Mindfulness-based interventions for mental well-being among people with multiple sclerosis: a systematic review and meta-analysis of randomised controlled trials

Objective: Impairment of mental well-being (anxiety, depression, stress) is common among people with multiple sclerosis (PwMS). Treatment options are limited, particularly for anxiety. The aim of this study was to update our previous systematic review (2014) and evaluate via meta-analysis the efficacy of mindfulness-based interventions (MBIs) for improving mental well-being in PwMS. Methods: Systematic searches for eligible randomised controlled trials (RCTs) were carried out in seven major databases (November 2017, July 2018), using medical subject headings and key words. Studies were screened, data extracted, quality appraised and analysed by two independent reviewers, using predefined criteria. Study quality was assessed using the Cochrane Collaboration risk of bias tool. Mental well-being was the primary outcome. Random effects model meta-analysis was performed, with effect size reported as standardised mean difference (SMD). Results: Twelve RCTs including 744 PwMS were eligible for inclusion in the systematic review, eight had data extractable for meta-analysis; n=635. Ethnicity, socioeconomic status, comorbidity and disability were inconsistently reported. MBIs varied from manualised to tailored versions, lasting 6–9 weeks, delivered individually and via groups, both in person and online. Overall SMD for mental well-being (eight studies) was 0.40 (0.28–0.53), p<0.01, I2=28%; against active comparators only (three studies) SMD was 0.17 (0.01–0.32), p<0.05, I2 =0%. Only three adverse events were reported. Conclusions: MBIs are effective at improving mental well-being in PwMS. More research is needed regarding optimal delivery method, cost-effectiveness and comparative-effectiveness

Teaching Indigenous children : listening to and learning from indigenous teachers

This article is based on the findings of a qualitative case study that examined the professional experiences and career pathways of fifty current and former Australian Indigenous teachers. Here, we draw on data obtained from semi-structured interviews with the teachers to highlight their knowledge in three key areas: ‘Indigenous ways of knowing’, ‘Indigenous learners’ lives beyond the classroom’ and ‘Building relationships with Indigenous students and communities’. We suggest that Indigenous teachers can potentially play important roles as teacher educators and as mentors to non-Indigenous teachers and preservice teachers. We argue that it is important for schooling systems and teacher education to create and formalise opportunities for non-Indigenous teachers and preservice teachers to listen to, and learn from their Indigenous colleagues

The diffusion of sustainability activism at an American universtiy

This is a qualitative study of collective action at a large American university. The project explores the motivations for civic engagement of individuals. Eighteen respondents that had been involved with a Sustainability and Greening (SAG) council were interviewed with a biographical in-depth interview approach using an open-ended interview guide. Data was analyzed deductively using Diffusion of Innovations theory as a guide. Categorizing individuals according to Diffusion of Innovation adopter categories proved useful in understanding motivations to engage. Results show that individuals went through an innovation-decision process and were motivated by perceived compatibility of the SAG council collective action with their prior knowledge and current social context, relative advantages of the SAG as an innovation, and most notably by opinion leader endorsements. The study contributes to collective action research by showing how actors can be differentially motivated over time and how engagement can be nurtured to meet our looming social problems

Teaching Indigenous Children: Listening To And Learning From Indigenous Teachers

This article is based on the findings of a qualitative case study that examined the professional experiences and career pathways of fifty current and former Australian Indigenous teachers. Here, we draw on data obtained from semi-structured interviews with the teachers to highlight their knowledge in three key areas: ‘Indigenous ways of knowing’, ‘Indigenous learners’ lives beyond the classroom’ and ‘Building relationships with Indigenous students and communities’. We suggest that Indigenous teachers can potentially play important roles as teacher educators and as mentors to non-Indigenous teachers and preservice teachers. We argue that it is important for schooling systems and teacher education to create and formalise opportunities for non-Indigenous teachers and preservice teachers to listen to, and learn from their Indigenous colleagues

Correcting surface wave bias in structure function estimates of turbulent kinetic energy dissipation rate

The combination of acoustic Doppler current profilers and the structure function methodology provides an attractive approach to making extended time series measurements of oceanic turbulence (the rate of turbulent kinetic energy dissipation ε) from moorings. However, this study shows that for deployments in the upper part of the water column, estimates of ε will be biased by the vertical gradient in wave orbital velocities. To remove this bias, a modified structure function methodology is developed that exploits the differing length scale dependencies of the contributions to the structure function resulting from turbulent and wave orbital motions. The success of the modified method is demonstrated through a comparison of ε estimates based on data from instruments at three depths over a 3-month period under a wide range of conditions, with appropriate scalings for wind stress and convective forcing

Understanding the attitudes and experiences of people living with potentially stigmatised long-term health conditions with respect to collecting and sharing health and lifestyle data

Background: The emerging landscape of patient-generated data (PGData) provides an opportunity to collect large quantities of information that can be used to develop our understanding of different health conditions and potentially improve the quality of life for those living with long-term health condition (LTHCs). If the potential benefits of PGData are to be realised, we need a better understanding of the psychological barriers and facilitators to the collection and beneficial sharing of health and lifestyle data. Due to the understudied role that stigma plays in sharing PGData, we explore the attitudes and experiences of those living with potentially stigmatised LTHCs with respect to collecting and sharing health and lifestyle data. Methods: This study used semi-structured interviews and a card sorting task to explore the attitudes and experiences of people living with potentially stigmatised LTHCs. Fourteen adult participants who reported having a range of conditions were recruited in England. Template analysis was used to analyse interview transcripts and descriptive statistics were used for the card sorting task. Results: The findings present four overarching themes: Preferences for collecting health and lifestyle data, Importance of anonymity, Expected use of data, and Sources of emotional support. Participants illustrated a general willingness to share health and lifestyle data; however, there were some notable differences in sharing experiences, varying both by information type and recipient group. Overall, participants did not identify health-related stigma as a barrier to collecting or sharing their personal health and lifestyle data. Conclusions: We outline a number of preferences that participants feel would encourage them to collect and share data more readily, which may be considered when developing data sharing tools for the future

Efficacy and safety of oral methazolamide in patients with type 2 diabetes: A 24-week, placebo-controlled, double-blind study

OBJECTIVE To evaluate the safety and efficacy of methazolamide as a potential therapy for type 2 diabetes. RESEARCH DESIGN AND METHODS This double-blind, placebo-controlled study randomized 76 patients to oral methazolamide (40 mg b.i.d.) or placebo for 24 weeks. The primary efficacy end point for methazolamide treatment was a placebo-corrected reduction in HbA1c from baseline after 24 weeks (ΔHbA1c). RESULTS Mean ± SD baseline HbA1c was 7.1 ± 0.7% (54 ± 5 mmol/mol; n = 37) and 7.4 ± 0.6% (57 ± 5 mmol/mol; n = 39) in the methazolamide and placebo groups, respectively. Methazolamide treatment was associated with a ΔHbA1c of –0.39% (95% CI –0.82, 0.04; P < 0.05) (–4.3 mmol/mol [–9.0, 0.4]), an increase in the proportion of patients achieving HbA1c ≤6.5% (48 mmol/mol) from 8 to 33%, a rapid reduction in alanine aminotransferase (∼10 units/L), and weight loss (2%) in metformin-cotreated patients. CONCLUSIONS Methazolamide is the archetype for a new intervention in type 2 diabetes with clinical benefits beyond glucose control