Transcendent Experiences Among Pilgrims to Lourdes: A Qualitative Investigation

This is the final version. Available on open access from Springer via the DOI in this recordMillions of pilgrims visit Lourdes each year, often seeking revitalisation rather than miraculous cures. We sought to understand the phenomenon of transcendent experiences. We spoke with 67 pilgrims including assisted pilgrims, young volunteers and medical staff. About two in five reported a transcendent experience: some felt they had communicated or had close contact with a divine presence, while others reported a powerful experience of something intangible and otherworldly. Transcendent experiences are an important feature of pilgrimage to Lourdes and the place offers the faithful a means of connecting with the divine, with nature and with the self.BIAL Foundatio

Addressing “nature-deficit disorder” : a mixed methods pilot study of young adults attending a wilderness camp

Background and Objectives: Rapid urbanization has increased concerns about the loss of opportunity to interact with the natural world and the rise of chronic human health issues, such as obesity, depression, and cardiovascular disease. “Nature-deficit disorder” is a non-clinical term that describes this potential impact on the well-being of youth. We hypothesized that naturebased camp experiences could increase connection to nature and promote multiple dimensions of well-being. We conducted a mixed methods pilot study of young adults attending a four-week wilderness camp. Methods: Participants completed pre-camp (n=46) and post-camp (n=36) on-line questionnaires including nature-related and holistic well-being measures. Differences were investigated using paired samples t-tests. Interviews (n=16) explored the experience of camp, of being in nature, and social relations. Results: All nature-related measures - exposure, knowledge, skills, willingness to lead in nature, perceived safety, sense of place, and nature connection - significantly increased. Well-being outcomes also significantly improved, including perceived stress, relaxation, positive and negative emotions, sense of wholeness, and experience of transcendence. Physical activity level and several psychological measures showed no change. Interviews described how the wilderness environment facilitated social connections. Conclusion: Findings illustrate the change in relationship to nature that wilderness camp experiences can provide while also delineating elements of well-being influenced by such time. Results can guide future research agendas and suggest that nature-immersion experiences could address the risk of “nature-deficit disorder”, improve health, and prepare future leaders

Pathways linking biodiversity to human health : a conceptual framework

Biodiversity is a cornerstone of human health and well-being. However, while evidence of the contributions of nature to human health is rapidly building, research into how biodiversity relates to human health remains limited in important respects. In particular, a better mechanistic understanding of the range of pathways through which biodiversity can influence human health is needed. These pathways relate to both psychological and social processes as well as biophysical processes. Building on evidence from across the natural, social and health sciences, we present a conceptual framework organizing the pathways linking biodiversity to human health. Four domains of pathways—both beneficial as well as harmful—link biodiversity with human health: (i) reducing harm (e.g. provision of medicines, decreasing exposure to air and noise pollution); (ii) restoring capacities (e.g. attention restoration, stress reduction); (iii) building capacities (e.g. promoting physical activity, transcendent experiences); and (iv) causing harm (e.g. dangerous wildlife, zoonotic diseases, allergens). We discuss how to test components of the biodiversity-health framework with available analytical approaches and existing datasets. In a world with accelerating declines in biodiversity, profound land-use change, and an increase in non-communicable and zoonotic diseases globally, greater understanding of these pathways can reinforce biodiversity conservation as a strategy for the promotion of health for both people and nature. We conclude by identifying research avenues and recommendations for policy and practice to foster biodiversity-focused public health actions

Examining group walks in nature and multiple aspects of well-being: A large-scale study

Purpose: Outdoor walking groups can facilitate interaction with nature, social interaction, and physical activity, yet little is known about their efficacy in promoting mental, emotional and social well-being. National group walk programs are especially under-evaluated for these outcomes. The present study sought to identify the mental, emotional and social well-being benefits from participating in group walks in nature. Design: Drawing on an evaluation of the Walking for Health program in England, a longitudinal study investigated the mental, emotional and social well-being of individuals who did (Nature Group Walkers) and did not (Non-Group Walkers) attend group walks in nature. Both groups were statistically matched using propensity score matching (n = 1,516). Between group t-tests and multiple regressions were performed to analyze the influence of nature-based group walks on depression, perceived stress, negative affect, positive affect, mental well-being, and social support. Findings: Group walks in nature were associated with significantly lower depression, perceived stress, and negative affect, as well as enhanced positive affect, and mental well-being, both before and after controlling for covariates. There were no group differences on social support. In addition, nature-based group walks appear to mitigate the effects of stressful life events on perceived stress and negative affect, while synergizing with physical activity to improve positive affect and mental well-being. Originality / Value: The present study identifies the mental and emotional well-being benefits from participation in group walks in nature and offers useful information about the potential health contribution of national outdoor group walk programs

Developing a patient-centered outcome measure for complementary and alternative medicine therapies I: <it>defining content and format</it>

<p>Abstract</p> <p>Background</p> <p>Patients receiving complementary and alternative medicine (CAM) therapies often report shifts in well-being that go beyond resolution of the original presenting symptoms. We undertook a research program to develop and evaluate a patient-centered outcome measure to assess the multidimensional impacts of CAM therapies, utilizing a novel mixed methods approach that relied upon techniques from the fields of anthropology and psychometrics. This tool would have broad applicability, both for CAM practitioners to measure shifts in patients' states following treatments, and conventional clinical trial researchers needing validated outcome measures. The US Food and Drug Administration has highlighted the importance of valid and reliable measurement of patient-reported outcomes in the evaluation of conventional medical products. Here we describe Phase I of our research program, the iterative process of content identification, item development and refinement, and response format selection. Cognitive interviews and psychometric evaluation are reported separately.</p> <p>Methods</p> <p>From a database of patient interviews (n = 177) from six diverse CAM studies, 150 interviews were identified for secondary analysis in which individuals spontaneously discussed unexpected changes associated with CAM. Using ATLAS.ti, we identified common themes and language to inform questionnaire item content and wording. Respondents' language was often richly textured, but item development required a stripping down of language to extract essential meaning and minimize potential comprehension barriers across populations. Through an evocative card sort interview process, we identified those items most widely applicable and covering standard psychometric domains. We developed, pilot-tested, and refined the format, yielding a questionnaire for cognitive interviews and psychometric evaluation.</p> <p>Results</p> <p>The resulting questionnaire contained 18 items, in visual analog scale format, in which each line was anchored by the positive and negative extremes relevant to the experiential domain. Because of frequent informant allusions to response set shifts from before to after CAM therapies, we chose a retrospective pretest format. Items cover physical, emotional, cognitive, social, spiritual, and whole person domains.</p> <p>Conclusions</p> <p>This paper reports the success of a novel approach to the development of outcome instruments, in which items are extracted from patients' words instead of being distilled from pre-existing theory. The resulting instrument, focused on measuring shifts in patients' perceptions of health and well-being along pre-specified axes, is undergoing continued testing, and is available for use by cooperating investigators.</p

Medicinas alternativas e complementares: Uma metassíntese

O aumento do uso de Medicinas Alternativas e Complementares (MAC) motivou o crescimento do número de estudos qualitativos sobre o tema, justificando a realização de sínteses sobre esse material. Este artigo apresenta uma revisão sistemática de pesquisas qualitativas sobre MAC publicadas em periódicos internacionais. Esta revisão se orientou pela metodologia dos metaestudos. Foi realizada busca em revistas do Portal Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior e foram selecionados 32 artigos para análise. Os estudos revisados apresentam questões que têm como foco: o paciente, suas experiências terapêuticas e seus contextos sociais e culturais; o profissional, as relações profissionais e o processo de profissionalização das MAC; a MAC e sua relação com a biomedicina. Conclui-se que as pesquisas qualitativas sobre as MAC ensejam um olhar exploratório sobre o tema, procurando identificar as experiências de pacientes e profissionais com essas terapêuticas, assim como buscam discutir as conseqüências desse uso para a Medicina Convencional ou biomedicina.<br>The growing use of Complementary and Alternative Medicines (CAM) has led to an increase in the number of qualitative studies on the subject, thus justifying a meta-synthesis of the resulting material. The current article presents a systematic review of qualitative studies on CAM published in international journals. The review was conducted according to the meta-synthesis methodology. A search was performed in journals through the Periodicals Periodical of CAPES, the National Agency for the Evaluation of Graduate Studies, and 32 articles were selected for analysis. The reviewed studies raise questions focusing on: patients, their therapeutic experiences, and their social and cultural contexts; professionals, professional relations, and the process of professionalization of CAM; and CAM and their relationship to biomedicine. The article concludes that qualitative studies on CAM call for an exploratory view of the theme, seeking to identify the experiences of patients and professionals with these therapies and discussing the impact of their use on conventional medicine or biomedicine