Medical and Psychology Student’s Experiences in Learning Mindfulness: Benefits, Paradoxes, and Pitfalls

Source:doi:10.1007/s12671-016-0521-0Mindfulness has attracted increased interest in the field of health professionals’ education due to its proposed double benefit of providing self-help strategies to counter stress and burnout symptoms and cultivating attitudes central to the role of professional helpers. The current study explored the experiential aspects of learning mindfulness. Specifically, we explored how first-year medical and psychology students experienced and conceptualized mindfulness upon completion of a 7-week mindfulness-based stress reduction program. Twenty-two students participated in either two focus group interviews or ten in-depth interviews, and we performed an interpretive phenomenological analysis of the interview transcripts. All students reported increased attention and awareness of psychological and bodily phenomena. The majority also reported a shift in their attitudes towards their experiences in terms of decreased reactivity, increased curiosity, affect tolerance, patience and self-acceptance, and improved relational qualities. The experience of mindfulness was mediated by subjective intention and the interpretation of mindfulness training. The attentional elements of mindfulness were easier to grasp than the attitudinal ones, in particular with respect to the complex and inherently paradoxical elements of non-striving and radical acceptance. Some participants considered mindfulness as a means to more efficient instrumental task-oriented coping, whilst others reported increased sensitivity and tolerance towards their own state of mind. A broader range of program benefits appeared dependent upon embracing the paradoxes and integrating attitudinal elements in practising mindfulness. Ways in which culture and context may influence the experiences in learning mindfulness are discussed along with practical, conceptual, and research implications

Lifestyle Factors and Breast Cancer in Females with PTEN Hamartoma Tumor Syndrome (PHTS)

Simple Summary: Females with PTEN Hamartoma Tumor Syndrome (PHTS) have very high hereditary breast cancer risks up to 76%. The aim of this European cohort study was to the describe the lifestyle in PHTS patients and to assess associations between physical activity, alcohol consumption, tobacco smoking, BMI and breast cancer in female adult PHTS patients. It was observed that of 125 patients who completed the questionnaire, 81% were >= 2 times/week physically active, 86% consumed on average = 2 times (ORtotal-adj = 0.9 (95%CI 0.3-2.6); consumed daily about 1.2-1.8 times more often >= 1 than 0-1 glasses of alcohol (ORtotal-adj = 1.2 (95%CI 0.4-4.0); ORnon-breastcancer-index-adj = 1.8 (95%CI 0.4-6.9); were about 1.04-1.3 times more often smokers than non-smokers (ORtotal-adj = 1.04 (95%CI 0.4-2.8); ORnon-breastcancer-index-adj = 1.3 (95%CI 0.4-4.2)); and overweight or obesity (72%) was about 1.02-1.3 times less common (ORtotal-adj = 0.98 (95%CI 0.4-2.6); ORnon-breastcancer-index-adj = 0.8 (95%CI 0.3-2.7)). Similar associations between lifestyle and breast cancer are suggested for PHTS and the general population. Despite not being statistically significant, results are clinically relevant and suggest that awareness of the effects of lifestyle on patients' breast cancer risk is important

Effect of telemedicine follow-up care of leg and foot ulcers: a systematic review

BACKGROUND: Leg ulcers and diabetes-related foot ulcers are frequent and costly complications of their underlying diseases and thus represent a critical issue for public health. Since the population is aging, the prevalence of these conditions will probably increase considerably and require more resources. Treatment of leg and foot ulcers often demands frequent contact with the health care system, may pose great burden on the patient, and involves follow-up in both primary and specialist care. Telemedicine provides potential for more effective care management of leg and foot ulcers. The objective of this systematic review of the literature was to assess the effect of telemedicine follow-up care on clinical, behavioral or organizational outcomes among patients with leg and foot ulcers. METHODS: We searched Ovid MEDLINE (1980–), Ovid EMBASE (1980–), Clinical Trials in the Cochrane Library (via Wiley), Ebsco CINAHL with Fulltext (1981–) and SveMed + (1977–) up to May 2014 for relevant articles. We considered randomized controlled trials, non-randomized trials, controlled before-after studies and prospective cohort studies for inclusion and selected studies according to predefined criteria. Three reviewers independently assessed the included studies using the Cochrane Collaboration risk-of-bias tool. We performed a narrative synthesis of results and assessed the strength of evidence for each outcome using GRADE (grading of recommendations, assessment, development and evaluation). RESULTS: Only one non-randomized study was included. The study (n = 140) measured the effect of real-time interactive video consultation compared with face-to-face follow-up on healing time, adjusted healing ratio and the number of ulcers at 12 weeks among patients with neuropathic forefoot ulcerations. There were no statistically significant differences in results of the different outcomes between patients receiving telemedicine and traditional follow-up. We assessed the study to have a high risk of bias. CONCLUSIONS: There is insufficient evidence available to unambiguously determine whether telemedicine consultation of leg and foot ulcers is as effective as traditional follow-up