Applying behavioral theory to increase mindfulness practice among adolescents : An exploratory intervention study using a within-trial RCT design

For mindfulness programs to have sustained benefits, participants should continue to practice mindfulness independently. Behavioral theories have been used to predict and change other health behaviors, but have rarely been applied to mindfulness practice. This research aimed to identify predictors/determinants of sustained mindfulness practice after a school-based mindfulness program (Study 1) and to develop and test a booster intervention to increase mindfulness practice (Study 2). These studies were embedded in a larger trial evaluating a school-based mindfulness program involving 12-15year-olds (Healthy Learning Mind, HLM). Study 1 examined theory-based predictors of mindfulness practice among participants in Batch 1 of the HLM trial (n=310). These findings were used to develop a brief motivational booster intervention, which Study 2 evaluated in a within-trial cluster-randomized controlled trial in Batch 3 of the HLM trial (HLM Only arm n=177; HLM+booster arm n=152). In Study 1, 40% of youths reported having practiced mindfulness ata 6-month follow-up. The perception that peers were practicing mindfulness exercises predicted mindfulness practice (=.497, p=.002), and a key self-reported reason for non-practice was that they did not find mindfulness useful. The booster intervention (designed to specifically target these descriptive norms and outcome expectations) demonstrated some positive trends in the determinants of mindfulness practice, but did not increase mindfulness practice. The limited effectiveness of the booster intervention might be explained by the minimal contact time of the booster intervention or its delivery in the later lessons of HLM. This study demonstrates how behavior change theories can be applied to help promote independent mindfulness practice outside of intervention settings.Peer reviewe

A follow up study on the efficacy of metadoxine in the treatment of alcohol dependence

BACKGROUND: We carried out a three months follow-up study on the efficacy of metadoxine in a cohort of alcoholics admitted to the Alcohol misuse Long-term Treatment (ALT) Unit – University of Pisa (Italy). We analyzed the clinical data, psychometric tests and blood tests of 160 alcoholics on admission and after 3 months of treatment. We compared 58 pts treated with metadoxine (MET) with 102 pts who did not receive (NULL) any drug as an adjunct to the psycho-educational interventions provided by the ALT Unit. RESULTS: At follow-up, the patients in treatment with metadoxine showed a significant improvement in the rate of complete abstinence (44.8% vs. 21.6%; chi square: 8.45, df = 1, p < 0.0037). Furthermore, the number of drop-outs at three months of treatment was also significantly lower in the MET than in the NULL group (17% vs. 57%; chi square of 23.22, df = 1, p < 0.001). CONCLUSION: Our findings support the use of metadoxine in the management of alcohol dependence. However, randomized clinical trials are necessary to confirm and replicate them. This study raises the importance of identifying new pharmacological compounds effective on the outcome of alcoholism in order to help patients to best adhere to treatment programs and to prevent the development of mental and physical complications due to chronic and heavy use of alcohol

Genomic insights into the origin of farming in the ancient Near East

We report genome-wide ancient DNA from 44 ancient Near Easterners ranging in time between ~12,000 and 1,400 BC, from Natufian hunter–gatherers to Bronze Age farmers. We show that the earliest populations of the Near East derived around half their ancestry from a ‘Basal Eurasian’ lineage that had little if any Neanderthal admixture and that separated from other non-African lineages before their separation from each other. The first farmers of the southern Levant (Israel and Jordan) and Zagros Mountains (Iran) were strongly genetically differentiated, and each descended from local hunter–gatherers. By the time of the Bronze Age, these two populations and Anatolian-related farmers had mixed with each other and with the hunter–gatherers of Europe to greatly reduce genetic differentiation. The impact of the Near Eastern farmers extended beyond the Near East: farmers related to those of Anatolia spread westward into Europe; farmers related to those of the Levant spread southward into East Africa; farmers related to those of Iran spread northward into the Eurasian steppe; and people related to both the early farmers of Iran and to the pastoralists of the Eurasian steppe spread eastward into South Asia

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Los beneficios de la aplicación de la musicoterapia en el tratamiento fisioterapéutico en los trabajadores con diagnóstico de cervicalgia en las edades de 20 a 70 años de ambos sexos de la Facultad Multidisciplinaria Oriental, Universidad de El Salvador, período: de julio a septiembre de 2004.

RESUMEN: Los beneficios de la aplicación de la musicoterapia en el tratamiento fisioterapéutico en los trabajadores con diagnóstico de cervicalgia en las edades de 20 a 70 años de ambos sexos de la Facultad Multidisciplinaria Oriental se realizó durante el período comprendido de julio a septiembre de 2004, dirigido a 21 pacientes con el fin de recibir un tratamiento para mejorar su estado físico y emocional, con el objetivo de detallar los efectos de la fisioterapia complementandose con la música y el ritmo, además, se puede enriquecer el conocimiento de esta área terapéutica. Los factores que hicieron y originaron la necesidad de aplicar estas dos áreas terapéuticas fueron: estrés, exceso de trabajo, malas posturas, y todo esto llegó a producir una cervicalgia. En la aplicación de estas dos modalidades se obtuvieron resultados satisfactorios que permitieron la aprobación de la hipótesis planteada y así mismo, el alcance de los diferentes objetivos que la investigación perseguía como por ejemplo: disminución del estrés, mejor desempeño laboral y buen estado emocional. El tipo de investigación utilizado en este documento fue el prospectivo y correlacional que eran los que más se adaptaban con el tipo de estudio, y habiendo finalizado el trabajo se pudo obtener como conclusión que al aplicar la musicoterapia en el tratamiento fisioterapéutico en los trabajadores con diagnóstico de cervicalgia, se comprobó una excelente evolución tanto física como emocional, ya que se pudo observar y verificar que la combinación de ambas técnicas hacía que el paciente se relajara y todas sus molestias que padecía disminuyeran y desaparecieran. ABSTRACT: The benefits of the application of musicotherapy in physiotherapy treatment in workers with cervical diagnosis in the ages of 20 to 70 years of both sexes of the Eastern Multidisciplinary Faculty was realized during the period from July to September 2004, aimed at 21 patients in order to receive a treatment to improve their physical and emotional state, with the aim of detailing the effects of physiotherapy complementing with music and rhythm, in addition, can enrich the knowledge of this therapeutic area. The factors that made and originated the need to apply these two therapeutic areas were: stress, overwork, bad postures, and all this came to produce a cervicalgia. In the application of these two modalities, satisfactory results were obtained that allowed the approval of the proposed hypothesis and the scope of the different objectives that the research pursued, such as: stress reduction, better job performance and good emotional state. The type of research used in this paper was the prospective and correlational research that best suited the type of study, and having finished the work it was possible to obtain as conclusion that when applying the musicotherapy in the physiotherapy treatment in the workers with diagnosis of cervicalgia, an excellent evolution was verified both physical and emotional, since it was possible to observe and verify that the combination of both techniques made the patient to relax and all the discomfort he suffered would diminish and disappear

Effect of Antiplatelet Therapy on Survival and Organ Support–Free Days in Critically Ill Patients With COVID-19

International audienc