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<p>This article draws upon and integrates a number of distinct but overlapping areas of inquiry in the literature on teaching: teacher inquiry, reflective practice, spirituality and education, and contemplative practice. In it, we examine the implementation of a particular phenomenological form of teacher inquiry, the Descriptive Review, in an urban teacher preparation program. The authors participated in a longitudinal study of graduates of the program and are engaged in the continual examination of student work to assess the efficacy of the inquiry process in helping students overcome bias and habitual thinking, become more mindful of the basis of their professional judgments, and develop a moral framework that might help them resist dehumanizing and ineffective policies and imposed practices. The article includes the authors' autobiographical reflections about what brought them to this form of practice, a description of the theory and practice of the Descriptive Review as it is carried out in their teacher preparation graduate programs, a description of the urban context in which the work takes place, and a student narrative of practice, which is analyzed in relation to the theory of phenomenological inquiry. The conclusions are tentative; although the efficacy of the method is clearly demonstrated in the narratives that students produce about their inquiries into practice, the complex and challenging environments that new urban teachers are facing are problematic in terms of the capacity to develop contemplative practice.</p>
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<p>Cultivating Awareness and Resilience in Education (CARE) is a professional development program designed to reduce stress and improve teachers' performance. Two pilot studies examined program feasibility and attractiveness and preliminary evidence of efficacy. Study 1 involved educators from a high-poverty urban setting (n = 31). Study 2 involved student teachers and 10 of their mentors working in a suburban/semi-rural setting (n = 43) (treatment and control groups). While urban educators showed significant pre-post improvements in mindfulness and time urgency, the other sample did not, suggesting that CARE may be more efficacious in supporting teachers working in high-risk settings. (Contains 2 tables, 1 figure and 1 footnote.)</p>
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OBJECTIVES: The objectives of this study were to assess the general acceptability and to assess domains of potential effect of a mindfulness-based stress reduction (MBSR) program for human immunodeficiency virus (HIV)-infected and at-risk urban youth.
METHODS: Thirteen-to twenty-one-year-old youth were recruited from the pediatric primary care clinic of an urban tertiary care hospital to participate in 4 MBSR groups. Each MBSR group consisted of nine weekly sessions of MBSR instruction. This mixed-methods evaluation consisted of quantitative data--attendance, psychologic symptoms (Symptom Checklist 90-Revised), and quality of life (Child Health and Illness Profile-Adolescent Edition)--and qualitative data--in-depth individual interviews conducted in a convenience sample of participants until interview themes were saturated. Analysis involved comparison of pre- and postintervention surveys and content analysis of interviews.
RESULTS: Thirty-three (33) youth attended at least one MBSR session. Of the 33 who attended any sessions, 26 youth (79%) attended the majority of the MBSR sessions and were considered "program completers." Among program completers, 11 were HIV-infected, 77% were female, all were African American, and the average age was 16.8 years. Quantitative data show that following the MBSR program, participants had a significant reduction in hostility (p = 0.02), general discomfort (p = 0.01), and emotional discomfort (p = 0.02). Qualitative data (n = 10) show perceived improvements in interpersonal relationships (including less conflict), school achievement, physical health, and reduced stress.
CONCLUSIONS: The data suggest that MBSR instruction for urban youth may have a positive effect in domains related to hostility, interpersonal relationships, school achievement, and physical health. However, because of the small sample size and lack of control group, it cannot be distinguished whether the changes observed are due to MBSR or to nonspecific group effects. Further controlled trials should include assessment of the MBSR program's efficacy in these domains.
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BACKGROUND: Despite the apparent high placebo response rate in randomized placebo-controlled trials (RCT) of patients with irritable bowel syndrome (IBS), little is known about the variability and predictors of this response.
OBJECTIVES: To describe the magnitude of response in placebo arms of IBS clinical trials and to identify which factors predict the variability of the placebo response.
METHODS: We performed a meta-analysis of published, English language, RCT with 20 or more IBS patients who were treated for at least 2 weeks. This analysis is limited to studies that assessed global response (improvement in overall symptoms). The variables considered as potential placebo modifiers were study design, study duration, use of a run-in phase, Jadad score, entry criteria, number of office visits, number of office visits/study duration, use of diagnostic testing, gender, age and type of medication studied.
FINDINGS: Forty-five placebo-controlled RCTs met the inclusion criteria. The placebo response ranged from 16.0 to 71.4% with a population-weighted average of 40.2%, 95% CI (35.9-44.4). Significant associations with lower placebo response rates were fulfillment of the Rome criteria for study entry (P=0.049) and an increased number of office visits (P=0.026).
CONCLUSIONS: Placebo effects in IBS clinical trials measuring a global outcome are highly variable. Entry criteria and number of office visits are significant predictors of the placebo response. More stringent entry criteria and an increased number of office visits appear to independently decrease the placebo response.
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