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Baer's review (2003; this issue) suggests that mindf ulness-based interventions are clinically efficacious, but that better designed studies are now needed to substantiate the field and place it on a firm foundation for future growth. Her review, coupled with other lines of evidence, suggests that interest in incorporating mindfulness into clinical interventions in medicine and psychology is growing. It is thus important that professionals coming to this field understand some of the unique factors associated with the delivery of mindfulness-based interventions and the potential conceptual and practical pitfalls of not recognizing the features of this broadly unfamiliar landscape. This commentary highlights and contextualizes (1) what exactly mindfulness is, (2) where it came from, (3) how it came to be introduced into medicine and health care, (4) issues of cross-cultural sensitivity and understanding in the study of meditative practices stemming from other cultures and in applications of them in novel settings, (5) why it is important for people who are teaching mind-fulness to practice themselves, (6) results from 3 recent studies from the Center for Mindfulness in Medicine, Health Care, and Society not reviewed by Baer but which raise a number of key questions about clinical applicability, study design, and mechanism of action, and (7) current opportunities for professional training and development in mindfulness and its clinical applications.

OBJECTIVES: The objectives of this study were to assess the general acceptability and to assess domains of potential effect of a mindfulness-based stress reduction (MBSR) program for human immunodeficiency virus (HIV)-infected and at-risk urban youth. METHODS: Thirteen-to twenty-one-year-old youth were recruited from the pediatric primary care clinic of an urban tertiary care hospital to participate in 4 MBSR groups. Each MBSR group consisted of nine weekly sessions of MBSR instruction. This mixed-methods evaluation consisted of quantitative data--attendance, psychologic symptoms (Symptom Checklist 90-Revised), and quality of life (Child Health and Illness Profile-Adolescent Edition)--and qualitative data--in-depth individual interviews conducted in a convenience sample of participants until interview themes were saturated. Analysis involved comparison of pre- and postintervention surveys and content analysis of interviews. RESULTS: Thirty-three (33) youth attended at least one MBSR session. Of the 33 who attended any sessions, 26 youth (79%) attended the majority of the MBSR sessions and were considered "program completers." Among program completers, 11 were HIV-infected, 77% were female, all were African American, and the average age was 16.8 years. Quantitative data show that following the MBSR program, participants had a significant reduction in hostility (p = 0.02), general discomfort (p = 0.01), and emotional discomfort (p = 0.02). Qualitative data (n = 10) show perceived improvements in interpersonal relationships (including less conflict), school achievement, physical health, and reduced stress. CONCLUSIONS: The data suggest that MBSR instruction for urban youth may have a positive effect in domains related to hostility, interpersonal relationships, school achievement, and physical health. However, because of the small sample size and lack of control group, it cannot be distinguished whether the changes observed are due to MBSR or to nonspecific group effects. Further controlled trials should include assessment of the MBSR program's efficacy in these domains.

This article presents a conceptual model for the mindfulness-based psychotherapeutic treatment of chronic pain. It describes the process of mindfulness meditation and places it in the context of a practical model for conceptualizing pain. It presents case vignettes on the phenomenology and treatment of chronic pain. Resources for mindfulness are presented.

In the rush of modern life, we tend to lose touch with the peace that is available in each moment. World-renowned Zen master, spiritual leader, and author Thich Nhat Hanh shows us how to make positive use of the very situations that usually pressure and antagonize us. For him a ringing telephone can be a signal to call us back to our true selves. Dirty dishes, red lights, and traffic jams are spiritual friends on the path to "mindfulness" -- the process of keeping our consciousness alive to our present experience and reality. The most profound satisfactions, the deepest feelings of joy and completeness lie as close at hand as our next aware breath and the smile we can form right now. Lucidly and beautifully written, "Peace Is Every Step" contains commentaries and meditations, personal anecdotes and stories from Nhat Hanh's experiences as a peace activist, teacher, and community leader. It begins where the reader already is -- in the kitchen, office, driving a car, walking a part -- and shows how deep meditative presence is available now. Nhat Hanh provides exercises to increase our awareness of our own body and mind through conscious breathing, which can bring immediate joy and peace. Nhat Hanh also shows how to be aware of relationships with others and of the world around us, its beauty and also its pollution and injustices. the deceptively simple practices of "Peace Is Every Step" encourage the reader to work for peace in the world as he or she continues to work on sustaining inner peace by turning the "mindless" into the mindFUL. "This book of illuminating reminders bid us to reorient the way we look at the world...toward a humanitarian perspective." -- "Publisher Weekly"

Background : Recent research suggests that the Mindfulness-Based Stress Reduction program has positive effects on health, but little is known about the immediate physiological effects of different components of the program. Purpose : To examine the short-term autonomic and cardiovascular effects of one of the techniques employed in mindfulness meditation training, a basic body scan meditation. Methods : In Study 1, 32 healthy young adults (23 women, 9 men) were assigned randomly to either a meditation, progressive muscular relaxation or wait-list control group. Each participated in two laboratory sessions 4 weeks apart in which they practiced their assigned technique. In Study 2, using a within-subjects design, 30 healthy young adults (15 women, 15 men) participated in two laboratory sessions in which they practiced meditation or listened to an audiotape of a popular novel in counterbalanced order. Heart rate, cardiac respiratory sinus arrhythmia (RSA), and blood pressure were measured in both studies. Additional measures derived from impedance cardiography were obtained in Study 2. Results : In both studies, participants displayed significantly greater increases in RSA while meditating than while engaging in other relaxing activities. A significant decrease in cardiac pre-ejection period was observed while participants meditated in Study 2. This suggests that simultaneous increases in cardiac parasympathetic and sympathetic activity may explain the lack of an effect on heart rate. Female participants in Study 2 exhibited a significantly larger decrease in diastolic blood pressure during meditation than the novel, whereas men had greater increases in cardiac output during meditation compared to the novel. Conclusions : The results indicate both similarities and differences in the physiological responses to body scan meditation and other relaxing activities.

The tensor-based morphometry (TBM) has been widely used in characterizing tissue volume difference between populations at voxel level. We present a novel computational framework for investigating the white matter connectivity using TBM. Unlike other diffusion tensor imaging (DTI) based white matter connectivity studies, we do not use DTI but only T1-weighted magnetic resonance imaging (MRI). To construct brain network graphs, we have developed a new data-driven approach called the e-neighbor method that does not need any predetermined parcellation. The proposed pipeline is applied in detecting the topological alteration of the white matter connectivity in maltreated children.
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There are a great many books now available describing the complex rituals and esoteric significance of the ancient practices of Buddhist tantra. But none take the friendly, helpful approach of Geshe Tashi Tsering’s Foundation of Buddhist Thought series. Understanding the many questions Westerners have upon first encountering tantra’s colorful imagery and veiled language, Geshe Tsering gives straight talk about deities, initiations, mandalas, and the various stages of tantric development. He even goes through a simple tantric compassion practice written by the Dalai Lama, using it to unpack the building blocks common to all such visualization techniques. Tantra is a fitting conclusion to the folksy and practical wisdom in the Foundation of Buddhist Thought series.

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