Effects of a mindfulness-based weight loss intervention in adults with obesity: A randomized clinical trial.

OBJECTIVE: To determine whether adding mindfulness-based eating and stress management practices to a diet-exercise program improves weight loss and metabolic syndrome components. METHODS: In this study 194 adults with obesity were randomized to a 5.5-month program with or without mindfulness training and identical diet-exercise guidelines. Intention-to-treat analyses with multiple imputation were used for missing data. The primary outcome was 18-month weight change. RESULTS: Estimated effects comparing the mindfulness to control arm favored the mindfulness arm in (a) weight loss at 12 months, -1.9 kg (95% CI: -4.5, 0.8; P = 0.17), and 18 months, -1.7 kg (95% CI: -4.7, 1.2; P = 0.24), though not statistically significant; (b) changes in fasting glucose at 12 months, -3.1 mg/dl (95% CI: -6.3, 0.1; P = 0.06), and 18 months, -4.1 mg/dl (95% CI: -7.3, -0.9; P = 0.01); and (c) changes in triglyceride/HDL ratio at 12 months, -0.57 (95% CI: -0.95, -0.18; P = 0.004), and 18 months, -0.36 (95% CI: -0.74, 0.03; P = 0.07). Estimates for other metabolic risk factors were not statistically significant, including waist circumference, blood pressure, and C-reactive protein. CONCLUSIONS: Mindfulness enhancements to a diet-exercise program did not show substantial weight loss benefit but may promote long-term improvement in some aspects of metabolic health in obesity that requires further study

A Randomized Controlled Trial of a Mindfulness-Based Weight Loss Intervention on Cardiovascular Reactivity to Social-Evaluative Threat Among Adults with Obesity.

Objective:Mindfulness-based interventions have been found to reduce psychological and physiological stress reactivity. In obesity, however, stress reactivity is complex, with studies showing both exaggerated and blunted physiological responses to stressors. A nuanced view of stress reactivity is the "challenge and threat" framework, which defines adaptive and maladaptive patterns of psychophysiological stress reactivity. We hypothesized that mindfulness training would facilitate increased challenge-related appraisals, emotions, and cardiovascular reactivity, including sympathetic nervous system activation paired with increased cardiac output (CO) and reduced total peripheral resistance (TPR) compared to a control group, which would exhibit an increased threat pattern of psychophysiological reactivity to repeated stressors.Methods:Adults (N=194) with obesity were randomized to a 5.5-month mindfulness-based weight loss intervention or an active control condition with identical diet-exercise guidelines. Participants were assessed at baseline and 4.5 months later using the Trier Social Stress Task. Electrocardiogram, impedance cardiography, and blood pressure were acquired at rest and during the speech and verbal arithmetic tasks to assess pre-ejection period (PEP), CO, and TPR reactivity.Results:Mindfulness participants showed significantly greater maintenance of challenge-related emotions and cardiovascular reactivity patterns (higher CO and lower TPR) from pre to post-intervention compared to control participants, but groups did not differ in PEP. Findings were independent of changes in body mass index.Conclusions:Mindfulness training may increase the ability to maintain a positive outlook and mount adaptive cardiovascular responses to repeated stressors among persons with obesity though findings need to be replicated in other populations and using other forms of mindfulness interventions

Negative Capability and the Capacity to Think in the Present Moment: Some Implications for Leadership Practice

Two themes that are prevalent in the literature on leadership practice are planning for the future and learning from the past. In this ‘Leading Questions’ piece, we raise the question of whether, in addition, attention needs to be given to a third element that is not well represented in the literature: the leader's capacity to think in the present. We suggest that such thinking requires the capacity to see what is actually going on, in contrast with what was planned for, expected or intended – even when what is actually going on is uncertain or even unknown. In keeping with the theme of this special issue we demonstrate that attending to the present moment is a refrain both ancient and modern, to be found in eastern and western religion and philosophy while having a direct impact on practical modern disciplines, such as psychoanalysis. For example, Wilfred Bion's writings on psychoanalytic theory explore the nature of mental and emotional capacities demanded by this focus on the present moment and its relationship to the development of thought. Using an idea employed by Bion in this context, we suggest that an important dimension of leadership practice is negative capability, which comprises patience and the ability to tolerate frustration and anxiety. This capability can help the leader to retain the capacity to think in the present moment, even in the face of uncertainty. In this context, important dimensions of leadership practice include the ability to embody key thoughts on behalf of an organization and the capacity to contain the impact of the new thinking that can arise in the present moment. © 2011, Sage Publications. All rights reserved

Young hands, old books: : Drawings by children in a fourteenth-century manuscript, LJS MS. 361

This article scrutinises three marginal drawings in LJS 361, Kislak Center for Special Collections, Rare Books and Manuscripts, University of Pennsylvania Libraries. It first considers the provenance of the manuscript, questioning how it got into the hands of children. Then, it combines developmental psychology with close examination of the material evidence to develop a list of criteria to attribute the drawings to children. There is consideration of the features that help us estimate the age of the artists, and which indicate that one drawing was a collaborative effort between two children. A potential relationship is identified between the doodles and the subject matter of the text, prompting questions about pre-modern child education and literacy. Finally, the article considers the implications of this finding in both codicology and social history since these marginal illustrations demonstrate that children were active in the material life of medieval books

A Systematic Review of the Effectiveness of Acceptance and Commitment Therapy (ACT) for Body Image Dissatisfaction and Weight Self-Stigma in Adults

© 2018, The Author(s). Body image dissatisfaction (BID) and weight self-stigma are prevalent and associated with physical and psychological ill-health. Acceptance and Commitment Therapy (ACT) is increasingly employed for both, yet little is known about its effectiveness. Searches of 12 databases identified six studies using online, face-to-face or self-help ACT interventions for BID or weight self-stigma, of varying duration and intensity. Their effectiveness and quality were evaluated. Two reported improved BID, three improved weight self-stigma, and one reported no impact on weight self-stigma. Methodological issues (small sample sizes, lack of allocation concealment, attention control and long-term follow up) impacted the validity of findings. Due to the small number of studies and poor study quality, the effectiveness of ACT for BID and weight self-stigma remains unclear. Nonetheless findings suggest psychological flexibility may facilitate reduction in BID and weight self-stigma and indicate that brief online as well as lengthy face-to-face delivery may be useful. Suggestions for further research are made

A taxonomy of dignity: a grounded theory study

Abstract Background This paper has its origins in Jonathan Mann's insight that the experience of dignity may explain the reciprocal relationships between health and human rights. It follows his call for a taxonomy of dignity: "a coherent vocabulary and framework to characterize dignity." Methods Grounded theory procedures were use to analyze literature pertaining to dignity and to conduct and analyze 64 semi-structured interviews with persons marginalized by their health or social status, individuals who provide health or social services to these populations, and people working in the field of health and human rights. Results The taxonomy presented identifies two main forms of dignity–human dignity and social dignity–and describes several elements of these forms, including the social processes that violate or promote them, the conditions under which such violations and promotions occur, the objects of violation and promotion, and the consequences of dignity violation. Together, these forms and elements point to a theory of dignity as a quality of individuals and collectives that is constituted through interaction and interpretation and structured by conditions pertaining to actors, relationships, settings, and the broader social order. Conclusion The taxonomy has several implications for work in health and human rights. It suggests a map to possible points of intervention and provides a language in which to talk about dignity

Theorizing compassion and empathy in educational contexts: what are compassion and empathy and why are they important?

The world is in constant change with growing inequality and access. When you watch the news, you are confronted with national disasters, wars/conflicts, waves of refugees and other crimes against humanity. At a national level, many countries have a changing political landscape that has seen a rise in fundamentalist nationalist parties leading to a discourse of 'problematic immigrants'. We also witness the decline of democratic ideals and the ethos of supporting people in society as politicians are influenced by capitalist ideals and individual gain. In essence, the world appears to be becoming meaner, with little understanding shown to others. When did values change

Initial validation of the mindful eating scale

Published Mindfulness, 2013, 5(6), pp. 719-729. The final publication is available at Springer via http://dx.doi.org/10.1007/s12671-013-0227-5Self-report scales for mindfulness are now widely used in applied settings, and have made a contribution to research, for instance in demonstrating mediation effects. To date there are no convincing data as to whether mindfulness skills generalise fully across life domains, and so some researchers have developed mindfulness scales for particular domains of behaviour. We present the development of a self-report scale to measure mindfulness with respect to eating behaviours