Mindfulness meditation represents a mental training framework for cultivating the state of mindful awareness in daily life. Recently, there has been a surge of interest in how mindfulness meditation ...improves human health and well‐being. Although studies have shown that mindfulness meditation can improve self‐reported measures of disease symptomatology, the effect that mindfulness meditation has on biological mechanisms underlying human aging and disease is less clear. To address this issue, we conducted the first comprehensive review of randomized controlled trials examining the effects of mindfulness meditation on immune system parameters, with a specific focus on five outcomes: (1) circulating and stimulated inflammatory proteins, (2) cellular transcription factors and gene expression, (3) immune cell count, (4) immune cell aging, and (5) antibody response. This analysis revealed substantial heterogeneity across studies with respect to patient population, study design, and assay procedures. The findings suggest possible effects of mindfulness meditation on specific markers of inflammation, cell‐mediated immunity, and biological aging, but these results are tentative and require further replication. On the basis of this analysis, we describe the limitations of existing work and suggest possible avenues for future research. Mindfulness meditation may be salutogenic for immune system dynamics, but additional work is needed to examine these effects.
In this study we test the efficacy of Moment-by-Moment in Women's Recovery (MMWR), a mindfulness-based intervention adapted to support women with substance use disorder (SUD) while in residential ...treatment. We use a parallel-group randomized controlled trial with a time-matched psychoeducation control to test MMWR effects on residential treatment retention. We used clinical staff-determined residential site discharge status and discharge date from the SUD treatment site record to determine retention. We tested for study group differences in retention defined as time to treatment non-completion without improvement (i.e., patient left treatment before completion of the treatment plan and made little or no progress toward achieving treatment goals based on clinical team determination), as well as differences in self-report of study intervention mechanisms of action (i.e., mindfulness, perceived stress, distress tolerance, emotion regulation, distress, affect, and drug and alcohol craving). The analytic timeframe for the survival analysis was from study intervention start date to 150 days later. The sample (N = 200) was female, majority amphetamine/methamphetamine users (76%), Hispanic (58%), with a history of incarceration (62%). By the 150-day analytic endpoint, the sample had 74 (37%) treatment Completers, 42 (21%) still In-residence, 26 (13%) Non-completers with satisfactory progress, and 58 (29%) Non-completers without satisfactory progress. Survival analysis of the intent-to-treat sample showed the risk of non-completion without improvement was lower in MMWR as compared to the control group (adjusted hazard ratio = 0.42, 95% CI: 0.16–1.08, p = .07). Both groups improved on select self-reported mechanism measure scores at immediate post-intervention, but only in the MMWR group did class attendance (dosage) have a large-size correlation with improved mindfulness (r = .61, p < .01), distress tolerance (r = 0.55, p < .01) and positive affect (r = 0.52, p < .01) scores. The hazard ratio for retention was of medium-to-large effect size, suggesting the clinical relevance of adding MMWR to an all-women's, ethnoracially diverse, SUD residential treatment center. An extended curriculum may be helpful considering the protective benefits of class attendance on psychological health indicators.
•MMWR versus attention controls were less likely to leave residential treatment without satisfactory progress.•The effect size was medium-to-large, thus suggesting clinical importance for effects on residential SUD retention.•The effect size for retention is impressive given the sample was simultaneously exposed to intensive residential services.•MMWR helps women manage the challenges posed by intensive SUD residential treatment.
The cultivation of mindfulness as an approach to human perception through the practice of meditation has become an increasingly popular treatment for medical and psychological symptoms and as a topic ...of scientific investigation. Substance user programs are also increasingly embracing this treatment strategy as either a stand-alone therapeutic modality or a complement to ongoing treatment. In this article, I supply an introduction to the special theme issue concerning mindfulness and substance use intervention by first providing a brief historical account of the secular Mindfulness-Based Stress Reduction program to introduce new readers to the more general topic of mindfulness-based interventions (MBIs), and to contextualize historical publishing trends observed in mindfulness research across the past four decades. I then examine the implications of MBIs for substance use, misuse, and addiction, especially in areas related to craving and suffering. To conclude, I outline the empirical and conceptual compendium of contributions offered in this special issue.
This field intervention trial evaluated the effect of a 5-week mindfulness-based curriculum on teacher-ratings of student classroom behavior at a Richmond, CA public elementary school, and examined ...if the addition of more sessions provided added benefit to student outcomes. Seventeen teachers reported on the classroom behaviors of 409 children (83 % enrolled in a California free lunch program and 95.7 % ethnic minority) in kindergarten through sixth grade at pre-intervention, immediate post-intervention, and 7 weeks post-intervention. Results showed that teachers reported improved classroom behavior of their students (i.e., paying attention, self-control, participation in activities, and caring/respect for others) that lasted up to 7 weeks post-intervention. Overall, improvements were not bolstered by the addition of extra sessions, with the exception of paying attention. The implications of this study are limited due to the lack of a mindfulness program-naïve control group, yet findings suggest that mindfulness training might benefit teacher-based perceptions of improved classroom behavior in a public elementary school, which has practice implications for improving the classroom learning environment for lower-income and ethnically-diverse children.
Although the efficacy of meditation interventions has been examined among adult samples, meditation treatment effects among youth are relatively unknown. We systematically reviewed empirical studies ...for the health-related effects of sitting-meditative practices implemented among youth aged 6 to 18 years in school, clinic, and community settings.
A systematic review of electronic databases (PubMed, Ovid, Web of Science, Cochrane Reviews Database, Google Scholar) was conducted from 1982 to 2008, obtaining a sample of 16 empirical studies related to sitting-meditation interventions among youth.
Meditation modalities included mindfulness meditation, transcendental meditation, mindfulness-based stress reduction, and mindfulness-based cognitive therapy. Study samples primarily consisted of youth with preexisting conditions such as high-normal blood pressure, attention-deficit/hyperactivity disorder, and learning disabilities. Studies that examined physiologic outcomes were composed almost entirely of African American/black participants. Median effect sizes were slightly smaller than those obtained from adult samples and ranged from 0.16 to 0.29 for physiologic outcomes and 0.27 to 0.70 for psychosocial/behavioral outcomes.
Sitting meditation seems to be an effective intervention in the treatment of physiologic, psychosocial, and behavioral conditions among youth. Because of current limitations, carefully constructed research is needed to advance our understanding of sitting meditation and its future use as an effective treatment modality among younger populations.
Lung cancer screening with low-dose computed tomography (LDCT) has been recommended, based primarily on the results of the NLST (National Lung Screening Trial). The American College of Radiology ...recently released Lung-RADS, a classification system for LDCT lung cancer screening.
To retrospectively apply the Lung-RADS criteria to the NLST.
Secondary analysis of a group from a randomized trial.
33 U.S. screening centers.
Participants were randomly assigned to the LDCT group of the NLST, were aged 55 to 74 years, had at least a 30-pack-year history of smoking, and were current smokers or had quit within the past 15 years.
3 annual LDCT lung cancer screenings.
Lung-RADS classifications for LDCT screenings. Lung-RADS categories 1 to 2 constitute negative screening results, and categories 3 to 4 constitute positive results.
Of 26 722 LDCT group participants, 26 455 received a baseline screening; 48 671 screenings were done after baseline. At baseline, the false-positive result rate (1 minus the specificity rate) for Lung-RADS was 12.8% (95% CI, 12.4% to 13.2%) versus 26.6% (CI, 26.1% to 27.1%) for the NLST; after baseline, the false-positive result rate was 5.3% (CI, 5.1% to 5.5%) for Lung-RADS versus 21.8% (CI, 21.4% to 22.2%) for the NLST. Baseline sensitivity was 84.9% (CI, 80.8% to 89.0%) for Lung-RADS versus 93.5% (CI, 90.7% to 96.3%) for the NLST, and sensitivity after baseline was 78.6% (CI, 74.6% to 82.6%) for Lung-RADS versus 93.8% (CI, 91.4% to 96.1%) for the NLST.
Lung-RADS criteria were applied retrospectively.
Lung-RADS may substantially reduce the false-positive result rate; however, sensitivity is also decreased. The effect of using Lung-RADS criteria in clinical practice must be carefully studied.
National Institutes of Health.
Noninvasive detection of Alzheimer's disease (AD) with high specificity and sensitivity can greatly facilitate identification of at-risk populations for earlier, more effective intervention. AD ...patients exhibit a myriad of retinal pathologies, including hallmark amyloid β-protein (Aβ) deposits.
Burden, distribution, cellular layer, and structure of retinal Aβ plaques were analyzed in flat mounts and cross sections of definite AD patients and controls (n = 37). In a proof-of-concept retinal imaging trial (n = 16), amyloid probe curcumin formulation was determined and protocol was established for retinal amyloid imaging in live patients.
Histological examination uncovered classical and neuritic-like Aβ deposits with increased retinal Aβ42 plaques (4.7-fold; P = 0.0063) and neuronal loss (P = 0.0023) in AD patients versus matched controls. Retinal Aβ plaque mirrored brain pathology, especially in the primary visual cortex (P = 0.0097 to P = 0.0018; Pearson's r = 0.84-0.91). Retinal deposits often associated with blood vessels and occurred in hot spot peripheral regions of the superior quadrant and innermost retinal layers. Transmission electron microscopy revealed retinal Aβ assembled into protofibrils and fibrils. Moreover, the ability to image retinal amyloid deposits with solid-lipid curcumin and a modified scanning laser ophthalmoscope was demonstrated in live patients. A fully automated calculation of the retinal amyloid index (RAI), a quantitative measure of increased curcumin fluorescence, was constructed. Analysis of RAI scores showed a 2.1-fold increase in AD patients versus controls (P = 0.0031).
The geometric distribution and increased burden of retinal amyloid pathology in AD, together with the feasibility to noninvasively detect discrete retinal amyloid deposits in living patients, may lead to a practical approach for large-scale AD diagnosis and monitoring.
National Institute on Aging award (AG044897) and The Saban and The Marciano Family Foundations.
The National Lung Screening Trial was conducted to determine whether three annual screenings (rounds T0, T1, and T2) with low-dose helical computed tomography (CT), as compared with chest ...radiography, could reduce mortality from lung cancer. We present detailed findings from the first two incidence screenings (rounds T1 and T2).
We evaluated the rate of adherence of the participants to the screening protocol, the results of screening and downstream diagnostic tests, features of the lung-cancer cases, and first-line treatments, and we estimated the performance characteristics of both screening methods.
At the T1 and T2 rounds, positive screening results were observed in 27.9% and 16.8% of participants in the low-dose CT group and in 6.2% and 5.0% of participants in the radiography group, respectively. In the low-dose CT group, the sensitivity was 94.4%, the specificity was 72.6%, the positive predictive value was 2.4%, and the negative predictive value was 99.9% at T1; at T2, the positive predictive value increased to 5.2%. In the radiography group, the sensitivity was 59.6%, the specificity was 94.1%, the positive predictive value was 4.4%, and the negative predictive value was 99.8% at T1; both the sensitivity and the positive predictive value increased at T2. Among lung cancers of known stage, 87 (47.5%) were stage IA and 57 (31.1%) were stage III or IV in the low-dose CT group at T1; in the radiography group, 31 (23.5%) were stage IA and 78 (59.1%) were stage III or IV at T1. These differences in stage distribution between groups persisted at T2.
Low-dose CT was more sensitive in detecting early-stage lung cancers, but its measured positive predictive value was lower than that of radiography. As compared with radiography, the two annual incidence screenings with low-dose CT resulted in a decrease in the number of advanced-stage cancers diagnosed and an increase in the number of early-stage lung cancers diagnosed. (Funded by the National Cancer Institute; NLST ClinicalTrials.gov number, NCT00047385.).
Sleep disturbances are most prevalent among older adults and often go untreated. Treatment options for sleep disturbances remain limited, and there is a need for community-accessible programs that ...can improve sleep.
To determine the efficacy of a mind-body medicine intervention, called mindfulness meditation, to promote sleep quality in older adults with moderate sleep disturbances.
Randomized clinical trial with 2 parallel groups conducted from January 1 to December 31, 2012, at a medical research center among an older adult sample (mean SD age, 66.3 7.4 years) with moderate sleep disturbances (Pittsburgh Sleep Quality Index PSQI >5).
A standardized mindful awareness practices (MAPs) intervention (n = 24) or a sleep hygiene education (SHE) intervention (n = 25) was randomized to participants, who received a 6-week intervention (2 hours per week) with assigned homework.
The study was powered to detect between-group differences in moderate sleep disturbance measured via the PSQI at postintervention. Secondary outcomes pertained to sleep-related daytime impairment and included validated measures of insomnia symptoms, depression, anxiety, stress, and fatigue, as well as inflammatory signaling via nuclear factor (NF)-κB.
Using an intent-to-treat analysis, participants in the MAPs group showed significant improvement relative to those in the SHE group on the PSQI. With the MAPs intervention, the mean (SD) PSQIs were 10.2 (1.7) at baseline and 7.4 (1.9) at postintervention. With the SHE intervention, the mean (SD) PSQIs were 10.2 (1.8) at baseline and 9.1 (2.0) at postintervention. The between-group mean difference was 1.8 (95% CI, 0.6-2.9), with an effect size of 0.89. The MAPs group showed significant improvement relative to the SHE group on secondary health outcomes of insomnia symptoms, depression symptoms, fatigue interference, and fatigue severity (P < .05 for all). Between-group differences were not observed for anxiety, stress, or NF-κB, although NF-κB concentrations significantly declined over time in both groups (P < .05).
The use of a community-accessible MAPs intervention resulted in improvements in sleep quality at immediate postintervention, which was superior to a highly structured SHE intervention. Formalized mindfulness-based interventions have clinical importance by possibly serving to remediate sleep problems among older adults in the short term, and this effect appears to carry over into reducing sleep-related daytime impairment that has implications for quality of life.
clinicaltrials.gov Identifier: NCT01534338.
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