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The number of scientific studies investigating mindfulness has increased exponentially over the past few decades. This chapter examines some of the science and research studies that are relevant to teaching mindfulness to emerging adults. The chapter briefly reviews the physiology of stress and relaxation. Additionally, the data supporting the efficacy of Koru are reviewed, and an overview of other research findings that may be of interest to emerging adults is provided. For example, studies showing the impact of mindfulness on academic performance are discussed, as well as studies looking at how mindfulness can overcome unconscious bias and can prompt compassionate action.

The third class follows the same structure as the previous classes. In this chapter, as with the others, there is a script for the opening short meditation. This is followed by typical student comments from check-in. The mindfulness skill taught in this class is guided imagery. The skill is introduced, and then there is a script developed by the Center for Mind–Body Medicine. The final guided meditation, also scripted, focuses on working with thoughts and learning how to label them. There are closing comments, and frequently asked questions are at the end. The questions and answers encompass the experience of meditation, the gratitude part of their meditation log, use of the gatha, anxiety about meditation, and difficulties developing a regular meditation practice.

Chapter 7 describes and provides scripts for teaching the second class in the Koru Basic series. The class begins with an opening meditation, then moves into “check-in.” During check-in, the students discuss their experience doing their mindfulness “homework” over the preceding week and ask questions. The mindfulness-based skill taught during the second class is walking meditation. The closing guided meditation teaches students to use a gatha, a meditation poem that is used to help anchor their awareness in the present moment. The chapter ends with closing comments for the class and frequently asked questions for the second class. Questions and answers in this chapter address goals of meditation, working with restlessness, working with thoughts, and strategies for staying consistent with meditation practice.

Considering the format, structure, and logistics of the Koru course, one is struck by how even these practical aspects of the model make it possible for students to learn the practice and skills being taught. A critical aspect of the model is the emphasis on both meditation and mindfulness-based stress-management skills. This chapter describes the structure and logistics involved in teaching Koru mindfulness. The following elements are reviewed: class structure, including the number and length of classes; recruitment; registration using the Koru teacher dashboard; communication with students; setting; structure; class commitments; and tools for teaching including the Koru mobile app.

Chapter 3 explores general strategies that are useful for teaching mindfulness to emerging adults. Traditional methods of teaching mindfulness and meditation are not always effective for engaging emerging adults. Often, students are enthusiastic about the idea of learning mindfulness, but they then have a hard time actually developing the skills in any meaningful way. This chapter looks at techniques that have proven useful for engaging the students in the study and practice of mindfulness. The strategies are divided into three categories: strategies related to the organization and structure of the class, strategies related to general teaching techniques, and strategies for dealing with typical student reactions. Each of these categories is fully explored, and examples of how to implement the various strategies are provided.

When the Koru courses started in 2005, the depth of the transformation that many students would experience in just four classes was not anticipated. Initially, the goals for the students mirrored their goals for themselves: less worry and stress, greater happiness, improved academic performance, and improved sleep. The hope was that the course could, in some small way, help them move toward the improved quality of life they were seeking. But the students have shown that they are capable of much more, many of them expressing their sense of having been transformed in important ways. The final chapter is about the transformation that emerging adults who have been through the Koru curriculum report experiencing. Drawing from the comments of students after completing Koru, the chapter explores how students feel they are impacted by having learned mindfulness and how they see it influencing their lives moving forward.

This chapter reviews the new developments in the Koru Mindfulness curriculum since the first edition of Mindfulness for the Next Generation was published in 2011. These developments include the creation of The Center for Koru Mindfulness to train and certify teachers to deliver the Koru Mindfulness curriculum, the expansion of the curriculum to include Koru 2.0 and Koru Retreat (a 4-hour experience that is conducted in silence and includes various meditations, such as sitting, walking, and eating, as well as a short talk on mindfulness by the teacher and a yoga experience), and the development of a Koru mobile app that communicates with the new Koru Teacher Dashboard.

Chapter 2 explores in greater detail the characteristics of the developmental stage of emerging adulthood as well as highlights the usefulness of mindfulness and meditation for this age group. Emerging adulthood is defined by Jeffrey Arnett as a time of identity development in multiple important areas. The developmental stage of emerging adulthood is often expressed differently across racial and ethnic groups and socioeconomic classes. Emerging adults are seeking to answer questions about their direction in life and to discern what relationships and careers are best for them. Mindfulness is a useful tool for this quest as it aids emerging adults in identifying their authentic wishes and needs. The mindfulness-based stress-management tools also allow them to tolerate the stress that comes from all the uncertainties and pressures inherent in this time of development.

To evaluate the effectiveness of Koru, a mindfulness training program for college students and other emerging adults.Ninety students (66% female, 62% white, 71% graduate students) participated between Fall 2012 and Spring 2013.Randomized controlled trial. It was hypothesized that Koru, compared with a wait-list control group, would reduce perceived stress and sleep problems, and increase mindfulness, self-compassion, and gratitude.As hypothesized, results showed significant Group (Koru, Wait-List)×Time (Pre, Post) interactions for improvements in perceived stress (F[1, 76.40]=4.50, p=.037, d=.45), sleep problems (F [1, 79.49]=4.71, p=.033, d=.52), mindfulness (F [1, 79.09]=26.80, p.001, d=95), and self-compassion (F[1, 74.77]=18.08, p.001, d=.75). All significant effects were replicated in the wait-list group. Significant correlations were observed among changes in perceived stress, sleep problems, mindfulness, and self-compassion.Results support the effectiveness of the Koru program for emerging adults in the university setting.

Summary Background Few data are available on the effect of social ties on dementia development. This study explored whether single social network components and different degrees of the social connections affect dementia incidence. Methods A community-based cohort of 1203 non-demented people, living at home in the Kungsholmen district of Stockholm, Sweden, and who had good cognition, was followed for an average period of 3 years. On the basis of medical and psychological data, 176 patients were diagnosed with dementia according to the criteria of the third edition revision of the Diagnostic and Statistical Manual of Mental Disorders. Information on social network was obtained by personal interview by trained nurses at baseline. The covariates included in the analysis were age, sex, education, cognitive and functional status, depressive symptoms, and vascular diseases. Findings Those individuals living alone, and those without any close social ties, both had an adjusted relative risk for developing dementia of 1·5 (95% CI 1·0–2·1 and 1·0–2·4, respectively). Compared with married people living with someone, single people and those living alone had an adjusted relative risk of 1·9 (95% CI 1·2–3·1). Infrequent contacts with network resources did not increase the risk of the disease if such contacts were experienced as satisfying. When all components were combined in an index, a poor or limited social network increased the risk of dementia by 60% (95% CI 1·2–2·1), and a significant gradient was found for the four degrees of social connections (p=0·0009). Interpretation An extensive social network seems to protect against dementia. Confirmation of this finding and further investigation to clarify the mechanisms are worthwhile due to the implications for prevention.

College students and other young adults today are experiencing high levels of stress as they pursue personal, educational, and career goals. In recent years there has been increased awareness of the seriousness of these struggles, which may increase the risk of psychological distress and mental illness among this age group now commonly referred to as “emerging adults.” Scientific research has shown that practicing mindfulness can help manage stress and enhance quality of life, but traditional methods of teaching mindfulness and meditation are not always effective for emerging adults. Mindfulness for the Next Generation is an easy-to-use guide that details Koru Mindfulness, a curriculum developed at Duke University, designed specifically for teaching mindfulness to emerging adults. Koru has been tested and shown to be effective for helping this age group learn the practice of mindfulness. Koru is now used at hundreds of universities in the United States and abroad. In Mindfulness for the Next Generation, authors Holly Rogers and Margaret Maytan, the developers of the Koru program, discuss the unique challenges emerging adults face, review the research on Koru and mindfulness in general for this population, and provide an overview of the Koru curriculum. This book is the primary resource for individuals learning to teach the Koru curriculum.

Chapter 6 provides a detailed description of the first of the four classes that comprise the Koru Basic curriculum developed at Duke University to teach mindfulness and meditation to students. The class starts with a brief opening meditation, and a sample script for this meditation is provided. This is followed by introductions and orientation to the class. In the first class, two stress-management tools are taught: belly breathing and dynamic breathing. Scripts are provided for teaching each of these skills. The class closes with a longer guided meditation, also scripted, that teaches the body-scan technique. The chapter ends with closing comments and frequently asked questions from the first class. The questions and answers address the definition of mindfulness, the breathing skills, specifics about meditation technique, and the attitude of acceptance.

This chapter describes the fourth and final class. There is a script for the opening meditation, followed by a description of check-in, with common student comments. The meditation skill taught is eating meditation, and a script is given which guides the students through the mindful eating of a grape or raisin. The final meditation, also scripted, gives the students more practice using labels and expands labeling practice to awareness and labeling of feelings. There is emphasis on how important it is for the students to find a direction for further learning and practice. There are frequently asked questions at the end of the chapter, which include the topics of eating meditation, labeling, how to continue the practice when the course is over, and the sharing of positive change brought about by the course.

The purpose of this research was to assess the frequency and severity of neuropsychiatric and behavioral symptoms and to examine the association between preexisting medical conditions and specific neuropsychiatric symptoms in demented individuals. We studied 211 demented subjects (87.7 percent male) who were participants in epidemiological studies of dementia. Using the Neuropsychiatric Inventory (NPI), we assessed the frequency and severity of neuropsychiatric symptoms. We collected medical history information during a structured telephone interview. Our analyses focused on determining prevalence of neuropsychiatric symptoms by dementia diagnosis and severity. We also examined the association of history of head injury, alcohol abuse, and stroke with development of neuropsychiatric symptoms. We found that neuropsychiatric symptoms were common, with approximately three-fourths of the subjects exhibiting at least one symptom during the preceding month. Apathy (39.3 percent), agitation (31.8 percent), and aberrant motor behavior (31.1 percent) were the most frequent symptoms. Frequency and severity of symptoms were similar for the all-dementia and Alzheimer's disease–only groups. neuropsychiatric symptoms varied by severity of dementia, but generally not in a consistent ordinal pattern. History of alcohol abuse, head injury, or stroke was associated with presence of specific neuropsychiatric symptoms in dementia. While psychiatric symptoms are common in dementia, they also vary by type and severity of dementia. The finding that certain medical conditions may increase risk for specific types of neuropsychiatric symptoms expands our knowledge of the natural history of dementia and should improve management of dementia in medically ill patients. Our results may also shed light on mechanisms that underlie neuropsychiatric symptoms.

It's a rare disease, this Streptococcal Toxic Shock Syndrome, and caused by what the press likes to refer to as the "killer bacteria" (Group A Streptococcus Type M). And yet in the summer of 1998 I got this disease. Out of the blue. At age 47, in perfect health. And thus began my saga of physician as patient, a story of great suffering and great blessings. I am a better physician because of it, and I have developed deeper, more loving connections with the people closest to me. My story is not told from memory. From the onset of the first symptoms until my awakening in an intensive care unit 14 days later I have total memory loss. I have slowly pieced together as much of these 2 weeks as possible. I have spoken with doctors and nurses, with family and friends. I have copies of all of my medical records. Yet there is an emotional gap, which I can't bridge. The powerful drama of those days is lost to me. This loss is a mercy and a sorrow. The memory loss has proved to be almost as dramatic and powerful as the illness and recovery.