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PubMedDate not supplied

The effects of mindfulness-based stress reduction on nurse stress and burnout, Part II: A quantitative and qualitative study.

This article is the second in a series reporting on research exploring the effects of Mindfulness-based Stress Reduction on nurses and describes the quantitative data. The third article describes qualitative data. Treatment group participants reduced scores on 2 of 3 subscales of the Maslach Burnout Inventory significantly more than wait-list controls; within-group comparisons for both groups pretreatment and posttreatment revealed similar findings. Changes were maintained as long as 3-month posttreatment. Implications of these findings are discussed.

Adult↗
PubMedDate not supplied

The effects of mindfulness-based stress reduction on nurse stress and burnout: a qualitative and quantitative study, part III.

Part III of the study on mindfulness-based stress reduction (MBSR) describes qualitative data and discusses the implications of the findings. Study analysis revealed that nurses found MBSR helpful. Greater relaxation and self-care and improvement in work and family relationships were among reported benefits. Challenges included restlessness, physical pain, and dealing with difficult emotions.

Adult↗
PubMedDate not supplied

Lessons learned: providing a mindfulness-based stress reduction program for low-income multiethnic women with abnormal pap smears.

Although the incidence rate of cervical cancer has decreased over the last several years, low-income ethnic minority women remain at increased risk for morbidity and mortality from cervical cancer. We conducted a pilot study to examine the feasibility and acceptability of mindfulness-based stress reduction (MBSR) program among multiethnic low-income women with abnormal Pap smears. Spanish- and English-speaking women recruited through convenience sampling participated in MBSR classes 2 hours each week over 6 consecutive weeks. State anxiety and self-compassion were measured before and after the MBSR program. Focus groups and surveys were used to evaluate the program. Although 51 women were initially recruited, pre- and post-MBSR data were available only for 8 women. There was a significant reduction in anxiety and a trend toward increased self-compassion in this group of women. The participants evaluated the MBSR program very positively. The high attrition rate highlights the challenges of conducting MBSR research with this demographic of women. Potential strategies for improving recruitment and retention of low-income multiethnic women are discussed.

Adult↗
PubMed2000

Zen leadership: balancing energy for mind, body, and spirit harmony.

This article explores leadership characteristics and practices that assist us both professionally and personally to be authentic and integrated in mind, body, and spirit for harmony. The transformational leadership characteristics--courage; belief in people; value driven; a life-long learner and teacher; a complexity, ambiguity, and uncertainty expert; and a visionary leader--all deal with the leader's ability to develop relationships through teamwork, collaboration, networking, mentoring, and establishing boundaries. The author realized the importance of reflection to maintaining a healthy relationship not only with others but also with self.

Adaptation, Psychological↗
PubMedDate not supplied

A pilot study of mindfulness-based stress reduction for hot flashes.

OBJECTIVE: A variety of results from both population and laboratory studies suggest that stress and hot flashes (HFs) are correlated and that HFs are more severe in women with lower coping abilities. The objective of this pilot study was to obtain information on the feasibility and effect of participation in a mindfulness-based stress reduction (MBSR) program on HF severity and menopause-related quality of life. DESIGN: Fifteen women volunteers reporting a minimum of seven moderate to severe HFs per day at study intake attended the eight weekly MBSR classes at the University of Massachusetts Medical School. Participants were assessed for menopause-related quality of life before beginning and at the conclusion of the MBSR program. Women also kept a daily log of their HFs through the course of the 7 weeks of the MBSR program and for 4 weeks after it. RESULTS: Women's scores on quality-of-life measures increased significantly, and the median reported HF severity, calculated as the weekly average of a daily HF severity score, decreased 40% over the course of the 11 weeks of the assessment period. The women were individually interviewed at the completion of their participation, and the results of the interviews were consistent with the results from daily diaries. CONCLUSIONS: These results provide preliminary positive evidence of the feasibility and efficacy of MBSR in supporting women who are experiencing severe HFs, and it warrants further investigation.

Female↗
PubMed2006

Outcomes after liver transplantation: keep the end in mind.

Since the advent of transplantation as a life-saving procedure for patients with end-stage liver disease, more than 15,000 children and adolescents have received liver transplants. With the improvements in long-term posttransplant survival offered by advances in medical and surgical therapy, the concept of transplantation outcome has expanded beyond simple patient and graft survival rates. The quality of the life years restored, the long-term complications of transplant immunosuppression, and the overall cost of care have been increasingly recognized as important components of liver transplantation outcome. This review focuses on the efforts of a single pediatric transplant center to examine the incidence of, and risk factors for, common posttransplantation complications, to characterize posttransplantation health-related quality of life, to describe the cost of posttransplant care, and to implement novel programs to improve health care delivery. Together, these projects set the future course for research and care improvement initiatives in this population and encourage us to "keep the end in mind" when considering pediatric liver transplantation.

Adolescent↗
PubMedDate not supplied

Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress, and immune parameters in breast and prostate cancer outpatients.

OBJECTIVES: This study investigated the relationships between a mindfulness-based stress reduction meditation program for early stage breast and prostate cancer patients and quality of life, mood states, stress symptoms, lymphocyte counts, and cytokine production. METHODS: Forty-nine patients with breast cancer and 10 with prostate cancer participated in an 8-week MBSR program that incorporated relaxation, meditation, gentle yoga, and daily home practice. Demographic and health behavior variables, quality of life (EORTC QLQ C-30), mood (POMS), stress (SOSI), and counts of NK, NKT, B, T total, T helper, and T cytotoxic cells, as well as NK and T cell production of TNF, IFN-gamma, IL-4, and IL-10 were assessed pre- and postintervention. RESULTS: Fifty-nine and 42 patients were assessed pre- and postintervention, respectively. Significant improvements were seen in overall quality of life, symptoms of stress, and sleep quality. Although there were no significant changes in the overall number of lymphocytes or cell subsets, T cell production of IL-4 increased and IFN-gamma decreased, whereas NK cell production of IL-10 decreased. These results are consistent with a shift in immune profile from one associated with depressive symptoms to a more normal profile. CONCLUSIONS: MBSR participation was associated with enhanced quality of life and decreased stress symptoms in breast and prostate cancer patients. This study is also the first to show changes in cancer-related cytokine production associated with program participation.

Adenocarcinoma↗
PubMed2005

Pain management in children: developmental considerations and mind-body therapies.

One of the most challenging roles of medical providers serving children is to appropriately assess and treat their pain. Pain is one of the most misunderstood, underdiagnosed, and undertreated/ untreated medical problems, particularly in children. New JCAHO regulations regard pain as "the fifth vital sign" and require caregivers to regularly assess and address pain. This review focuses on the clinical assessment of pain, based on a developmental model and addresses common beliefs and myths that affect the management of pain in children. We provide a review of the pain literature that focuses on the integration of mind-body therapies into the management of procedure-related pain, headache, and recurrent abdominal pain in children.

Adolescent↗
PubMed2005

Inflammation: nutritional, botanical, and mind-body influences.

Chronic inflammation is becoming an important risk factor to identify in regard to inhibiting disease onset and its progression. Nutritional science attempted to improve health by manipulating fats so that we could consume "healthy" nonsaturated fats while simultaneously allowing foods to have a longer shelf-life. However, despite our good intentions, trans-fats and partially hydrogenated oils have been found to promote inflammation and adversely affect health. This article reviews how essential fatty acids, the ratio of omega-3 to omega-6 fatty acids, glycemic load, the Mediterranean diet, specific foods and botanicals, and the mind-body relation influence the inflammatory cascade.

Chronic Disease↗
PubMed2003

The enactive mind, or from actions to cognition: lessons from autism.

Normative-IQ individuals with autism are capable of solving explicit social cognitive problems at a level that is not matched by their ability to meet the demands of everyday social situations. The magnitude of this discrepancy is now being documented through newer techniques such as eye tracking, which allows us to see and measure how individuals with autism search for meaning when presented with naturalistic social scenes. This paper offers an approach to social cognitive development intended to address the above discrepancy, which is considered a key element for any understanding of the pathophysiology of autism. This approach, called the enactive mind (EM), originates from the emerging work on 'embodied cognitive science', a neuroscience framework that views cognition as bodily experiences accrued as a result of an organism's adaptive actions upon salient aspects of the surrounding environment. The EM approach offers a developmental hypothesis of autism in which the process of acquisition of embodied social cognition is derailed early on, as a result of reduced salience of social stimuli and concomitant enactment of socially irrelevant aspects of the environment.

Autistic Disorder↗
PubMed2003

Understanding autism: insights from mind and brain.

Autism is a developmental disorder characterized by impaired social interaction and communication as well as repetitive behaviours and restricted interests. The consequences of this disorder for everyday life adaptation are extremely variable. The general public is now more aware of the high prevalence of this lifelong disorder, with ca. 0.6% of the population being affected. However, the signs and symptoms of autism are still puzzling. Since a biological basis of autism was accepted, approaches from developmental cognitive neuroscience have been applied to further our understanding of the autism spectrum. The study of the behavioural and underlying cognitive deficits in autism has advanced ahead of the study of the underlying brain abnormalities and of the putative genetic mechanisms. However, advances in these fields are expected as methodological difficulties are overcome. In this paper, recent developments in the field of autism are outlined. In particular, we review the findings of the three main neuro-cognitive theories of autism: theory-of-mind deficit, weak central coherence and executive dysfunction.

Autistic Disorder↗
PubMed2004

In search of inner wisdom: guided mindfulness meditation in the context of suicide.

Spiritual concerns are highly relevant, but often ignored, in psychotherapy in general and in suicide in particular. This article presents Internet data and clinical case material bearing on the topic, and describes an innovative therapeutic intervention administered in a group-workshop format with suicide survivors and mental health professionals. The technique incorporates relaxation and mindfulness meditation, with the addition of guided meditation in search of inner wisdom. Results of the group intervention are described and illustrated. Many participants reported a significant positive experience including connection to knowledge that was highly relevant to them in their current state of life. Whether such insights were experienced as coming from within (a deeper part of the self) or from an external source (a guiding figure or presence), indications are that guided meditation can be a powerful resource for therapists and their clients, suicidal and otherwise. Possible applications in diverse populations and settings, as well as the need for further research, are discussed.

Adult↗
PubMed2005

Adolescent aggression and differentiation of self: guided mindfulness meditation in the service of individuation.

This paper presents adolescent aggression as mediated by the level of differentiation of self. No research has directly addressed Bowen's notion that level of differentiation impacts child functioning including aggression. Level of differentiation is discussed in conjunction with social, gender and cultural norms as manifested in aggressive behavior. Female adolescent aggression is described as mainly relationship focused and expressed via verbal threats, intimidation and manipulation, while male aggression is described mainly as overt physical violence involving dominance and competitiveness. Research on differentiation focuses mainly on Western cultures that tend to be individualistic. Jewish-Israeli society is in transition from collectivistic to individualistic cultural values in the midst of ongoing hostilities. These processes create conflict regarding togetherness and individuality needs among adolescents, who are exposed to contradictory messages regarding separating and staying close. External as well as internal expressions of aggression (depression, suicide) are presented as coping strategies in the service of a wounded self-negotiating with the world. Guided mindfulness meditation is a powerful technique for facilitating healing and growth toward autonomy by helping adolescents connect to their inner voice. This technique may be especially useful in the adolescent search for self-awareness, meaning and life purpose. Bodily, cognitive and emotional experiences are treated as informative regarding the 'self' and facilitate expansion of self-perception and individuality.

Adolescent↗
PubMed1997

Cloning of two human homologs of the Drosophila single-minded gene SIM1 on chromosome 6q and SIM2 on 21q within the Down syndrome chromosomal region.

As part of our effort to clone genes of human chromosome 21 that may contribute to Down syndrome, we have previously isolated four exons with homology to Drosophila single-minded (sim) gene, which encodes a transcription factor that is a master regulator of fruit fly neurogenesis. These exons were used to clone and characterize two human homologs of the Drosophila sim gene, SIM1 and SIM2, which map to chromosomes 6q16.3-q21 and 21q22.2, respectively; SIM2 maps within the so-called Down syndrome chromosomal region. Recently, two mouse homologs, Sim1 and Sim2, also have been identified. There is a high level of homology among human, mouse, and Drosophila sim genes in their amino-terminal half where the conserved bHLH, PAS1, PAS2, and HST domains are present. In contrast, the carboxy-terminal parts are only homologous between SIM1 and Sim1 and SIM2 and Sim2. Two isoforms (SIM2 and SIM2s) of human SIM2 have been detected that differ in their 3' ends. Northern blot analysis revealed one mRNA SIM1 species of approximately 9.5 kb and four different mRNA SIM2 species of 2.7, 3, 4.4, and 6 kb in human fetal kidney. The function of both human SIM1 and SIM2 is unknown. However, three copies of SIM2 may contribute to some specific Down syndrome phenotypes because of (1) mapping position, (2) potential function as transcriptional repressor, (3) likely dimerization with other transcription factors, (4) the temporal and spatial expression pattern of mouse Sim2, and (5) the potentially analogous role of human SIM2 to that of Drosophila sim during neurogenesis.

Amino Acid Sequence↗
PubMed2002

A few thoughts about the mind, the brain, and a child with early deprivation.

Infant brain research is having an increasing impact on child psychotherapy and our understanding of the neurobiological effects of trauma and neglect. This paper outlines the 'experience-dependent' nature of brain development in infancy and the concept of critical periods in such development. The effects of deprivation on child development are illustrated and case material from a child who was institutionalized during his second year is used as a basis for posing questions about the nature of the mind and the brain. In spite of his deprivation, he was able to communicate imaginatively. Schore's proposal for the use of early interventions is put forward to counter discouragement that can be engendered by work with severely deprived children.

Age Factors↗
PubMed2003

Can we help addicts become more autonomous? Inside the mind of an addict.

I examine the impact of addiction on autonomy in terms of the standard literature on addiction--referred to also as 'substance dependence.' Then in terms of the criteria for substance dependence, by developing a set of practical strategies to help people with addictions think more clearly, I test the idea of whether addicts can be helped to become more autonomous. Given that unsuccessful attempts to quit constitute part of the criteria of substance dependence, I look at what goes wrong when people try to quit using a substance. The subjective experience of addiction is an important aid in understanding addiction and first person accounts and literary characterisations of addiction provide insight into the addict's mind and assist us in deciding whether addicts can be helped to become more autonomous.

Behavior Therapy↗
PubMedDate not supplied

Where theories of mind meet magic: the development of children's beliefs about wishing.

In two studies, we probed children's beliefs about wishing. In Study 1, we gathered initial data on 50 3- to 6-year-old children's concepts of wishing and beliefs about its efficacy, with both a semistructured interview and a variety of tasks. Results revealed considerable knowledge about wishing in young children, along with an age-related decrease in beliefs about its efficacy. Parents were not found to encourage differently the beliefs of children at different ages, nor were they found to begin actively discouraging such beliefs at any particular age. A moderate relation was found between environmental supports for wishing and children's beliefs in its efficacy. In Study 2, we continued to probe these issues and also address the nature of the broader conceptual context in which children situate their beliefs about wishing. Participants were 92 3- to 6-year-old children. Results of this study suggest that children may reconcile beliefs in the efficacy of wishing with knowledge about everyday mental-physical relations by situating these beliefs more within their emerging beliefs about magic than within their theories of mind.

Chi-Square Distribution↗
PubMedDate not supplied

Theory of mind, emotion understanding, language, and family background: individual differences and interrelations.

Individual differences in young children's social cognition were examined in 128 urban preschoolers from a wide range of backgrounds. comprehensive assessments were made of children's false-belief understanding, emotion understanding, language abilities, and family background information was collected via parent interview. Individual differences in children's understanding of false-belief and emotion were associated with differences in language ability and with certain aspects of family background, in particular, parental occupational class and mothers' education. The number of siblings that children had did not relate to their social cognition. Individual differences in false-belief and emotion understanding were correlated, but these domains did not contribute to each other independently of age, language ability, and family background. In fact, variance in family background only contributed uniquely to false-belief understanding. The results suggest that family background has a significant impact on the development of theory of mind. The findings also suggest that understanding of false-belief and understanding of emotion may be distinct aspects of social cognition in young children.

Affect↗