Mindfulness in informal caregivers of palliative patients.

OBJECTIVES: Mindfulness is a concept of growing impact on psychotherapy and has been shown to be effective for stress reduction and to improve psychological well-being. Existential Behavioural Therapy (EBT) was developed to support relatives of palliative care (PC) patients to cope with their situation during caregiving and bereavement. Mindfulness training was a core element of the intervention. We investigated the relationship between mindfulness, mental distress, and psychological well-being in informal caregivers, and evaluated if the effects of the intervention were mediated by mindfulness. METHODS: Relatives of PC inpatients took part in a randomized-controlled EBT trial and completed the Cognitive and Affective Mindfulness Scale-Revised, items from the Five Facets of Mindfulness as well as the Brief Symptom Inventory, the Satisfaction with Life Scale, the WHOQOL-BREF, a numerical rating scale on quality of life (range 0-10), and the Schedule for Meaning in Life Evaluation at pre- and post-intervention, and a 3- and 12-months follow-up. RESULTS: One-hundred-and-thirty carers were included, most of them (71.6%) recently being bereaved at the beginning of the intervention. High correlations between mindfulness and mental distress (r = -0.51, p < 0.001) as well as life satisfaction (r = 0.52, p < 0.001) were found. Mindfulness was a significant predictor of improvement in psychological distress, meaning in life and quality of life three months after the intervention. The EBT effects were partly mediated by mindfulness. SIGNIFICANCE OF RESULTS: Mindfulness seems to be a promising concept in supporting informal caregivers of PC patients. Further research is needed to identify the required format and intensity of mindfulness practice necessary for improvement

Experience of meaning in life in bereaved informal caregivers of palliative care patients.

PURPOSE: Providing care for terminally ill family members places an enormous burden on informal caregivers. Meaning in life (MiL) may be a protective factor, but is jeopardised in caregiving and bereavement. This study evaluates the following questions: To what extent do bereaved informal caregivers of palliative care (PC) patients experience meaning in their lives? What differences emerge in carers compared to the general German population? How does MiL relate to well-being in former caregivers? METHODS: Eighty-four bereaved PC caregivers completed the Schedule for Meaning in Life Evaluation, the Brief Symptom Inventory, the WHOQOL-BREF, a single-item numerical rating scale of quality of life, and the Satisfaction with Life Scale. The experience of MiL of bereaved caregivers was compared to a representative population sample (n=977). RESULTS: The overall MiL fulfillment of bereaved caregivers (69 % female, age 55.5 ± 12.9 years) was significantly lower than in the general population (68.5 ± 19.2 vs. 83.3 ± 14, p<.001), as was the overall importance ascribed to their meaning framework (76.6 ± 13.6 vs. 85.6 ± 12.3, p< .001). PC caregivers are far more likely to list friends, leisure, nature/animals, and altruism. Higher MiL was correlated with better life satisfaction and quality of life. CONCLUSION: Coping with the loss of a loved one is associated with changes in MiL framework and considerably impairs a carer's experience of MiL fulfillment. Individual MiL is associated with well-being in PC caregivers during early bereavement. Specific interventions for carers targeted at meaning reconstruction during palliative care and bereavement are needed to help individuals regain a sense of meaning and purpose

Experience of meaning in life in bereaved informal caregivers of palliative care patients.

PURPOSE: Providing care for terminally ill family members places an enormous burden on informal caregivers. Meaning in life (MiL) may be a protective factor, but is jeopardised in caregiving and bereavement. This study evaluates the following questions: To what extent do bereaved informal caregivers of palliative care (PC) patients experience meaning in their lives? What differences emerge in carers compared to the general German population? How does MiL relate to well-being in former caregivers? METHODS: Eighty-four bereaved PC caregivers completed the Schedule for Meaning in Life Evaluation, the Brief Symptom Inventory, the WHOQOL-BREF, a single-item numerical rating scale of quality of life, and the Satisfaction with Life Scale. The experience of MiL of bereaved caregivers was compared to a representative population sample (n=977). RESULTS: The overall MiL fulfillment of bereaved caregivers (69 % female, age 55.5 ± 12.9 years) was significantly lower than in the general population (68.5 ± 19.2 vs. 83.3 ± 14, p<.001), as was the overall importance ascribed to their meaning framework (76.6 ± 13.6 vs. 85.6 ± 12.3, p< .001). PC caregivers are far more likely to list friends, leisure, nature/animals, and altruism. Higher MiL was correlated with better life satisfaction and quality of life. CONCLUSION: Coping with the loss of a loved one is associated with changes in MiL framework and considerably impairs a carer's experience of MiL fulfillment. Individual MiL is associated with well-being in PC caregivers during early bereavement. Specific interventions for carers targeted at meaning reconstruction during palliative care and bereavement are needed to help individuals regain a sense of meaning and purpose

Evaluation of the impact of low emission zone and heavy traffic ban in Munich (Germany) on the reduction of PM₁₀ in ambient air.

Concentrations of ambient fine particles (PM10: particles with an aerodynamic diameter ≤ 10 µm) are still exceeding current air quality standards in many European cities. In Munich (Germany), low emission zone and transit bans for heavy-duty vehicles were introduced in 2008 aiming at reduction of traffic emissions contribution to PM10. The effects of those measures on PM10 mass concentrations in Munich were investigated with a semiparametric regression model for modeling PM10 levels adjusted for time, background pollution, public holidays and wind direction. The reduction of PM10 concentration after the introduction of the measures was larger at a traffic monitoring site (13.0 %, 19.6 % in summer, and 6.8 % in winter) and smaller in urban background (4.5 %, 5.7 % in summer, and 3.2 % in winter). The effect was most pronounced on Fridays and on the weekends in summer

Assessing the potential of Southern Caribbean corals for reconstructions of Holocene temperature variability

We present a 40-year long monthly resolved Sr/Ca record from a fossil Diploria strigosa coral from Bonaire (Southern Caribbean Sea) dated with U/Th at 2.35 ka before present (BP). Secondary modifiers of this sea surface temperature (SST) proxy in annually-banded corals such as diagenetic alteration of the skeleton and skeletal growth-rate are investigated. Extensive diagenetic investigations reveal that this fossil coral skeleton is pristine which is further supported by clear annual cycles in the coral Sr/Ca record. No significant correlation between annual growth rate and Sr/Ca is observed, suggesting that the Sr/Ca record is not affected by coral growth. Therefore, we conclude that the observed interannual Sr/Ca variability was influenced by ambient SST variability. Spectral analysis of the annual mean Sr/Ca record reveals a dominant frequency centred at 6–7 years that is not associated with changes of the annual growth rate. The first monthly resolved coral Sr/Ca record from the Southern Caribbean Sea for preindustrial time suggests that fossil corals from Bonaire are suitable tools for reconstructing past SST variability. Coastal deposits on Bonaire provide abundant fossil D. strigosa colonies of Holocene age that can be accurately dated and used to reconstruct climate variability. Comparisons of long monthly resolved Sr/Ca records from multiple fossil corals will provide a mean to estimate seasonality and interannual to interdecadal SST variability of the Southern Caribbean Sea during the Holocene