Mindfulness meditation targets transdiagnostic symptoms implicated in stress-related disorders: Understanding relationships between changes in mindfulness, sleep quality, and physical symptoms

Mindfulness-Based Stress Reduction (MBSR) is an 8-week meditation program known to improve anxiety, depression, and psychological well-being. Other health-related effects, such as sleep quality, are less well established, as are the psychological processes associated with therapeutic change. This prospective, observational study (n=213) aimed to determine whether perseverative cognition, indicated by rumination and intrusive thoughts, and emotion regulation, measured by avoidance, thought suppression, emotion suppression, and cognitive reappraisal, partly accounted for the hypothesized relationship between changes in mindfulness and two health-related outcomes: sleep quality and stress-related physical symptoms. As expected, increased mindfulness following the MBSR program was directly correlated with decreased sleep disturbance (r=-0.21, p=0.004) and decreased stress-related physical symptoms (r=-0.38, p<0.001). Partial correlations revealed that pre-post changes in rumination, unwanted intrusive thoughts, thought suppression, experiential avoidance, emotion suppression, and cognitive reappraisal each uniquely accounted for up to 32% of the correlation between the change in mindfulness and change in sleep disturbance and up to 30% of the correlation between the change in mindfulness and change in stress-related physical symptoms. Results suggest that the stress-reducing effects of MBSR are due, in part, to improvements in perseverative cognition and emotion regulation, two “transdiagnostic” mental processes that cut across stress-related disorders

Mindfulness-based stress reduction lowers psychological distress in medical students

Background: Medical students confront significant academic, psychosocial, and existential stressors throughout their training. Mindfulness-based stress reduction (MBSR) is an educational intervention designed to improve coping skills and reduce emotional distress. Purpose: The purpose of this study was to examine the effectiveness of the MBSR intervention in a prospective, nonrandomized, cohort-controlled study. Methods: Second-year students (n = 140) elected to participate in a 10-week MBSR seminar. Controls (n = 162) participated in a didactic seminar on complementary medicine. Profile of Mood States (POMS) was administered preintervention and postintervention. Results: Baseline total mood disturbance (TMD) was greater in the MBSR group compared with controls (38.7 ± 33.3 vs. 28.0 ± 31.2; p \u3c .01). Despite this initial difference, the MBSR group scored significantly lower in TMD at the completion of the intervention period (31.8 ± 33.8 vs. 38.6 ± 32.8; p \u3c .05). Significant effects were also observed on Tension–Anxiety, Confusion–Bewilderment, Fatigue–Inertia, and Vigor–Activity subscales. Conclusion: MBSR may be an effective stress management intervention for medical students

Jeely Beely: Rolling into the Russian Fairy Tale

When I was a child, I used to think that fairy tales always ended happily, and that winning a prince\u27s affection was life\u27s grand goal. I thought so because I was exposed to Disney versions: tales of a handsome prince rescuing an isolated stepchild from boring housework as in Cinderella (1950) and tales of a kiss literally saving at least two girls\u27 lives as in Snow White and the Seven Dwarfs (1937) and in Sleeping Beauty (1959). While I recollect my father reading to my brother and me from an encyclopedia-sized collection of Aesop \u27s Fables, I do not recall him reading Brothers Grimms\u27 and Charles Perrault\u27s fairy tales to us, unfortunately (or fortunately, since their tales employ violence that would have deprived six-year-old me of sleep). Instead, my primary experience with fairy tales was that of most children\u27s who grew up in the nineties: I watched the animated fairy tales of Walt Disney (1901-66). I can confidently inform you that the first Disney film in my possession was The Fox and the Hound (1981), and I watched it on our home\u27s static-prone, fickle operating videocassette recorder with a friend, by myself, or with my cabbage patch dolls, each time in wonder and awe. Admittedly, Disney\u27s films had a tyrannous hold on my adolescent imagination. They became, and still are, a part of our formative American culture.... It makes sense, then, that fairy tales might also influence the formative culture of international societies, even those outside of the western hemisphere. Particularly, how might a Russian child be influenced by her country\u27s familiar fairy tales? This question charged my research. I was convinced that delving into a comparative literary study on three different variants of a fairy tale would improve my understanding of Russian culture

The Association between Quality of HIV Care, Loss to Follow-Up and Mortality in Pediatric and Adolescent Patients Receiving Antiretroviral Therapy in Nigeria

Access to pediatric HIV treatment in resource-limited settings has risen significantly. However, little is known about the quality of care that pediatric or adolescent patients receive. The objective of this study is to explore quality of HIV care and treatment in Nigeria and to determine the association between quality of care, loss-to-follow-up and mortality. A retrospective cohort study was conducted including patients ≤18 years of age who initiated ART between November 2002 and December 2011 at 23 sites across 10 states. 1,516 patients were included. A quality score comprised of 6 process indicators was calculated for each patient. More than half of patients (55.5%) were found to have a high quality score, using the median score as the cut-off. Most patients were screened for tuberculosis at entry into care (81.3%), had adherence measurement and counseling at their last visit (88.7% and 89.7% respectively), and were prescribed co-trimoxazole at some point during enrollment in care (98.8%). Thirty-seven percent received a CD4 count in the six months prior to chart review. Mortality within 90 days of ART initiation was 1.9%. A total of 4.2% of patients died during the period of follow-up (mean: 27 months) with 19.0% lost to follow-up. In multivariate regression analyses, weight for age z-score (Adjusted Hazard Ratio (AHR): 0.90; 95% CI: 0.85, 0.95) and high quality indicator score (compared a low score, AHR: 0.43; 95% CI: 0.26, 0.73) had a protective effect on mortality. Patients with a high quality score were less likely to be lost to follow-up (Adjusted Odds Ratio (AOR): 0.42; 95% CI: 0.32, 0.56), compared to those with low score. These findings indicate that providing high quality care to children and adolescents living with HIV is important to improve outcomes, including lowering loss to follow-up and decreasing mortality in this age group

Decreased symptoms of depression after mindfulness-based stress reduction: potential moderating effects of religiosity, spirituality, trait mindfulness, sex, and age

Objective: mindfulness-based stress reduction (MBSR) is a secular meditation training program that reduces depressive symptoms. Little is known, however, about the degree to which a participant's spiritual and religious background, or other demographic characteristics associated with risk for depression, may affect the effectiveness of MBSR. Therefore, this study tested whether individual differences in religiosity, spirituality, motivation for spiritual growth, trait mindfulness, sex, and age affect MBSR effectiveness.Methods: as part of an open trial, multiple regression was used to analyze variation in depressive symptom outcomes among 322 adults who enrolled in an 8-week, community-based MBSR program.Results: as hypothesized, depressive symptom severity decreased significantly in the full study sample (d=0.57; p&lt;0.01). After adjustment for baseline symptom severity, moderation analyses revealed no significant differences in the change in depressive symptoms following MBSR as a function of spirituality, religiosity, trait mindfulness, or demographic variables. Paired t tests found consistent, statistically significant (p&lt;0.01) reductions in depressive symptoms across all subgroups by religious affiliation, intention for spiritual growth, sex, and baseline symptom severity. After adjustment for baseline symptom scores, age, sex, and religious affiliation, a significant proportion of variance in post-MBSR depressive symptoms was uniquely explained by changes in both spirituality (?=?0.15; p=0.006) and mindfulness (?=?0.17; p&lt;0.001).Conclusions: these findings suggest that MBSR, a secular meditation training program, is associated with improved depressive symptoms regardless of affiliation with a religion, sense of spirituality, trait level of mindfulness before MBSR training, sex, or age. Increases in both mindfulness and daily spiritual experiences uniquely explained improvement in depressive symptom

Gendering the Republic and the Nation: Political Poster Art of the Spanish Civil War, 1936-1939

The Spanish Civil War is typically presented as a military narrative of the ideological battle between socialism and fascism, foreshadowing World War II. Yet the Spanish war continued trends begun during World War I, notably the use of propaganda posters and the movement of women into visible roles within the public sphere. Employing cultural studies methods to read propaganda poster art from the Spanish war as texts, this thesis analyzes the ways in which this persuasive medium represented extremes of gender discourse within the context of letters, memoirs, and other experiential accounts. This thesis analyzes symbols present in propaganda art and considers how their meanings interacted with the changing gendered identities of Republic and nation. Even within the relatively egalitarian Republic, political factions constructed conflicting representations of femininity in propaganda art, and women’s accounts indicate that despite ideological differences, both sides still shared a patriarchal worldview