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As mindfulness-based programs (MBPs) become widespread, MBP research samples should be representative of the general public to avoid exclusion of minoritized groups. This systematic review retrospectively investigates demographic diversity in MBP research, based on reported variables and patterns of omission during that time. We reviewed randomized controlled trials (RCTs) of standard MBSR and MBCT that targeted self-regulation outcomes through 2016 with healthy and clinical adult populations. Completeness of documentation and analyses for race, ethnicity, gender, sexual orientation, language, education, age, and intersectionality were extracted, compared with census data when possible, and tracked over time based on the date of publication. The included 94 RCTs comprised populations that were predominantly White (79%), middle-aged (46 years), highly educated (15 years), and female (70%). The composition of studies from the USA differed significantly from the US census data. Only 41% of studies reported race or ethnicity, 95% reported gender without non-binary categories, 64% reported education, 89% reported age variance, 2% reported sexual orientation, 9% stratified analyses by demographic variables, and none reported identity multiplicity or intersectionality. MBP efficacy could not be determined for subgroups due to lack of subgroup analyses. Temporal trends show limited improvements in diversity composition and reporting of race over time. MBPs’ potential benefit for diverse populations will depend on adequate reporting of currently underreported demographic variables. To develop culturally responsive interventions, MBPs research must include underrepresented populations to counter observed systemic bias and address inclusion disparities in the field. We offer recommendations to further this aim. The PROSPERO review registration (number: CRD42016051765 (Loucks et al., American Journal of Health Behavior 40:258–267, 2016)) with a review protocol was submitted on December 9, 2016, and confirmed on December 16, 2016.

Lack of adequate caloric intake shifts the body’s neurohumoral mediators so that the balance between anabolism and catabolism is tipped in favor of catabolism. Two types of starvation have been recognized. Simple starvation is a lack of adequate calories and protein, whereas stress starvation is a consequence of systemic inflammation and physiologic stress (critical illness and injury) concurrent with a lack of adequate calories and protein. In animals without injury or illness, several metabolic adaptations result from the lack of nutrient intake. The physiologic stress associated with severe illness or injury often leads to a pronounced catabolic state characterized by hypermetabolism that is compounded by patients that are unable or unwilling to eat. The effects of starvation are well documented, both clinically and experimentally. Despite the known consequences of calorie and protein restriction, there is much debate over whether providing nutritional support truly influences recovery and outcome in humans as well as in veterinary patients.

Despite the interest in mindfulness over the past 20 years, studies have only recently begun to examine mindfulness in older adults. The primary aim of this study was to evaluate pretreatment to post-treatment change in negative affect variability (NAV) following a mindfulness training among 134 mildly stressed, middle-aged to older adults. The secondary aim was to assess if the effects of mindfulness training on NAV would be partially explained by pretreatment to post-treatment reductions in perceived stress, a trend that would be congruent with several stress models. In this randomized control trial, participants were assigned to either a 6-week mindfulness meditation training programme or to a wait list control. Ecological momentary assessment, a data capturing technique that queries about present moment experiences in real time, captured NAV. Mixed-model ANOVAs and a path analysis were conducted. Participants in the mindfulness meditation training significantly reduced NAV when compared with wait list control participants. Further, there was a significant indirect group effect on reductions in NAV through change in perceived stress. Few studies have tested mechanisms of action, which connect changes that occur during mindfulness training with psychological outcomes in older adults. Understanding the mechanisms by which mindfulness enhances well-being may optimize interventions.

Much of the extant cortisol awakening response (CAR) literature posits that CAR is an anticipatory response to perceived demands later that same day. However, expanding and switching the temporal order of cortisol and psychosocial influences may motivate more flexible approaches to understanding the dynamic relationship between mind and body, including cumulative strain on the HPA axis. This study was novel because we used two models to explore the effects of one day’s emotion regulation and cortisol levels on cortisol and CAR the following day in 100 mildly stressed adults aged 50–81 years old, which contrasts with the more common CAR-anticipatory-response design. In the first model, High negative-affect-variation on day 1 predicted a higher risk of having a flat CAR the next day, relative to the moderate-affect-variation group (RR = 10.10, p

Objectives . Older African Americans have a significantly higher risk than older white Americans for cognitive decline and other health problems. Much of this may be due to the unique stressors, both historically and in-the-moment, that African Americans face in contrast to whites, such as gentrification and health disparities. Gender further exacerbates this effect. This study aims to understand stressors unique to older African American women, as well as coping strengths that have emerged organically over time for use in tailoring stress-reduction mindfulness classes in this community Design and setting . A four-week mindfulness training class adapted from mindfulness-based stress reduction (MBSR) was implemented in a historically black, gentrifying neighborhood in Portland, Oregon with 10 older African American women aged 50–89. Main outcome measures . Focus groups discussed stressors, coping, responses to mindfulness classes, and preferences to better reflect older African American cultural values and norms. Results . Stressors reflected participants’ intersectionality as older black women, including neighborhood and workplace race-based microagressions, and gentrification-related cultural and generational incongruences. Coping strategies included self-care, remembering core-self amidst stress, and drawing strength from family and faith. Participants found mindfulness classes appropriate for addressing stress and felt that classes provided a forum for connecting on issues of race and community. Conclusion . Tailoring classes to older African American women should consider integrating biblical teachings, African American instructors who understand socio-historical contexts of older black women’s stressors and strengths, and time for group-reflection to support community building.

As many health disparities in American minority communities (AMCs) are stress-related, there has been an increased interest in the development of mindfulness programs as potential stress reduction measures in these communities. However, the bulk of the extant literature on mindfulness research and mindfulness interventions is based upon experiences with the larger White community. The intent of this commentary is to share a framework that includes key cultural considerations for conducting research and developing culturally-salient mindfulness programs with AMCs. We build on our experiences and the experiences of other researchers who have explored mindfulness in African and Native American communities; in particular, we examine issues around community outreach with an emphatic gesture toward emphasizing protection of AMCs and their participants. Discussed are considerations with respect to attitudinal foundations in mindfulness-based research and program development with these communities. However, the overall message of this paper is not to provide a "to-do" list of research steps, but to rather, encourage researchers to turn inward and consider the development of skillful characteristics that will increase the likelihood of a successful research venture while also protecting the cultural traditions of the AMC of interest.

This study used mixed methods to examine the feasibility of implementing a 4-week mindfulness class with 10 elder African American women (aged 50 – 69). We measured changes in PSS, PANAS, LSI, Perseverative Cognition Scale, and the Multidimensional Inventory of Black Identity before and after the intervention. We also used these measures as a means to assess the salience of these scales to this population. Focus groups provided information on motivation, effective strategies, preferences, and perceived benefits of the mindfulness class. There was a significant change in numbers of participants who reported a meditation practice (1 person at time 1; 8 people at time 2, chi2(1) = 5.84, p < .05). There were marginally significant improvements in PSS, t(18) = 1.99, p = .06, and PANAS positive affect, t(18) = -1.99, p = .06. Stressors that motivated participation in the mindfulness class included family obligations and daily race-based microagressions. Effective strategies to address stressors salient to our participants included taking time for self-care, quiet prayer, removing oneself from stressful people, remembering one’s core self in the face of discrimination (i.e., centering), and having a positive mindset. Preferences included integration of faith-based language, using a facility recognized as a community center for the classes (e.g., church), and African American class instructors. Participants noted perceived benefits such as mindfulness as calming and centering, better body and pain awareness, an increased sense that one can better tune out chaos, and that the mindfulness group can provide a forum for race and diversity.

Stress-related growth (SRG) is defined as positive outcomes resulting from stressful or traumatic experiences, such as increases in mastery or coping skills, closeness to others, and spirituality. SRG varies by age, sex, and ethnicity, and is influenced by coping strategies, social support, and stress severity. SRG can occur through mobilization of resources, coping strategies, reconstruction of global beliefs, and meaning making. SRG can be assessed by both quantitative and qualitative measures. Although much of the research in this field has been limited by self-report, further investigation of SRG may prove to be important for clinicians and intervention programs.

The occurrence of hypocalcemia is well documented in clinical veterinary medicine. In this article, we have attempted to provide an overview of the established causes as well as information on more recently recognized etiologies such as the ionized hypocalcemia seen in cats with urethral obstruction and the presence of the disorder in critically ill patient populations. Hypomagnesemia has been identified as the most common electrolyte abnormality in canine and feline critically ill patients. Magnesium depletion and experience with supplementation appear to have most significance in diabetic ketoacidotic patients with the development of associated refractory hypokalemia. (N. Dhupa, BVM, MRCVS, unpublished observations, 1997). Although cardiac arrythmias are associated with hypomagnesemia in human patients, documentation of this association in veterinary patients is lacking. Because hypomagnesemia has been associated with other electrolyte abnormalities in human and veterinary populations, the detection of hypokalemia (particularly if refractory to therapy), hyponatremia, hypophosphatemia, or hypocalcemia should indicate the possibility of coexisting hypomagnesemia.

This study aimed to examine reciprocal relations between cholesterol and depression. We assessed cholesterol and depressive symptoms twice over a 3-year interval, using 842 men from the Veterans Affairs Normative Aging Study ( M = 64, standard deviation = 8). Because depressive symptoms were skewed, we used zero-inflated Poisson analyses. Cross-lagged models showed that cholesterol levels at T1 predicted the existence of depressive symptoms at T2, covarying T1 depressive symptoms, age, smoking status, body mass index, and medications. Depressive symptoms at T1 did not predict cholesterol at T2. Low cholesterol levels may be risk factors for development of depressive symptoms in late life.

The use of arterial blood gas analysis, pulse oximetry, and capnography has become commonplace in the assessment of veterinary patients. Blood gas analysis allows for the qualitative and quantitative assessment of both metabolic and respiratory acid-base problems, including the interrelationships between ventilation, oxygenation, and metabolic conditions. Blood gas analysis is a useful adjunct to clinical patient assessment and other diagnostics in determining appropriate therapy for specific and complex conditions. Both pulse oximetry and capnography are useful monitoring tools. However, they have technical limitations and cannot comprehensively evaluate patient oxygenation and ventilation. Pulse oximetry and capnography are not replacements for arterial blood gas analysis, but rather serve as adjunctive monitoring tools.