The New Urban Spiritual? Tentative Framings for a Debate and a Project

AHRC-funded project 'The Urban Spiritual: Placing Spiritual Practices in Context' (AH/H009108/1), Working Paper #1

'Its a fine line between . . . self discipline, devotion and dedication: negotiating authority in the teaching and learning of Ashtanga yoga

This article looks at the production and shaping of the self via Ashtanga yoga, a bodily practice, growing in significance in Western cultures, which can involve a radical form of (re)shaping the self. In particular, it looks at the interaction of external and internal sources of authority, including the yoga student’s own expertise of themselves (experiential authority), the authority of the practice and the authority of the teacher. This allows the article to rethink standard models of authority in educational and ‘spiritualities of life’ literatures, which have generally imagined a top-down singular form of authority, essentially stamped onto the subjects being educated. The article outlines what might enter into a more ‘distributed’ form of authority – being not simply the educator figure (their positionality, status, institutional location, contextualisation within prior fields of knowledge/belief) but also how their exertion of authority meshes (and sometimes conflicts with) the ‘experiential authority’ of the subjects being educated, articulating with their own ‘self-authority’ (what they know, expect and command from themselves, on the basis of countless prior experiences, encounters, interactions, times and spaces). The article draws upon qualitative fieldwork carried out in Brighton, UK

An evaluation of novel psychological interventions for depression and the anxiety disorders within community-dwelling adults

Background Depression and anxiety are both highly prevalent and debilitating disorders. Whilst current treatments for depression and the anxiety disorders are efficacious, there remain high relapse rates and frequently a high level of residual symptoms. Additionally, current diagnosis-specific treatments do not account for the high levels of comorbidity seen between disorders. Therefore, in order to augment treatment efficacy and clinical utility, novel transdiagnostic interventions have been developed. Method This portfolio evaluated the efficacy of two types of novel transdiagnostic intervention in community-dwelling adult populations with symptoms of depression or anxiety. A systematic review evaluated the efficacy of rumination-focused interventions on reduction of both rumination and severity of symptoms of depression and anxiety. A meta-analysis evaluated the efficacy of positive psychological interventions (PPIs) on increasing wellbeing and reducing depressive symptoms. Results Rumination-focused interventions were shown to be efficacious at reducing rumination in populations with depression, however there was not evidence for their efficacy in the anxiety disorders. There was evidence for the potential efficacy of positive psychological interventions in increasing wellbeing and reducing symptoms of depression with medium effect sizes found for both outcomes, however there was a high level of heterogeneity present, therefore these results must be interpreted cautiously. Conclusions Although currently small, the evidence-base suggests there are clinical benefits of specific rumination-focused interventions in depression, especially those that work on underlying cognitive processes. There is also emerging evidence for the efficacy of positive psychological interventions however the high heterogeneity found raises questions about the constructs of PPIs suggesting further clarification is required

Implementation of research, education, and leadership placements into Operating Department Practitioner training: A 4-pillar practice-based learning approach

Practice-based learning (PBL) has traditionally focused on clinical practice in pre-registration courses. However, recent national strategies emphasise the importance of incorporation of all four pillars, clinical, education, leadership, and research, into PBL (placements). This article details the introduction of PBL in research, education, and leadership alongside clinical placements for BSc Operating Department Practice (ODP) students at XXXXXX. It provides insights into the benefits of this approach, outlines the components of each placement with examples of completed projects, shares feedback from students and practice partners, and addresses challenges. The authors advocate for adoption of this approach across all preregistration ODP courses, to ensure a workforce capable of meeting evolving healthcare needs and driving the ODP profession forwards

Efficacy of D-cycloserine augmented brief intensive cognitive-behavioural therapy for paediatric obsessive-compulsive disorder: A randomised clinical trial

Objective: To examine the efficacy of weight-adjusted D-cycloserine (DCS) (35 or 70 mg) relative to placebo augmentation of intensive exposure therapy for youth with obsessive-compulsive disorder (OCD) in a double-blind, randomised controlled trial, and examine whether antidepressant medication or patient age moderated outcomes. Methods: Youth (n = 100, 7–17 years) with OCD were randomised in a 1:1 ratio to either DCS + exposure (n = 49) or placebo + exposure (n = 51). Assessments occurred posttreatment, 1 month later, and at 3 and 6 months. Pills were ingested immediately before sessions. Results: Significant improvements on all outcomes were observed at posttreatment, and to 6-month follow-up. Treatment arms did not differ across time, with no significant time-by-medication interactions on symptom severity (T1 to T2 estimate: 9.3, 95% confidence interval [CI]: −11.2 to −7.4, and estimate −10.7, 95% CI: −12.6 to −8.7), diagnostic severity (T1 to T2 estimate: −2.0, 95% CI: −2.4 to −1.5 and estimate −2.5, 95% CI: −3.0 to −2.0) or global functioning (T1 to T2 estimate: 13.8, 95% CI: 10.6 to 17.0, and estimate 16.6, 95% CI: 13.2 to 19.9). Neither antidepressants at baseline nor age moderated primary outcomes. There were significantly fewer responders/remitters at 1- and 6-month follow-up among youth in the DCS condition stabilised on SSRIs, relative to youth not taking SSRIs. Conclusions: DCS augmented intensive exposure therapy did not result in overall additional benefits relative to placebo. Intensive exposure proved effective in reducing symptoms for the overall sample

New energy geographies : a case study of yoga, meditation and healthfulness

Beginning with a routine day in the life of a practitioner of yoga and meditation and emphasising the importance of nurturing, maintaining and preventing the dissipation of diverse ‘energies’, this paper explores the possibilities for geographical health studies which take seriously ‘new energy geographies’. It is explained how this account is derived from in-depth fieldwork tracing how practitioners of yoga and meditation find times and spaces for these practices, often in the face of busy urban lifestyles. Attention is paid to the ‘energy talk’ featuring heavily in how practitioners describe the benefits that they perceive themselves to derive from these practices, and to claims made about ‘energies’ generated during the time-spaces of these practices which seemingly flow, usually with positive effects, into other domains of their lives. The paper then discusses the implications of this energy talk in the context of: (a) critically reviewing conventional approaches to studying ‘energy geographies’; (b) identifying an alertness to the likes of ‘affective energies’ surfacing in recent theoretically-attuned works of human geography (and cognate disciplines); and (c) exploring differing understandings of energy/energies extant in geographical studies of health and in step with the empirical research materials presented about yoga, meditation and healthfulness. While orientated towards explicitly geographical inquiries, the paper is intended as a statement of interest to the wider medical humanities

Exposure to natural environments during pregnancy and birth outcomes in 11 European birth cohorts

Research suggests that maternal exposure to natural environments (i.e., green and blue spaces) promotes healthy fetal growth. However, the available evidence is heterogeneous across regions, with very few studies on the effects of blue spaces. This study evaluated associations between maternal exposure to natural environments and birth outcomes in 11 birth cohorts across nine European countries. This study, part of the LifeCycle project, was based on a total sample size of 69,683 newborns with harmonised data. For each participant, we calculated seven indicators of residential exposure to natural environments: surrounding greenspace in 100m, 300m, and 500m using Normalised Difference Vegetation Index (NDVI) buffers, distance to the nearest green space, accessibility to green space, distance to the nearest blue space, and accessibility to blue space. Measures of birth weight and small for gestational age (SGA) were extracted from hospital records. We used pooled linear and logistic regression models to estimate associations between exposure to the natural environment and birth outcomes, controlling for the relevant covariates. We evaluated the potential effect modification by socioeconomic status (SES) and region of Europe and the influence of ambient air pollution on the associations. In the pooled analyses, residential surrounding greenspace in 100m, 300m, and 500m buffer was associated with increased birth weight and lower odds for SGA. Higher residential distance to green space was associated with lower birth weight and higher odds for SGA. We observed close to null associations for accessibility to green space and exposure to blue space. We found stronger estimated magnitudes for those participants with lower educational levels, from more deprived areas, and living in the northern European region. Our associations did not change notably after adjustment for air pollution. These findings may support implementing policies to promote natural environments in our cities, starting in more deprived areas

Green spaces and respiratory, cardiometabolic, and neurodevelopmental outcomes:An individual-participant data meta-analysis of >35.000 European children

Studies evaluating the benefits and risks of green spaces on children's health are scarce. The present study aimed to examine the associations between exposure to green spaces during pregnancy and early childhood with respiratory, cardiometabolic, and neurodevelopmental outcomes in school-age children. We performed an Individual-Participant Data (IPD) meta-analysis involving 35,000 children from ten European birth cohorts across eight countries. For each participant, we calculated residential Normalized Difference Vegetation Index (NDVI) within a 300 m buffer and the linear distance to green spaces (meters) during prenatal life and childhood. Multiple harmonized health outcomes were selected: asthma and wheezing, lung function, body mass index, diastolic and systolic blood pressure, non-verbal intelligence, internalizing and externalizing problems, and ADHD symptoms. We conducted a two-stage IPD meta-analysis and evaluated effect modification by socioeconomic status (SES) and sex. Between-study heterogeneity was assessed via random-effects meta-regression. Residential surrounding green spaces in childhood, not pregnancy, was associated with improved lung function, particularly higher FEV1 (β = 0.06; 95 %CI: 0.03, 0.09 I2 = 4.03 %, p &lt; 0.001) and FVC (β = 0.07; 95 %CI: 0.04, 0.09 I2 = 0 %, p &lt; 0.001) with a stronger association observed in females (p &lt; 0.001). This association remained robust after multiple testing correction and did not change notably after adjusting for ambient air pollution. Increased distance to green spaces showed an association with lower FVC (β = −0.04; 95 %CI: −0.07, −0.02, I2 = 4.8, p = 0.001), with a stronger effect in children from higher SES backgrounds (p &lt; 0.001). No consistent associations were found between green spaces and asthma, wheezing, cardiometabolic, or neurodevelopmental outcomes, with direction of effect varying across cohorts. Wheezing and neurodevelopmental outcomes showed high between-study heterogeneity, and the age at outcome assessment was only associated with heterogeneity in internalizing problems. This large European meta-analysis suggests that childhood exposure to green spaces may lead to better lung function. Associations with other respiratory outcomes and selected cardiometabolic and neurodevelopmental outcomes remain inconclusive.</p

Associations of Maternal Educational Level, Proximity to Green Space During Pregnancy, and Gestational Diabetes With Body Mass Index From Infancy to Early Adulthood:A Proof-of-Concept Federated Analysis in 18 Birth Cohorts

International sharing of cohort data for research is important and challenging. We explored the feasibility of multicohort federated analyses by examining associations between 3 pregnancy exposures (maternal education, exposure to green vegetation, and gestational diabetes) and offspring body mass index (BMI) from infancy to age 17 years. We used data from 18 cohorts (n = 206,180 mother-child pairs) from the EU Child Cohort Network and derived BMI at ages 0-1, 2-3, 4-7, 8-13, and 14-17 years. Associations were estimated using linear regression via 1-stage individual participant data meta-analysis using DataSHIELD. Associations between lower maternal education and higher child BMI emerged from age 4 and increased with age (difference in BMI z score comparing low with high education, at age 2-3 years = 0.03 (95% confidence interval (CI): 0.00, 0.05), at 4-7 years = 0.16 (95% CI: 0.14, 0.17), and at 8-13 years = 0.24 (95% CI: 0.22, 0.26)). Gestational diabetes was positively associated with BMI from age 8 years (BMI z score difference = 0.18, 95% CI: 0.12, 0.25) but not at younger ages; however, associations attenuated towards the null when restricted to cohorts that measured gestational diabetes via universal screening. Exposure to green vegetation was weakly associated with higher BMI up to age 1 year but not at older ages. Opportunities of cross-cohort federated analyses are discussed.</p