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Objectives This paper describes the emergence of the scientific study of mindfulness in schools; summarizes findings of experimental research on the impacts of school-based mindfulness programs (SBMPs) on student outcomes in prekindergarten, primary, and secondary school settings (ages 4–18 years); discusses scientific limitations and wider critiques of this work; and offers suggestions for future research. Methods Public data are used to describe the emergence of science on SBMPs, the foci of this research, and the academic disciplines contributing to it. A narrative summary of scientific findings regarding the impacts of SBMPs on students, and critiques of this work, is also presented. Results Research is increasing and is primarily psychological and prevention-oriented. Evidence shows SBMPs can enhance students’ self-regulation abilities, but SBMPs’ impacts on other student outcomes at different ages are equivocal. The current research has significant limitations, and these, alongside wider critiques of the work, suggest important directions for research. Conclusions In the next generation of science, we suggest (a) improving the experimental research; (b) expanding developmental research; and (c) re-envisioning assumptions, theories, and methods in research to go “beyond all splits” towards a non-dualistic and relationally, culturally, contextually, ethically, and developmentally grounded science on mindfulness and compassion for students in schools.

Significant concerns have been raised about the "mental health crisis" on college campuses, with attention turning to what colleges can do beyond counseling services to address students' mental health and well-being. We examined whether primarily first-year (89.1%) undergraduate students (In a two-wave, multi-site, propensity-score matched controlled trial (ASHFASHF participants reported significantly improved mental health (i.e., reduced depression) and flourishing, improvements on multiple attention and social-emotional skills (e.g., attention function, self-compassion), and increases in prosocial attitudes (empathic concern, shared humanity; Cohen'sThis research provides initial evidence that the ASHF course may be a promising curricular approach to reduce and potentially prevent poor mental health while promoting flourishing in college students. Continued research is needed to confirm these conclusions.

There is a consensus among educators, parents, and policymakers that education should include a focus on supporting essential social and emotional capacities to help children navigate the world successfully. To develop these competencies, many schools adopt social and emotional learning (SEL) programs. The report on which this brief is based reviews the findings from 12 meta-analyses of school-based SEL programs. Across these studies, there is a consistent, reliable effect of tested, evidence-based SEL programs on students’ social, emotional, behavioral, and academic outcomes in PreK–12th grade, including the development of social and emotional skills, improved academic engagement and performance, growth of positive social behaviors, and lower rates of behavior problems and psychological distress. These findings are applicable across gender, ethnicity and race, income, and other demographic variables.

Recent studies suggest mental health in youths is deteriorating. The current policy in the United Kingdom emphasizes the role of schools for mental health promotion and prevention, but little data exist on what aspects of schools influence mental health in pupils. This study explored school-level influences on the mental health of young people in a large school-based sample from the United Kingdom.Baseline data from a large cluster randomized controlled trial collected between 2016 and 2018 from mainstream secondary schools selected to be representative in relation to their quality rating, size, deprivation, mixed or single-sex pupil population, and country were analyzed. Participants were pupils in their first or second year of secondary school. The study assessed whether school-level factors were associated with pupil mental health.The study included 26,885 pupils (response rate = 90%; age range, 11‒14 years; 55% female) attending 85 schools in the United Kingdom. Schools accounted for 2.4% (95% CI: 2.0%‒2.8%; p .0001) of the variation in psychopathology, 1.6% (95% CI: 1.2%‒2.1%; p .0001) of depression, and 1.4% (95% CI: 1.0%‒1.7%; p .0001) of well-being. Schools in urban locations, with a higher percentage of free school meals and of White British, were associated with poorer pupil mental health. A more positive school climate was associated with better mental health.School-level variables, primarily related to contextual factors, characteristics of pupil population, and school climate, explain a small but significant amount of variability in mental health of young people. This information might be used to identify schools that are in need of more resources to support mental health of young people.MYRIAD: My Resilience in Adolescence, a Study Examining the Effectiveness and Cost-Effectiveness of a Mindfulness Training Programme in Schools Compared With Normal School Provision; https://www.isrctn.com/; 86619085.

This study explores whether variability in the implementation of an undergraduate course on human flourishing is differentially associated with student outcomes. 101 students in the “Art and Science of Human Flourishing” course across three large, public, R1 universities in Fall 2018 participated in the study. Formative course data included researcher observations of weekly class pedagogy, students’ weekly meditation practice logs and end−of−course assessments, and pre/post surveys measuring changes in participating students’ outcomes related to flourishing (e.g., attentional skills, social−emotional skills, perspectives on flourishing, mental and physical health). Although course pedagogy and student engagement varied across the three universities, students’ outcomes were nonetheless similar. Variability in course implementation did not appear to differentially affect students’ outcomes. We tentatively conclude that other institutions interested in offering the flourishing course may make limited adaptations to fit their pedagogical preferences without concern for altering its impact on students.

Highlights • One-in-five adolescents reported suicidality or pain. • Pain was associated with an increased risk of suicidality and vice versa (OR=4.00). • Network analysis supported the pain-suicidality association (aOR=1.39). • This cross-sectional association was not moderated by depression. • Pain should be considered as a key risk correlate of suicidality in adolescents., Background Whilst growing research suggests that pain is associated with suicidality in adolescence, it remains unclear whether this relationship is moderated by co-morbid depressive symptoms. The present study aimed to investigate whether the pain-suicidality association is moderated by depressive symptoms. Methods We performed secondary analyses on cross-sectional, pre-intervention data from the ‘My Resilience in Adolescence’ [MYRIAD] trial (ISRCTN ref: 86619085; N=8072, 11-15 years). Using odds ratio tests and (moderated) network analyses, we investigated the relationship between pain and suicidality, after controlling for depression, anxiety, inhibitory control deficits and peer problems. We investigated whether depression moderates this relationship and explored gender differences. Results Overall, 20% of adolescents reported suicidality and 22% reported pain, whilst nine percent of adolescents reported both. The experience of pain was associated with a four-fold increased risk of suicidality and vice versa (OR=4.00, 95%-CI=[3.54;4.51]), with no gender differences. This cross-sectional association remained significant after accounting for depression, anxiety, inhibitory control deficits and peer problems (aOR=1.39). Depression did not moderate the pain-suicidality association. Limitations The item-based, cross-sectional assessment of pain and suicidality precludes any conclusions about the direction of the effects and which aspects of suicidality and pain may drive this association. Conclusions Our findings underscore the need to consider pain as an independent risk correlate of suicidality in adolescents. Longitudinal research should examine how this relationship develops during adolescence. Clinically, our findings emphasise the need to assess and address suicidality in adolescents with pain, even in the absence of depressive symptoms.

BackgroundEducation is broader than academic teaching. It includes teaching students social–emotional skills both directly and indirectly through a positive school climate.ObjectiveTo evaluate if a universal school-based mindfulness training (SBMT) enhances teacher mental health and school climate.MethodsThe My Resilience in Adolescence parallel group, cluster randomised controlled trial (registration: ISRCTN86619085; funding: Wellcome Trust (WT104908/Z/14/Z, WT107496/Z/15/Z)) recruited 85 schools (679 teachers) delivering social and emotional teaching across the UK. Schools (clusters) were randomised 1:1 to either continue this provision (teaching as usual (TAU)) or include universal SBMT. Data on teacher mental health and school climate were collected at prerandomisation, postpersonal mindfulness and SBMT teacher training, after delivering SBMT to students, and at 1-year follow-up.FindingSchools were recruited in academic years 2016/2017 and 2017/2018. Primary analysis (SBMT: 43 schools/362 teachers; TAU: 41 schools/310 teachers) showed that after delivering SBMT to students, SBMT versus TAU enhanced teachers’ mental health (burnout) and school climate. Adjusted standardised mean differences (SBMT minus TAU) were: exhaustion (−0.22; 95% CI −0.38 to −0.05); personal accomplishment (−0.21; −0.41, −0.02); school leadership (0.24; 0.04, 0.44); and respectful climate (0.26; 0.06, 0.47). Effects on burnout were not significant at 1-year follow-up. Effects on school climate were maintained only for respectful climate. No SBMT-related serious adverse events were reported.ConclusionsSBMT supports short-term changes in teacher burnout and school climate. Further work is required to explore how best to sustain improvements.Clinical implicationsSBMT has limited effects on teachers’ mental and school climate. Innovative approaches to support and preserve teachers’ mental health and school climate are needed.

Purpose: We explored what predicts secondary school students’ mindfulness practice and responsiveness to universal school-based mindfulness training (SBMT).Methods: Participants were 4,232 students (aged 11-13) in 43 UK secondary schools, who received universal SBMT (i.e., “.b” program), within the MYRIAD trial (ISRCTN86619085). Theory-driven student, teacher, school, and implementation factors were evaluated as potential predictors of students’ home-based mindfulness practice and responsiveness (i.e., interest in and attitudes towards SBMT), using mixed effects linear regressions. We explored pupils’ SBMT experiences using thematic content analysis of their answers to two free response questions, one focused on positive experiences and one on difficulties/challenges.Results: Students reported practicing home-based mindfulness exercises on average ‘once’ during the intervention (M (SD) = 1.16 (1.07), range 0-5). Students’ average ratings of responsiveness were intermediate (M (SD) = 4.72 (2.88), range 0-10). Girls reported more mindfulness practice and responsiveness. High-risk of mental health problems was associated with lower responsiveness. White ethnicity and higher school deprivation were related to greater responsiveness. More SBMT sessions and better quality of delivery were associated with greater mindfulness practice and responsiveness. In terms of students’ experiences of SBMT, the most frequent themes (60% of the minimally elaborated responses) were an increased awareness of bodily feelings/sensations and increased ability to regulate emotions. Conclusions: Most students did not engage with home-based mindfulness practice. While responsiveness to the SMBT was intermediate on average, there was substantial variation with some youth rating it negatively and others rating it positively. Future SBMT developers should codesign curricula with students, carefully considering the student characteristics, aspects of the school environment, and implementation factors associated with mindfulness practice and responsiveness. SBMT teacher training is key, as more observed proficiency in SBMT teaching is associated with greater students’ mindfulness practice and responsiveness to SBMT.

The purpose of this study was to assess the effectiveness of a manualized mindfulness-based program for adolescents, Learning to Breathe (L2B), on indicators of adolescent social-emotional well-being, mental health, substance use, and executive function. Participants included 251 high school students attending an urban school district who were randomly assigned to required health education classes that offered L2B or the business-as-usual health curriculum. No direct effects on self-report measures were found. Students exposed to L2B demonstrated significant improvements on executive functioning measures related to susceptibility to cognitive interference and working memory. Subsequent tests of moderation revealed beneficial program effects within the treatment group were dependent on rates of practice, and those that used L2B strategies regularly showed small-to-moderate improvements on indices of emotional awareness, emotional clarity, impulse control, social connectedness, mind-wandering, substance use, perceived stress, and self-compassion relative to controls. This study provides mixed support regarding the potential effectiveness of a universal mindfulness program for high school students. The absence of direct effects on self-report measures implies that simply exposing adolescents to a mindfulness curriculum within the context of typical instruction, in the absence of supports for implementation, is unlikely to impact youth socio-emotional well-being or behavior. However, changes in EF favoring the intervention group suggest that possible benefits on tasks related to susceptibility, cognitive interference, and selective attention are possible. Tests of moderation revealed dosage effects, and students who adopt mindfulness practices can indeed benefit on multiple fronts.

Research on mindfulness-based programs (MBPs) for adolescents suggests improvements in stress, emotion regulation, and ability to perform some cognitive tasks. However, there is little research examining the contextual factors impacting why specific students experience particular changes and the process by which these changes occur. Responding to the NIH call for “n-of-1 studies” that examine how individuals respond to interventions, we conducted a systematic case study, following an intervention trial (Learning to BREATHE), to investigate how individual students experienced an MBP. Specifically, we examined how students’ participation impacted their perceived stress and well-being and why students chose to implement practices in their daily lives. Students in health classes at two diverse high schools completed quantitative self-report measures (pre-, post-, follow-up), qualitative interviews, and open-ended survey questions. We analyzed self-report data to examine whether and to what extent student performance on measures of psychological functioning, stress, attention, and well-being changed before and after participation in an MBP. We analyzed qualitative data to investigate contextual information about why those changes may have occurred and why individuals chose to adopt or disregard mindfulness practices outside the classroom. Results suggest that, particularly for high-risk adolescents and those who integrated program practices into their daily lives, the intervention impacted internalizing symptoms, stress management, mindfulness, and emotion regulation. Mindful breathing was found to be a feasible practice easily incorporated into school routines. Contextual factors impacted practice uptake and program outcomes. Implications for practitioners aiming to help high school students manage stress are discussed.

This study evaluated emerging adult effects of the PROmoting School-Community-University Partnerships to Enhance Resilience (PROSPER) universal prevention delivery system implemented in middle schools. Twenty-eight rural school districts were randomized to intervention and control conditions, with 1985 nineteen-year-old participants (90.6% White, 54.1% female) evaluated through age 25. Intent-to-treat, multi-level, point-in-time analyses of covariance and growth analyses were conducted. Outcomes were assessed with self-report measures of substance misuse (lifetime, current, frequency) and conduct problem behaviors. Analyses showed very limited point-in-time effects; there were growth pattern effects on measures of illicit drugs, non-prescribed drugs, cigarettes, and drug problems. When risk moderation was observed, it favored higher-risk participants. These emerging adult effects concerning slower growth of lifetime misuse combine with more robust adolescent stage findings to support PROSPER's public health value.

There is evidence that universal school-based mindfulness training (SBMT) can have positive effects for young people. However, it is unknown who benefits most from such training, how implementation quality impacts effects, and how training exerts effects. No known scoping reviews have comprehensively reviewed moderation, mediation and implementation factors of SBMT. This study aimed to provide an overview of the evidence on the mediators, moderators, and implementation factors of SBMT and propose a conceptual model that can be used both to summarize the evidence and provide a framework for future research. A scoping review was performed based on methodology outlined by the Joanna Briggs Institute’s Manual. Six databases and grey literature were searched. Inclusion and exclusion criteria were applied to select relevant material. Quantitative and qualitative information was extracted from eligible articles and reported in accordance with PRISMA-ScR guidelines. The search produced 5, 479 articles, of which 37 were eligible and included in the review. Eight studies assessed moderators of SBMT on pupil outcomes, with mixed findings for all variables tested. Four studies examined the mediating effect of specific variables on pupil outcomes, with evidence that increases in trait mindfulness and decreases in cognitive reactivity and self-criticism post-intervention are related to better pupil outcomes at follow-up. Twenty-five studies assessed implementation factors. We discuss key methodological shortcomings of included studies of SBMT, and integrate our findings with existing implementation frameworks to propose a conceptual model. Widespread interest in universal SBMT has led to increased research over recent years, exploring who SBMT works for and how it might work, but the current evidence is limited. We make recommendations for future research and provide a conceptual model to guide theory-led developments and research in SBMT.

There are fewer evidence-based social and emotional learning programs for middle school students compared to younger grades. This randomized controlled trial tests the effectiveness of Facing History and Ourselves (hereafter, Facing History) with a sample of 694 (Facing History n = 437; Comparison n = 257) students from a low-resourced school district. Youth self-identified as female (59%), Black/African American (61%), Hispanic/Latinx (18%), White (2%), and multi-racial or some other race/ethnicity (19%). Intervention students perceived their classrooms as more caring and democratic than students in the comparison group. They reported higher levels of empathy, prosocial behavior, and stronger participatory citizenship beliefs. This study expands the evidence-based of effective SEL programs available to schools.

Mindfulness training (MT) is considered appropriate for school teachers and enhances well-being. Most research has investigated the efficacy of instructor-led MT. However, little is known about the benefits of using self-taught formats, nor what the key mechanisms of change are that contribute to enhanced teacher well-being. This study compared instructor-led and self-taught MT based on a book (Williams & Penman, 2011) in a sample of secondary school teachers. We assessed expectancy, the degree to which participants believed the intervention was effective, their program engagement, well-being and psychological distress, and evaluated whether mindfulness and self-compassion skills acted as mediators of outcomes. In total, 206 teachers from 43 schools were randomized by school to an instructor-led or self-taught course—77% female, mean age 39 years (SD = 9.0). Both MT formats showed similar rates of participant expectancy and engagement, but the instructor-led arm was perceived as more credible. Using linear mixed-effects models, we found the self-taught arm showed significant pre-post improvements in self-compassion and well-being, while the instructor-led arm showed such improvements in mindfulness, self-compassion, well-being, perceived stress, anxiety, depression, and burnout. Changes over time significantly differed between the groups in all these outcomes, favoring the instructor-led arm. The instructor-led arm, compared with the self-taught, indirectly improved teacher outcomes by enhancing mindfulness and self-compassion as mediating factors. Mindfulness practice frequency had indirect effects on teacher outcomes through mindfulness in both self-taught and instructor-led arms. Our results suggest both formats are considered reasonable, but the instructor-led is more effective than the self-taught. Trial registration: ISRCTN18013311., Educational Impact and Implications Statement Mindfulness training enhances teachers’ well-being. This study compared two different mindfulness training formats with a sample of 206 secondary school teachers using an experimental design. Results suggested that teachers’ well-being was increased in both formats of delivery and both generated similar expectancy and engagement with the mindfulness practice; but the instructor-led format appeared to be more credible and effective and was also able to reduce teachers’ stress, anxiety, depressive symptomatology, and burnout. In contrast, the self-taught program might be useful for those teachers who cannot access or commit to an instructor-led program, provided they engage with mindfulness practice. This study suggests two forms for teachers to learn mindfulness, instructor-led and self-taught, as a way to support well-being, each with its own advantages.

BackgroundSystematic reviews suggest school-based mindfulness training (SBMT) shows promise in promoting student mental health.ObjectiveThe My Resilience in Adolescence (MYRIAD) Trial evaluated the effectiveness and cost-effectiveness of SBMT compared with teaching-as-usual (TAU).MethodsMYRIAD was a parallel group, cluster-randomised controlled trial. Eighty-five eligible schools consented and were randomised 1:1 to TAU (43 schools, 4232 students) or SBMT (42 schools, 4144 students), stratified by school size, quality, type, deprivation and region. Schools and students (mean (SD); age range=12.2 (0.6); 11–14 years) were broadly UK population-representative. Forty-three schools (n=3678 pupils; 86.9%) delivering SBMT, and 41 schools (n=3572; 86.2%) delivering TAU, provided primary end-point data. SBMT comprised 10 lessons of psychoeducation and mindfulness practices. TAU comprised standard social-emotional teaching. Participant-level risk for depression, social-emotional-behavioural functioning and well-being at 1 year follow-up were the co-primary outcomes. Secondary and economic outcomes were included.FindingsAnalysis of 84 schools (n=8376 participants) found no evidence that SBMT was superior to TAU at 1 year. Standardised mean differences (intervention minus control) were: 0.005 (95% CI −0.05 to 0.06) for risk for depression; 0.02 (−0.02 to 0.07) for social-emotional-behavioural functioning; and 0.02 (−0.03 to 0.07) for well-being. SBMT had a high probability of cost-effectiveness (83%) at a willingness-to-pay threshold of £20 000 per quality-adjusted life year. No intervention-related adverse events were observed.ConclusionsFindings do not support the superiority of SBMT over TAU in promoting mental health in adolescence.Clinical implicationsThere is need to ask what works, for whom and how, as well as considering key contextual and implementation factors.Trial registrationCurrent controlled trials ISRCTN86619085. This research was funded by the Wellcome Trust (WT104908/Z/14/Z and WT107496/Z/15/Z).

This study examines crossover effects of adolescent substance misuse preventive interventions on academic success in college. It evaluates pathways of influence on college grades, via effects on school engagement, problem-solving skills, and substance misuse in high school. Data were collected as part of an Randomized Controlled Trial (RCT) evaluating a multicomponent intervention conducted in 28 school districts with middle school students. At age 19, study participants (N = 1,488) enrolled in college reported on college grades. The model fit the data, supporting hypothesized pathways of intervention impacts. Inclusion of a significant direct effect on college grades further improved model fit. Results support the potential for universal substance misuse preventive interventions delivered by community partnerships during middle school to yield effects on long-term academic success. [ABSTRACT FROM AUTHOR]

The current study examined unfolding relations among mothers' mindful parenting, parent-adolescent recurrent conflict, and adolescents' externalizing and internalizing problems. In a community sample of 117 families (31% black, Asian, American Indian, or Latino), parents and adolescents (52% female; average age = 12.13 years) were followed over 15 months. Parents answered questions about mindful parenting and recurrent conflict, and adolescents reported on their own externalizing and internalizing problems. Path analyses indicated that higher levels of mindful parenting were significantly related to lower levels of recurrent conflict 2-3 months later, controlling for previous levels of recurrent conflict. Moreover, lower levels of recurrent conflict were significantly related to lower levels of externalizing problems and internalizing problems 1 year later, controlling for previous levels of those problems. Subgroup analyses indicated that relations were comparable across subgroups defined by adolescent gender, race, parent marital status, and family financial strain. The effects of mindful parenting were robust even after accounting for other indicators of positive and supportive parenting, namely inductive reasoning and warmth in the parent-adolescent relationship. These findings highlight the potential of mindful parenting to improve family interactions and adolescent adjustment.

This study qualitatively examined the relationship between home practice and reperceiving for teachers who participated in the CARE program. We used distress tolerance, mindfulness, burnout, efficacy, compassion, and self-care as proxies for (or direct representations of) underlying components of reperceiving—awareness, emotion regulation, and compassion. From a larger study of 224 elementary teachers in a large urban district, 16 teachers were purposively selected for semi-structured interviews. Selected teachers fit one of three profiles: no adopted mindfulness practice; no practice at baseline but practice at post and follow-up; practice at baseline, post, and follow-up. Four coders employed a directed content analysis to (1) investigate the outcomes discretely, examining their prevalence within the three practice groups; (2) analyze the relationships between outcomes and whether these differed across practice groups; and (3) examine teachers’ descriptions of how they used the practices. There were no differences between practice groups in teachers’ reported amounts of stress, but differences were found across outcomes, specifically mindfulness and efficacy. The no practice group engaged in more suppression and felt less capable of handling their stressors. Teachers who adopted practice described an emerging awareness of their negative emotions, more facility to let go of their stressors, and greater affirmation of the importance of self-care and use of strategies to promote it. Compassion lacked prevalence across practice groups. Adoption of mindfulness practice may impact teachers’ capacity to reperceive through emotional awareness and self-regulation, but additional research is required to examine the role of compassion.

Head trauma in early childhood has been hypothesized as a potential risk factor for childhood brain tumours (CBTs). However, head trauma has not been extensively studied in the context of CBTs and existing studies have yielded conflicting results. A population- and hospital-based case-control study of children 0-15 years with newly diagnosed CBTs from 1997-2003 recruited across Ontario through pediatric oncology centres was conducted. Controls were frequency-matched with cases by age, sex and geographical region. The association was assessed based on multivariable logistic regressions, accounting for child's age, sex, ethnicity, highest level of maternal education, and maternal pack-years of smoking during the pregnancy. Analyses were conducted separately based on age of first head trauma, sex and histology. A latency period analysis was conducted. Overall, based on 280 cases and 919 controls, CBTs were not significantly associated with previous history of head trauma (OR 1.34, 95% CI 0.96, 1.86), head trauma severity, number of head injuries, nor head or neck X-rays or computed tomography (CT) examinations. Results were consistent across sexes and histological subtypes. However, head trauma within the first year of life was significantly associated with CBTs (OR 2.00, 95% CI 1.01, 3.98), but the association diminished when adjusted for X-ray or CT occurring during the same time period (OR 1.62, 95% CI 0.75, 3.49), albeit limited sample size. Overall, no association was observed between head trauma and CBTs among all children, while head trauma occurring within first year of life may warrant further investigation in future research. This article is protected by copyright. All rights reserved.

a.Objectives: Significant concerns have been raised about the “mental health crisis” on college campuses, with attention turning to to what colleges can do beyond counseling services to address students’ mental health and well-being. We examined whether primarily first-year (87.3%) undergraduate students (n=651) who enrolled in the Art and Science of Human Flourishing (ASHF), a novel academic and experiential for-credit course on human flourishing, would demonstrate improved mental health and strengthen skills and behaviors associated with flourishing relative to students who did not enroll in this course.b.Methods: In a two-wave, multi-site, propensity-score matched controlled trial (ASHF n=217, Control n=434; N=651), we used hierarchal linear models and false discovery rate corrected doubly robust estimates to evaluate the impact of the ASHF on attention and social-emotional skill development, flourishing perspectives, mental health, and risk behavior outcomes.c.Results: ASHF participants reported significantly improved mental health (i.e., reduced depression) and flourishing, improvements on multiple attention and social-emotional skills (e.g., attention function, self-compassion), and increases in prosocial attitudes (empathic concern, shared humanity; Cohen’s ds= 0.18–0.46) compared to controls. There was no evidence for ASHF course impacts on health or risk behaviors, raising the possibility that these behaviors may take more time to change.d.Conclusions: This research provides initial evidence that the ASHF course may represent an effective curricular approach to reducing and potentially preventing poor mental health and promoting flourishing in college students.

OBJECTIVE: Mindfulness training has been shown to reduce rates of depression, anxiety and perceived stress, but its impact on stress and emotion regulation in real-world settings in the college-aged population is unknown. This study examines the effect of an 8-session long mindfulness training on first-year college students’ daily experiences of stress and emotion regulation. METHODS: Fifty-two first-year students were randomized to the mindfulness training or the waitlist-control group during the fall academic semester. Before, during and after the trial, students completed 10-days of ecological momentary assessments (EMA), reporting on family and school or work stress, negative emotion, rumination, and interference by unwanted thoughts and emotions up to four times a day. Multilevel regression analysis compared levels of momentary stress and emotion regulation difficulties, as well as the strength of the moment-level association between stress and emotion regulation, by intervention condition, before, during and after the trial. RESULTS: Controls showed an exacerbation of family stress related negative emotion, rumination and interference, across the fall semester. However, intervention youth showed stable levels of emotion regulation responses to family stress across the semester. Emotion regulation responses to school or work stress did not differ by intervention condition. CONCLUSIONS: Mindfulness training helps to prevent the depletion of emotion regulation capacity in this sample of relatively healthy first-year college students. EMAs allow the assessment of emotion regulation in the context of naturally occurring stress, and enhances the specificity and external validity of evaluations of psychological interventions.

Introduction Several prior studies have demonstrated an association between trisomy 21 and airway-related anesthetic complications. However, there is a paucity of large clinical studies characterizing the airway challenges associated with trisomy 21. In this analysis, we examine anesthetic-related airway complications in children with trisomy 21 and compare our findings to well-matched controls. Methods A chart review of all general anesthetics occurring between 2011 and 2017 at a single pediatric hospital was performed. Children with trisomy 21 were identified. Matched controls were created using a 1:1 propensity score and controlling for patient sex, patient age, surgical specialty, airway management, and anesthetic induction technique. The primary outcomes were the numbers of difficult intubations and perioperative respiratory adverse events. Secondary outcomes included the number of intubation attempts and the Cormack-Lehane grade in each cohort. Results/data analysis A total of 2702 anesthetic records were reviewed. Propensity score matching resulted in adequately matched control groups as indicated by a standard mean difference below 0.2 in each case. Logistic regression analysis between trisomy 21 patients and matched controls demonstrated that the trisomy 21 cohort had a higher incidence of perioperative respiratory adverse events (OR 2.04, 95% CI 1.34-3.09, p = .0008) due largely to a higher incidence of airway obstruction (1.7% vs. 0.2%, p = .0005). The trisomy 21 group had a lower rate of difficult intubation (OR 0.26, 95% CI 0.07-0.91, p = .034). There was no association between trisomy 21 and the number of intubation attempts (RR 0.99, 95% CI 0.88-1.13, p = .92) or Cormack-Lehane grade (RR 0.95, 95% CI 0.87-1.05, p = .35). Discussion The trisomy 21 cohort had an increased incidence of perioperative respiratory adverse events compared to matched controls, largely secondary to a higher rate of obstructed ventilation, but without statistically different rates of laryngospasm, bronchospasm, postextubation stridor, or other desaturation events. Our trisomy 21 cohort had a decreased incidence of difficult intubation. There was no association between trisomy 21 and number of attempts required to successfully place an endotracheal tube or a less favorable CL grade. Conclusions Compared to matched controls, children with trisomy 21 have a lower incidence of difficult intubation and a higher incidence of perioperative respiratory adverse events, largely due to increased rate of airway obstruction.

BackgroundThere is growing research support for the use of mindfulness training (MT) in schools, but almost no high-quality evidence about different training models for people wishing to teach mindfulness in this setting. Effective dissemination of MT relies on the development of scalable training routes.ObjectiveTo compare 4 training routes for school teachers wishing to deliver MT differing in intensity and potential scalability, considering teaching competency, training acceptability, and cost-effectiveness.MethodsSchools were randomized to an existing route comprising an 8-session instructor-led personal mindfulness course, combined with 4-day MT program training, or 1 of 3 more scalable, lower intensity, alternatives: an instructor-led personal mindfulness course combined with 1-day MT program training, a self-taught personal mindfulness course (delivered through a course book) combined with 4-day MT program training, and a self-taught personal mindfulness course combined with 1-day MT program training.ResultsAttrition from training was substantial across all routes. The instructor-led course was more effective than the self-taught course in increasing teachers’ personal mindfulness skills. Even the most intensive (existing) training route brought only 29% of the teachers commencing training, and 56% of those completing the study protocol, to the required minimum competency threshold (an advanced beginner rating on an adapted version of the Mindfulness-based Interventions Teaching Assessment Criteria). The differences in levels of competency achieved by existing training compared with the more scalable alternatives were modest, with economic evaluation suggesting that the existing route was both more expensive and more effective than lower intensity alternatives, but with no statistically significant differences between routes.ConclusionsThis research questions the move toward abbreviating teacher training to increase scalability and suggests instead that many teachers require additional support to ensure competency from first delivery of MT in the classroom.

Social emotional learning (SEL) programs are increasingly being implemented in elementary schools to facilitate development of social competencies, decision-making skills, empathy, and emotion regulation and, in effect, prevent poor outcomes such as school failure, conduct problems, and eventual substance abuse. SEL programs are designed to foster these abilities in children with a wide range of behavioral, social, and learning needs in the classroom, including children who are economically disadvantaged. In a previous study of kindergartners residing in a high-poverty community (N = 327 at baseline), we observed significant behavioral improvements in children receiving an SEL program—The PATHS® curriculum (PATHS)—relative to an active control condition within one school year. The present investigation sought to determine whether these improvements were sustained over the course of two school years with intervention and an additional year when intervention was no longer provided. Further, using multilevel models, we examined whether baseline measures of neurocognition and stress physiology—known to be adversely impacted by poverty—moderated heterogeneous outcomes. Finally, a preliminary linear regression analysis explored whether neurocognition and physiological stress reactivity (heart rate variability, HRV) predict change in outcomes postintervention. Results confirmed that students who received PATHS sustained significant behavioral improvements over time. These effects occurred for the full sample, irrespective of putative baseline moderators, suggesting that children in high-risk environments may benefit from SEL interventions irrespective of baseline cognitive functioning as a function of overall substantial need. Of interest is that our exploratory analysis of change from waves three to four after the intervention concluded brought to light possible moderation by baseline physiology. Should subsequent studies confirm this finding, one plausible explanation may be that, when an intervention providing protective effects is withdrawn, children with higher HRV may not be able to regulate physiological stress responses to environmental challenges, leading to an uptick in maladaptive behaviors. In reverse, children with lower HRV—generally associated with poorer emotion regulation—may incur relatively greater gains in behavioral improvement due to lesser sensitivity to the environment, enabling them to continue to accrue benefits. Results are discussed in the context of possible pathways that may be relevant to understanding the special needs of children reared in very low-income, high-stress neighborhoods.

This study evaluated how individuals’ own substance use and their perception of peers’ substance use predict each other across development from early adolescence to middle adulthood. Participants were from two longitudinal studies: Fast Track (FT; N = 463) and Child Development Project (CDP; N = 585). Participants reported on their own and peers’ substance use during early and middle adolescence and early adulthood, and their own substance use in middle adulthood. From adolescence to early adulthood, individuals’ reports of their own substance use in a given developmental period predicted reports of their peers’ substance use in the next developmental period more than peers’ substance use in a given developmental period predicted individuals’ own substance use in the next. In the higher-risk FT sample, individuals’ own substance use in early adulthood predicted alcohol, cannabis, and other substance use in middle adulthood, and peers’ substance use in early adulthood predicted cannabis use in middle adulthood. In the lower-risk CDP sample, participants’ own substance use in early adulthood predicted only their own cannabis use in middle adulthood, whereas peers’ substance use in early adulthood predicted participants’ alcohol, cannabis, opioid, and other substance use in middle adulthood. The findings suggest that peer substance use in early adulthood may indicate a greater propensity for subsequent substance use in lower-risk groups, whereas those in higher-risk groups may remain more stable in substance use, with less variability explained by peer contexts.

Social and emotional learning (SEL) has become more central to education because of demand from educators, parents, students, and business leaders alongside rigorous research showing broad, positive impacts for students and adults. However, all approaches to SEL are not equal. Systemic SEL is an approach to create equitable learning conditions that actively involve all Pre-K to Grade 12 students in learning and practicing social, emotional, and academic competencies. These conditions require aligned policies, resources, and actions at state and district levels that encourage local schools and communities to build the personal and professional capacities of adults to: implement and continuously improve evidence-based programs and practices; create an inclusive culture that fosters caring relationships and youth voice, agency, and character; and support coordinated school-family-community partnerships to enhance student development. Promoting social and emotional competencies-including the abilities to understand and manage emotions, achieve positive goals, show caring and concern for others, establish and maintain positive relationships, and make responsible decisions-are important for success at school and in life. In this article, we summarize key concepts and evidence for systemic SEL. Next, we explain interrelated Theories of Action and resources developed by the Collaborative for Academic, Social, and Emotional Learning (CASEL) to implement and continuously improve systemic SEL in schools, districts, and states. We discuss research on nested, interacting settings and processes involved in systemic SEL at proximal (classrooms, schools, families, and communities) and distal (districts, states, national, and international) ecological levels. We conclude with recommendations for future SEL research, practice, and policy. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Deficits in social-emotional skills are common among students with (or at high-risk for) emotional and behavioral disorders (EBD) and they disrupt children’s functioning at school, impairing social, behavioral, and academic performance. This chapter provides an overview of the social-emotional skill deficits that are common among students with or at risk for EBD and describes the utility of a multi-tiered social-emotional skill training approach that includes tier one classroom-wide (and school-wide) programming along with tier two small group programming for children who need remedial support. The featured interventions include the Fast Track adaptation of the PATHS® Curriculum (Kusche, Greenberg, & CPPRG, 2011) as an exemplary tier one program and the Fast Track Friendship Group (Bierman et al., 2017) as a coordinated and complementary tier two program. Program content and implementation are described, along with evidence from the Fast Track randomized-controlled trial and other studies demonstrating the efficacy of these programs, when integrated, to promote social competence, self-regulation skills and adaptive learning behaviors, and to reduce aggressive-disruptive behavior in children with or at risk for EBDs.

This qualitative collective case study investigates elementary teachers’ experience with stress and the mechanisms of change related to developing resilience following a mindfulness-based intervent...

As the demand for mindfulness-based interventions grows, so does the need to monitor implementation to ensure effective delivery. Research has shown that the fidelity and quality of program implementation can impact intervention outcomes. This study reports on the development and use of implementation monitoring measures for the Cultivating Awareness and Resilience in Education (CARE) professional development program. Three facilitator-focused observer-rated measures of fidelity and quality of intervention delivery and three participant-focused measures that examined responsiveness and attendance to the program were used. Data were evaluated from six intervention implementations including 166 teachers from 36 schools in New York; 80% of participants provided follow-up data on engagement in mindful practices. We report on regression analyses that examined relationships between implementation monitoring measures and follow-up teacher outcomes related to uptake and sustainment of mindful awareness practices. Results indicated significant positive relationships with an alternative measure of adherence focused on completion of participant objectives and facilitation quality with follow-up teacher reports of continued practice (mindfulness practices used weekly, length of practices, extent that practices helped with stress). Further, participants’ perceived usefulness of the material demonstrated a strong positive relationship with length of practice and whether practices helped to reduce stress. Finally, interactions were found between attendance and adherence, and between facilitation quality and participant knowledge on practice outcomes. We explore the way these measures were used to support program delivery and facilitator training, and discuss the utility of an alternative measure of adherence focused on completion of participant learning objectives.

A female western lowland gorilla (Gorilla gorilla gorilla) infant was delivered by cesarean section (C-section) to an 18-year-old primiparous dam after prolonged labor. The infant required resuscitation at birth and was hospitalized for management of pneumonia and associated respiratory distress secondary to the aspiration of meconium-stained amniotic fluid. The infant received nine days of intensive care with respiratory support, antibiotics, intravenous fluid therapy, anti-inflammatory drugs, bronchodilators, and chest physiotherapy. Respiratory support included nasal continuous positive airway pressure (CPAP), and supplemental oxygen. Complications included right lung atelectasis secondary to bronchial obstruction and pneumonia. Following the resolution of pneumonia, visual reintroductions with the troop were initiated. The dam was given a medical lactation supplement (metoclopramide) and her mammary glands were stimulated to increase milk production. After several days of visual and olfactory introductions, the infant was successfully physically reintroduced to her dam at 12 days of age; the dam showed appropriate maternal response and nursing of the infant. The infant had appropriate growth and development, and 4 years later, has no evidence of negative side effects of neonatal respiratory disease. This is the first reported case of management of neonatal gorilla respiratory disease associated with a C-section, with successful reintroduction to the family group after hospitalization.

As interest increases in mindfulness in education programs for youth, there is a need to develop reliable measures of the quality of program implementation. This paper describes the development and psychometric properties of a measure that can be used to assess and monitor quality of implementation of mindfulness programs/curricula in typical classroom or out-of-school settings. The Teaching Mindfulness in Education Observation Scale (TMEOS) is a 28-item instrument that integrates qualitative and quantitative aspects of mindfulness instruction. Items focus on procedural adherence as well as aspects of implementation that reflect embodiment during instructional delivery (e.g., alignment with the attitudinal foundations of mindfulness). Reliability and validity data were examined and indicated that the four major scoring domains and key features showed adequate inter-rater reliability and internal consistency. We conclude that observational assessment of multiple dimension of implementation quality, including adherence and process-oriented aspects of implementation such as embodiment, can be reliably used to assess implementation quality of mindfulness programs in education settings. However, adequate preparation and training are critical. Implications and directions for future research are discussed.