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Background: To evaluate the effects of different interventions on adolescent internet addiction, a meta-analysis and network meta-analysis were performed to determine the possible intervention effects of these interventions., Methods: Computer searches of the China National Knowledge Network, Wanfang, VIP, EMBASE, PubMed, Web of Science, EBSCO, and Cochrane Library databases were performed. The relevant randomized controlled trials were designed to assess the effects of interventions on adolescent internet addiction. The retrieval period ranged from the establishment of the database to January 31, 2024. Literature screening, data extraction, and bias risk assessment were carried out independently by two researchers. CMA 3.3, Stata 17.0 software and Review Manager 5.3 were used for the data analysis., Results: A total of 89 studies with 6876 samples were included. A traditional meta-analysis of 51 single interventions and controlled studies revealed that sports intervention, cognitive behavior therapy, family therapy, mindfulness intervention, attention bias training and group counseling significantly improved adolescent Internet addiction [standardized mean difference (SMD) = -1.75, 95 % CI (-2.07, -1.44), p < 0.01; I 2  = 94 %] compared to no-treatment groups. A network meta-analysis showed that combined intervention (Sucra = 93.5) had the highest probability of being the best intervention for adolescent Internet addiction, and acupuncture interventions showed the most promise as a single intervention modality; however, due to the limited number of studies, we believe that sports intervention could be the most appropriate single intervention., Discussion: The evidence provided by existing studies shows that compared with other single interventions, combined interventions have the greatest effect on adolescent IA, and sports may be the best single intervention. However, because of the limitations of sample size and quality of individual studies, the strength of the evidence still needs to be further verified by additional standardized and high-quality studies., Competing Interests: Declaration of competing interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as potential conflicts of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Individuals with Post COVID-19 condition (PCC), or long COVID, experience symptoms such as fatigue, muscle weakness, and psychological distress, including anxiety, depression, or sleep disorders that persist after recovery from COVID-19. These ongoing symptoms significantly compromise quality of life and diminish functional capacity and independence. Multimodal digital interventions targeting behavioural factors such as nutrition and mindfulness have shown promise in improving health outcomes of people with chronic health conditions and may be beneficial for those with PCC. The BLEND study (weB-based pLatform to improve nutrition, mindfulnEss, and physical function, in patients with loNg COVID) study is an 8-week pilot randomized controlled trial evaluating the feasibility of a digital wellness platform compared to usual care among individuals with PCC. The web-based wellness platform employed in this study, My Viva Plan (MVP)®, integrates a holistic, multicomponent approach to promote wellness. The intervention group receives access to the digital health platform for 8 weeks with encouragement for frequent interactions to improve dietary intake and mindfulness. The control group receives general content focusing on improvements in dietary intake and mindfulness. Assessments are conducted at baseline and week 8. The primary outcome is the feasibility of platform use. Secondary and exploratory outcomes include a between-group comparison of changes in body composition, nutritional status, quality of life, mindfulness, physical activity, and physical performance after 8 weeks. Findings of this study will inform the development of effective web-based wellness programs tailored for individuals with PCC to promote sustainable behavioural changes and improved health outcomes., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper other then funding disclosures listed above., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: Studies have shown that an emergent interventional program, called surf therapy, can enhance physical and mental health indicators. This approach entails structured sessions that combine surfing lessons, nature exposure, mindfulness practices and psychoeducation with other therapeutic actions., Objective: This study aimed to present and discuss the results obtained in a psychosocial project that combined actions for mental health promotion, using integrative and complementary practices with surfing and training sessions. More specifically, the study investigated whether participation in surf therapy could influence resilience capabilities, reduce dysexecutive symptoms, and improve mood states., Methods: The intervention was conducted with 10 participants over 5 weeks, involving 2 weekly meetings lasting 2 hours each. The effects of the intervention were evaluated through psychometric measures using the Resilience Scale, the Dysexecutive Questionnaire and the Brunel Mood Scale. Qualitative information was additionally obtained in a non-systematic way through field diaries with records of narratives and behavioral observations., Results: A significant increase in the resilience scale score was observed at the end of the intervention (P = 0.01, d = 2.535). No significant variations were observed in the Mood scale scores. Qualitative data revealed that the intervention received a positive evaluation and was effective in promoting better psychological conditions., Conclusions: Considering both quantitative and qualitative data, the study concludes that the project positively influenced mental health indicators, mainly resilience, but also improved well-being and self-esteem, fostered positive moments and feelings, developed skills in the sea, stimulated citizenship, and provided physical and mental care. The present study demonstrated an effective application of an adapted surf therapy protocol to promote mental health during the social restriction period due to the coronavirus pandemic. By documenting this experience, it is possible to contribute to enhancing the scientific discussion surrounding the surf therapy intervention, especially regarding its structure and expected effects. It is expected that this report can stimulate advancements and innovations in alternative and integrative practices for mental health promotion in natural outdoor spaces.

Excess body weight, suboptimal diet, physical inactivity, alcohol consumption, sleep disruption, and elevated stress are modifiable risk factors associated with the development of chronic diseases. Digital behavioural interventions targeting these factors have shown promise in improving health and reducing chronic disease risk. The Digital Intervention for behaviouR changE and Chronic disease prevenTION (DIRECTION) study is a parallel group, two-arm, randomized controlled trial evaluating the effects of adding healthcare professional guidance and peer support via group-based sessions to a web-based wellness platform (experimental group, n = 90) compared to a self-guided use of the platform (active control group, n = 90) among individuals with a body mass index (BMI) of 30 to <35 kg/m 2 and aged 40-65 years. Obesity is defined by a high BMI. The web-based wellness platform employed in this study is My Viva Plan (MVP)®, which holistically integrates nutrition, physical activity, and mindfulness programs. Over 16 weeks, the experimental group uses the web-based wellness platform daily and engages in weekly online support group sessions. The active control group exclusively uses the web-based wellness platform daily. Assessments are conducted at baseline and weeks 8 and 16. The primary outcome is between-group difference in weight loss (kg) at week 16, and secondary outcomes are BMI, percent weight change, proportion of participants achieving 5% or more weight loss, dietary intake, physical activity, alcohol consumption, sleep, and stress across the study. A web-based wellness platform may be a scalable approach to promote behavioural changes that positively impact health. This study will inform the development and implementation of interventions using web-based wellness platforms and personalized digital interventions to improve health outcomes and reduce chronic disease risk among individuals with obesity., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: CMP has previously received honoraria and/or paid consultancy from Almased. NM has since become an employee of My Viva Plan. CEO, TG, SV, CFT, IMS, MFP, STJ, AAK, DK, NM, JFM, SENS, MQ, BOS – no conflicts of interest. See Funding section above for additional competing interests., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: This systematic review aims to examine effects of nonpharmacologic treatment options for pediatric tension-type headache patients as well as evaluate current results from these treatment options. Background: Headache is a worldwide problem among both adults and children, with tension-type headache among the most common. Methods: Eighteen relevant studies were found using PubMed and evaluated in this review. These include therapy programs, biofeedback, alternative medicine, strength exercise, physical therapy, mindfulness therapy, and psychotherapy. Results: Several nonpharmacologic treatment methods showed improvement in pediatric headache patients, with few reported adverse effects. This suggests that nonpharmacologic treatment is safe for use and might have an effect in most cases. Conclusion: No single intervention has been proven superior to another, and some studies would need replication with a control group to confirm the findings. This study illustrates the variety of nonpharmacologic treatment options and the importance of future research on this topic., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objectives: Insomnia and chronic pain are common symptoms in people with HIV. Poor sleep has been associated with chronic pain. While cognitive behavioral therapy for insomnia improves insomnia in clinical populations, there are barriers to people with HIV accessing treatment including the lack of trained providers and lengthy sessions. Only one study has examined the efficacy of brief behavioral treatment for insomnia (BBTI) in people with HIV. This study examined BBTI effects on sleep and pain in people with HIV., Methods: Ten adults with HIV and chronic pain completed a 4-week, telephone-delivered BBTI treatment. A control group (n = 10) completed a brief mindfulness training (BMT). The Insomnia Severity Index and Brief Pain Inventory were used to assess insomnia severity and pain outcomes, respectively., Results: There was a significant interaction between intervention and time on insomnia severity, F (2,14) = 5.7, p  = .02, partial η 2  = 0.45). The BBTI group demonstrated significant improvements in insomnia severity from pre- to post-intervention ( p  < .001) and from pre-intervention to one-month post-intervention ( p  = .001) compared to the BMT group. There was a significant interaction between intervention and time on pain interference, F (1,18) = 4.9, p  = .02, partial η 2  = 0.27). The BBTI group demonstrated a significant decrease in pain interference from pre- to post-intervention ( p  < .001) compared to the BMT group., Conclusions: This pilot study demonstrated that BBTI improved insomnia in people with HIV for up to one-month post-treatment. Novel preliminary evidence suggests that BBTI may also improve pain outcomes in people with HIV.

Mindfulness-based interventions (MBIs) for depression use regular mindfulness practice as a means of helping patients build skills that allow them to respond more adaptively to negative mood. Although effects of practice are assumed to accumulate over time, little is known about the trajectories of change in skills and symptoms beyond the duration of standard eight-week interventions. Forty-four patients with persistent depression were recruited to participate in a 6-month blended MBI and provided self-reports of depressive symptomatology and their ability to decenter, the core skill cultivated in MBIs, at baseline, mid-intervention and after the end of the intervention. Trajectories of change were analysed using latent change score modelling. Thirty-one participants (70 %) completed the intervention having engaged in 68.6 % of practices on average. Trajectories of change in decentering and depression were best described by a combination of a constant change component and a limiting factor indicating decreasing rates with higher previous gains. Bivariate analyses showed significant lagged change to change coupling linking earlier changes in decentering with later changes in symptoms. The findings suggest that decentering skills increase throughout longer periods of practice and drive changes in symptoms to move patients closer to recovery or remission., Competing Interests: Declaration of competing interest Jonathan Hamilton declares that he has no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Thorsten Barnhofer is receiving royalties for a book on Mindfulness-Based Cognitive Therapy and offers workshops on mindfulness-based interventions., (Copyright © 2024. Published by Elsevier B.V.)

Background: Anhedonia, deficits in motivation and pleasure, is a transdiagnostic symptom of psychopathology and negative prognostic marker., Methods: In this randomized, parallel-arm clinical trial, a novel intervention, Behavioral Activation Treatment for Anhedonia (BATA), was compared to an individually administered Mindfulness-Based Cognitive Therapy (MBCT) in a transdiagnostic cohort of adults with clinically significant anhedonia (ClinicalTrials.gov Identifiers NCT02874534 and NCT04036136). Participants received 8-15 individual psychotherapy sessions, once weekly, with either BATA (n = 61) or MBCT (n = 55) and completed repeated self-report assessment of anhedonia and other internalizing symptoms., Results: Indicators of treatment feasibility were similar across conditions, though MBCT showed a trend towards greater attrition rates than BATA, with an adjusted odd's ratio of 2.04 [0.88, 4.73]. Treatment effects on the primary clinical endpoint of anhedonia symptoms did not significantly differ, with a 14-week estimated difference on the Snaith Hamilton Pleasure Scale (SHAPS) of -0.20 [-2.25, 1.84] points in BATA compared to MBCT (z = 0.19, p = 0.845, d = 0.05). The expected 14-week change in SHAPS scores across conditions was -7.18 [-8.22, -6.15] points (z = 13.6, p < 0.001, d = 1.69). There were no significant differences in the proportion of participants demonstrating reliable and clinically significant improvements in SHAPS scores, or in the magnitude of internalizing symptom reductions., Limitations: Limitations included a modest sample size, lack of longer-term follow up data, and non-preregistered analytic plan., Discussion: There was no evidence to support superior clinical efficacy of BATA over MBCT in a transdiagnostic cohort of adults with elevated anhedonia. Both interventions reduced anhedonia symptoms to a comparable magnitude of other existing treatments., Competing Interests: Declaration of competing interest The work described in this manuscript has not been published previously, is not under consideration for publication elsewhere, and the publication of this manuscript is approved by all authors and tacitly or explicitly by the responsible authorities where the work was carried out. If accepted, this work will not be published elsewhere in the same form, in English or in any other language, including electronically, without written consent of the copyright holder. We have no conflicts of interest, financial or otherwise, that would preclude a fair review or publication of this manuscript., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Healthcare professionals work in challenging environments with extended working hours and excessive workloads to provide high-quality care. However, they hardly get the time to care for themselves. Online mindfulness-based interventions-which are not restricted by time or location-can be a powerful strategy to help healthcare professionals., Objectives: This scoping review aims to explore the current evidence about online mindfulness-based interventions for healthcare professionals., Design: A scoping review was conducted., Methods: A literature search was conducted to retrieve articles published between October 2016 and March 2023 in seven databases, including backward and forward citation tracking from the included articles. Among 1,278 articles retrieved, 33 met the criteria for review., Results: Two-thirds of the studies utilized commercialized mindfulness programs ( n = 22). Duration of the mindfulness interventions varied from 1 week to 4 months, and half of the studies used audio-guided programs. Online mindfulness-based intervention studies were targeted to reduce burnout ( n = 26), and the majority reported reduction in burnout ( n = 18)., Conclusion: Most studies used individual audio-guided programs that warrant the use of diverse delivery methods such as video media, simulation, and virtual reality for interactions in the future. Although the literature has accumulated evidence for commercialized online mindfulness-based interventions, further studies are needed to develop and test tailored interventions for healthcare professionals., Competing Interests: Author ContributionsChiyoung Cha & Miran LeeSubstantial contributions to the conception or design of the work.The acquisition, analysis, or interpretation of data for the work.Final approval of the version to be published.Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.Gumhee Baek & Aram ChoThe acquisition, analysis, or interpretation of data for the work.Drafting the work and revising it critically for important intellectual content.Final approval of the version to be published.Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Until recently, research examining the application of Rational Emotive Behavior Therapy (REBT) in sports settings was virtually absent in South Africa. Despite the growing evidence of REBT's potential as a psychological intervention in Western nations, its use within the multicultural and sports-fervent context of South Africa remains unexplored. Moreover, limited research has addressed the impact of REBT on rugby players, with only a few case studies being reported. The current experiment employs a cluster randomized trial (CRT) to compare the effects of a 7-week preferential REBT program with a 7-week Mindfulness-Acceptance-Commitment (MAC) program on irrational beliefs, competitive anxiety and subjective performance, among adolescent South African rugby players. We also include a wait-list control group who received neither REBT nor MAC. Results indicate that athletes receiving REBT reported greater improvements in irrational beliefs, anxiety, and subjective performance, while that athletes receiving MAC also reported some improvements in anxiety. This study highlights the potential of REBT as a valuable psychological intervention in the context of South African adolescent rugby players., Competing Interests: Declaration of competing interest “A cluster randomized trial of a v-emotive behavior therapy program and a mindfulness-acceptance-commitment program, with South African adolescent rugby players," The aforementioned authors affirm that we tried to adhere to the highest ethical standards and scientific integrity when conducting and writing about this research. We affirm that the results presented in this manuscript are based solely on the data collected and analyzed during the course of the study, and they are reported with objectivity and impartiality., (Copyright © 2024. Published by Elsevier Ltd.)

Background: Mindfulness-based interventions can improve psychological health; yet the mechanisms of change are underexplored. This pre-registered remote RCT evaluated a freely accessible digital mindfulness programme aiming to improve well-being, mental health and sleep quality. Health behaviour cognitions were explored as possible mediators., Methods: Participants from 91 countries (N = 1247, M age  = 27.03 [9.04]) were randomized to 30 days of mindfulness practice or attention-matched control condition. Measures of well-being, depression, anxiety, stress, sleep quality, barriers self-efficacy, self-regulation and behavioural predictors (e.g., attitudes and behavioural intentions) were taken at baseline, 1-month (post-intervention) and 2-months (follow-up). Linear regression examined intervention effects between and within groups. Longitudinal mediation analyses explored indirect effects through health behaviour cognitions., Results: Three hundred participants completed post-intervention measures. Those receiving mindfulness training reported significantly better well-being (M difference  = 2.34, 95%CIs .45-4.24, p = .016), lower depression (M difference  = -1.47, 95%CIs -2.38 to -.56, p = .002) and anxiety symptoms (M difference  = -.77, 95%CIs -1.51 to -.02, p = .045) than controls. Improvements in well-being and depression were maintained at follow-up. Intervention effects on primary outcomes were mediated by attitudes towards health maintenance and behavioural intentions. Mediating effects of attitudes remained when controlling for prior scores in models of depression and well-being., Conclusions: Digital, self-administered mindfulness practice for 30 days meaningfully improved psychological health, at least partially due to improved attitudes towards health behaviours and stronger behavioural intentions. This trial found that digital mindfulness is a promising and scalable well-being tool for the general population, and highlighted its role in supporting health behaviours., (© 2024 The Author(s). British Journal of Health Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)

Purpose of Review: Mindfulness therapy is a widely used treatment for many diseases and has been shown to improve pain-related functions. There is growing support for the use of psychotherapy in the treatment of chronic pain. While studies have shown a positive effect of mindfulness therapy, it is important to consider psychosocial factors as there are still a small number of studies that question its effectiveness., Recent Findings: Based on current studies, mindfulness therapy involves cognitive factors related to chronic pain, both in terms of cognitive production and its impact on cognitive control. Psychological and neurobasic studies were reviewed to provide a deeper understanding of these components, which include thought inhibition, attention deficit, pain catastrophizing, and self-efficacy. Mindfulness therapy has the potential to normalize psychology and nerves, and increase internal and external connectivity to work networks related to stress perception, cognition, and emotion. However, further research is needed to fully understand its effects. By exploring the relationship between mindfulness therapy and chronic pain. This review provides a new avenue for future research in psychotherapy for patients with chronic pain., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: To explore the effect of breathing meditation training on nursing work quality, occurrence risk of adverse events, and attention level of operating room nurses., Methods: Taking the starting time of breathing meditation training of operating room nurses in our hospital in July 2020 as the dividing line, operating room nurses who implemented routine management from April 2020 to June 2020 were selected as the control group (n=30), and operating room nurses who carried out breathing meditation training from July 2020 to September 2020 were included in the intervention group (n=30). The emotional state [Hamilton Anxiety Scale (HAMA) score, Hamilton Depression Scale (HAMD) score], Mindfulness Attention Awareness Scale (MAAS) score, electrocardiogram indicators (blood pressure, pulse, and respiration), electroencephalogram indicators (SMR wave, β wave, and θ wave EEG frequency), attention level (attention quotient, visual attention, and auditory attention), nursing work quality (health education, theoretical knowledge, nursing operation, and operating room management) and the number of reported adverse events were compared between the two groups before and after training., Results: After breathing meditation training, the intervention group's Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale (HAMD) scores were significantly reduced (P < .05), while the Mindfulness Attention Awareness Scale (MAAS) score was significantly increased (P < .05). ). In addition, blood pressure and respiratory rate were reduced in the intervention group (P < .05), with significant differences compared with the control group (P < .05). The SMR waves and beta waves in the intervention group increased (P < .05), while theta waves decreased (P < .05). Attention quotient, visual attention and auditory attention scores were improved in the intervention group compared with the control group (P < .05). The scores of health education, theoretical knowledge, nursing operations and operating room management of the intervention group after training were higher than those of the control group (P < .05). The intervention group reported a lower number of adverse events than the control group (74.42% vs. 25.58%). The application of breathing meditation training in special training for operating room nurses can effectively relieve negative emotions, enhance mindfulness scores, reduce blood pressure and respiratory rate, regulate brain wave frequency, improve attention status and quality of nursing work, and reduce the risk of adverse events. These outcomes may have a positive impact on improving the quality of nursing practice and patient care in the operating room. For operating room nurses, the negative emotional stress caused by sustained high levels of mental concentration may affect work efficiency and the entire surgical process. Breathing meditation training can enhance nurses' emotional resilience, thereby improving the efficiency and safety of operating room care., Conclusion: The application of breathing meditation training in the special training of operating room nurses can effectively alleviate negative emotions, enhance the mindfulness score, reduce blood pressure and respiratory rate, regulate brain wave frequency, improve the attention state and nursing work quality, and reduce the occurrence risk of adverse events. Future research should conduct longitudinal studies to evaluate the long-term effects of breathing meditation training on the quality of nursing work and the prevention of adverse events. Additionally, research could explore advanced neuroimaging techniques to gain structural insights, integrate meditation into existing training programs, tailor interventions for different healthcare settings, assess patient outcomes, explore technology-assisted meditation, and investigate interprofessional collaboration. Through these pathways, a more complete understanding of the impact and best integration of breath meditation in healthcare settings can be achieved, providing valuable insights into improving the well-being of healthcare professionals and potentially overall patient care and satisfaction.

Mindfulness-based interventions (MBIs) have been shown to improve chronic pain and associated conditions like depression, anxiety, and sleep disorders. However, there is limited research on how veterans with chronic pain apply mindfulness skills to manage pain in daily life. This cross-sectional study examined the association between applied mindfulness practice, pain, and several pain-related conditions among 1,737 veterans with chronic pain prior to enrollment in a trial of 2 MBIs. Applied mindfulness practice was assessed using the Applied Mindfulness Process Scale (AMPS). The outcomes included pain interference, pain intensity, pain catastrophizing, fatigue, sleep disturbance, anxiety, depression, post-traumatic stress disorder, physical function, and social participation. Higher overall AMPS scores, as well as the positive and negative emotional regulation subscales of the AMPS, were associated with less pain interference and catastrophizing, as well as better outcomes for all pain-related conditions. The positive emotional regulation subscale had the strongest associations with outcomes. There was no significant association between the AMPS and pain intensity. The results suggest applied mindfulness practice, especially positive emotional regulation, may improve pain and functioning. In addition, the AMPS shows promise as a process measure of mindfulness skills applied in daily life. Additional research is needed to examine different aspects of mindfulness in the context of MBIs. PERSPECTIVE: This article describes the relationship between applied mindfulness practice and pain-related outcomes, prior to a MBI, using a novel measure of mindfulness practice. These findings underscore the importance of measuring applied mindfulness practice prior to and during clinical interventions to treat chronic pain., (Published by Elsevier Inc.)

Background: Nurses experience high job demands, which makes recovery particularly necessary to maintain well-being and performance. However, these demands also make recovery challenging. Short mindfulness meditations could potentially help alleviate this paradox., Methods: Two ecological momentary intervention studies were conducted among geriatric nurses (Study 1: break study) and hospital nurses (Study 2: after-work study) to investigate whether short audio-guided mindfulness meditations are beneficial for recovery during breaks and psychological detachment after work. Furthermore, break recovery and after-work detachment were examined as mediators of the associations between mindfulness meditations and after-break/after-sleep mood and attention after respective recovery periods. Multilevel path models were based on a sample of 38 nurses and 208 after-break surveys in the break study and 26 nurses and 192 after-sleep surveys in the after-work study., Results: Compared to breaks spent as usual, breaks that incorporated short mindfulness meditations were associated with higher break recovery, which mediated the positive associations between mindful breaks and after-break calmness, valence, and energetic arousal. Only with certain constraints did mindfulness meditations predict a lower rate of attention failures. In the after-work study, short mindfulness meditations were positively related to psychological detachment, which mediated the positive associations between the intervention and after-sleep valence and calmness., Conclusion/application to Practice: Both pilot studies showed that short mindfulness meditations aid in recovery among nurses. However, to fully utilize the advantages of recovery-promoting breaks, structural changes are necessary to ensure that breaks of an appropriate duration are consistently implemented., Competing Interests: Conflict of InterestThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: To explore mediated effects of Mindfulness-Based Cognitive Therapy-"Taking it Further" (MBCT-TiF) on mental well-being through changes in mindfulness, self-compassion, and decentering., Method: A secondary analysis of an RCT using simple mediation, with 164 graduates of MBCT and mindfulness-based stress reduction (MBSR), was implemented whereby MBCT-TiF (vs ongoing mindfulness practice; OMP) was the independent variable; changes in mindfulness, self-compassion, and decentering during the intervention were the mediators; and mental well-being at post-intervention, whilst controlling for baseline, was the dependent variable. Secondary outcomes included psychological quality of life, depression, and anxiety., Results: Compared to OMP, MBCT-TiF experienced significant improvements in mental well-being through changes in all three mediators (mindfulness: ab  = 0.11 [0.03, 0.25]; decentering: ab  = 0.16 [0.05, 0.33]; self-compassion: ab  = 0.07 [0.01, 0.18]). A similar pattern was demonstrated for depression, but only mindfulness and decentering mediated effects on psychological quality of life and anxiety., Conclusion: The findings provide preliminary support for all three mediators in driving change in mental well-being in a sample of MBCT/MBSR graduates. Future work must be theory-driven and powered to test all mediators in parallel and alongside other potential mediators (e.g., equanimity) to further understand independent contributions and interacting effects. Trial registration: ClinicalTrials.gov identifier: NCT05154266.

Background: Caregiver wellness programs need to be easily accessible to address caregivers' constraints to participation., Objective: We aimed to assess the feasibility of 5Minutes4Myself app's mindfulness module (usability, usage, and impact on caregivers' levels of mindfulness and perceived stress)., Methods: Before and after participation in the 5Minutes4Myself program, 15 participants were asked to complete the Perceived Stress Scale (PSS) and Five Facet Mindfulness Questionnaire (FFMQ). Data on the usage of app-delivered meditations were collected electronically via the app, and app usability was rated on the Modified System Usability Scale. Analyses assessed participants' frequency of use of app-delivered meditations, app usability, and changes in participants' stress and mindfulness post intervention., Results: Overall, participants completed 10.9 minutes of mindfulness meditations per week and rated the app 76.7, indicating above-average usability. Related samples t tests (2-tailed) found that group PSS (t10=1.20, P=.26) and FFMQ (t10=-1.57, P=.15) pre- or postintervention mean scores were not significantly different. However, a visualization of pre- and post-PSS and mindfulness scores suggested there was a group of responders who had decreased stress with increased mindfulness. This was confirmed via an individual change analysis. The effect size of the FFMQ scores (d=0.47) suggests there may be treatment effects with a larger sample. A hierarchical multiple regression analysis examined the degree mindfulness impacted perceived stress; 20% of the variance in participants' perceived stress could be attributed to increases in self-rated mindfulness (P=.04) when controlling for preintervention stress levels., Conclusions: Caregivers found the app highly usable and on average used low-dose levels of mindfulness meditations (10 min/wk). For responders, increased mindfulness was related to stress reduction to population-based levels., (© Elizabeth Larson, Rebecca L Mattie, Sophia A Riffkin. Originally published in JMIR Human Factors (https://humanfactors.jmir.org).)

Importance: Approximately 50% of clinicians experience excessive emotional, physical, and mental stress, with repercussions across the entire medical system. Mindfulness exercises may mitigate this excessive stress. Heart rate variability (HRV) is an objective stress measure that can quantify which mindfulness exercises provide the greatest stress reduction., Objectives: To define the impact of specific mindfulness exercises on HRV, a surrogate for physiologic stress, and the relationship between physiologic (HRV) and subjective stress measured by the State-Trait Anxiety Inventory during a one-day mindfulness workshop., Design, Setting, and Participants: This was a prospective observational pilot study performed at a quaternary children's hospital with diverse subspecialists of pediatric nurses, nurse practitioners, and physicians., Main Outcomes and Measures: Our primary outcome measure was change in HRV from baseline during three mindfulness exercises., Results: The grounding, deep breathing, and body scan exercises all produced statistically significant changes in HRV among our 13 female participants. The body scan exercise produced statistically significant changes in all studied HRV parameters compared with baseline. We observed significant increases in Root Mean Square of Successive Differences between normal heartbeats (p = 0.026), high frequency (p ≤ 0.001), and the parasympathetic nervous system index (p ≤ 0.001) reflecting increased parasympathetic tone (e.g., relaxation), whereas sd 2/sd 1 ratio (p ≤ 0.001) and the stress index (p = 0.004) were decreased reflecting sympathetic withdrawal (e.g., decreased stress). Subjective stress decreased after 1-day mindfulness training (44.6 to 27.2) (p < 0.001). Individuals with the largest decrease in subjective stress also had the most improvement in HRV during the body scan exercise., Conclusions: Clinician stress levels (HRV) improved after participating in grounding, deep breathing, and body scan meditations, which may highlight their importance as stress reduction tools for clinicians. Monitoring of HRV during mindfulness exercises may provide deeper understanding of which specific exercises produce the greatest physiologic stress reduction for individual participants and the trend of these changes over time., Competing Interests: The authors have disclosed that they do not have any potential conflicts of interest., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.)

Objective: People commonly cope with chronic low back pain (cLBP) by ignoring and distraction. Can mindful interoceptive exposure to the pain sensation itself and its phenomenological components be an alternative approach?, Methods: Single-arm feasibility study in patients with cLBP using a 2-minute attention exercise guided by a smartphone app several times per day over 8 weeks. We assessed feasibility, pre/post pain, function, and psychological parameters using mixed methods: standard questionnaires, ecological momentary assessment, and exit interviews that included micro-phenomenology technique and subsequent reflexive thematic qualitative analysis., Results: We enrolled 31 participants, mostly female, mean age 48, the majority had pain for >5 years; 29 completed. Mean pain intensity [0-10] improved from 4.8 ±1.7 to 3.1 ±1.9 (p < .0001); mean PEG scores (intensity and interference with daily life; range 0-30) improved from 13.7 ±6.2 to 8.4 ±6.6 (p < .0001); pain impact (9 items incl physical function) 22.3 ±8.7 to 19.7 ±8.1 (p = .0010). Twenty-one of 29 improved PEG score ≥30%. There were significant improvements in PCS Rumination and MAIA Not-Worrying. Participants became aware of their usual habit of avoidance and the challenge of and resistance to focusing on pain. They were surprised how pain sensations varied over time, and that pain intensity and the threat value of pain could diminish by focusing on it. They described a variety of 3D pain shapes (e.g., football, pool ball, rod, nail, brick, stars) with a range of colors, transparency, temperature, and density that for some changed with mindful attention. Most struggled to find appropriate words for sensory awareness and attention regulation and found that the threat value of their pain diminished., Conclusions: Mindful interoceptive exposure to the sensations of their cLBP using a 2-minute attention exercise with a phone app-rather than ignoring and distracting from it-may be a beneficial intervention for cLBP., Trial Registration: ClinicalTrials.gov #NCT06186193., Competing Interests: Research reported in this publication was supported by the National Institute Of Arthritis And Musculoskeletal And Skin Diseases of the National Institutes of Health under Award Number U19AR076737. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The Back Pain Consortium (BACPAC) Research Program is administered by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)., (Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)

Background: The COVID-19 pandemic has increased the level of anxiety among Indonesian senior high school teachers, who face challenges to treat their mental disorder symptoms that arise during their working hours, as mental health services in Indonesia are limited. Therefore, it is vital to equip schoolteachers in Indonesia with early interventions that are easily available, private, and affordable, and 1 feasible approach is to deploy a smartphone mobile app., Objective: The objectives of this study are (1) to evaluate the feasibility of a brief mindfulness-based mobile app (BM-MA) for Indonesian senior high school teachers experiencing anxiety and stress and (2) to examine the effects of using the BM-MA on anxiety, stress, life satisfaction, self-efficacy, trait mindfulness, self-compassion, and physical and social dysfunction among the participants., Methods: We followed the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) 2013 statement for this feasibility randomized controlled trial (RCT) protocol. A total of 60 Indonesian senior high school teachers were recruited for this study and randomly assigned to either the intervention group (BM-MA) or a wait-list control group (CG) in a 1:1 ratio. The BM-MA group was required to engage in mindfulness practices using the app for 10-20 minutes per day for 3 weeks. All participants were assessed with a battery of self-report measures at baseline, postintervention, and at 1-month follow-up. Validated scales used to measure the outcome variables of interest included the Satisfaction With Life Scale (SLS), the Teachers' Sense of Efficacy Scale (TSES), the Self-Compassion Scale-Short Form (SCS-SF), Generalized Anxiety Disorder-7 (GAD-7), General Health Questionnaire-12 (GHQ-12), and the Five Facet Mindfulness Questionnaire (FFMQ). The practicality and acceptability of the app will be evaluated using the Client Satisfaction Questionnaire-8 (CSQ-8) and structured qualitative interviews. Data from the interviews will be analyzed with the deductive thematic analysis framework as a process of qualitative inquiry. Repeated measures ANOVA with groups (intervention vs control) as a between-subject factor and time as a within-subject factor (baseline, postintervention, and 1-month follow-up) will be used to examine the effects of the BM-MA on the outcome variables. The data will be analyzed using an intent-to-treat approach and published in accordance with CONSORT (Consolidated Standards of Reporting Trials) recommendations., Results: Participants were recruited in December 2023, and this pilot RCT was conducted from January through March 2024. Data analysis was conducted from March through May 2024. The results of this study are expected to be published in December 2024. The trial registration of this protocol was submitted to the Chinese Clinical Trial Registry., Conclusions: This study aims to determine the feasibility and efficacy of the BM-MA, a digital mental health intervention developed using an existing mindfulness-based app, and assess its potential for widespread use., Trial Registration: Chinese Clinical Trial Registry ChiCTR2300068085; https://tinyurl.com/2d2x4bxk., International Registered Report Identifier (irrid): DERR1-10.2196/56693., (©Gede Rasben Dantes, Nice Maylani Asril, Andrian Liem, Ni Komang Arie Suwastini, Shian-Ling Keng, Ni Wayan Surya Mahayanti. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 23.10.2024.)

Introduction: Caregivers of patients with end-stage kidney disease (ESKD) face significant challenges that contribute to caregiver burden, negatively impacting their psychosocial well-being. Virtual-reality (VR)-guided mindfulness interventions have shown promise in reducing stress, anxiety and depression in various populations., Methods and Analysis: This pilot study aims to evaluate the efficacy and feasibility of a VR-guided mindfulness intervention for ESKD caregivers. A single-centre, single-blind, parallel-group pilot randomised controlled trial will be conducted. Thirty ESKD caregivers will be randomly allocated to either the VR-guided mindfulness intervention group or the sham VR control group. The intervention group will receive a 6 week home-based VR-guided mindfulness programme, while the control group will view relaxing nature videos without mindfulness content. Participants will be assessed at baseline, post-intervention (6 weeks) and follow-up (12 weeks) using validated questionnaires for caregiver burden (Zarit Burden Interview (ZBI)), stress, anxiety, depression (Depression Anxiety Stress Scale-21 (DASS-21)), quality of life (36-Item Short Form Health Survey (SF-36)) and mindfulness (Five Facet Mindfulness Questionnaire (FFMQ)). Feasibility outcomes include accrual rates, retention, adherence, questionnaire completion and side effect rates. Semi-structured interviews will explore participants' experiences with the intervention., Ethics and Dissemination: The study has been approved by the NHG Domain Specific Review Board (Reference: 2024-3940-APP1). The results of this pilot study will be reported in peer-reviewed open-access journals and shared with participants and stakeholders., Trial Registration: NCT06479200., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Caregiver stress can pose serious health and psychological concerns, highlighting the importance of timely interventions for family caregivers of people with dementia. Single-session mindfulness-based interventions could be a promising yet under-researched approach to enhancing their mental well-being within their unpredictable, time-constrained contexts. This trial will evaluate the effectiveness and feasibility of a blended mindfulness-based intervention consisting of a single session and app-based follow-up in reducing caregiver stress., Methods/design: The study is a single-blinded randomized controlled trial with two arms (intervention versus an education session on dementia care) and assessments at baseline, 8 weeks, and 6 months. The eligibility criteria include: family caregivers aged 18 years or older; providing care for an individual with a confirmed medical diagnosis of dementia for at least 3 months prior to recruitment, with a minimum of 4 hours of daily contact; and exhibiting a high level of caregiver stress. The intervention comprises a 90-minute group-based session with various mindfulness practices and psychoeducation. Participants will receive a self-practice toolkit to guide their practice over a duration of 8 weeks. Sharing activities will be implemented through an online social media platform. The primary outcome is perceived caregiving stress. The secondary outcomes include depressive symptoms, positive aspects of caregiving, dyadic relationship, trait mindfulness, and neuropsychiatric symptoms of care recipients. The feasibility outcomes include eligibility and enrollment, attendance, adherence to self-practice, and retention, assessed using mixed methods., Discussion: The study will contribute to the evidence base by investigating whether a single-session mindfulness intervention is effective and feasible for reducing caregiver stress among family caregivers of people with dementia., Trial Registration: ClinicalTrials.gov, NCT06346223. Registered on April 3, 2024., (© 2024. The Author(s).)

Background: It is well-recognized that maintaining a regular yogic practice is associated with numerous physical and psychological health benefits. However, few studies have explored the possible psychological and neurophysiological mediators through which the component parts of yoga-ethics, breath regulation, postures, and meditation-work to produce salutary effects., Purpose: To address this gap, we conducted a cluster randomized trial to test the following set of theory-based mechanisms: emotion regulation for ethics, self-control for breath regulation, discomfort and distress tolerance for postures, and mindfulness for meditation. We also explored yoga's effects on the autonomic nervous system by examining salivary acetylcholinesterase levels., Methods: Participants (N = 260) were randomly assigned in clusters (n = 37) to a single, hour-long standard or postures-only yoga class., Results: Findings suggest that a single yoga class may confer both psychological and neurophysiological benefits, yet there were few differences between the two types of yoga classes. Pre- to post-session main effects of time, all in the expected direction, emerged for five of eight theoretical mediators, as well as for salivary acetylcholinesterase levels. Time X condition interactions observed for three of the mediators-cognitive reappraisal, discomfort tolerance, and expressive suppression-along with findings from the exploratory mediation analysis suggest potential unique benefits of the two yoga sessions for certain outcomes., Conclusions: Additional studies are needed to replicate these results and to test other potential mediators and/or primary outcomes through which yoga might work to promote health., (© Society of Behavioral Medicine 2024. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

(1) Background: Lesbian, gay, bisexual, transgender, queer and other gender and sexual minority-identified (LGBTQ+) adolescents face mental and physical health disparities compared to their heterosexual and cisgender counterparts. Mindfulness-based interventions (MBIs) may be a potential method to intervene upon health disparities in this population. This pilot study explores the initial acceptability and feasibility, along with the descriptive health changes of an online MBI, Learning to Breathe-Queer (L2B-Q), which was adapted to meet the needs of LGBTQ+ adolescents. (2) Methods: Twenty adolescents completed baseline and post-intervention assessments of mental health, stress-related health behaviors, physical stress, and LGBTQ+ identity indicators. In addition, the adolescents participated in a post-intervention focus group providing qualitative feedback regarding the acceptability of L2B-Q. (3) Results: L2B-Q demonstrated feasible recruitment and assessment retention, acceptability of content with areas for improvement in delivery processes, and safety/tolerability. From baseline to post-intervention, adolescents reported decreased depression and anxiety and improved intuitive eating, physical activity, and LGBTQ+ identity self-awareness with moderate-to-large effects. (4) Conclusions: These findings underscore the need and the benefits of adapted interventions among LGBTQ+ youth. L2B-Q warrants continued optimization and testing within the LGBTQ+ adolescent community.

Introduction: High-grade glioma patients and their caregivers often suffer from distress and a lower quality of life. Results from studies with patients with mixed cancer entities suggest that yoga can be an effective support. However, it is unclear whether this also applies to high-grade glioma patients and their caregivers. This study aims to investigate the effects of mindfulness-based online yoga for patients and their caregivers on emotional distress, quality of life and stress-associated physiological parameters compared with a waiting control group (WCG)., Methods & Analysis: The study is designed as a multicentre randomised controlled trial. Adult glioma patients (central nervous system WHO grades 3 and 4) and their caregivers will be recruited. Examined yoga instructors deliver the intervention (1 hour per week) in a synchronous format over 8 weeks via video conferencing. The WCG will receive standard care during the 8-week waiting period. Data will be collected before and after the end of the intervention and another 3 months later using questionnaires as well as blood serum and hair samples to evaluate biochemical stress parameters. Primary outcome is self-reported generalised anxiety and secondary outcomes are self-reported fear of progression, depression and quality of life as well as brain-derived neurotrophic factor (BDNF), dehydroepiandrosterone (DHEA)/dehydroepiandrosterone sulfate (DHEAS), ferritin and hair cortisol. We hypothesise better outcomes in the intervention group compared with the WCG at all measurement points. 70 patients and 70 caregivers will be recruited consecutively. Primary endpoints are significant effect detections in the Generalised Anxiety Disorder scale-7 of patients and caregivers at the end of the intervention. Analyses of covariance will be performed to analyse the treatment effects., Ethics and Dissemination: The Ethics Committee of the University of Würzburg approved the YINOTA-O ( Y oga- I ntervention bei N euroonkologischen T umorpatienten und deren A ngehörigen - O nline) study on 26 October 2021 (No.185/18-me). Results will be presented at conferences and published in peer-reviewed journals., Trial Registration Number: German Clinical Trials Register No. DRKS00029554., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Major Depressive Disorder (MDD) is a global health issue, and a significant portion of individuals with MDD experience Treatment-Resistant Depression (TRD), characterized by the lack of response to adequately trialed antidepressant medication and therapy. This systematic review aims to investigate the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) as an intervention for individuals with TRD., Materials and Methods: We will conduct a thorough search for publications of randomized clinical trials and quasi-experimental studies in MEDLINE, Embase, PsycINFO, Web of Science databases, and ClinicalTrials.gov. Furthermore, reference lists of included studies will be manually screened for additional relevant articles, with no restrictions on language or publication date. The search will be conducted from the inception of the databases until June 2024. Our PICO-guided research questions are: (1) In adults with Treatment-Resistant Depression, is MBCT more effective than standard care or other active treatments in reducing depressive symptoms? (2) In adults with Treatment-Resistant Depression, does MBCT demonstrate a comparable safety profile to standard care or other active treatments? The quality of the included studies will be assessed independently using the Cochrane Risk of Bias Tool (RoB 2). This study seeks to evaluate the effectiveness and tolerability of Mindfulness-Based Cognitive Therapy as an intervention for Treatment-Resistant Depression, and will employ the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology to appraise the confidence in the evidence., Prospero Registration: Prospero registration ID: CRD42023411978. Registered on April 07, 2023., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 F. Rodrigues et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Mindfulness improves well-being, improves emotional regulation, reduces impulses to eat, and is linked to increased physical activity. Mindfulness interventions usually focus on 1 aspect but do not offer an approach to holistically improving lifestyle., Objective: This study aims to address this gap by designing and evaluating a holistic mindfulness intervention., Methods: Committing to a 12-week intervention with 2-hour sessions without knowing whether you will enjoy it can be a hindrance for someone completely unfamiliar with mindfulness. For this reason, we decided to design a mindfulness intervention with short sessions over a reduced number of weeks. The aim is to enable novices to discover different aspects of mindfulness while at the same time offering a satisfactory practice for people who are already practicing mindfulness. We designed and evaluated a web-based mindfulness intervention in 5 sessions of 5 to 10 minutes each on well-being, diet, and physical activity to support a healthier lifestyle. The first 2 sessions focus on formal mindfulness meditation to enable novices to discover mindfulness and its main principles. Then there are 2 sessions about food. The first session about food aims to develop a sense of satisfaction with the food we eat and to focus our attention on new sensations. The second session about food aims to develop the ability to resist the lure of unhealthy foods. Finally, there is a session on physical activity. The aim is to develop a particular awareness of the body during movement, to increase satisfaction with physical activity, and to develop regular exercise., Results: In total, 32 participants completed the intervention. After the intervention, we observed decreases in negative affect, anxiety, and emotional distress, and an increase in dispositional mindfulness. There was no effect on reported healthy eating habits and physical activity habits. Few participants repeated the exercises as recommended. The majority of our participants were new to mindfulness. The majority of our participants reported being satisfied with the different sessions. A few minor difficulties were mentioned, mainly related to the environment in which the participants carried out the sessions. Only 1 session was less satisfactory for one-third of the participants. The session on resistance to unhealthy foods was formulated too strictly and the idea of banning certain foods was a hindrance for one-third of the participants. A reformulation is needed., Conclusions: The mindfulness exercises were well accepted and promoted a state of mindfulness. It would be interesting to provide easier technical access to the exercises via a mobile app so that they can be repeated easily., (©Morghane Aubert, Céline Clavel, Christine Le Scanff, Jean-Claude Martin. Originally published in JMIR Formative Research (https://formative.jmir.org), 15.10.2024.)

Background: The mindfulness level of hospitalized elderly is influenced by factors such as physical health, emotional resilience, and social support. However, little is known regarding the relationship between medical coping styles and mindfulness levels of hospitalized elderly. The aims of this study were to explore the association between medical coping styles and mindfulness levels in hospitalized elderly patients, with a focus on identifying actionable strategies to enhance patient well-being., Methods: A survey of 253 elderly patients was conducted in the Department of Geriatrics of a 3 A hospital in Tangshan from September to November 2022 using the General Questionnaire, Medical Coping Style Scale (MCMQ), and Mindfulness-Attention Awareness Scale (MAAS)., Results: The average mindfulness level score of the hospitalized elderly was (59.71 ± 13.90), with a scoring rate of 66.34%, at a moderate mindfulness level. This study revealed a strong positive correlation (r = 0.725, P < 0.05) between confrontation coping and mindfulness, highlighting the importance of promoting active coping strategies to improve mindfulness levels in elderly patients., Conclusion: The mindfulness level of the hospitalized elderly shows potential for improvement, their coping styles are closely related to their mindfulness level, and positive coping styles can help improve the mindfulness level of the hospitalized elderly. This study suggested that medical staff can consider formulating targeted interventions, contingent upon available resources and training, guide patients to establish positive coping styles, and improve the mindfulness level of hospitalized elderly people., (© 2024. The Author(s).)

Background: Stress related to Alzheimer disease and related dementias (ADRD) is common, particularly among those who care for persons with challenging behaviors and personality or mood changes. Mindfulness and self-compassion programs are efficacious for managing stress. The skills of mindfulness and self-compassion, however, must be integrated with behavioral management skills in order to effectively improve caregiver stress., Objective: In this study, we aimed to describe the development of the Mindful and Self-Compassionate Care (MASC) program, the first program that combines mindfulness and self-compassion with behavioral management skills to decrease caregiver stress, and its evaluation in the Supporting Our Caregivers in ADRD Learning (SOCIAL) study., Methods: Using the National Institutes of Health (NIH) stage model, we describe 3 phases of work encompassing NIH Stages 1A and 1B. In phase 1, we conducted 5 focus groups (N=28) of stressed individuals caring for persons with ADRD and challenging behaviors. Rapid data analysis informed the development of a 6-week online intervention. Phase 2 (NIH stage 1A) includes an open pilot (N>10) with optional exit interviews. Phase 3 (NIH stage 1B) is a feasibility randomized controlled trial of the intervention versus the Health Education Program control. Primary outcomes focus on feasibility with secondary outcomes encompassing acceptability, credibility, fidelity, and signals of preliminary efficacy. Phase 1 follows traditional recommendations for qualitative analyses (at the point of thematic saturation) which was achieved after 5 focus groups (N=28). For the phase 2 open pilot, up to 12 participants will be recruited. For the phase 3 feasibility study, recruitment of 80 caregivers will allow the assessment of feasibility benchmarks. Data for phase 1 included 5 focus groups. In phases 2 and 3, data collection will occur through REDCap (Research Electronic Data Capture; Vanderbilt University) surveys and an optional qualitative exit interview. Analyses will include hybrid inductive-deductive analyses for qualitative data and assessment of changes in our intervention targets and outcomes using t tests and correlation analyses., Results: In phase 1, caregivers reported interest in a brief, online stress management program. Participants held misconceptions about mindfulness and self-compassion, but after detailed explanation thoughts, these skills could be helpful when directly linked to implementation during caregiving routines. Phases 2 and 3 will be completed by the end of 2025., Conclusions: We describe the protocol for the Supporting Our Caregivers in ADRD Learning study, as well as the development and feasibility testing of the Mindful and Self-Compassionate Care intervention. Future work will include a fully powered efficacy-effectiveness randomized controlled trial., Trial Registration: ClinicalTrials NCT05847153; https://clinicaltrials.gov/study/NCT05847153; and ClinicalTrials.gov NCT06276023; https://clinicaltrials.gov/study/NCT06276023., International Registered Report Identifier (irrid): DERR1-10.2196/58356., (©Aniyah Travis, Arden O’Donnell, Natalia Giraldo-Santiago, Sarah M Stone, Daniel Torres, Shelley R Adler, Ana-Maria Vranceanu, Christine S Ritchie. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 11.10.2024.)

Study Objectives: Mindfulness-based interventions (MBI) have been shown to improve psychosocial functioning in medical populations but have not been studied in narcolepsy. This study examined the feasibility and acceptability of an MBI that was adapted for narcolepsy, including three variations in program length., Methods: Adults with narcolepsy (N = 60) were randomized to MBI groups of varying durations: brief (4 weeks), standard (8 weeks), or extended (12 weeks). Participants completed assessments at baseline, 4, 8, and 12 weeks. To assess feasibility and acceptability, primary outcomes included attendance, meditation practice, and data completeness. Additionally, participants completed measures of mindfulness, self-compassion, mood, sleep, psychosocial functioning, and cognition. An effect size of Cohen's d ≥ 0.5 was used as the prespecified benchmark for a minimal clinically important difference (MCID)., Results: The attendance, meditation, and data completeness benchmarks were met by 71.7%, 61.7%, and 78.3% of participants, respectively. Higher proportions of the brief and extended groups met these benchmarks compared to the standard group. All groups met the MCID for mindfulness, self-compassion, self-efficacy for managing emotions, positive psychosocial impact, global mental health, and fatigue. Standard and extended groups met the MCID for anxiety and depression, and extended groups met the MCID for additional measures including social and cognitive functioning, daytime sleepiness, hypersomnia symptoms, and hypersomnia-related functioning., Conclusions: Results suggest that the remote delivery and data collection methods are feasible to employ in future clinical trials, and it appears that the extended MBI provides the most favorable clinical impact while maintaining attendance and engagement in meditation practice., Clinical Trial Registration: Awareness and Self-Compassion Enhancing Narcolepsy Treatment (ASCENT), NCT04306952, https://clinicaltrials.gov/ct2/show/NCT04306952., (© The Author(s) 2024. Published by Oxford University Press on behalf of Sleep Research Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Aims: The treatment of diabetes distress plays an important role in diabetes care; however, no meta-analysis has been performed to synthesize the short- and long-term effects of psychological interventions tailored for diabetes distress in people with type 2 diabetes. We aim to evaluate the evidence on tailored psychological interventions for diabetes distress as the primary outcome, focusing on individuals with type 2 diabetes., Methods: Two reviewers independently searched eight databases from their inception to September 2024. EndNote X9 was used to screen records. The Revised Cochrane risk-of-bias tool for randomized trials was used to assess the risk of bias. The GRADE system was used to assess the overall certainty of the evidence. A random effect model was used to determine the mean difference or standardized mean difference with 95% CIs. Subgroup analyses based on several intervention characteristics and sensitivity analyses were also conducted., Results: Totally, 22,279 records were yielded, and we finally included 18 studies in our systematic review. The meta-analysis included data from 16 studies representing 1639 participants. Interventions types included mindfulness-based and cognitive behavioral therapy, among others. Duration of interventions ranged from 4 weeks to 6 months. We found that psychological interventions that measured diabetes distress significantly reduced diabetes distress in the short-term in people with type 2 diabetes (SMD= -0.56; 95% CI= -0.90, -0.22; p = 0.001). Subgroup analysis indicated that this effect could be enhanced when delivered in a group format, by psychologist, using a technology component, or including participants having elevated baseline diabetes distress. However, the short- and long-term effects on HbA1c were non-significant, with results showing (MD = 0.02; 95% CI = -0.23 to 0.26; p = 0.89) and (MD = -0.27; 95% CI = -0.64 to 0.10; p = 0.15), respectively. The long-term effect on diabetes distress was also non-significant (SMD = -0.45; 95% CI = -0.93 to 0.03; p = 0.07)., Conclusions: Psychological interventions tailored for diabetes distress in people with type 2 diabetes are effective in reducing the level of diabetes distress immediately after the intervention. More trials are still needed to further enrich the evidence in this area., (© 2024. The Author(s).)

Objectives: to assess the association between indicators of emotional distress and dispositional mindfulness in health students at a Brazilian federal public university., Methods: a cross-sectional study, developed with university students in the health area of a public institution from May to June 2022. In the analysis, multiple linear regression was used using SPSS software., Results: the sample was mostly female, ≤ 22 years old, non-white, studying the first semesters, with a higher prevalence for the medicine course. Students presented moderate dispositional mindfulness scores. It was observed that the variables of stress, depression and current suicide risk were associated with the capacity for mindfulness., Conclusions: knowing the indicators of emotional distress that are related to the potential of mindfulness can contribute as a situational diagnosis to better design strategies that promote the improvement of emotional indicators of health students.

Mindfulness is an increasingly popular practice among elite athletes to improve performance and well-being, but its application for coaches is still very limited. Therefore, a new program (M×E; Mindfulness para Entrenadores) was designed and implemented online for 6 weeks for coaches, support staff, and technical directors. Participants were 58 (57 men), aged between 23 and 58 (M = 31.8). The between-subject analysis (RM ANOVA 2×2) included experimental (n = 26) and wait-list control group (n = 21). A total of 29 completed the within-subject analysis (RM ANOVA) completing follow-up measurements until six months. The analysis was complemented with 21 individual semi-structured interviews. The experimental group showed significant improvements in mindfulness trait (p < .001), interpersonal mindfulness (p = .010), and a significant improvement in emotional regulation (p = .010) in comparison to the wait-list control group. The experimental group's positive trend in all variables' levels was maintained until six months after the program. The qualitative analysis showed a positive impact on professional, personal, and social areas with improvements related to performance and well-being. Several participants considered the program as "fundamental" for their professional role. This study provides information on best practices in implementing mindfulness-based programs, highlighting their practical orientation, the training plan, and the safe space. These results offer initial validation of the potential of the M×E and invite sports organizations to incorporate mindfulness-based programs specially designed for coaches, support staff and technical directors., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Gibert et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Kangaroo mother care (KMC) can have a positive effect on the mental well-being of a mother. However, there are specific challenges associated with the process that may contribute to increased anxiety for the mother. By integrating nurse-assisted mindfulness training alongside KMC guidance, nurses may effectively alleviate maternal stress to a greater extent., Methods: A single-centre randomized controlled trial was conducted to investigate the effects of KMC combined with nurse-assisted mindfulness training. The study included preterm infants with a gestational age of less than 32 weeks or a birth weight of less than 1500 g and their mothers, who were randomly divided into two groups. The intervention group consisted of mothers who received KMC combined with nurse-assisted mindfulness training for 14 days. The control group comprised mothers who received only KMC for 14 days. Data from both groups were collected and compared for analysis., Results: Forty-seven infants and their mothers were included in the intervention group, whereas 44 pairs were included in the control group. After the intervention, the parental stressor scale scores for the neonatal intensive care unit (PSS: NICU) (3), PSS: NICU (4), and Hospital Anxiety and Depression Scale (HADS) scores for the intervention group were lower than those for the control group, whereas the Five Facet Mindfulness Questionnaire (FFMQ) (1), FFMQ (4), and FFMQ (5) scores for the intervention group were higher. The degree of change in the PSS: NICU and HADS scores was inversely correlated with the degree of change in the FFMQ score. The breast milk feed rate and weight gain rate were greater in the intervention group than in the control group. No adverse reactions were observed in either group., Conclusions: Kangaroo mother care combined with nurse-assisted mindfulness training is an acceptable, feasible, and effective procedure for reducing anxiety in mothers of preterm infants in the NICU, with potential benefits for the short-term prognosis of these infants., Trial Registration: Chinese Clinical Trial Registry, ChiCTR1900023697, registered on June 8, 2019, retrospectively registered., (© 2024. The Author(s).)

Objective: This article reviews the latest literature regarding chronic pain epidemiology and describes pain-specific psychological factors associated with the development and maintenance of chronic pain, mental health conditions that co-occur with chronic pain, and advances in the psychobehavioral treatment of chronic pain, including established treatments (ie, cognitive behavioral therapy [CBT], acceptance and commitment therapy, and mindfulness-based stress reduction) and emerging treatments (ie, pain reprocessing therapy)., Latest Developments: In addition to CBT and acceptance and commitment therapy for pain, numerous other psychological treatment modalities have been integrated into chronic pain management, including mindfulness-based stress reduction, mindfulness meditation, chronic pain self-management, relaxation response, pain neuroscience education, biofeedback, hypnosis, and, more recently, integrative psychological treatment for centralized pain. This article gives an overview of these methods and contextualizes their use within the standard psychological treatment of chronic pain., Essential Points: Guided by the biopsychosocial treatment model, pain psychologists use numerous evidence-based psychological methods to treat patients with chronic pain conditions. Familiarity with the psychological tools available for pain management will aid neurologists and their patients in navigating the psychological aspects of living with chronic pain., (Copyright © 2024 American Academy of Neurology.)

Introduction: Mobile health (mHealth) technologies, including smartphone apps and wearables, have improved health care by providing innovative solutions for monitoring, education and treatment, particularly in mental health., Method: This review synthesises findings from a series of reviews on mHealth interventions in psychiatry. Publications were systematically searched in PubMed, MEDLINE, PsycINFO, ScienceDirect, Scopus, Web of Science and Cochrane Library., Results: Out of 2147 records, 111 studies from 2014 to 2024 focusing on anxiety and depression were included. These studies highlight the effectiveness of mHealth interventions in reducing symptoms through cognitive-behavioural therapy, mindfulness and psychoeducation, benefitting adolescents, perinatal women and marginalised groups. Additionally, mHealth shows promise in managing substance use disorders and severe mental illnesses like schizophrenia, bipolar disorder and psychosis., Conclusion: Despite positive outcomes, challenges such as data privacy, user engagement and healthcare integration persist. Further robust trials and evidence-based research are needed to validate the efficacy of mHealth technologies., (Copyright © 2024 Copyright: © 2024 Singapore Medical Journal.)

Background: The Cardio-Thoracic (CT) professional group experienced a significant increase in stress and workload during and after the COVID-19 pandemic. The Society for Cardiothoracic Surgery (SCTS) in Great Britain and Ireland with the aim of endorsing positive change. Aim of this project was to understand the Mental Health (MH) and wellbeing status of the CT professionals and to explore Virtual Reality Mindfulness as an intervention to improve MH and wellbeing., Methods: In February 2022, the SCTS created a Mental Health and Wellbeing Working Group to identify the problem and find solutions. This exploratory project was carried out in two stages. Stage one was an online survey conducted in March 2022 and stage two was a Virtual Reality (VR) mindfulness workshop in March 2023, using the Rescape™ VR mindfulness tool., Results: Stage one: An online QR code survey was sent out to 150 members with 129 (86%) completed responses. 92% expressed that SCTS should create awareness about mental health and wellbeing. 99% said that they should be allowed to speak up and create interventions for members to access, support and relax. Three main themes identified about why CT staff do not discuss their Mental Health problems were fear of lack of awareness (72%), lack of confidentiality (60%) and impact on career (60%). Stage two: 88 members attended the VR session of which 76 (86%) completed the anonymous questionnaire. 97% reported usage was a pleasurable experience, 91% felt more relaxed, 82% felt less stressed, 90% felt calmer and 89% had their mood enhanced., Conclusion: Our study findings indicate that CT staff experience considerable effects on their mental health and wellbeing. However, there is a hesitancy to recognise and seek assistance due to concerns about confidentiality and career repercussions. The virtual reality mindfulness session served as a beneficial supplement, with a positive impact in this pilot cohort., (© 2024. Crown.)

Introduction: With the spread of COVID-19, certain population groups, including pregnant women, were more susceptible than others. This disease can lead to postpartum complications, including mental disorders, in mothers. Few studies have investigated the impact of mindfulness-based interventions on mental health, and the most effective counseling approach to promote mental health has not been identified., Objective: This study aimed to determine the impact of online mindfulness-based counseling on improving mental health among women with a history of COVID-19 during pregnancy in Iran., Methods: The present study was a quasi-experimental design conducted on 100 women with a history of coronavirus infection during pregnancy referred to the Mother's Clinic of Yahya Nejad and Ayatollah Rouhani Educational-Treatment Hospital, affiliated with Babol University of Medical Sciences, Iran, via convenience sampling. The women were randomly assigned to the intervention (mindfulness-based counseling) and control groups. The intervention group received eight 45-min weekly mindfulness-based counseling sessions over 8 weeks. Data were collected via a demographic information questionnaire and the Goldberg General Health Questionnaire before and after the intervention, which were completed by both groups. Independent t-tests and analysis of covariances (ANCOVAs) were used to compare the outcomes of the two groups., Results: After controlling for confounding variables, the mean mental health scores before and after counseling were 29.42 ± 4.49 and 19.80 ± 3.88, respectively, in the intervention group and 26.26 ± 2.29 and 25.92 ± 2.15, respectively, in the control group. The mean mental health score in the intervention group was significantly lower than that in the control group (F = 266.7, p < 0.001). The mean scores for somatic symptoms (F = 89.30, p < 0.001), depression symptoms (F = 142.71, p < 0.001), anxiety and insomnia symptoms (F = 120.56, p < 0.001), and social dysfunction scores (F = 127.77, p < 0.001) were significantly different between the two groups after counseling., Conclusion: The findings indicated that online mindfulness-based counseling positively affects mental health and its domains during the postpartum period. However, further randomized clinical trials are needed before a definitive conclusion can be drawn., Trial Registration: We were not allowed to register according to the law of our country., (© 2024 The Author(s). Brain and Behavior published by Wiley Periodicals LLC.)

Background: Anxiety disorder is one of the most common mental disorders and often accompanied with sleep disturbance which can in turn exacerbate anxiety symptoms, creating a vicious cycle. In addition to psychopharmacological therapy, the effectiveness of psychotherapy as cognitive behavioral therapy (CBT) for treating anxiety disorders and insomnia has been well documented and widely accepted, but it is labor-intensive and costly. However, virtual reality (VR)-integrated CBT may improve this condition but needs more evidences to support its extensive application in routine clinical practice., Objectives: This explorative study was aimed to conduct a retrospective analysis to evaluate the acute (2 weeks) augmented effect of VR-integrated relaxation and mindfulness exercising in improving anxiety and insomnia symptoms for patients who were diagnosed with anxiety disorders and concurrently with prominent insomnia symptoms and admitted to the Department of Psychiatry, The Affiliated Guangdong Second Provincial General Hospital of Jinan University during January 2021 to June 2021., Methods: All patients who were admitted to the department of psychiatry during January 1, 2021 to June 30, 2021 were screened with inclusion criteria and exclusion criteria, and the sociodemographic and clinical data of those included patients were collected from the electronic medical record system of the hospital using a self-designed case report form (CRF). Subjects who were administrated with medication alone were designated as conventional group, and those receiving treatment of medication combined with VR-integrated CBT (VR relaxation and mindfulness exercising) as VR group. The baseline and 2-week posttreatment data were compared between the two groups., Results: In total, there were 103 patients (70 female, 68%) included in the study. Among all, 68 (66.02%) were designated as the "VR group," and 35 (33.98%) as the "conventional group." The majority of patients (67%) were diagnosed with generalized anxiety disorder (GAD). Twenty-three (22.3%) patients had a comorbid diagnosis with primary insomnia, and insomnia was just one of the accompanying symptoms with anxiety for the rest 80 subjects. No statistically significant differences were found between VR and conventional groups in all baseline sociodemographic and clinical characteristics except for occupation. There were statistically significant differences for the remission rates of anxiety symptoms or insomnia symptoms and reduction of Hamilton Anxiety Rating Scale or Insomnia Severity Index total scores between conventional and VR groups. Greater remission rates or score reductions were found in VR group than in conventional group either for anxiety or for insomnia. Robust differences still existed when controlled for the variable "occupation.", Conclusions: Two-week augmented VR-integrated relaxation and mindfulness exercising is acutely beneficial for relieving both anxiety and insomnia symptoms and worth being recommended for routine clinical practice. Further prospective and randomized study compared to traditional CBT to explore its acute and long-term effect on anxiety and insomnia is needed., (© 2024 The Author(s). Brain and Behavior published by Wiley Periodicals LLC.)

When used separately, virtual reality (VR) and mind-body therapies (MBTs) have the potential to reduce pain across various acute and chronic conditions. While their combination is increasingly used, no study offers a consolidated presentation of VR and MBTs. This study aims to propose an overview of the effectiveness of VR combined with MBTs (i.e., meditation, mindfulness, relaxation, and hypnosis) to decrease the pain experienced by healthy volunteers or patients. We conducted a scoping review of the literature using PubMed, Science Direct and Google Scholar and included 43 studies. Findings across studies support that VR combined with MBTs is a feasible, well-tolerated, and potentially useful to reduce pain. Their combination also had a positive effect on anxiety, mood, and relaxation. However, insufficient research on this VR/MBTs combination and the lack of multidimensional studies impede a comprehensive understanding of their full potential. More randomized controlled studies are thus needed, with usability evaluation protocols to better understand the effects of VR/MBTs on patients wellbeing and to incorporate them into routine clinical practice.

Background: In recent years, both meditation and psychedelics have attracted rapidly increasing scientific interest. While the current state of evidence suggests the promising potential of psychedelics, such as psilocybin, to enhance meditative training, it remains equivocal whether these effects are specifically bound to psilocybin or if other classical psychedelics might show synergistic effects with meditation practice. One particularly promising candidate is N,N -dimethyltryptamine (DMT), an active ingredient of ayahuasca., Aim: This study aims to investigate the effect of the psychedelic substance DMT, combined with the monoamine oxidase inhibitor harmine ( DMT-harmine ), on meditative states, compared to meditation with a placebo., Method: Forty experienced meditators (18 females and 22 males) participated in a double-blind, placebo-controlled study over a 3-day meditation retreat, receiving either placebo or DMT-harmine. Participants' levels of mindfulness, compassion, insight, and transcendence were assessed before, during, and after the meditation group retreat, using psychometric questionnaires., Results: Compared to meditation with a placebo, meditators who received DMT and harmine self-attributed greater levels of mystical-type experiences, non-dual awareness, and emotional breakthrough during the acute substance effects and, when corrected for baseline differences, greater psychological insight 1 day later. Mindfulness and compassion were not significantly different in the DMT-harmine group compared to placebo. At 1-month follow-up, the meditators who received DMT and harmine rated their experience as significantly more personally meaningful, spiritually significant, and well-being-enhancing than the meditators who received placebo., Conclusion: Investigating the impact of DMT-harmine on meditators in a naturalistic mindfulness group retreat, this placebo-controlled study highlights the specific effects of psychedelics during meditation., Trial Registration: ClinicalTrials.gov identifier NCT05780216., Competing Interests: Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: DM, KE, HDA, JJR, JM, JD, ET, EAV, LC, DJP, JTTS, and JWS report having no conflicts of interest with respect to research, authorship, and/or publication of this article. MS and DAD declare that they co-founded Reconnect Labs, an academic spin-off at the University of Zurich, focused on the development of psychedelic medicines for mental health.

Background: Hypertension is a leading contributor to cardiovascular disorders globally. There has been a recent upsurge in non-pharmacological management involving mindfulness-based meditation (MBM) in lowering blood pressure (BP) among the hypertensive population; however, the level of supportive evidence among patients primarily diagnosed with hypertension remain limited. Therefore, this systematic review aimed to synthesize the evidence of randomized controlled trials (RCTs) on the effect of MBM on BP explicitly in adults primarily diagnosed with elevated blood pressure or hypertension., Methods: A database search of RCTs was conducted in PubMed, Scopus, Cochrane Central Register of Controlled Trials, and Web of Science until December 2023. The effect size score was calculated for variables of interest followed by qualitative analysis., Results: Nine studies with 543 participants (mean age 54.9±9.0) met the pre-specified eligibility criteria. Eight trials reported MBM convincing in lowering the systolic BP (p=0.001-0.020) and 6 in reducing the diastolic BP (p=0.001-0.01) among this target population. There was a disparity of gender in 7 studies and 4 trials did not report the ethnicity of participants. The methodological quality of the trials was gratifying, however, most studies presented with absence of allocation concealment and blinding of outcome assessors, fragmentary reporting of data, and high attrition rate that potentially affected the validity of trials., Conclusion: MBM interventions may serve as an early preventive and supportive measure for adults with elevated BP or hypertension. However, more robust and rigorous trials with a larger, homogeneous sample and long-term follow-up are necessary to quantify the magnitude of this intervention. Moreover, the methodological issues may affect the overall quality and reliability of MBM interventions; hence, future studies must also address the risk of bias due to inadequate blinding and high attrition through treatment concealment and personalized engagement measures., Competing Interests: Declaration of Competing Interest All the authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objective: This research was conducted to determine the effects of acupressure, laughter yoga, and a mindfulness-based stress reduction program applied to postmenopausal women for menopause symptoms and quality of life., Methods: A randomized controlled design was used. The study was conducted with a total of 146 women, including 41 acupressure, 31 laughter yoga, 37 mindfulness-based stress reduction, and 37 control group women. The women in the acupressure group were administered acupressure twice a week, which accounted for 16 sessions in total. Women in the laughter yoga and mindfulness-based stress reduction groups received a total of eight sessions of the related intervention, which was performed once a week. Study data were collected using a participant information form, the Menopause Rating Scale (MRS), and the Menopause-Specific Quality of Life Scale (MENQOL). Descriptive statistics, paired-samples t test, χ 2 test, analysis of variance test, and intention to treat analysis were used to analyze the data. Before the intention to treat analysis was performed, the multiple imputation method was employed to deal with missing data., Results: In the study, it was found that there was a decrease in the MRS total score after the intervention in women in all three intervention groups compared to the control group ( P < 0.05). In the laughter yoga group, total MRS scores decreased by 3.16 points ( P < 0.05). In the acupressure group, total MRS scores decreased by 5.46 points ( P < 0.05). In the mindfulness-based stress reduction (MBSR) program group, total MRS scores decreased by 4.65 points ( P < 0.05). It was determined that the mean scores of women in the laughter yoga and acupressure groups on all subscales of the MENQOL decreased after the intervention compared to the control group ( P < 0.05). The comparison of the MBSR group and the control group showed that there was a decrease only in the psychosocial domain subdimension of the MENQOL ( P < 0.05)., Conclusions: In conclusion, it was determined that laughter yoga, acupressure, and MBSR could be effective in reducing menopause symptoms and improving quality of life, although findings require further testing in a rigorously controlled study and in a study with only a single prespecified outcome., Competing Interests: Financial disclosure/conflicts of interest: None reported., (Copyright © 2024 by The Menopause Society.)

Objective: To compare the effects of aromatherapy with lavender and mindfulness-based cognitive therapy for sexuality (MBCT-S) on female sexual function., Design: Randomized controlled trial., Setting: Health centers in Roudan city, Iran., Participants: Sixty married women, ages 18 to 45 years, were recruited using the Female Sexual Function Index (FSFI). Participants were selected from health centers in 2022 via convenience sampling., Intervention and Measurements: Upon their completion of a demographic checklist and the FSFI as a pretest, participants were divided into three groups, including lavender aromatherapy (n = 20), MBCT-S (n = 20), and control (n = 20) through random selection with permutation blocks. All groups completed FSFI as a posttest. Data were analyzed by SPSS 26 using chi-square, Wilcoxon, Kruskal-Wallis, and Mann-Whitney statistical tests., Results: There was no statistically significant difference among the three groups before the intervention (p = .652), but there was a significant difference among them after the intervention (p = .001). There was a significantly positive difference between the intervention groups and the control group (p < .001). A significant relationship was observed among the three groups in sexual desire, pain, satisfaction, lubrication, and arousal. The mean scores of the posttest in sexual desire, pain, satisfaction, and lubrication were positively higher in the MBCT-S group than in the aromatherapy group, and both intervention groups showed the same effect for sexual arousal. Aromatherapy and counseling had no significant effect on improving sexual orgasm., Conclusion: MBCT-S can be used to improve many aspects of female sexual function, except for orgasm disorders; aromatherapy may improve sexual arousal., (Copyright © 2024 AWHONN. Published by Elsevier Inc. All rights reserved.)

Objective: To evaluate feasibility/acceptability of a virtual, group mindfulness-based intervention (MBI) adapted for pediatric type 1 diabetes (T1D)., Methods: This two-way controlled trial randomized adolescents 1:1 to MBI (n = 20) or health education (HE; n = 22) groups lasting 6-7 weeks. Eligibility included 12-17 years, T1D ≥ 1 year, and elevated scores on PROMIS depression or anxiety measures. Recruitment, retention, and session attendance were tracked to measure feasibility. Acceptability was measured via youth-reported post-session surveys. Adolescents completed depression, anxiety, and diabetes-specific surveys at baseline, immediately post-program, and 3 months post-program completion. HbA1c values approximating these timeframes were obtained from chart review., Results: 55% of screened participants were eligible to participate, and 100% of eligible youth enrolled. There was 93% study retention and 96% session attendance rates. Survey data were 100% complete at baseline, and 93% complete at post-program and 3-month follow-ups; 83% and 78% of MBI participants rated sessions as at least somewhat enjoyable and helpful, respectively, and 91% and 82% of HE participants rated sessions as at least somewhat enjoyable and helpful, respectively. Mean scores showed declines in depression, anxiety, disordered eating, diabetes distress, and HbA1c in both groups across time, with trends toward potential greater reductions in depression and HbA1c in MBI., Conclusions: This pilot provides preliminary evidence that virtual MBI and HE groups adapted for adolescents with T1D are feasible to deliver and acceptable, with potential improvement in psychosocial, behavioral, and diabetes-specific outcomes. Whether MBI is more effective for targeting negative affect and glycemic control in the context of adolescent T1D requires testing in a full-scale efficacy trial., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Introduction: Undergoing complex diagnostic investigation of positron emission tomography-computed tomography (PET-CT) scans is associated with high levels of distress, fear, and anxiety in oncological patients. This study evaluated the effects of a single 20-min session of an innovative mindfulness-based swinging technique (MBST) intervention on emotional distress in cancer patients scheduled for PET-CT scans. Material and Methods: Adult cancer patients undergoing PET-CT scans ( n = 57) were assigned to the intervention group ( n = 27) or the control group ( n = 30). The emotion thermometer (ET) was used to measure distress, anxiety, depression, anger, and need for help at baseline and after the PET-CT scan. Participants in the intervention group received a 5-min psycho-education followed by listening to an audio recording of the MBST intervention just before their PET-CT scan. The session included mindfulness-based visualization, imaginary swinging activity, and synchronized breathing. The control group participants received brief 5-min counseling. Results: There was a statistically significant reduction in distress ( p < 0.001), anxiety ( p < 0.001), depression ( p < 0.001), anger ( p = 0.002), and need for help ( p < 0.001) in the intervention group compared with the control group. Safety: None of the participants reported adverse events caused by the MBST intervention. The intervention was well accepted by the participants. However, n = 3 participants could not complete the intervention due to mind wandering, inability to focus, difficulty complying with the guided instructions, falling asleep, and physical discomfort unrelated to the intervention. Conclusion: The findings suggest the potential role of MBST intervention in mitigating emotional distress in patients undergoing complex diagnostic imaging procedures. Integrating this with conventional care in nuclear medicine settings can provide patient-centered care that addresses their unmet requirements. There is a need for further validation with a larger sample size. Clinical Trial Registration Number: CTRI/2023/04/051243 (Registered prospectively on 03/04/2023).

Background: Mindfulness-based treatments gained popularity for migraine treatment. In this manuscript we report the results of a single-arm open pilot study that evaluated the impact of a multimodal web-based intervention combining home-based medication withdrawal, patients' education, and online mindfulness-based interventions. We aimed to address whether our program had the ability to show a change in the observed parameters and the study should therefore be intended as an early phase trial., Methods: Consecutive patients with chronic migraine associated with medication overuse headache were enrolled, followed-up for 12 months, in a program that included home-based medication withdrawal, education on the correct use of drugs and lifestyle issues, prescription of tailored pharmacological prophylaxis, and attendance to six online mindfulness-based sessions. We tested the effect of the program on improving headache frequency, medication intake, quality of life (QoL), headache impact, depression, self-efficacy, and pain catastrophizing., Results: A total of 37 patients completed the study (10 dropped out). We observed a large improvement in headache frequency, medication intake, headache impact, and QoL, a moderate improvement in pain catastrophizing and a mild improvement in depression symptoms; 70% to 76% of patients achieved 50% or more reduction in headache frequency from baseline to each follow-up (p < .01)., Conclusions: The results of our multimodal program showed significant improvements in headache frequency, medication intake, and patient-reported outcomes. Future studies are needed to better identify patients who might benefit most from Digital Health Interventions and to demonstrate at least an equivalence in outcome with in-person programs carried out in hospital settings., (© 2024. Fondazione Società Italiana di Neurologia.)

The COVID-19 pandemic generated distinct mental health challenges, characterised by stress and anxiety due to its unpredictable duration and continuous threat. This study examined the role of meditation practice on anxiety symptoms and perceived stress, considering co-variables such as self-compassion, acceptance, awareness, brooding, lockdown duration, and sociodemographic characteristics. The study used a longitudinal design and data were collected through online surveys from April 2020 to January 2021 (at four different time points) and included 238 participants from Portugal (165 had prior experience with meditation practices, 73 were non-meditators) with a mean age of 43.08 years (SD = 10.96). Linear mixed models revealed that over time, during the lockdown, the non-meditators group demonstrated a greater increase of anxiety symptoms (β = -0.226, SE = 0.06, p = 0.006) and perceived stress (β = -0.20, SE = 0.06, p = 0.004), whereas the meditators group showed non-significant (p > 0.05) variations in anxiety and stress symptoms during the same period of time. The effect of meditation on anxiety symptoms was moderated by sex, days of lockdown, self-compassion, and acceptance. The effect of meditation on perceived stress was moderated by sex, years of education, days of lockdown, and levels of awareness. Additionally, the study explored the potential predictive effect of different meditation session lengths, indicating that longer meditation practices offered greater protection against an increase in anxiety symptoms. These findings highlight the importance of cultivating self-regulation skills and investing in preventive mental health strategies to promote well-being and autonomy. Mental health professionals should prioritise educating communities on evidence-based practices like meditation and compassion exercises to enhance overall health., (© 2024 John Wiley & Sons Ltd.)