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Background: Mindfulness meditation has been shown to alleviate pain and may be an appealing adjunctive pain management option. Objective: To compare measures of pain, mindfulness, and opioid usage, and collect evaluative feedback among patients undergoing septorhinoplasty with and without guided meditation. Methods: Patients undergoing septorhinoplasty were randomized to online-guided meditation postoperative days 0-3 versus standard care; all received the same pain medications. Primary outcome measures included pain intensity, opioid consumption, mindfulness scores, and evaluative feedback. Results: Twenty-one patients received guided meditation and 24 received standard care. No significant difference in opioid consumption or pain scores was seen with the exception of higher opioid use in patients with intranasal splints in the standard care group. Twenty out of 21 patients provided evaluative feedback; all recommended mindfulness meditation to friends undergoing nasal surgery, 90% reported it was beneficial, 85% believed it eased pain/discomfort, and 80% believed it aided with sleep. Conclusion: Although no objective difference was found in opioid consumption or pain scores, most patients reported that guided mindfulness meditation was beneficial to their recovery following septorhinoplasty.

This study investigated whether indoor plants were as effective as a guided meditation for enabling psychological recovery after fatigue induced by the abbreviated vigilance task. Sixty students were randomly assigned to an indoor plant, guided meditation, or control rest-break condition. The psychological processes most in need of recovery were identified as cognitive and affective restoration. Measures of affect, stress, and working memory were taken before and after the vigilance task, and again after a rest intervention. The vigilance task-induced fatigue as shown by a significant vigilance decrement and also significantly lowered positive affect and cognitive engagement, and significantly increased distress across all three conditions. After exposure to the break interventions, distress significantly decreased for participants in the indoor plant break condition while distress significantly decreased and engagement significantly increased in the guided meditation break condition. Indoor plants and guided meditation had a small, but significant positive impact on affective restoration and no significant impact on cognitive restoration.

Background Student pharmacists and faculty exhibit high levels of stress, independent of the current coronavirus 2019 pandemic, and their path toward wellness, including a reduction in stress and anxiety, is of the utmost importance. Yoga and meditation are proven interventions to reduce stress and anxiety and increase wellness. Yin yoga is an adaptable, quiet practice ideal for those lacking previous yoga experience, flexibility, and time. Objective To evaluate the impact of a 6-week yin yoga and meditation intervention on College of Pharmacy faculty and students’ stress perception, anxiety levels, and mindfulness skills. Methods Faculty and students participated in a 6-week pilot program comprising a once-weekly yin yoga class followed by guided meditation. Yin yoga was selected for its quiet meditative style. Participants completed a pre- and postquestionnaire at 6 weeks and 3 and 6 months to evaluate potential changes in perceived stress scores, anxiety scores, and mindfulness skills. The questionnaire was composed of 3 self-reporting tools: Beck Anxiety Inventory (BAI), Perceived Stress Scale, and the Five Facet Mindfulness Questionnaire. Results Twenty participants, 12 students and 8 faculty (ages 18-66 years), completed the study. Anxiety and stress scores decreased, and mindfulness increased at 6 weeks, 3 months and 6 months, with all changes reaching statistical significance. No participants reported being in the “high” category of anxiety after intervention using BAI categorical data, although this finding was not statistically significant. Conclusion Faculty and students demonstrated a reduction in stress and anxiety levels and an increase in mindfulness after a 6-week yin yoga and meditation program. Outcomes suggest that inclusion of an adaptable, meditative practice, which may easily be replicated at home, for as little as once per week for 6 weeks may reduce stress and anxiety and increase mindfulness long term. Creating a culture of wellness should be a priority for all Colleges of Pharmacy.

As nursing education searches for ways to advance the simulation experience for students, improving methods of prebriefing are essential. Student anxiety is commonly reported in and around the simulated learning experience. The aim of this study was to determine if a brief mindfulness exercise could influence anxiety for students entering the simulation laboratory. In this mixed-methods study, a visual analog scale (VAS) was used for students to self-report anxiety. Data analysis revealed that a brief guided meditation in the simulation prebriefing decreased self-reports of anxiety in the simulated learning experience. Students reported lowered anxiety, reported a feeling of “being in the moment”, but were also distracted by what others thought about the exercise. As we work towards a theoretical framework for the prebriefing phase of simulation, incorporating mindfulness may be as important as some of the other established best practices.

Hospitalization of COVID- 19 patients may lead to the development of varied levels of anxiety, depression, and sleep disturbances. The present study was conceptualized to investigate the effect of guided meditation on anxiety, depression, and sleep quality among the hospitalized Covid-19 patients in a tertiary care facility. Materials and Methods: A total of 60 COVID-19 patients were conveniently enrolled and randomized to experimental (30) and control arms (30) using a computer-generated random table and opaque sealed envelope technique in a selected COVID unit of a tertiary care facility. The subjects were enrolled in accordance to the inclusion criteria. Intervention: The guided meditation was an audio recording of Sri Sri Ravi Shankar of 20 minutes duration. The intervention was provided twice a day to the experimental group for consecutive 5 days. A close watch was kept on the vital signs of the subjects during the intervention using a pulse oximeter. At the same time, the control group continued to receive the standard routine care. Results: There was a significant difference observed in the post-test anxiety and depression scores in the experiment and control groups (4.83±3.68 vs. 12.37±3.9 p=0.001 and 7.90±2.41 vs.12.67±2.65 p=0.001). A significant difference was also observed in the global sleep quality index (median (IQR)) in the experimental and control groups (11(9-14) vs. 15(10.75-17) p= 0.01). Conclusion: The guided meditation was effective in improving the global sleep quality index and alleviating the anxiety and depression to great extent as compared to the standard routine care provided to COVID-19 patients admitted in a tertiary care facility.

The use of mindfulness meditation for enhancing athletic performance has surged in recent years. What remains unclear is what type of meditation best suits the type of sport and the demands of the sport. The aim of the present study is to investigate different types of meditation and their benefits on golf performance in a closed-skill golf task. Golfers will be randomly assigned to either a focused attention meditation (FAM), open monitoring-meditation (OMM), or a control group and will complete two trials of hitting golf balls at a 150-yard target (one pre-manipulation trial and one post-manipulation trial). Mixed-measure ANOVAs are planned to assess objective performance, state mindfulness, state anxiety, and flow. Hypothetical results suggest that FAM will lead to significantly better golf performance than OMM and control groups. Furthermore, it is predicted that both meditation groups will experience higher state mindfulness, flow, and lower state anxiety compared with the control group. Predicted results will support the notion that different types of meditation benefit different sports, based on the sport’s demands, and will allow instructors to tailor mindfulness interventions for different athletes.

This study examined trait mindfulness, spiritual well-being, and distress tolerance as moderators of the effect of a brief mindfulness intervention on anxiety reported during stereotactic breast biopsy (SBB). This is a secondary analysis of an RCT examining guided meditation (GM; n = 30), focused breathing (FB; n = 30), or standard care (SC; n = 16) on anxiety for women undergoing SBB. Women in GM and FB were guided through their respective interventions for 10 min before and during biopsy. Anxiety (0–10 visual analogue scale), trait mindfulness (FFMQ), spiritual well-being (FACIT-SP), and discomfort intolerance (DI) were assessed at baseline, and anxiety was assessed every 4 min during SBB. Multilevel modeling examined moderator-by-group-by-time interactions. Significant 3-way interactions were decomposed using a median split. FFMQ observing, FFMQ describing, FACIT-SP meaning/peace, and DI moderated the group-by-time effects on anxiety during biopsy (p’s

New health behaviors are difficult to maintain and meditation is no different. We tested two key pathways of the upward spiral theory of lifestyle change (Fredrickson, 2013), which identifies positive emotions as critical ingredients for the maintenance of new health behaviors. The present experiment combined a laboratory session that introduced novices to meditation with a 3-week follow-up period to assess the extent to which study participants maintained this new health behavior. In a 2 × 2 experimental design, midlife adults (N = 240) were randomized to (a) learn about judicious ways to prioritize positivity (labeled "prioritizing positivity plus") or about a control topic that also featured the science of positive emotions and (b) follow a guided meditation based on either loving-kindness, which provided an opportunity to self-generate positive emotions, or mindfulness, which did not. All participants rated their emotions following the initial guided meditation and reported, week by week, whether they meditated during the ensuing 21 days. Analyses revealed that being exposed to the prioritizing positivity plus microintervention, relative to a control passage, amplified the effect of engaging in loving-kindness (vs. mindfulness) meditation on positive emotions. Additionally, the degree to which participants experienced positive emotions during first exposure to either meditation type predicted the frequency and duration at which they practiced meditation over the next 21 days. These findings show that the enjoyment of meditation can be experimentally amplified and that initial enjoyment predicts continued practice. Discussion spotlights the importance of differentiating effective and ineffective ways to pursue happiness. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Previous literature suggests that cross-frequency phase synchronization is a mechanism by which information is transmitted and coordinated in the brain. Since cross-frequency phase synchronization is only strictly possible when two oscillators form a harmonic frequency ratio (e.g., 2:1, 3:1), a recent theory posited that interactions between brain oscillations at different frequencies are facilitated/hindered by the transient occurrence of harmonic/non-harmonic cross-frequency arrangements. In this line, recent evidence has shown that 2:1 harmonic relationships between alpha (8–14 Hz) and theta (4–8 Hz) rhythms are reduced during meditative states in experienced practitioners. In the present study, we investigated whether mindfulness training in novices is associated with longitudinal changes in alpha-theta cross-frequency dynamics during meditation practice. Thirty-six participants (mean age = 30.3; 2 men) underwent an 8-week mindfulness training program based on the mindfulness-based stress reduction (MBSR) syllabus and electroencephalography (EEG) recordings (64 electrodes) were performed during a guided meditation before and after the training. Mindfulness training compliance (quantified by minutes of attendance and practice at home) was significantly correlated to decreased 3:1 harmonicity and cross-frequency phase synchrony between alpha and theta rhythms during meditation. Mindfulness training in novices was shown to be associated with a reduction in alpha-theta cross-frequency coupling during meditation. EEG parameters based on alpha-theta cross-frequency dynamics may be adequate for quantifying and/or facilitating mindfulness meditation training.

Mindfulness-based interventions (MBI) have been shown to be effective in increasing empathy in health professionals. Yet, more research is needed to analyse the specific influence of mindfulness exercises on biological variables involved in empathy, such as the biological system of oxytocin activity. In this study, we analyse the effects of a brief mindfulness session on positive and negative affect, state anxiety and salivary oxytocin (sOXT) in psychology students (N = 68). In the experimental group (n = 42), a mindfulness session was performed that included different guided meditation exercises. In the control group (n = 26), an emotion recognition exercise was carried out, along with a series of creative activities. Results showed that the mindfulness session was effective, because there was a significant reduction in negative affect (d = -.56, p < .001) and state anxiety (d = -.54, p = .007) in the experimental group. Likewise, there was an increase in sOXT (d = .99, p < .001) in this group, compared with the control group. Guided mindfulness meditation practice could be useful to reach an emotional and biological state that facilitates empathy. In this regard, the increase in sOXT after the mindfulness session adds further evidence about the biological mechanisms underlying the benefits of MBI on empathy.

Mindfulness practices are well-known for their benefits to mental and physical well-being. Given the prevalence of smartphones, mindfulness applications have attracted growing global interest. However, the majority of existing applications use guided meditation that is not adaptable to each user's unique needs or pace. This article proposes a novel framework called Attention Regulation Framework (ARF) , which studies how more flexible and adaptable mindfulness applications could be designed, beyond guided meditation and toward self-regulated meditation. ARF proposes mindfulness interaction design guidelines and interfaces whereby practitioners naturally and constantly bring their attention back to the present moment and develop non-judgmental awareness. This is achieved by the performance of subtle movements, which are supported by non-intrusive detection-feedback mechanisms. We used two design cases to demonstrate ARF in static and kinetic meditation conditions. We conducted four user evaluation studies in unique situations where ARF is particularly effective, vis-à-vis mindfulness practice in busy environments and mindfulness interfaces that adapt to the pace of the user. The studies show that the design cases, compared with guided meditation applications, are more effective in improving attention, mindfulness, mood, well-being, and physical balance. Our work contributes to the development of self-regulated mindfulness technologies.

Post-traumatic stress disorder is a major public health concern with a lifetime prevalence rate of 6.1-9.2% in North America. PTSD is known to alter the autonomic nervous system leading to chronic sympathetic arousal including heightened anxiety and hypervigilance. Pupillometry offers a quick and accessible measure of autonomic nervous system imbalances characteristic of PTSD. This study investigates the utility of pupillometry as a biomarker to detect PTSD in a sample of 39 adults with (n = 22) and without (n = 17) PTSD. Participants viewed a 25-minute computer protocol consisting of 5-minute rest phase, 10-minute negative emotionally valent images, and 10-minute guided meditation. We relied on a time-frequency analysis to represent the pupillary responses of two different groups (PTSD-affected individuals and healthy-control subjects). These data were then employed with a CNN network to learn a prediction model. Individuals with PTSD demonstrated increased pupil dilation across the entire protocol. The final outcome revealed an accuracy of 81.09% which indicates the feasibility of using this approach to detecting participants with PTSD in an automated way. Findings from this research have important implications for clinical mental health assessment, diagnostics and treatment.

Study Objective To evaluate the use of virtual reality (VR) as a noninvasive and nonpharmacologic analgesic during office hysteroscopy procedures. Design Single site, parallel group, unblinded randomized controlled trial. Setting Single academic outpatient minimally invasive gynecology surgery clinic. Patients or Participants Women over 18 years of age scheduled to undergo in office hysteroscopy were invited to participate in the study. 85 participants were approached, 50 consented to participate and were randomized using a computerized random number generator (n=25 in VR group and n=25 in standard group). Interventions Patients were randomized to VR intervention or standard of care from May to November 2020. The VR intervention consisted of listening to a 10-minute guided Zen meditation using The Guided Meditation VR App through an Oculus Go headset. Measurements and Main Results Primary outcome was peak pain score during the procedure based on a 100 mm visual analogue scale (VAS) score. The secondary outcomes were change in pain score (peak pain score minus baseline pain score) and change in participant's HR (average BPM before procedure – average BPM during procedure). Data was also collected to assess patient and surgeon satisfaction. The peak pain score during the procedure for the VR group was 35 [15, 60] vs 30 [9, 54] for the standard hysteroscopy group (P=0.317). Compared with the standard of care, VR had no significant effect on median heart rate change during the procedure (-4.6 [-0.5,11.1] vs +2.8 [0.1,7.7] P=0.327). Participants in the VR group had a positive experience with VR and 88% reported the music was very or slightly calming and 84% reported meditation was very or slightly helpful. No serious adverse events occurred. Conclusion This study found no statistically significant difference in pain scores or change in heart rate prior to, during, or after hysteroscopic procedures with VR compared to standard of care. Participants were satisfied with the VR intervention.

Background: Currently, the population with myopia climbs steadily, and developing toward younger age, posing a great concern to the health of adolescents. Myopia in severe cases can cause irreversible consequences such as glaucoma, blindness and other complications. At present, the solutions for myopia are glasses, medication and surgery. This study aims to investigate the role of a physiotherapy category based on guided meditation for vision acuity training on adolescent myopia. Methods: This is a prospective, randomized, multicenter clinical trial. 1140 primary and secondary school students aged 8-18 years old from 27 schools will be recruited and randomly divided into an experimental group and a control group at a ratio of 2:1 in two phases, with a training period of 30 days in each phase and a follow-up period of 3 months. No interventions will be conducted during the follow-up period, nor will other interventions employed. Inclusion criteria will meet the diagnostic criteria for simple myopia and -6.00D ≤ spherical lenses ≤ -0.50D, cylindrical lenses ≤ 1.50D. The primary observation index will be to compare the statistical differences in distant visual acuity between the two groups; the secondary observation indexes will be ocular symptoms (mainly including eye fatigue, dryness, pain, double vision, neck pain, thought disorders, and lags in response), diopter and astigmatism. Discussion: The purpose of this two-phase trial is to compare the clinical effectiveness of focused vision-guided meditation with Chinese eye exercises that are also non-pharmacological, non-invasive interventions for myopia, and to maximize the benefit to the subjects. The results will indicate whether the training based on focused vision-guided meditation has the ability to improve distant visual acuity, relieve ocular symptoms and ameliorate diopter. In addition, this trial will provide clinical efficacy of the training, which is expected to provide meaningful data for vision rehabilitation. At the same time, the vision acuity training method, which is permeated with the concept of Traditional Chinese Medicine (TCM) rehabilitation and health maintenance, will be applied to achieve the goal of preventing or alleviating myopic development and reducing myopia rate. Trial registration: Chinese Clinical Trial Registry (identifier: ChiCTR2000038642; Registered 26 September 2020, http://www.chictr.org.cn/showproj.aspx?proj=61729).

In this study, we examined the effect of mindfulness meditation facilitated by human-robot interaction (HRI) on brain activity. EEG signals were collected from two groups of participants; Meditation group who practiced mindfulness meditation with a social robot and Control group who only listened to a lecture by the robot. We compared brain functional connectivity between the two groups by computing EEG phase synchrony during HRI session. The results revealed a significantly lower global phase synchrony in beta frequency band of the Meditation group, which has been previously reported as an indication of reduced cognitive processing and achieving the mindful state in experienced meditators. Our findings demonstrate the potential of Socially-Assistive Robots (SAR) for integration in mental healthcare and optimization of the intervention effects. Additionally, our study puts forward new measures for objective monitoring of HRI effect on the user's neurophysiological responses.

This paper explores the promising practice of an emerging culturally adapted, trauma-informed yoga program for Indigenous adolescent girls. I draw from my experiential learning during a series of 12 yoga sessions over 2018 and 2019 with eight Indigenous girls (ages 13–17) from rural and remote Inuit communities in Quebec, Canada. Participants had experienced varying degrees of child maltreatment and interaction with the child welfare system, and they were all under the care of youth protection services in a residential facility. The yoga and mindfulness intervention provided weekly 60-minute sessions in the residential unit. Yoga sessions integrated a blended model of cultural teachings, group dialogue, and trauma-informed yoga. The approach included circle sharing, cultural teachings, gentle progressions of physical postures, guided meditation, breathing techniques, centring practices, and beadwork. This promising practice explores trauma-informed yoga as a strengths-based community strategy for relational healing that promotes cultural connectedness, safety, and resilience among Indigenous adolescent girls removed from their rural and remote communities to a residential facility in an urban area. This paper outlines an introductory framework for health professionals, paraprofessionals, program administrators, and staff working with Indigenous children and youth in residential facilities. Specifically, this promising practice builds on existing findings of trauma-informed yoga with adolescents, as well as movement and centring approaches through an Indigenous lens of relational healing.

BACKGROUND The benefits of mindfulness interventions are well-known, but their challenges and individual differences in reactions to these challenges are much less clear. METHODS The study used a mixed-methods design to investigate the individual trajectories of daily experiences during meditation in a sample of novice volunteers participating in a 3-week, distance-based, guided meditation intervention (N = 175). RESULTS Multilevel modelling revealed individual differences in the change trajectories of the experiences of effort, meaning, and boredom during meditation, indicating that meditation gradually became less effortful, less boring, more interesting, and more important over the 3 weeks. The individual differences in the levels of these experiences and their change trends were associated with baseline differences in well-being, reflective processes, self-management, and self-control skills, as well as autonomous motivation to engage in the course. CONCLUSIONS Individuals who are initially more autonomous and mindful find it easier to engage with online mindfulness interventions and draw more benefits from the process, whereas those with lower self-regulation skills or higher proneness to rumination are more likely to experience mindfulness as effortful and boring, and, eventually, to give it up.

Background Smartphones have become ubiquitous in China, offering a promising way to deliver mental health interventions; however, little is known about the current use and characteristics of smartphone apps for mental health. Objective The purpose of this study was to gain insight into mobile mental health apps available in China as of December 2018. Methods A systematic search was conducted to identify and evaluate the most downloaded apps from iOS and Android platforms. Apps were categorized according to their main purpose and downloaded to evaluate their content. Each app’s affiliation, cost, target users, information security, and evidence-based nature were evaluated. Results Of the 172 unique apps that were identified, there were 37 apps (21.5%) for psychological counseling, 50 apps (29.1%) for assessment, 12 apps (7.0%) to relieve stress, 24 apps (14.0%) for psychoeducation, and 49 (28.4%) multipurpose apps (ie, a combination of counseling and assessment). Most apps were developed for adults in the general population (166/172, 96.5%), rather than for psychiatric patients. App-based counseling was mostly provided by psychologists, and of the assessed apps, only 40% (70/172) used evidence-based scales to assess mental health problems such as anxiety or depressed mood. Guided meditation was used as the main technique in stress-relieving apps. Conclusions Many apps contained useful and evidence-based elements, such as good quality information, validated measurements, and useful meditation methods; however, for mobile apps to contribute significantly to mental health care in China, considerable challenges remain, including the need for more patient-focused apps that can actually take on the role of a health care provider. In addition, efficacy studies are needed.

Today's busy lifestyle can make us feel overwhelmed. Mindfulness meditation supports our well-being by slowing things down and drawing our attention to the present moment. Accordingly, a wealth of guided mindfulness meditation apps have emerged in the past years. Despite the many apps and an increasing interest within the HCI literature, there is little consensus of how to evaluate these apps and how to derive opportunities for re-design from the results. Our new MindPeaks method utilizes electroencephalography (EEG) to link design elements to meditative states and the user`s self-regulation of attention. This information can help designers to understand and optimize the efficacy of, for example, applications supporting mindfulness meditation.

Background Psychophysiological stress and decreased well-being are relevant issues during prolonged social isolation periods. Relaxation practices may represent helpful exercises to cope with anxiety and stressful sensations. Objective The aim of this research protocol is to test whether remote relaxation practices such as natural sounds, deep respiration, and body scan meditation promote relaxation and improved emotional state and reduce psychomotor activation and the preoccupation related to the coronavirus disease (COVID-19) pandemic. Methods The study population will consist of 3 experimental groups that will randomly receive one of 3 internet-based audio clips containing a single session of guided breathing exercise, guided body scan exercise, or natural sounds. The participants will listen to the fully automated audio clip for 7 minutes and complete pre-post self-assessment scales on their perceived relaxation, psychomotor activation, level of worry associated with COVID-19, and emotional state. At the end of the session, the participants will also be asked to provide qualitative reports on their subjective experiences. Results Analyses will be performed to test the differences in the efficacy of the different audio clips in an internet-based intervention on 252 participants (84 per group), investigating whether natural sounds or remote guided practices such as deep respiration and body scan meditation positively enhance the participants’ perceived psychological state. Conclusions The study will provide information on if and to what extent guided practices can help in reducing psychological side effects related to social isolation during the COVID-19 pandemic. International Registered Report Identifier (IRRID) PRR1-10.2196/19236

Objective The human mind-body possesses a remarkable innate ability to heal. Grounded in the evolutionarily conserved systems of the brain and body, nature appears to function as the fundamental source of wellness along the two vectors of attention and relaxation. Yet, our species is moving away from nature at a time when humanity is just beginning to rediscover its benefits. Conclusions Exposure to natural environments may provide a "window" of healing that can be extended through a continuum of intervention through the use of guided meditation and ultimately hypnotic suggestion. The result may be an improved ability to promote greater executive functioning and more robust immune regulation. The time has come for a more holistic medicine guided by the hand of nature.

Author(s): Chung, Arlene S.; Smart, Jon; Zdradzinski, Michael; Roth, Sarah; Gende, Alecia; Conroy, Kylie; Battaglioli, Nicole | Abstract: Introduction: Burnout, depression, and suicidality among residents of all specialties have become a critical focus of attention for the medical education community. Methods: As part of the 2017 Resident Wellness Consensus Summit in Las Vegas, Nevada, resident participants from 31 programs collaborated in the Educator Toolkit workgroup. Over a seven-month period leading up to the summit, this workgroup convened virtually in the Wellness Think Tank, an online resident community, to perform a literature review and draft curricular plans on three core wellness topics. These topics were second victim syndrome, mindfulness and meditation, and positive psychology. At the live summit event, the workgroup expanded to include residents outside the Wellness Think Tank to obtain a broader consensus of the evidence-based toolkits for these three topics. Results: Three educator toolkits were developed. The second victim syndrome toolkit has four modules, each with a pre-reading material and a leader (educator) guide. In the mindfulness and meditation toolkit, there are three modules with a leader guide in addition to a longitudinal, guided meditation plan. The positive psychology toolkit has two modules, each with a leader guide and a PowerPoint slide set. These toolkits provide educators the necessary resources, reading materials, and lesson plans to implement didactic sessions in their residency curriculum. Conclusion: Residents from across the world collaborated and convened to reach a consensus on high-yield—and potentially high-impact—lesson plans that programs can use to promote and improve resident wellness. These lesson plans may stand alone or be incorporated into a larger wellness curriculum.

Background Mindfulness-based stress reduction has demonstrated some efficacy for chronic pain management. More recently, virtual reality (VR)–guided meditation has been used to assist mindfulness-based stress reduction. Although studies have also found electroencephalograph (EEG) changes in the brain during mindfulness meditation practices, such changes have not been demonstrated during VR-guided meditation. Objective This exploratory study is designed to explore the potential for recording and analyzing EEG during VR experiences in terms of the power of EEG waveforms, topographic mapping, and coherence. We examine how these measures changed during a VR-guided meditation experience in participants with cancer-related chronic pain. Methods A total of 10 adult patients with chronic cancer pain underwent a VR-guided meditation experience while EEG signals were recorded during the session using a BioSemi ActiveTwo system (64 channels, standard 10-20 configuration). The EEG recording session consisted of an 8-minute resting condition (pre), a 30-minute sequence of 3 VR-guided meditation conditions (med), and a final rest condition (post). Power spectral density (PSD) was compared between each condition using a cluster-based permutation test and across conditions using multivariate analysis of variance. A topographic analysis, including coherence exploration, was performed. In addition, an exploratory repeated measures correlation was used to examine possible associations between pain scores and EEG signal power. Results The predominant pattern was for increased β and γ bandwidth power in the meditation condition (P Conclusions This study demonstrates the feasibility of EEG recording in exploring neurophysiological changes in brain activity during VR-guided meditation and its effect on pain reduction. These findings suggest that distinct altered neurophysiological brain signals are detectable during VR-guided meditation. However, these changes were not necessarily associated with pain. These exploratory findings may guide further studies to investigate the highlighted regions and EEG bands with respect to VR-guided meditation. Trial Registration ClinicalTrials.gov NCT00102401; http://clinicaltrials.gov/ct2/show/NCT00102401

Introdução: Relata-se a experiência da intervenção em saúde denominada: “Cuidando do cuidador”, junto a profissionais da equipe mínima de um Centro de Saúde da Família (CSF). A aplicação desta intervenção teve como objetivo propiciar incentivo, apoio e autocuidado aos profissionais da unidade da linha de frente da pandemia da Covid-19. Metodologia: Trata-se de estudo descritivo e qualitativo, realizado no Centro de Saúde da Família, Dr. Grijalba Mendes Carneiro, localizado em Sobral, zona Norte do Ceará, no mês de outubro de 2020. A intervenção dividiu-se em momentos de aplicação técnicas de relaxamento, com alongamentos, massagens, musicoterapia e meditação guiada, além de educação em saúde com residentes da unidade. Participaram da intervenção: agentes comunitários de saúde, enfermeiros, auxiliares administrativos, técnicos de enfermagem e médico. Resultados: Após a intervenção, foi perceptível a diminuição da tensão destes profissionais, pois precisavam de autocuidado, relaxamento físico e mental após a sobrecarga exaustiva do trabalho na pandemia Covid-19. Os participantes relataram desejo que tais práticas acontecessem com regularidade no CSF. Conclusão: A intervenção mostrou-se relevante ao melhor bem-estar físico e mental desses profissionais, ao reduzir estresse e tensão decorrentes da sobrecarga laboral pandêmica. Assim, promoveu-se autocuidado àqueles que tanto se doam para cuidar do outro.

Introduction Insomnia and related anxiety affect 30 - 50% of the US adult population. These conditions often coexist, and contribute to increased mortality from depression, heart disease, and stroke. The current COVID-19 pandemic has heightened anxiety and sleeplessness, and 53% of US adults report the pandemic has affected their mental health. There is a need for research into therapies for anxiety and insomnia that can be delivered remotely for increased accessibility to reach more individuals in need. Methods To contribute to this need, we examined the effects of remotely delivered Yoga Nidra (translated to mean “yogic sleep”), a guided meditation practice, on anxiety and sleep. The practice was delivered in real-time before bed, or asynchronously via an online REDCap-based platform, once per week for 16-weeks from April to July (during the early months of the COVID-19 pandemic). Results Seventy-four individuals joined the study, of whom 71% reported subthreshold insomnia (Insomnia Severity Index score of 14 ± 4), and 74% reported anxiety (Generalized Anxiety Disorder Index score of 10 ± 5). Seventy-one (96%) participants accessed the asynchronous recordings. Remote delivery of this practice proved very feasible, with no adverse events reported, and although we provided no monetary compensation, 50% of our sample still completed a post-intervention survey. Further, 52% of n=25 respondents who completed both pre- and post-intervention sleep surveys reported decreased sleep onset latency (SOL) the following day, with a mean decrease of 10 minutes (95% CI = −19.0, −0.5) for all respondents, and strongest change (−34 min; p=.017) measured for those who reported SOL between 30-120 min at baseline. Overall state anxiety was decreased by 41% for n=32 respondents who completed pre-post State Trait Anxiety Index (STAI) surveys surrounding a single practice (average score of 47 ± 11 before practice vs. 27 ± 8 after practice, p Conclusion Remotely delivered Yoga Nidra is feasible to deliver, and demonstrates potential benefits for anxiety and insomnia, warranting additional research. Support (if any) This work was supported by the R90 BRIDG grant at the Helfgott Research Institute at the National University of Natural Medicine.

Instructors of a middle school gifted language arts class implemented a 30-day unit of study on mindfulness in order to help students learn techniques to alleviate stress, perfectionistic tendencies, and anxiety. Practicing mindfulness techniques, such as meditation, provides individuals with tools to understand the mind and body and encourages individuals to not dwell on past events or fixate on future events, appreciating the here and now and living in the moment. Some gifted students struggle with social and emotional issues such as perfectionism and anxiety, and these conditions can create a cycle of stress rooted in nervousness, agitation, and compulsive thoughts. Instructors explained the components of mindfulness, provided daily guided meditations, and encouraged students to apply the techniques in their everyday lives. Results varied for each student with some able to use the mindfulness exercises to combat problems, while others struggled with understanding the purpose or potential benefits of mindfulness.

An experiment involving 115 undergraduate students (74.8% females; mean age = 20.5 years, SD = 4.3) was conducted to explore effects of meditation on social connectedness, nature connectedness, and affect. Participants listened to one of three brief guided meditation Mp3 recordings via the internet, which involved mindfulness meditation (MM), loving-kindness meditation (LKM), or progressive muscle relaxation (active control group). Participants in the MM and LKM groups reported greater social and nature connectedness at post-test than those in the control group. There were no significant differences in connectedness between the MM and LKM groups, suggesting they are both effective for enhancing connectedness. There were no significant changes in negative or positive affect at post-test due to the interventions. Recommendations for future research are provided.

Objective. To evaluate the impact of a six-week yoga and meditation intervention on college students' stress perception, anxiety levels, and mindfulness skills. Methods. College students participated in a six-week pilot program that consisted of a 60-minute vinyasa flow yoga class once weekly, followed by guided meditation delivered by trained faculty members at the University of Rhode Island College of Pharmacy. Students completed pre- and post-intervention questionnaires to evaluate changes in the following outcomes: stress levels, anxiety levels, and mindfulness skills. The questionnaire consisted of three self-reporting tools: the Beck Anxiety Inventory (BAI), the Perceived Stress Scale (PSS), and the Five Facet Mindfulness Questionnaire (FFMQ). Students' scores on each were assessed to detect any changes from baseline using the numerical and categorical scales (low, medium, and high) for each instrument. Results. Seventeen participants, aged 19 to 23 years, completed the study. Thirteen participants were female and four were male. Nine of the students were enrolled in the Doctor of Pharmacy program and eight were enrolled in other academic programs. Students' anxiety and stress scores decreased significantly while their total mindfulness increased significantly. Changes in categorical data from pre- to post-intervention on the BAI and PSS were significant, with no students scoring in the "high" category for stress or anxiety on the post-intervention questionnaire. Conclusion. Students experienced a reduction in stress and anxiety levels after completing a six-week yoga and meditation program preceding final examinations. Results suggest that adopting a mindfulness practice for as little as once per week may reduce stress and anxiety in college students. Administrators should consider including instruction in nonpharmacologic stress and anxiety reduction methods, within curricula in order to support student self-care.

Issue or Challenge Addressed and Why Diabetes Mellitus Type 2 (DMT2) continues to be the 7th leading cause of death in the United States affecting an estimated 30.3 million people. It is well recognized that socioeconomic stressors can worsen effects of disease states and increase poor health outcomes among more socially disadvantaged patients with DMT2. Research also shows a connection between high stress levels, high amounts of cortisol, and decreased insulin sensitivity with higher blood sugar/HA1C levels. This project aimed to improve stress levels and regimen compliance in DMT2 patients by providing a daily meditation program as a supplement to their medical treatment. Population Targeted Our population were patients of Beaufort Jasper Hampton Comprehensive Health Services (BJHCHS) in coastal (Low Country) South Carolina with DMT2. Description of Innovation/Methodology The project team created a six minute recorded meditative/mindfulness breathing exercise composed of guided meditation and Native American Flute music designed to help patients enter a state of mindful relaxation. This program was stored in an audio file that patients could listen to digitally or by using a CD. It was designed to improve the accessibility of daily mindful meditation practice and to help DMT2 patients develop a sense of control over their lives and disease management. Medical students of A.T. Still University of Osteopathic Medicine, Arizona (ATSU-SOMA) met directly with patients, shared the research-backed benefits of mindful meditation, and described how to use the recording during an in clinic educational session. A baseline survey measuring stress and anxiety levels, perception of their disease, and familiarity with mindfulness was administered. Patients then completed their first six minute session in the exam room. After, patients were given a copy of the recording and were asked to complete a post-interventional survey covering their experience with the program after 4 weeks. Staff Involved and Their Roles ATSU-SOMA students comprised the main agents in our innovation and directly administered the program to eligible patients during clinical exam time as an adjunct to their current pharmacologic treatment. The role of the students was to describe the program, enroll patients, and demonstrate use of the media during the patients’ first session. Students had the responsibility of measuring and recording survey data as patients used and evaluated the meditation program. Primary care providers of BJHCHS worked with students to facilitate patient referrals for the study and to support/reinforce the program with their patients to ensure participation and compliance with the recorded meditation regimen. The program was also made available to the Nutrition department and Diabetes Outreach staff affiliated with the clinic to introduce the innovation to a wider array of patients. External Partners Involved and Their Roles This innovation was a partnership between the BJHCHS and ATSU-SOMA. Coordinating staff for ATSU-SOMA played a role in assisting student participation in developing this project. Resources or Levers Used The spoken portion of the recorded meditation used by this study was originally created by the ATSU-SOMA Chicago Community Health Center (CHC) class of 2018. Patients were enticed to enroll in the study by being offered entry into a raffle for a FitBit Versa smartwatch. Patients who received the recording but were not part of the study were not offered any incentives to use the program. Impact or Result A study to document the effect of the innovation is ongoing. Preliminary feedback from patients has been very positive. There is significant interest among providers in implementing this innovation into their practice as well. We do not have data from a statistically large enough sample size at this time to make final conclusions. However, we have observed that the recording has subjective benefits for patients based on patient feedback and the completed surveys we have so far. When our study is completed, we expect the data to support our hypothesis that practicing daily mindfulness has beneficial impacts on patient compliance and self-empowerment with their diabetes management. We also expect to see improvements in stress levels, and a decrease in symptoms of anxiety and depression based on answers to completion surveys after 4 weeks of using the recording. Challenges Faced and Overcoming Those Challenges Our most significant challenge was the time consuming and restrictive nature of the measurement tools used in our study. Completing our baseline survey took an average of 20-30 minutes, slowing down primary care providers too much to allow them to participate. Because of this, only medical students were able to recruit patients or administer the innovation. Students were only at clinic once a week, which greatly reduced patient recruitment opportunities. During the study, we decided to hand out the recording to any patient with abnormal blood sugar that expressed concern about stress management, even if they were not able to participate in the study. To date, we have handed out over 30 copies of the recording within a 4 week period and are currently producing more. When it could be prescribed in less than 5 minutes, providers were also able to give the recording to patients and help distribute the program further. Replicating This Innovation in Other Organizations This innovation has minimal material/start-up costs and can easily be replicated at any institution. We adapted this innovation based on several studies in similar patient populations. Our most significant accomplishment has been to standardize the meditation/mindfulness component with a uniform, self-contained recorded 6 minute breathing session that can be easily distributed and accessed by patients, rather than referring patients to YouTube or an external resource. Tips for Sustaining this Innovation Based on conversations with patients and our experience administering the study, we observed the most important asset in the success of this innovation is cooperation and advocacy from primary care providers. A successful adaptation of this innovation will need to facilitate the providers’ ability to introduce this tool and use their provider-patient relationship to encourage patients to use the program consistently by discussing it at regular checkups. For example, the audio file/CD could be given with brief written instructions, like a prescription. This would allow providers to integrate the innovation into their practice in a consistent and accessible way initially designed. Other Information or Lessons Learned Our innovation is expected to positively impact the long-term wellbeing of the community by helping to reduce the impact of daily stressors on DMT2 patients. Use of the meditation program is generalizable to just about any DMT2 patient in an outpatient setting due to the recognized biochemical connection between stress and increased blood sugar. We hope to create an easy to use, cost-free, non-pharmaceutical lifestyle intervention program that can be effectively utilized by socioeconomically disadvantaged DMT2 patients to help control their blood sugar. Ideally, this program could also be expanded to other chronic disease patients and any condition which is worsened by high stress levels, which will reduce healthcare costs and foster patient wellbeing.

Integrative and complementary non-pharmacological treatments have proven efficacious in treating both the physiological and psychological symptoms of chronic pain conditions but the potential of many combined therapies is unknown. This study examined the effects of a combined intervention of mindfulness meditation followed by aerobic walking exercise in chronic low back pain (cLBP) patients. We hypothesized that meditation before exercise would reduce disability and pain by increasing mindfulness prior to physical activity. Thirty-eight adults completed either meditation and exercise treatment (MedExT) (n=18) or an audiobook control condition (n=20). Over a 4-week period, participants in the MedExT group performed 12-17 minutes of guided meditation followed by 30 minutes of moderate intensity walking exercise 5 days per week. Measures of disability, pain, mindfulness and anxiety were taken at baseline and post-intervention. Ratings of pain were also assessed by participant self-report, before and after each intervention session. Following MedExT, participants showed significant improvement in our primary outcome of disability compared to the control group (p

Objective As technology continues to improve, it plays an increasingly vital role in the practice of medicine. This study aimed to assess the feasibility of the implementation of virtual reality (VR) in a rheumatology clinic as a platform to administer guided meditation and biofeedback as a means of reducing chronic pain. Methods Twenty participants were recruited from a rheumatology clinic. These participants included adults with physician-diagnosed autoimmune disorders who were on a stable regimen of medication and had a score of at least 5 on the pain Visual Analog Scale (VAS) for a minimum of 4 days during the prior 30 days. VAS, part of most composite outcome measurements in rheumatology, is an instrument used to assess pain that consists of a straight line with the endpoints ranging from "no pain at all" and "pain as bad as it could be." Patients were randomized into two groups that differed in the order in which they experienced the two VR modules. One module consisted of a guided meditation (GM) environment, whereas the other module consisted of a respiratory biofeedback (BFD) environment. Data on pain and anxiety levels were gathered before, during, and after the two modules. Results The three most common diagnoses among participants were rheumatoid arthiritis (RA), lupus, and fibromyalgia. There was a significant reduction in VAS scores after BFD and GM (P values = 0.01 and 0.04, respectively). There was a significant reduction in Facial Anxiety Scale after the GM compared with the BFD (P values = 0.02 and 0.08, respectively). Conclusion This novel study demonstrated that VR could be a feasible solution for the management of pain and anxiety in rheumatology patients. Further trials with varying treatment exposures and durations are required to solidify the viability of VR as a treatment option in rheumatology clinics.

Literature supports the efficacy and acceptability of VR exposure therapy (VRET) for the treatment of phobia and trauma-related disorders, although not all trauma-related mental health problems are of a phobic or avoidant nature, therefore may not be amenable to VRET. The current study intends to transition past the scope of VRET to expand the application of commercially available VR to areas of psychotherapy that are instead associated with increasing positive emotions and wellbeing to target mental illness such as depression, anxiety, and stress. Specifically, the current study compared participant (n=80) affective, satisfaction, and meditative responses to VR guided meditation (VRGM) to their responses to non-VR guided meditation (non-VRGM). Participants reported greater positive affect, satisfaction, and desirable meditative experiences following the VRGM compared to non-VRGM. A positive correlation between pre-meditation symptoms of PTSD and depression and distress experienced during the guided meditations was also reflected, however the correlation was reduced in size during the VR vs. the non-VRGM. We conclude that psychotherapeutic applications of VR outside the scope of VRET is warranted. Limitations and future directions are discussed.

This paper describes a unique technique of training social work students: self observation via guided meditation. A workshop was conducted with two groups of students: one participated in a single-session mindfulness meditation; the other participated in this as well as three additional sessions. The workshop trained students in creative focusing while facilitating connection to inner guidance (inner voice). Tuning in to inner guidance is presented as a developmental process and an important source of knowledge about the "self." Students' experiences included various bodily sensations, interactions with a guiding figure, verbal messages or advice, and significant insights. Messages and insights were content analyzed; examples presented illustrate transitions in students' personal and professional self-concept.

The purpose of this study was to introduce mindfulness meditation, a recommended adjunctive treatment for trauma in juvenile justice-involved youth, to incarcerated young women and collect narrative commentary about their experiences to answer the following research questions: What is the experience of incarcerated young women who participate in Internet-based mindfulness meditation classes? How do incarcerated young women apply mindfulness meditation to life in a juvenile justice facility? Participants attended bi-weekly guided meditation sessions and wrote about their experiences after each session in a journal. Three coders used open-coding content analysis to identify topics and themes across 38 journal entries. The primary theme, found in 61% of entries, described the difficulties of living in a juvenile justice facility, providing context for the descriptions found in 58% of entries regarding the usefulness of mindfulness meditation to cope with those difficulties. This study highlights the challenges of living in a correctional institution as a young woman and the barriers such settings pose to the wellbeing and healthy development of their residents. It also points to mindfulness meditation as an operative method of supporting these highly traumatized young women until that time when alternatives to incarceration can be identified.

Background Cardiac surgical procedures are associated with postoperative neurological complications such as cognitive decline and delirium, which can complicate recovery and impair quality of life. Perioperative depression and anxiety may be associated with increased mortality after cardiac surgeries. Surgical prehabilitation is an emerging concept that includes preoperative interventions to potentially reduce postoperative complications. While most current prehabilitation interventions focus on optimizing physical health, mind–body interventions are an area of growing interest. Preoperative mind–body interventions such as Isha Kriya meditation, may hold significant potential to improve postsurgical outcomes. Methods This is a prospective, randomized controlled feasibility trial. A total of 40 adult patients undergoing cardiac surgery will be randomized to one of three study groups. Participants randomized to either of the two intervention groups will receive meditative intervention: (1) commencing two weeks before surgery; or (2) commencing only from the day after surgery. Meditative intervention will last for four weeks after the surgery in these groups. Participants in the third control group will receive the current standard of care with no meditative intervention. All participants will undergo assessments using neurocognitive, sleep, depression, anxiety, and pain questionnaires at various time points in the perioperative period. Blood samples will be collected at baseline, preoperatively, and postoperatively to assess for inflammatory biomarkers. The primary aim of this trial is to assess the feasibility of implementing a perioperative meditative intervention program. Other objectives include studying the effect of meditation on postoperative pain, sleep, psychological wellbeing, cognitive function, and delirium. These will be used to calculate effect size to design future studies. Discussion This study serves as the first step towards understanding the feasibility of implementing a mind–body intervention as a prehabilitative intervention to improve postoperative surgical outcomes after cardiac surgery. Trial registration Clinicaltrials.gov, NCT03198039. Registered on 23 June 2017. Electronic supplementary material The online version of this article (10.1186/s13063-018-3103-8) contains supplementary material, which is available to authorized users.