many facets of their school including academic success of the students, physical and emotional safety, and the relationship between the students and teachers. Strategies the participating schools used to implement SEL programming were also discovered in this study. These consist of having distinct lessons on SEL topics and skills, integrating parts of SEL throughout the entire school, use of mentoring, inclusion of aspects of SEL in student discipline, having programming meet the unique needs of the school, and evaluating the students' progression in SEL. Results of this study also indicated several design elements of SEL programming, which include having SEL be a united effort of all faculty and administration, providing teachers with support, sharing responsibility for the programming with the students, and allocating sufficient time to SEL programming. The findings of this study have been used by the author to inform the creation of the school development plan included in this thesis. By adding to the discussion of how to provide SEL to middle school students in NC, this study can be a resource to any educator in the process of developing SEL programming for their students.
The use of indicators to gauge human progress is common and well understood; Gross Domestic Product and the Index of Leading Economic Indicators are two well-known examples. Yet most of the widely cited indicators focus exclusively on economic activity, and even the most progressive of indicators fail to account for key issues of sustainability. The Wellbeing of Nations addresses that shortcoming by combining indicators of human well-being with those of environmental stability to generate a more comprehensive picture of the state of our world.The author combines 39 indicators of health, population, wealth, education, communication, freedom, peace, crime, and equity into a Human Wellbeing Index, and 39 indicators of land health, protected areas, water quality, water supply, global atmosphere, air quality, species diversity, energy use, and resource pressures into an Ecosystem Wellbeing Index. The two indexes are then combined into a Wellbeing/Stress Index that measures how much human wellbeing each country obtains for the amount of stress it places on the environment. Seventy color-coded geopolitical maps vividly portray the performance of each of the 180 nations for all indexes, and the main indicators that go into them. In addition, all data are given in 160 pages of tables, and the highly accessible methodology is described in appendices so that readers can undertake their own assessments.Produced in collaboration with the leading international organizations involved with sustainable development, The Wellbeing of Nations is a one-of-a-kind reference for development and environmental policy professionals, as well as for students and scholars in environmental studies, international studies, and international development.