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BACKGROUND: Family caregivers of dementia patients experience high levels of interpersonal stress that often results in elevated anxiety, and depression, and negative impacts on interpersonal relationships. Changes in behaviors and the structure of relationships with the care recipient (CR) and others in the social milieu challenge the caregivers ability to mentalize, or understand the links between mental states and behaviors. This study investigates the experiences and perceived benefits of family dementia caregivers who underwent Mentalizing Imagery Therapy (MIT), a treatment aiming to improve balanced self-other mentalizing and reduce psychological symptoms. METHODS: Purposeful sampling was used to select 11 family dementia caregivers who underwent a 4-week pilot trial of MIT. Semi-structured interviews were completed post-intervention to identify subjective benefits, putative psychological mediators and perceived active components. RESULTS: Caregivers reported improvements in well-being, mood, anxiety, and sleep, and a majority stated MIT helped with forming and maintaining healthier relationships. Some participants noted benefits extending to how they reacted to their social environment and perceived themselves more objectively from others perspectives. Specific elements of MIT, including self-compassion, self-care, and the ability to reflect on emotionally arousing challenges, might have mediated these improvements. CONCLUSION: Family dementia caregivers perceived salutary benefits of MIT on multiple domains of well-being. The self reports suggest MIT holds promise for improving well-being, reducing non-mentalizing patterns of thought, and facilitating improvements in balanced mentalization within the caregivers relationships.

IntroductionFamily caregivers of patients with dementia suffer a high burden of depression and reduced positive emotions. Mentalizing imagery therapy (MIT) provides mindfulness and guided imagery skills training to improve balanced mentalizing and emotion regulation.ObjectiveOur aims were to test the hypotheses that MIT for family caregivers would reduce depression symptoms and improve positive psychological traits more than a support group (SG), and would increase dorsolateral prefrontal cortex (DLPFC) connectivity and reduce subgenual anterior cingulate cortex (sgACC) connectivity.MethodsForty-six caregivers participated in a randomized controlled trial comparing a 4-week MIT group (n = 24) versus an SG (n = 22). Resting state neuroimaging was obtained at baseline and post-group in 28 caregivers, and questionnaires completed by all participants. The primary outcome was change in depression; secondary measures included anxiety, mindfulness, self-compassion, and well-being. Brain networks with participation of DLPFC and sgACC were identified. Connectivity strengths of DLPFC and sgACC with respective networks were determined with dual regression. DLPFC connectivity was correlated with mindfulness and depression outcomes.ResultsMIT significantly outperformed SG in improving depression, anxiety, mindfulness, self-compassion, and well-being, with moderate to large effect sizes. Relative to SG, participants in MIT showed significant increases in DLPFC connectivity - exactly replicating pilot study results - but no change in sgACC. DLPFC connectivity change correlated positively with mindfulness and negatively with depression change.ConclusionsIn this trial, MIT was superior to SG for reducing depression and anxiety symptoms and improving positive psychological traits. Neuroimaging results suggested that strengthening DLPFC connectivity with an emotion regulation network might be mechanistically related to MIT effects.

Evidence of the health and wellbeing benefits of Tai Chi and Qigong (TQ) have emerged in the past two decades, but TQ is underutilized in modern health care in Western countries due to lack of promotion and the availability of professionally qualified TQ instructors. To date, there are no government regulations for TQ instructors or for training institutions in China and Western countries, even though TQ is considered to be a part of Traditional Chinese medicine that has the potential to manage many chronic diseases. Based on an integrative health care approach, the accreditation standard guideline initiative for TQ instructors and training institutions was developed in collaboration with health professionals, integrative medicine academics, Tai Chi and Qigong master instructors and consumers including public safety officers from several countries, such as Australia, Canada, China, Germany, Italy, Korea, Sweden and USA. In this paper, the rationale for organizing the Medical Tai Chi and Qigong Association (MTQA) is discussed and the accreditation standard guideline for TQ instructors and training institutions developed by the committee members of MTQA is presented. The MTQA acknowledges that the proposed guidelines are broad, so that the diversity of TQ instructors and training institutions can be integrated with recognition that these guidelines can be developed with further refinement. Additionally, these guidelines face challenges in understanding the complexity of TQ associated with different principles, philosophies and schools of thought. Nonetheless, these guidelines represent a necessary first step as primary resource to serve and guide health care professionals and consumers, as well as the TQ community.

Surcharging or preloading is one of the oldest and most widely used in situ ground improvement techniques to strengthen weak compressible clays and to remove undesirable settlements prior to erection of permanent infrastructure. Recently, the ground improvement technique has been adopted in combination with many other techniques. The current design methodology for surcharging based on the concept of average degree of consolidation is inadequate, as all the primary consolidation settlement to be induced by the permanent load is not eliminated by the surcharging process. The problem is quantitatively analysed using Terzaghi's one-dimensional consolidation theory. The proportion of residual primary consolidation settlement is quantified, and the starting time of the re-occurrence of primary consolidation on exertion of the permanent load is determined. The effect of a change in surcharging duration on the proportion of residual settlement is quantified. The results are presented in design charts to facilitate application of the results by practicing geotechnical engineers. [ABSTRACT FROM AUTHOR]

A brief daily body-mind-spirit (BMS) workplace well-being program has been developed for community mental health workers (CMHW). Aiming to evaluate the program's efficacy, this study adopted a multi-site randomized controlled trial design. Primary outcome measures included work engagement and burnout. The data analysis included 175 participants. ANOVA revealed significant group x time interaction effects on work engagement (η2 = 0.037, p = 0.039) and on one of its sub-scores: absorption (η2 = 0.048, p = 0.014). Regarding burnout, ANOVA revealed that at T4 there were significant group x time effects on burnout total score and all three of its sub-scores, including work-related burnout, client-related burnout and personal burnout. Partial eta squared ranged between 0.028 and 0.071, suggesting a small-to-medium effect size. Overall findings demonstrated the protective effect of the Brief Daily BMS program in preserving work engagement during challenging conditions, and to a lesser extent in reducing burnout among CMHW. [ABSTRACT FROM AUTHOR]