One of society’s greatest challenges is to sustain natural resources while promoting economic growth and quality of life. In the face of this challenge, society must measure the effectiveness of programs established to safeguard the environment. The impetus for demonstrating positive results from government-sponsored research and regulation in the United States comes from Congress (General Accountability Office; GAO) and the Executive Branch (Office of Management and Budget; OMB). The message is: regulatory and research programs must demonstrate outcomes that justify their costs. Although the concept is simple, it is a complex problem to demonstrate that environmental research, policies, and regulations cause measurable changes in environmental quality. Even where changes in environmental quality can be tracked reliably, the connections between government actions and environmental outcomes seldom are direct or straightforward. In this article, we describe emerging efforts (with emphasis on the role of the U.S. Environmental Protection Agency; EPA) to frame and measure environmental outcomes in terms of ecosystem services and values—societally and ecologically meaningful metrics for gauging how well we manage environmental resources. As examples of accounting for outcomes and values, we present a novel, low-cost method for determining relative values of multiple ecosystem services, and describe emerging research on indicators of human well-being.
Critical pedagogy, even as inflected by certain poststructuralisms, tends to reinforce rather than subvert deep-seated humanist assumptions about humans and nature by taking for granted the borders that define nature as the devalued Other. These assumptions are called into question by discussion of how relationships between language, communication, and meaningful experience are conceptualized outside the field of critical pedagogy. We deal constructively with some anthropocentric blind spots within critical pedagogy generally and within poststructuralist approaches to critical pedagogy in particular. We hope to illuminate places where these streams of thought and practice move in directions compatible with critical environmental education.
"We know that educational system problems, such as bullying, student dropout, suicide, and poor conduct are reduced by elevations in SEL skills. Therefore, the continued development, study, and refinement of SEL interventions is an important component in our efforts to maintain positive school environments for our children. This study examined archival data collected by the Bay Area Family Therapy Training Associates as part of a currently ongoing Brain Powers Project Efficacy Study (BPPES) to determine efficacy of a social emotional learning (SEL) intervention for elementary school classrooms called the Brain Powers Project (BPP). Data collection included 450 students. This study predicted a higher rate of significant positive change between the pre and post-test responses of the BPP intervention group over control group students on five social-emotional measures, including the Child Acceptance of Mindfulness Measure, the Cognitive and Affective Mindfulness Scale-Revised, the Bryant Index of Empathy, the Strengths and Difficulties Questionnaire (SDQ), and the Impersonal Reactivity Index. Analysis of the results did not reveal conclusive support for the study's prediction. Results showed significant time-group interaction for the intervention group on the conduct problems scale and the hyperactivity scale on the SDQ, from T1 to T2. This presents the possibility that the intervention influences conduct and hyperactivity in the children who participated. However, more research should be done to better understand any interactions between the intervention and the constructs assessed by these subscales. In regards to the insignificant results, these may have been due to the fact that researchers made the decision to not offer the mindfulness part of the intervention to schools with limited time; this resulted in the first two measures being collected from only a few classrooms. It is highly likely that removing the mindfulness part of the intervention produced inconsistent results and compromised within group validity. Qualitative study may be useful in the future to allow students to speak about their successes in using the program tools to navigate everyday challenges."--Pages iv-v.
<p>Objective Evaluate the evidence for clinical applications of yoga among the pediatric population. Methods We conducted an electronic literature search including CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, Medline, PsycINFO, and manual search of retrieved articles from inception of database until December 2008. Randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) were selected including yoga or yoga-based interventions for individuals aged from 0 to 21 years of age. Data were extracted and articles critically reviewed utilizing a modified Jadad score and descriptive methodological criteria with summarization in tables. Results Thirty four controlled studies were identified published from 1979 to 2008, with 19 RCTS and 15 NRCTs. Many studies were of low methodological quality. Clinical areas for which yoga has been studied include physical fitness, cardio-respiratory effects, motor skills/strength, mental health and psychological disorders, behavior and development, irritable bowel syndrome, and birth outcomes following prenatal yoga. No adverse events were reported in trials reviewed. While a large majority of studies were positive, methodological limitations such as randomization methods, withdrawal/dropouts, and details of yoga intervention preclude conclusive evidence. Conclusions There are limited data on the clinical applications of yoga among the pediatric population. Most published controlled trials were suggestive of benefit, but results are preliminary based on low quantity and quality of trials. Further research of yoga for children utilizing a higher standard of methodology and reporting is warranted.</p>
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Introduction: Breathing pattern disorders (BPDs) are characterized by persistent, suboptimal breathing strategies that may result in additional musculoskeletal pain and/or dysfunction. The purpose of this case series was to examine the effects of Primal Reflex Release Technique (PRRT) and breathing exercise interventions in physically active individuals that presented with a primary complaint of musculoskeletal pain, a BPD, and startle reflexes.
BackgroundMindfulness-based approaches for adults are effective at enhancing mental health, but few controlled trials have evaluated their effectiveness or cost-effectiveness for young people. The primary aim of this trial is to evaluate the effectiveness and cost-effectiveness of a mindfulness training (MT) programme to enhance mental health, wellbeing and social-emotional behavioural functioning in adolescence.
Methods/design
To address this aim, the design will be a superiority, cluster randomised controlled, parallel-group trial in which schools offering social and emotional provision in line with good practice (Formby et al., Personal, Social, Health and Economic (PSHE) Education: A mapping study of the prevalent models of delivery and their effectiveness, 2010; OFSTED, Not Yet Good Enough: Personal, Social, Health and Economic Education in schools, 2013) will be randomised to either continue this provision (control) or include MT in this provision (intervention). The study will recruit and randomise 76 schools (clusters) and 5700 school students aged 12 to 14 years, followed up for 2 years.
Discussion
The study will contribute to establishing if MT is an effective and cost-effective approach to promoting mental health in adolescence.
A growing body of literature has identified a range of beneficial physiological and psychological outcomes from the regular practice of mindfulness meditation. For healthcare professionals, mindfulness meditation is claimed to reduce stress, anxiety and burnout, and enhance resilience.
PurposeTo examine the effects of a 12-week tai chi program on quality of life and exercise capacity in patients with heart failure.
Methods
Thirty patients with chronic stable heart failure and left ventricular ejection fraction ≤40% (mean [± SD] age, 64 ± 13 years; mean baseline ejection fraction, 23% ± 7%; median New York Heart Association class, 2 [range, 1 to 4]) were randomly assigned to receive usual care (n = 15), which included pharmacologic therapy and dietary and exercise counseling, or 12 weeks of tai chi training (n = 15) in addition to usual care. Tai chi training consisted of a 1-hour class held twice weekly. Primary outcomes included quality of life and exercise capacity. Secondary outcomes included serum B-type natriuretic peptide and plasma catecholamine levels. For 3 control patients with missing data items at 12 weeks, previous values were carried forward.
Results
At 12 weeks, patients in the tai chi group showed improved quality-of-life scores (mean between-group difference in change, –25 points, P = 0.001), increased distance walked in 6 minutes (135 meters, P = 0.001), and decreased serum B-type natriuretic peptide levels (–138 pg/mL, P = 0.03) compared with patients in the control group. A trend towards improvement was seen in peak oxygen uptake. No differences were detected in catecholamine levels.
Conclusion
Tai chi may be a beneficial adjunctive treatment that enhances quality of life and functional capacity in patients with chronic heart failure who are already receiving standard medical therapy.
A systematic review of the literature on the effect of tai chi exercise on blood pressure (BP) was performed. The authors searched Medline, CAB, Alt HealthWatch, BIOSIS previews, Science Citation Index, and EMBASE systems (inception through January 2007); researched Chinese Medical, China Hospital Knowledge, China National Knowledge Infrastructure, and China Traditional Chinese Medicine databases (inception to June 2005); and performed hand searches at the medical libraries of Beijing and Nanjing Universities. Clinical studies of tai chi examining BP as an outcome published in English or Chinese were included. Studies reporting only acute exercise effects were excluded. Data were extracted in a standardized manner and 2 independent investigators assessed methodologic quality. Twenty-six studies examining patients with and without cardiovascular conditions met inclusion criteria: 9 randomized controlled trials, 13 nonrandomized studies, and 4 observational studies. Study heterogeneity precluded formal meta-analyses. Twenty-two studies (85%) reported reductions in BP with tai chi (3–32 mm Hg systolic and 2–18 mm Hg diastolic BP reductions). Five randomized controlled trials were of adequate quality (Jadad score ≥3). No adverse effects were reported. Tai chi exercise may reduce BP and serve as a practical, nonpharmacologic adjunct to conventional hypertension management.
In a recent article, Russell and Hutzel, two of the authors of this article, proposed a framework for teaching social and emotional learning (SEL) in art education through collaborative service-learning. As defined in that article, SEL is a "process through which children and adults develop the skills, attitudes, and values necessary to acquire social and emotional competence." The core competencies of SEL include self-awareness, social-awareness, self-management, responsible decision making, and relationship skills, and within each competency is a set of skills. This article describes a situation in which the proposed concepts of SEL, coupled with service-learning and art education, were included in a curriculum unit and implemented during two sequential years in a private middle school near Akron, Ohio. This article considers potential outcomes in addition to SEL competencies in art education, namely the students' positions as role models in the experience. The authors present an analysis and interpretation of the learning experience for the eighth-graders, including (1) the teacher's description of the experience; (2) analysis of outcomes related to SEL core competencies; and (3) possibilities for further engaging social and emotional learning in the middle school art classroom. (Contains 2 figures.)
ObjectiveTo assess the effects of a 12-week Tai Chi exercise program on sleep using the sleep spectrogram, a method based on a single channel electrocardiogram (ECG)-derived estimation of cardiopulmonary coupling, previously shown to identify stable and unstable sleep states.
Methods
We retrospectively analyzed 24-h continuous ECG data obtained in a clinical trial of Tai Chi exercise in patients with heart failure. Eighteen patients with chronic stable heart failure, left ventricular ejection fraction ⩽40% (mean [±standard deviation] age, 59±14 years, mean baseline ejection fraction 24%±8%, mean) were randomly assigned to receive usual care (N=10), which included pharmacological therapy and dietary and exercise counseling, or 12 weeks of Tai Chi training (N=8) in addition to usual care. Using the ECG-based sleep spectrogram, we compared intervention and control groups by evaluating baseline and 12-week high (stable) and low (unstable) frequency coupling (HFC & LFC, respectively) as a percentage of estimated total sleep time (ETST).
Results
At 12 weeks, those who participated in Tai Chi showed a significant increase in HFC (+0.05±0.10 vs. −0.06±0.09 % ETST, p=0.04) and significant reduction in LFC (−0.09±0.09 vs. +0.13±0.13 % ETST, p<0.01), compared to patients in the control group. Correlations were seen between improved sleep stability and better disease-specific quality of life.
Conclusions
Tai Chi exercise may enhance sleep stability in patients with chronic heart failure. This sleep effect may have a beneficial impact on blood pressure, arrhythmogenesis and quality of life.
Medical pain management is in crisis; from the pervasiveness of pain to inadequate pain treatment, from the escalation of prescription opioids to an epidemic in addiction, diversion and overdose deaths. The rising costs of pain care and managing adverse effects of that care have prompted action from state and federal agencies including the DOD, VHA, NIH, FDA and CDC. There is pressure for pain medicine to shift away from reliance on opioids, ineffective procedures and surgeries toward comprehensive pain management that includes evidence-based nonpharmacologic options. This White Paper details the historical context and magnitude of the current pain problem including individual, social and economic impacts as well as the challenges of pain management for patients and a healthcare workforce engaging prevalent strategies not entirely based in current evidence. Detailed here is the evidence-base for nonpharmacologic therapies effective in postsurgical pain with opioid sparing, acute non-surgical pain, cancer pain and chronic pain. Therapies reviewed include acupuncture therapy, massage therapy, osteopathic and chiropractic manipulation, meditative movement therapies Tai chi and yoga, mind body behavioral interventions, dietary components and self-care/self-efficacy strategies. Transforming the system of pain care to a responsive comprehensive model necessitates that options for treatment and collaborative care must be evidence-based and include effective nonpharmacologic strategies that have the advantage of reduced risks of adverse events and addiction liability. The evidence demands a call to action to increase awareness of effective nonpharmacologic treatments for pain, to train healthcare practitioners and administrators in the evidence base of effective nonpharmacologic practice, to advocate for policy initiatives that remedy system and reimbursement barriers to evidence informed comprehensive pain care, and to promote ongoing research and dissemination of the role of effective nonpharmacologic treatments in pain, focused on the short- and long-term therapeutic and economic impact of comprehensive care practices.
The aims of this exploratory pilot study were to examine how a substance use disorder (SUD) treatment program for young adult males integrated mindfulness-based experiences into the treatment process, and to assess the impact of these experiences on the development of mindfulness skills and treatment outcome. The study utilized a within-subject naturalistic mixed-method design that integrated quantitative and qualitative data where all participants who entered treatment and agreed to participate in the evaluation were included in the data collection. A total of 32 young men were included in the analysis with an average age of 22.9 years. Statistically significant changes in scores on the Five Facet Mindfulness Questionnaire (FFMQ) from pre- to post-treatment were noted for all clients as a result of treatment, and these changes were strongly correlated to treatment outcome as indicated by statistically significant changes in total OQ-45.2 scores. Clients also showed specific improvement in scores on mindfulness skills related to the nonjudging and nonreactivity facets of the FFMQ which were related to reductions in the client’s overall subjective distress as measured by the OQ-45.2. Qualitative findings from analysis of client comments support these findings and highlight client perspective of the value of mindfulness-based experiences in addictions treatment. Despite the limitations inherent in this exploratory study, mindfulness-based experiences (MBEs) are discussed as a promising approach in the treatment of SUD and suggest further research in this area of addiction treatment.
PURPOSE: To describe the effect of therapeutic yoga on child and parental reports of quality of life in children hospitalized with oncological diagnoses.METHODS: Six children participated in 5 yoga sessions over 2 months. The PedsQL 4.0 was administered to each child and participating parent/caregivers at baseline and after completion of the yoga intervention. The Wilcoxon nonparametric rank test measured individual differences over time.
RESULTS: Statistically significant differences (P < .05) were found in child perception of gross motor function.
CONCLUSION: These feasibility study data suggest that therapeutic yoga positively affected child perception of gross motor function measured on the PedsQL 4.0. Further studies are needed, including a randomized control trial and with a larger number of participants, to clarify and confirm the effect of therapeutic yoga.
The science of meditation has grown tremendously in the last two decades. Most studies have focused on evaluating the clinical effectiveness of mindfulness-based interventions, neural and other physiological correlates of meditation, and individual cognitive and emotional aspects of meditation. Far less research has been conducted on more challenging domains to measure, such as group and relational, transpersonal and mystical, and difficult aspects of meditation; anomalous or extraordinary phenomena related to meditation; and post-conventional stages of development associated with meditation. However, these components of meditation may be crucial to people’s psychological and spiritual development, could represent important mediators and/or mechanisms by which meditation confers benefits, and could themselves be important outcomes of meditation practices. In addition, since large numbers of novices are being introduced to meditation, it is helpful to investigate experiences they may encounter that are not well understood. Over the last four years, a task force of meditation researchers and teachers met regularly to develop recommendations for expanding the current meditation research field to include these important yet often neglected topics. These meetings led to a cross-sectional online survey to investigate the prevalence of a wide range of experiences in 1120 meditators. Results show that the majority of respondents report having had many of these anomalous and extraordinary experiences. While some of the topics are potentially controversial, they can be subjected to rigorous scientific investigation. These arenas represent largely uncharted scientific terrain and provide excellent opportunities for both new and experienced researchers. We provide suggestions for future directions, with accompanying online materials to encourage such research.
Branching Out is a 12?week ecotherapy programme for clients who use mental health services within the Greater Glasgow and Clyde area. Over the course of a year 110 clients attended the programme, of whom 77 (70%) completed the course. In order to ascertain the outcomes of the programme and the elements that appeared to facilitate change, semi?structured interviews with clients (n=28) and two focus groups with clinicians (n=5 and n=3) from the referring services were conducted.The data gathered therein was analysed using interpretive phenomenological analysis (IPA). From the results, five themes emerged as client outcomes. These were: improvements to mental well?being, improvements to physical health, provision of daily structure and routine, transferable knowledge and skill acquisition, and increased social networking and social skills development. Three themes pertaining to the service logistics (team building and social inclusion, contrast of environments and work and recognition) emerged as potential explanations for the client outcomes. There was a perception among clients and clinicians that Branching Out represented a ?stepping stone to further community engagement?. The results reflect a recovery?oriented approach to health care. The limitations of the evaluation and implications for the future are discussed.
OBJECTIVES:Stress is a well-known predictor of smoking relapse, and cortisol is a primary biomarker of stress. The current pilot study examined changes in levels of cortisol in hair within the context of two time-intensity matched behavioral smoking cessation treatments: mindfulness training for smokers and a cognitive-behavioral comparison group.
PARTICIPANTS:
Eighteen participants were recruited from a larger randomized controlled trial of smoking cessation.
OUTCOME MEASURES:
Hair samples (3 cm) were obtained 1 month after quit attempt, allowing for a retrospective analysis of hair cortisol at preintervention and post-quit attempt time periods. Self-reported negative affect was also assessed before and after treatment.
INTERVENTION:
Both groups received a 7-week intensive intervention using mindfulness or cognitive-behavioral strategies.
RESULTS:
Cortisol significantly decreased from baseline to 1 month after quit attempt in the entire sample (d=-0.35; p=.005). In subsequent repeated-measures analysis of variance models, time by group and time by quit status interaction effects were not significant. However, post hoc paired t tests yielded significant pre-post effects among those randomly assigned to the mindfulness condition (d=-0.48; p=.018) and in those abstinent at post-test (d=-0.41; p=.004). Decreased hair cortisol correlated with reduced negative affect (r=.60; p=.011).
CONCLUSIONS:
These preliminary findings suggest that smoking cessation intervention is associated with decreased hair cortisol levels and that reduced hair cortisol may be specifically associated with mindfulness training and smoking abstinence. RESULTS support the use of hair cortisol as a novel objective biomarker in future research.
Ecosystems provide many of the material building blocks for human well-being. Although quantification and appreciation of such contributions have rapidly grown, our dependence upon cultural connections to nature deserves more attention. We synthesize multidisciplinary peer-reviewed research on contributions of nature or ecosystems to human well-being mediated through nontangible connections (such as culture). We characterize these connections on the basis of the channels through which such connections arise (i.e., knowing, perceiving, interacting with, and living within) and the components of human well-being they affect (e.g., physical, mental and spiritual health, inspiration, identity). We found enormous variation in the methods used, quantity of research, and generalizability of the literature. The effects of nature on mental and physical health have been rigorously demonstrated, whereas other effects (e.g., on learning) are theorized but seldom demonstrated. The balance of evidence indicates conclusively that knowing and experiencing nature makes us generally happier, healthier people. More fully characterizing our intangible connections with nature will help shape decisions that benefit people and the ecosystems on which we depend.
Using data for 25,780 species categorized on the International Union for Conservation of Nature Red List, we present an assessment of the status of the world’s vertebrates. One-fifth of species are classified as Threatened, and we show that this figure is increasing: On average, 52 species of mammals, birds, and amphibians move one category closer to extinction each year. However, this overall pattern conceals the impact of conservation successes, and we show that the rate of deterioration would have been at least one-fifth again as much in the absence of these. Nonetheless, current conservation efforts remain insufficient to offset the main drivers of biodiversity loss in these groups: agricultural expansion, logging, overexploitation, and invasive alien species.Though the threat of extinction is increasing, overall declines would have been worse in the absence of conservation.
Though the threat of extinction is increasing, overall declines would have been worse in the absence of conservation.
OBJECTIVE: Fatigue and other treatment-related symptoms are critical therapeutic targets for improving quality of life in patients with colorectal cancer during chemotherapy. Yoga is a promising intervention for improving these therapeutic targets and has been primarily investigated in the group-class format, which is less feasible for cancer patients with high symptom burden to attend. Thus, we developed a protocol for implementing yoga individually in the clinic among patients receiving chemotherapy.METHODS: We followed recommended domains for developing a yoga protocol to be used in an efficacy trial. These recommendations include consideration to the style, delivery, components of the intervention, dose, specific class sequences, facilitation of home practice, measurement of intervention fidelity, selection of instructors, and dealing with modifications. The intervention protocol was developed by an interdisciplinary team.
PROTOCOL: Yoga Skills Training (YST) consists of four 30-minute in-person sessions and was implemented while in the chair during chemotherapy infusions for colorectal cancer with recommended daily home practice for eight weeks. Therapeutic goals of the YST are to reduce fatigue, circadian disruption, and psychological distress. Elements of the YST are awareness meditation, gentle seated movement, breathing practice, and relaxation meditation. Attention, comfort, and ease are also highlighted.
CONCLUSION: This description of a protocol for integrating yoga with conventional cancer treatment will inform future study designs and clinical practice. The design of the YST is novel because it implements yoga-most commonly studied when taught to groups outside of the clinical setting- individually during clinical care.
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