The double-edged sword of mindfulness: Maintaining integrity whilst increasing access

Recent NHS initiatives aim to increase the implementation of mindfulness-based cognitive therapy (MBCT). We highlight considerations for maintaining integrity whilst increasing access through an enhanced understanding of the complexity of MBCT, teacher training requirements, good practice guidelines, and the evidence base

A mixed methods evaluation of a mindfulness-based stress reduction course for people with Parkinson's disease

Objective The aim of this study was to evaluate the effects of an 8-week Mindfulness-Based Stress Reduction course (MBSR) on people with Parkinson's disease who experienced depression, anxiety, stress or difficulty coping with Parkinson's. Methods Thirteen participants were recruited and six completed the full MBSR course. Data were analysed using repeated measures analysis of variance and thematic analysis. Results There were significant improvements in levels of depression, anxiety and stress at weeks eight and sixteen, as measured by the Depression Anxiety and Stress Scale, short version (DASS-21). Themes of ‘mindfulness as challenging’ and ‘mindfulness as life-enhancing’ were identified from follow-up questionnaire responses. All participants reported they would recommend MBSR to other people with Parkinson's. Conclusion This study supports previous preliminary findings that mindfulness-based interventions could benefit people with Parkinson's experiencing non-motor symptoms. Further research using larger sample sizes, a control group, and a longer follow-up period is required

Coastal Upwelling Supplies Oxygen-Depleted Water to the Columbia River Estuary

Low dissolved oxygen (DO) is a common feature of many estuarine and shallow-water environments, and is often attributed to anthropogenic nutrient enrichment from terrestrial-fluvial pathways. However, recent events in the U.S. Pacific Northwest have highlighted that wind-forced upwelling can cause naturally occurring low DO water to move onto the continental shelf, leading to mortalities of benthic fish and invertebrates. Coastal estuaries in the Pacific Northwest are strongly linked to ocean forcings, and here we report observations on the spatial and temporal patterns of oxygen concentration in the Columbia River estuary. Hydrographic measurements were made from transect (spatial survey) or anchor station (temporal survey) deployments over a variety of wind stresses and tidal states during the upwelling seasons of 2006 through 2008. During this period, biologically stressful levels of dissolved oxygen were observed to enter the Columbia River estuary from oceanic sources, with minimum values close to the hypoxic threshold of 2.0 mg L−1. Riverine water was consistently normoxic. Upwelling wind stress controlled the timing and magnitude of low DO events, while tidal-modulated estuarine circulation patterns influenced the spatial extent and duration of exposure to low DO water. Strong upwelling during neap tides produced the largest impact on the estuary. The observed oxygen concentrations likely had deleterious behavioral and physiological consequences for migrating juvenile salmon and benthic crabs. Based on a wind-forced supply mechanism, low DO events are probably common to the Columbia River and other regional estuaries and if conditions on the shelf deteriorate further, as observations and models predict, Pacific Northwest estuarine habitats could experience a decrease in environmental quality

Affirming identity and control for people with dementia through person-centred approaches to support

Semi-structured interviews were conducted with five people with dementia. Questions concerned the experience of being diagnosed, experience of support services and their opinion of alternative support options. Interviews were audio-recorded, transcribed and analysed using thematic analysis. Suggested guidance for psychotherapists working with people with dementia included seeing the whole person rather than the person defined in terms of their dementia, with an emphasis on a holistic and broad view. Personal and social factors are just as important as the biological factors in our understanding and treatment of people with illnesses. The way a person reacts to and experiences the symptoms of dementia, as well as their treatment by ‘healthy others’ and their reaction to this treatment, are all important factors in the experience of living with dementia

Teaching an Adolescent With Autism and Intellectual Disability to Tolerate Routine Medical Examination: Effects of a Behavioral Compliance Training Package

The present study evaluated graduated exposure and positive reinforcement in a compliance training intervention package with an adolescent female who had autistic disorder, intellectual disability, and long-standing avoidance of routine medical examination. Intervention consisted of slowly introducing her to a 12-step examination hierarchy and reinforcing compliant responding within a changing criterion experimental design. Reinforcement for appropriate alternative behavior and modeling were also components of intervention. A behavioral clinician first implemented procedures that were subsequently generalized to nurses. The participant learned to comfortably tolerate a medical examination that she had resisted for nearly 2 years. We discuss clinical and research implications of the case