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Objective: The primary aim of this study was to analyse the efficacy of a 'mindful eating' programme for reducing emotional eating in patients with overweight or obesity. Method: A cluster randomized controlled trial (reg. NCT03927534) was conducted with 76 participants with overweight/obesity who were assigned to 'mindful eating' (7 weeks) + treatment as usual (TAU), or to TAU alone. They were assessed at baseline, posttreatment and 12‐month follow‐up. The main outcome was 'emotional eating' (Dutch Eating Behaviour Questionnaire, DEBQ); other eating behaviours were also assessed along with psychological and physiological variables. Results: 'Mindful eating' + TAU reduced emotional eating both at posttreatment (B = −0.27; p = 0.006; d = 0.35) and follow‐up (B = −0.53; p < 0.001; d = 0.69) compared to the control group (TAU alone). 'External eating' (DEBQ) was also significantly improved by the intervention at both timepoints. Significant effects at follow‐up were observed for some secondary outcomes related to bulimic behaviours, mindful eating, mindfulness, and self‐compassion. Weight and other physiological parameters were not significantly affected by 'mindful eating' + TAU. Conclusions: These findings support the efficacy of the 'mindful eating' + TAU programme for reducing emotional and external eating, along with some other secondary measures, but no significant changes in weight reduction were observed. Highlights: 'Mindful eating' added to treatment as usual (TAU) is more effective than TAU alone for reducing the emotional eating pattern of obese and overweight patients in primary care (PC) settings.The programme produced improvements in secondary outcomes such as external eating, the severity of bulimic symptoms, the frequency of binge episodes, and some mindfulness and self‐compassion facets.The body mass index (BMI) and other physiological variables were not significantly reduced by the 'Mindful eating' programme; future studies should try to overcome some methodological shortcomings of the present study. [ABSTRACT FROM AUTHOR]

Blood flow partially determines specific climbing endurance (SCE) as it mediates oxygen bio-availability in the finger flexors. Blood flow is related to occlusion threshold (OT), which is defined as the contraction intensity at which intramuscular pressure exceeds perfusion blood pressure resulting in the cessation of local blood flow. The OT is represented as an inflection point on a force-time graph when isometric force is registered and applied through maximal and continuous tests. Endurance time (ET) to exhaustion is influenced by the relative isometric applied force and is different for each climber. The aim of this study was to explore whether an approximation of the finger flexoŕs OT in sport climbers through records of ET to exhaustion at different isometric relative intensities was possible. We measured maximum finger hang ETs at 6 intensities ranging from 85% to 35% maximal force in 34 sport climbers of advanced and elite level. The values obtained were analysed by two different methods in an attempt to determine a change in the shape of the curve in the intensity-ET relationship graphs that approximated the OT for each climber. The results suggest that the finger flexoŕs OT could be different among climbers, regardless of their strength and ability level. The presented methods do not accurately reflect the OT, but could indicate the intensity at which blood flow is restored in the active muscles. This is the first study to indirectly approximate the finger flexors OT in sport-climbers, a parameter that could be essential to assess SCE. [ABSTRACT FROM AUTHOR]

Generalized Anxiety Disorder (GAD) is a very prevalent disorder in primary care (PC). Most patients with GAD never seek treatment, and those who do seek treatment often drop out before completing treatment. Although it is an understudied treatment, Mindfulness-Based Interventions (MBIs) indicate preliminary efficacy for the treatment of GAD symptoms, but many patients with GAD present other associated symptoms (e.g., attention deficits) that complicate the treatment. Virtual Reality DBT® Mindfulness Skills learning has recently been developed to make learning mindfulness easier for patients with emotion dysregulation who have trouble concentrating. Virtual Reality (VR) might serve as a visual guide for practicing mindfulness as it gives patients the illusion of "being there" in the 3D computer generated world. The main goal of this study was to evaluate the effect of two MBIs (a MBI in a group setting alone and the same MBI plus 10 min VR DBT® Mindfulness skills training) to reduce GAD symptoms. A secondary aim was to explore the effect in depression, emotion regulation, mindfulness, and interoceptive awareness. Other exploratory aims regarding the use of VR DBT® Mindfulness skills were also carried out. The sample was composed of 42 patients (roughly half in each group) with GAD attending PC visits. After treatment, both groups of patients showed significant improvements in General Anxiety Disorder measured by the GAD-7 using mixed regression models [MBI alone (B = -5.70; p < 0.001; d = -1.36), MBI+VR DBT® Mindfulness skills (B = -4.38; p < 0.001; d = -1.33)]. Both groups also showed significant improvements in anxiety, depression, difficulties of emotion regulation and several aspects of mindfulness and interoceptive awareness. Patients in the group that received additional 10 min VR DBT Mindfulness Skills training were significantly more adherent to the treatment than those receiving only standard MBI (100% completion rate in MBI + VR vs. 70% completion rate in MBI alone; Fisher = 0.020). Although randomized controlled studies with larger samples are needed, this pilot study shows preliminary effectiveness of MBI to treat GAD, and preliminary evidence that adjunctive VR DBT® Mindfulness Skills may reduce dropouts. [ABSTRACT FROM AUTHOR]

Purpose: Positive effects have been reported after mindfulness-based interventions (MBIs) in diverse clinical and nonclinical populations. Primary care is a key health care setting for addressing common chronic conditions, and an effective MBI designed for this setting could benefit countless people worldwide. Meta-analyses of MBIs have become popular, but little is known about their efficacy in primary care. Our aim was to investigate the application and efficacy of MBIs that address primary care patients.Methods: We performed a meta-analytic review of randomized controlled trials addressing the effect of MBIs in adult patients recruited from primary care settings. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and Cochrane guidelines were followed. Effect sizes were calculated with the Hedges g in random effects models.Results: The meta-analyses were based on 6 trials having a total of 553 patients. The overall effect size of MBI compared with a control condition for improving general health was moderate (g = 0.48; P = .002), with moderate heterogeneity (I(2) = 59; P <.05). We found no indication of publication bias in the overall estimates. MBIs were efficacious for improving mental health (g = 0.56; P = .007), with a high heterogeneity (I(2) = 78; P <.01), and for improving quality of life (g = 0.29; P = .002), with a low heterogeneity (I(2) = 0; P >.05).Conclusions: Although the number of randomized controlled trials applying MBIs in primary care is still limited, our results suggest that these interventions are promising for the mental health and quality of life of primary care patients. We discuss innovative approaches for implementing MBIs, such as complex intervention and stepped care. [ABSTRACT FROM AUTHOR]

The psychological construct of mindfulness refers to an awareness that emerges by intentionally paying attention to the present experience in a non-judgmental or evaluative way. This particular quality of awareness has been associated to several indicators of physical and psychological health, and can be developed using mindfulness-based interventions (MBIs), and therefore MBIs have been successfully applied as preventive and complementary interventions and therapies in medicine and psychology. Together with quiet sitting and lying meditation practices, mindful physical exercises such as "mindful walking" and "mindful movement" are key elements in MBIs and couple muscular activity with an internally directed focus, improving interoceptive attention to bodily sensations. In addition, MBIs seem to share similar mechanisms with physical fitness (PF) by which they may influence cardiovascular responses to stress. Based on these facts, it is feasible to raise the question of whether physical training itself may induce the development of that particular quality of awareness associated with mindfulness, or if one's dispositional mindfulness (DM) (the tendency to be more mindful in daily life) could moderate the effects of exercise on cardiovascular response to stress. The role of mindfulness as a mediator or moderator of the effect of exercise training on cardiovascular responses to stress has barely been studied. In this study, we have hypothesized pathways (moderation and mediation) by which mindfulness could significantly influence the effects of PF on cardiovascular responses to stress and discussed potential practical ways to test these hypotheses. [ABSTRACT FROM AUTHOR]

BackgroundOne-quarter of the world’s population will suffer from depression symptoms at some point in their lives. Mental health services in developed countries are overburdened. Therefore, cost-effective interventions that provide mental health care solutions such as Web-based psychotherapy programs have been proposed. ObjectiveThe intent of the study was to identify expectations regarding Web-based psychotherapy for the treatment of depression in primary care among patients and health professionals that might facilitate or hinder its effects. MethodsThe expectations of untreated patients and health professionals were examined by means of interviews and focus groups. There were 43 participants (20 patients with mild and moderate levels of depression, 11 primary care physicians, and 12 managers; 22 of them for interviews and 21 for groups). A thematic content analysis from the grounded theory for interviews, and an analysis of the discursive positions of participants based on the sociological model for groups were performed. Interpretations were achieved by agreement between three independent analysts. ResultsAll participants showed a good general acceptance of Web-based psychotherapy, appreciating possible advantages and improvements. Patients, physicians, and managers shared the same conceptualization of their expectations, although highlighting different aspects. Patients focused on the need for individualized and personalized interaction, while professionals highlighted the need for the standardization of the program. Physicians were concerned with extra workload, while managers were worried about optimizing cost-effectiveness. ConclusionsExpectations of the different participants can conflict with each other. Finding a balanced position among them is needed if we are to harmoniously implement effective Web-based interventions for depression in routine clinical practice.

Generalized Anxiety Disorder (GAD) is a very prevalent disorder in primary care (PC). Most patients with GAD never seek treatment, and those who do seek treatment often drop out before completing treatment. Although it is an understudied treatment, Mindfulness-Based Interventions (MBIs) indicate preliminary efficacy for the treatment of GAD symptoms, but many patients with GAD present other associated symptoms (e.g., attention deficits) that complicate the treatment. Virtual Reality DBT ® Mindfulness Skills learning has recently been developed to make learning mindfulness easier for patients with emotion dysregulation who have trouble concentrating. Virtual Reality (VR) might serve as a visual guide for practicing mindfulness as it gives patients the illusion of "being there" in the 3D computer generated world. The main goal of this study was to evaluate the effect of two MBIs (a MBI in a group setting alone and the same MBI plus 10 min VR DBT ® Mindfulness skills training) to reduce GAD symptoms. A secondary aim was to explore the effect in depression, emotion regulation, mindfulness, and interoceptive awareness. Other exploratory aims regarding the use of VR DBT ® Mindfulness skills were also carried out. The sample was composed of 42 patients (roughly half in each group) with GAD attending PC visits. After treatment, both groups of patients showed significant improvements in General Anxiety Disorder measured by the GAD-7 using mixed regression models [MBI alone ( B = -5.70; p < 0.001; d = -1.36), MBI+VR DBT ® Mindfulness skills ( B = -4.38; p < 0.001; d = -1.33)]. Both groups also showed significant improvements in anxiety, depression, difficulties of emotion regulation and several aspects of mindfulness and interoceptive awareness. Patients in the group that received additional 10 min VR DBT Mindfulness Skills training were significantly more adherent to the treatment than those receiving only standard MBI (100% completion rate in MBI + VR vs. 70% completion rate in MBI alone; Fisher = 0.020). Although randomized controlled studies with larger samples are needed, this pilot study shows preliminary effectiveness of MBI to treat GAD, and preliminary evidence that adjunctive VR DBT ® Mindfulness Skills may reduce dropouts.