Nature's therapeutic power: a study on the psychophysiological effects of touching ornamental grass in Chinese women.

The health of city residents is at risk due to the high rate of urbanization and the extensive use of electronics. In the context of urbanization, individuals have become increasingly disconnected from nature, resulting in elevated stress levels among adults. The goal of this study was to investigate the physical and psychological benefits of spending time in nature. The benefits of touching real grass and artificial turf (the control activity) outdoors with the palm of the hand for five minutes were measured. Blood pressure and electroencephalography (EEG) as well as State-trait Anxiety Inventory (STAI) scores, and the semantic differential scale (SDM) were used to investigate psychophysiological responses. Touching real grass was associated with significant changes in brainwave rhythms and a reduction in both systolic and diastolic blood pressure compared to touching artificial turf. In addition, SDM scores revealed that touching real grass increased relaxation, comfort, and a sense of naturalness while decreasing anxiety levels. Compared to the control group, the experimental group had higher mean scores in both meditation and attentiveness. Our findings indicate that contact with real grass may reduce physiological and psychological stress in adults.

Analyzing the stress management intervention impacting the mindfulness and well-being of employees.

BACKGROUND: Developing employee well-being as well as lowering stress may have several benefits for organizations. Stress management intervention techniques utilized via organizations help to develop worker mindfulness and well-being, and reduce stress. OBJECTIVE: To review stress management interventions to determine the effectiveness of diverse interventions in improving the mindfulness and well-being of employees working in an organization. METHODS: This work is split into two main sections: collection of data and analysis of data. First, data collection is carried out. The structured questionnaire was organized and distributed to managers and working employees of an organization. Based on the developed hypothesis, the questionnaire was arranged and all queries were compulsory. Subsequently, the collected data were performed by Structural Equation Modeling (SEM) and One Way Analysis of Variance (ANOVA) analysis. RESULTS: The Standard Mean Residual Root Square for the baseline model of mindfulness and well-being of employees working in an organization is 0.2156, which is better than threshold value. CONCLUSION: From the analysis, the goodness of fit and significant relation among the stress intervention techniques as well as mindfulness and well-being of employees in an organization has been found.

The Effects of Mindfulness Meditation on Nursing Students' Stress and Anxiety Levels.

AIM: The aim of this study was to evaluate the effects of a virtual mindfulness meditation intervention on stress and anxiety levels of 145 nursing students. BACKGROUND: Because of the twin demands of classroom and clinical workloads, nursing students experience greater amounts of stress and anxiety than the average college student. Mindfulness meditation is a promising method to alleviate stress and anxiety. METHOD: A pretest-posttest randomized controlled design was used. Participants received either weekly mindfulness meditation recordings or recordings on nursing information. Participants completed the Perceived Stress Scale and the Generalized Anxiety Disorder-7 Scale. RESULTS: A two-way mixed analysis of variance and follow-up simple main effects tests revealed that participants in the experimental group, who received meditation recordings, experienced significantly lower levels of stress and anxiety on posttest surveys than the control group. CONCLUSION: Mindfulness meditation can reduce stress and anxiety levels in nursing students. This can improve students' overall mental and physical well-being.

A brief intervention decreases student distress.

PURPOSE OF THE ARTICLE: Health professions graduate students have experienced substantial increases in stress and anxiety in recent years. This can result in decreased academic performance, poor retention, and burnout. Interventions to help students cope are therefore a critical need for academic institutions. The current study sought to demonstrate the effectiveness of a brief multimodal intervention in reducing student distress. METHOD: The study was a randomised controlled design that evaluated a brief intervention of cognitive-behavioural therapy, mindfulness, and healthy lifestyle choices. The Depression Anxiety Stress Scale-21 was administered to participants at baseline and two post-intervention time points. Control participants did not participate in any intervention. Participants were recruited from graduate students in first-year classes within the School of Health Professions at UT Southwestern Medical Center. RESULTS: Analysis revealed an overall mild to moderate decline in Depression Anxiety Stress Scale-21 total scores over three assessment periods for both treatment and control groups, with no statistical differences noted between groups; however, the treatment group's scores declined approximately 6 weeks before the control participants' scores declined. CONCLUSION: The pattern of change in the two groups suggests that our intervention facilitated the reduction in student anxiety more quickly than would have occurred normally and with sustained results.

The MEDITAGING study: protocol of a two-armed randomized controlled study to compare the effects of the mindfulness-based stress reduction program against a health promotion program in older migrants in Luxembourg.

BACKGROUND: Migration is a phenomenon worldwide, with older migrants, particularly those with fewer socioeconomic resources, having an increased risk of developing adverse cognitive and health outcomes and social isolation. Therefore, it is of utmost importance to validate interventions that promote healthy aging in this population. Previous studies have shown a positive impact of mindfulness based-stress reduction (MBSR) on outcomes such as cognition and sleep. However, only a few studies verified its potential in older adults, especially with vulnerable populations such as migrants. This article presents the protocol of the MEDITAGING study, which is the first to investigate the MBSR effects in migrants aged ≥55 in comparison to a health promotion program. METHODS: MEDITAGING is a two-arm randomized, double-blinded, controlled study, which will include older Portuguese-speaking migrants (n = 90). Participants are randomized to the MBSR or a health promotion program. Both interventions are conducted in groups over a total of 8 weeks, incorporating weekly meetings, an additional 4-hour class, and extra at-home tasks. The health promotion program has the same structure as the MBSR but comprises different activities related to dementia prevention, healthy habits, cognitive stimulation, sleeping, nutrition, watercolor painting, and physical activity. The assessment of executive functioning, physiological stress measures, self-reported questionnaires, and qualitative interviews are conducted at baseline, after 8 weeks (post-intervention), and at a follow-up session (from one to 3 months thereafter). Analyzes will be conducted using a modified intention-to-treat approach (all participants with at least 3 days of participation in the group-sessions and one post-intervention observation). DISCUSSION: This study will test effects of a mindfulness-based intervention against an active control condition in older adult migrants, which few studies have addressed. TRIAL REGISTRATION: ClinicalTrials.gov NCT05615337 (date of registration: 27 September 2022; date of record verification: 14 November 2022).

The Effect of Mindfulness-Based Stress Reduction Counseling on Blood Glucose and Perceived Stress in Women with Gestational Diabetes.

OBJECTIVE: Gestational diabetes can cause maternal and neonatal morbidity. Psychological factors, especially stress, play a meaningful role in diabetes management. Therefore, the present study aimed to investigate the effect of Mindfulness-Based Stress Reduction counseling on blood sugar and perceived stress in women with gestational diabetes. METHODS: The present quasi-experimental interventional study was performed on 78 women with gestational diabetes. In the intervention group, a Mindfulness-Based Stress Reduction counseling program was conducted by the researcher in 8 sessions of 90 minutes twice a week. The Cohen stress questionnaire was filled in both groups. Also, fasting blood sugar and 2-hour blood sugar levels were measured in both groups. Statistical analysis was performed using the independent T-Test, the paired T-Test, the Mann-Whitney and Wilcoxon Tests using IBM SPSS Statistics for Windows version 20 version (IBM Corp., Armonk, NY, USA). RESULTS: The mean age of pregnant women in the intervention group was 28.84 ± 6.20 years old and 29.03 ± 5.42 years old in the control group. There was a significant mean difference between the fasting blood sugar score (p = 0.02; - 6.01; and - 11.46) and the 2-hour fasting blood sugar score (p < 0.001;12.35; and - 5.3) and the perceived stress score (p < 0.001; 35.57; and - 49.19) existed between the intervention and control groups after the intervention. CONCLUSION: The results of the present study showed that mindfulness-based stress reduction counseling is effective in reducing blood sugar levels and reducing perceived stress in women with gestational diabetes treated with diet.

The effect of a distance-delivered mindfulness-based psychoeducation program on the psychological well-being, emotional intelligence and stress levels of nursing students in Turkey: a randomized controlled study.

Nursing students who started university during the COVID-19 pandemic had to attend via distance education, which increased their stress. This study aimed to determine the effect of a mindfulness-based psychoeducation program on the psychological well-being, emotional intelligence and stress levels of young adults in their first year of an undergraduate nursing program at a university in Turkey. The sample consisted of 59 students (mean age 19.3 years) who were randomized to the intervention group (n = 29) and control group (n = 30). Those in the intervention group participated in a mindfulness-based psychoeducation program twice a week for 4 weeks via video conference. The Perceived Stress Scale (PSS-14), Psychological Well-Being Scale (PWB) and Revised Schutte Emotional Intelligence Scale (SEIS) were used as measurement tools. Between the pretest and posttest assessments, students in the intervention group showed a significant decrease in perceived stress scores and increases in emotional intelligence and psychological well-being scores. There were statistically significant differences in perceived stress, emotional intelligence and psychological well-being scores between the intervention and control groups in the posttest. Online mindfulness psychoeducation via video conferencing can be a useful intervention for nursing students to reduce stress and support psychological well-being and emotional intelligence.

Impact of Hatha Yoga on Level of Perceived Stress in Doctor of Physical Therapy Students.

BACKGROUND: Doctor of Physical Therapy (DPT) students experience an increased level of stress throughout their curriculum. Hatha Yoga is associated with stress reduction; however, no study has investigated its efficacy on DPT students' level of perceived stress. OBJECTIVE: To determine what difference Hatha Yoga has on DPT students' level of perceived stress. METHODS: A pretest/posttest quasi experimental design was utilized. Repeated measures included the Perceived Stress Scale 10-item instrument (PSS-10). The convenience sample included 22 DPT students. RESULTS: The intervention had a statistically significant influence on perceived stress reduction, observed by a decrease in perceived stress scores from 21.32 to 13.23 (p < 0.001). CONCLUSION: Hatha Yoga is an effective strategy to reduce perceived stress in DPT students and improve wellbeing.

Using Meditation to Reduce Stress, Anxiety, and Depression in Nursing Students.

BACKGROUND: Nursing students experience higher rates of mental health issues than other college students. This study examined the effect of a mindfulness meditation intervention on nursing students' levels of self-reported depression, stress, and anxiety. METHOD: This randomized, experimental study implemented an online mindfulness meditation intervention for an experimental group of nursing students and provided nursing news modules for a control group of nursing students. Participants in experimental and control groups completed the Depression, Anxiety, and Stress Scale online before and after completing 4 weeks of audio modules. RESULTS: Results showed a statistically significant decrease in reported scores for depression, stress, and anxiety in the experimental group. CONCLUSION: This study demonstrated the potential benefits of implementing an online mindfulness meditation intervention to support and improve mental health for nursing students. [J Nurs Educ. 2023;62(8):443-449.].

Effects of a prenatal mindfulness program on longitudinal changes in stress, anxiety, depression, and mother-infant bonding of women with a tendency to perinatal mood and anxiety disorder: a randomized controlled trial.

BACKGROUND: Stress is a risk factor for poor physical and mental health, affecting new mothers' ability, especially those with perinatal mood and anxiety disorders, to maintain their everyday lives. Over the past 50 years, global incidences of depression and anxiety disorders have increased, reaching pandemic levels. These incidences represent major public health issues that are challenging to detect and treat. Mindfulness programs are viable for reducing stress, anxiety, and depression. The present study evaluates mindfulness intervention effects on stress, anxiety, depression, and mother-infant bonding. METHODS: We collected data on 102 women participating in a prenatal mindfulness program between July 2021 and March 2022; they were parallel and randomly assigned to experimental or control groups. The intervention group received an 8-week course in a prenatal mindfulness program, and the control group received usual standard prenatal care. The self-reported stress, pregnancy-related anxiety, and depression were assessed before and after the intervention and at 36 weeks of gestation. At 2 and 4 months postpartum, all participants provided self-reported their levels of stress, depression, and quality of mother-infant bonding. RESULTS: Compared to the control group, the experimental group that received the prenatal mindfulness intervention experienced reduced prenatal stress, anxiety, and depression and reduced postnatal stress and depression. Despite this, there was no significant difference between the groups in terms of the quality of mother-infant bonding. CONCLUSIONS: Mindfulness prenatal programs are convenient and effective methods of decreasing stress, anxiety, and depression during the perinatal period. Based on our findings, prenatal mindfulness may play a role in mitigating mood and anxiety disorders and should be considered in future approaches to preventing psychological distress. TRIAL REGISTRATION NUMBER: This trial has been prospectively registered at ClinicalTrials.gov (NCT04693130) and the first registration date was 12/24/2020.

Eficácia de uma intervenção online para prevenção da ansiedade: um ensaio clínico / Efectividad de una intervención online para prevención de ansiedad: un ensayo clínico / Efficacy of an online intervention for anxiety prevention: a clinical trial

The purpose of this study was to test the effectiveness, and the sustained effect (follow-up) of a fourweek mindfulness intervention in reducing anxiety and stress in a group of Brazilian university students, the intervention was adapted to be made available through the application Neurosaúde, created as part of this work to serve as a platform for intervention. The research as a whole took place in a virtual environment, with forty-eight participants recruited who were randomly allocated to the intervention group or to the waiting list control. Measures were used to access the levels of mindfulness, anxiety and stress before, after the intervention and at the 4-week follow-up. Applying the intention-to-treat analysis, we found significant differences between the groups for the measurement of anxiety in the follow-up with a large feat size (F (2.92) = 10.275, p = 0.000, η2 = 0.183). Our results suggest that the 4-week mindfulness intervention through a mobile application was able to act as a protective factor against the anxiety developed by university students during the occurrence of the pandemic caused by Covid-19, whereas while the treatment group maintained levels reduced anxiety the control group demonstrated a continuous increase in anxiety in the post-test and follow-up that coincided with the first wave of Covid-19 in the region where the participants lived.

El propósito de este estudio fue probar la eficacia y el efecto sostenido (seguimiento) de una intervención de atención plena de cuatro semanas para reducir la ansiedad y el estrés en un grupo de estudiantes universitarios brasileños, la intervención se adaptó para estar disponible a través del app. Neurosaúde, creada como parte de este trabajo para servir como plataforma de intervención. La investigación en su conjunto se llevó a cabo en un entorno virtual, siendo reclutados cuarenta y ocho participantes que fueron asignados aleatoriamente al grupo de intervención o al control en lista de espera. Se utilizaron medidas para evaluar los niveles de atención plena, ansiedad y estrés antes, después de la intervención y en el seguimiento a las 4 semanas. Al aplicar el análisis por intención de tratar, encontramos diferencias significativas entre los grupos para la medida de ansiedad en el seguimiento con un tamaño de efecto grande (F (2.92) = 10.275, p = 0.000, η2 = 0.183). Nuestros resultados sugieren que la intervención de mindfulness de 4 semanas a través de una aplicación móvil fue capaz de actuar como factor protector contra la ansiedad desarrollada por estudiantes universitarios durante la ocurrencia de la pandemia de Covid-19, ya que mientras el grupo de tratamiento mantuvo niveles, el grupo control demostró un aumento continuo de la ansiedad en el postest y seguimiento que coincidió con la primera ola de Covid-19 en la región donde residían los participantes.

O propósito deste estudo foi testar a eficácia e o efeito sustentado (follow-up) de uma intervenção de mindfulness de quatro semanas na redução da ansiedade e estresse em um grupo de estudantes universitários brasileiros. A intervenção foi adaptada para ser disponibilizada pelo aplicativo Neurosaúde, criado como parte deste trabalho para servir de plataforma para a intervenção. A pesquisa como um todo ocorreu em ambiente virtual, sendo recrutados 48 participantes que foram alocados randomicamente para o grupo intervenção ou para o controle de lista de espera. Medidas foram utilizadas para acessar os níveis de mindfulness, ansiedade e estresse antes, após a intervenção e no follow-up de quatro semanas. Aplicando a análise por intenção de tratar, encontramos diferenças significativas entre os grupos para a medida de ansiedade no follow-up com um tamanho de efeito grande (F (2.92) = 10.275, p = 0.000, η2 = 0.183). Nossos resultados sugerem que a intervenção de mindfulness de quatro semanas por meio de um aplicativo móvel foi capaz de agir como um fator protetor contra a ansiedade desenvolvida pelos estudantes universitários durante a ocorrência da pandemia causada pelo Covid-19, visto que, enquanto o grupo tratamento manteve níveis reduzidos de ansiedade, o grupo controle demonstrou um contínuo aumento de ansiedade no pós-teste e follow-up que coincidiu com a primeira onda de Covid-19 na região onde os participantes residiam.

Observed Improvement in Cognition During a Personalized Lifestyle Intervention in People with Cognitive Decline.

BACKGROUND: Alzheimer's disease (AD) is a chronic condition marked by progressive objective cognitive impairment (OCI). No monotherapy has substantially altered disease progression, suggesting the disease is multifactorial and may require a multimodal therapeutic approach. OBJECTIVE: We sought to determine if cognitive function in a sample with OCI would change in response to a multimodal, individualized care plan based on potential contributors to cognitive decline (e.g., nutritional status, infection, etc.). METHODS: Participants (n = 34) were recruited from the San Diego, CA area. The multimodal intervention included lifestyle changes (i.e., movement, diet, and stress management), nutraceutical support, and medications. It was delivered pragmatically over four clinical visits, and outcome measures were gathered at four study visits, occurring at baseline, one, three, and six months (primary endpoint). Study participants received weekly phone calls for nutrition support throughout study participation. Outcome measures included the Cambridge Brain Sciences (CBS) battery, and the Montreal Cognitive Assessment (MoCA). RESULTS: At 6 months, mean MoCA scores improved from 19.6±3.1 to 21.7±6.2 (p = 0.013). Significant improvement was observed in mean scores of the CBS memory domain [25.2 (SD 23.3) to 35.8 (SD 26.9); p < 0.01] and CBS overall composite cognition score [24.5 (SD 16.1) to 29.7 (SD 20.5); p = 0.02]. All CBS domains improved. CONCLUSION: Multiple measures of cognitive function improved after six months of intervention. Our results support the feasibility and impact of a multimodal, individualized treatment approach to OCI, warranting further research.

Effectiveness of training programs based on mindfulness in reducing psychological distress and promoting well-being in medical students: a systematic review and meta-analysis.

BACKGROUND: Medical schools have used mindfulness meditation as a strategy to assist students in stress management. This study aimed to seek evidence regarding the effectiveness of mindfulness-based training programs in reducing psychological distress and promoting the well-being of medical students. METHODS: We conducted a systematic review and meta-analysis. Cochrane Library, Embase, PubMed/MEDLINE, PsycINFO/PsycNet, LILACS/BVS, ERIC (ProQuest), Web of Science, OpenGrey, and Google Scholar were searched for randomized clinical trials published until March 2022, without time or language restrictions. Two authors independently screened the articles, extracted data using a standardized extraction form, and assessed the methodological quality of the included studies using the Cochrane's Risk of Bias 2 (ROB 2) tool and the quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. RESULTS: Of the 848 articles retrieved, 8 met the inclusion criteria. Mindfulness-based training improved the outcomes: mindfulness (small post-intervention effect: SMD = 0.29; 95% CI: 0.03 to 0.54; p = 0.03; I2 = 46%; high evidence quality, and small effect at follow-up: SMD = 0.37; 95% CI: 0.04 to 0.70; p = 0.03; I2 = 53%; low evidence quality), psychological well-being/health (there was no statistically significant difference between the groups in the post-intervention effect: SMD = - 0.27; 95% CI: - 0.67 to 0.13; p = 0.18; I2 = 76%; moderate evidence quality, and a significant difference at follow-up: SMD = - 0.73; 95% CI: - 1.23 to - 0.23; p = 0.004; I2 = 61%; low evidence quality), and stress (small post-intervention effect: SMD = - 0.29; CI of 95%: - 0.56 to - 0.02; p = 0.04; I2 = 57%; moderate evidence quality, and moderate effect at follow-up: SMD = - 0.45, 95% CI: - 0.67 to - 0.22, p = 0.0001, I2 = 0%, moderate evidence quality). The quality of evidence for the anxiety, depression, and resilience outcomes is low and for the empathy outcome, very low. CONCLUSION: The results indicate that the students who participated in the mindfulness training perceived improvements in the stress and psychological distress symptoms and improved health perception and psychological well-being. However, the significant heterogeneity among studies should be considered when interpreting these findings. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020153169.

The effect of a brief mindfulness-based stress reduction program on strengthening awareness of medical errors and risks among nursing students.

INFORMATION: Healthcare professionals' awareness of medical errors and risks results in effective medical error reporting and patient safety. Mindfulness has positive effects on strengthening attention and awareness. However, little is known about the use of mindfulness in patient safety education among nursing students. This study aimed to examine if a brief mindfulness-based stress reduction program would have a beneficial impact on (a) medical error attitudes, (b) the number of medical errors and risks in a simulation environment, and (c) self-confidence and satisfaction among nursing students. METHODS: A quasi-experimental design with a control group was conducted with 78 third-year nursing students at a private, accredited, nursing program in Istanbul, Türkiye. RESULTS: There was a statistically significant improvement in the intervention group between the pre-test and post-test for medical error attitudes (p < 0.001), and the number of medical errors and risks in a simulation environment (p < 0.001). There was no statistical difference in the intervention and control groups for self-confidence and satisfaction (p > 0.05). CONCLUSION: These results suggest that a brief mindfulness-based stress reduction program positively strengthens nursing students' awareness of medical errors and risks.

Effect of online modified mindfulness-based stress reduction training on the resilience of nursing interns in China.

AIM: This study aimed to adopt online mindfulness-based stress reduction (MBSR) training to increase the resilience of nursing interns and help them to achieve a smooth transition. DESIGN: A one-group pretest-posttest study design was used. METHODS: A total of 119 college nursing interns were recruited from 12 tertiary hospitals in Beijing on Feb.20, 2021. The MBSR training was organized into 4 weeks of courses, conducted online using Tencent Meeting and taught by a certified teacher at the Oxford Mindfulness Centre. Resilience was assessed before and 2 weeks after the training, respectively, using Resilience Scale for Chinese Adolescents via an online questionnaire tool. RESULTS: Seventy-nine college nursing interns finished both of the resilience questionnaire surveys. The mean resilience values before and after the training were 98.7 ± 13.69 and 104.57 ± 16.64 respectively. The 4-week online MBSR training considerably increased the resilience of nursing interns. This can be an effective measure to maintain a balanced state among nursing interns and help them smoothly transition from school to clinical practice. No Patient or Public Contribution.

Improving stress management, anxiety, and mental well-being in medical students through an online Mindfulness-Based Intervention: a randomized study.

Pressures and responsibilities of medical school put a strain on medical student's personal wellbeing, leading among all to high rates of anxiety, emotional discomfort and stress. In this work we evaluated the effectiveness of a comprehensive Mindfulness-Based Intervention (MBI) in reducing this load. The intervention comprised 10 twice-a-week Integral Meditation classes, dietary advice, and brief yoga sessions. We performed a randomized trial on two cohort of medical students from Italian universities: 239 in cohort 1 (106 treated and 133 controls), and 123 in cohort 2 (68 treated and 55 control) for a total sample of 362 students. Nine questionnaires for evaluating the effectiveness of our intervention on stress (PSS), state anxiety (STAIX-1), well-being (WEMWBS), mind-wandering (MW-S), overall distress (PANAS), emotion regulation (DERS), resilience (RS-14), and attentional control (ACS-C and ACS-D) were collected both pre and post intervention. Linear mixed effect models were run on the whole sample showing that, after multiple testing correction, our intervention was effective in reducing perceived stress (ß = - 2.57 [- 4.02; - 1.12], p = 0.004), improving mental well-being (ß = 2.82 [1.02; 4.63], p = 0.008) and emotional regulation (ß = - 8.24 [- 12.98; - 3.51], p = 0.004), resilience (ß = 3.79 [1.32; 6.26], p = 0.008), reducing the tendency to wander with the mind (ß = - 0.70 [- 0.99; - 0.39], p = 0.0001), ameliorating the ability to maintain attention (AC-S (ß = - 0.23 [- 0.44; - 0.02], p = 0.04) and AC-D (ß = - 0.19 [- 0.36; - 0.01], p = 0.04)), and the overall distress (ß = 1.84 [0.45; 3.23], p = 0.02).

The effect of laughter yoga applied before simulation training on state anxiety, perceived stress levels, self-confidence and satisfaction in undergraduate nursing students: A pragmatic randomized controlled trial.

AIM: This study aimed to examine the effect of laughter yoga applied before simulation training on state anxiety, perceived stress levels, self-confidence and satisfaction in undergraduate nursing students. BACKGROUND: Clinical simulation-based teaching implied a revolution in nursing education. Along with the many opportunities that simulation offers, some disadvantages, such as anxiety and stress experienced during simulation scenarios, could affect students' satisfaction and self-confidence in learning. Therefore, laughter yoga could be an alternative method that reduces students' anxiety and stress levels and increases their self-confidence and satisfaction with simulation training. DESIGN: The study was designed as a pragmatic randomized controlled trial. SETTING: This study was conducted at a university in Turkey. PARTICIPANTS: A total of 88 undergraduate nursing students were randomized to the intervention group (n = 44) or control group (n = 44). METHODS: The intervention group participated in the laughter yoga sessions just before the clinical simulation scenario, while the control group only performed the simulation training. The researchers examined the effect of laughter yoga on state anxiety, perceived stress levels, self-confidence and satisfaction in learning before and after the intervention. Data were collected between January - February 2022. RESULTS: This study showed that the mean scores of state anxiety, perceived stress, mean pulse rate and arterial pressure of the intervention group were significantly lower than those of the control group (p < 0.05). In addition, there was also a significant group*time interaction between the groups on state anxiety, perceived stress, pulse, respiratory and mean arterial pressure scores (p < 0.05). Moreover, the mean scores of student satisfaction and self-confidence in the learning of the intervention group were significantly higher than those of the control group (p < 0.05). CONCLUSION: The findings showed that laughter yoga helped nursing students reduce their state anxiety and perceived stress levels related to simulation training and improved their self-confidence and satisfaction with learning. Additionally, it enhanced the students' vital signs (including mean pulse rate and mean arterial pressure). These positive results are promising for using LY as an easy, safe and effective method to reduce undergraduate nursing students' stress and anxiety levels and to improve their learning satisfaction and self-confidence levels in clinical skills training such as simulation training.

Protocol for a bandit-based response adaptive trial to evaluate the effectiveness of brief self-guided digital interventions for reducing psychological distress in university students: the Vibe Up study.

INTRODUCTION: Meta-analytical evidence confirms a range of interventions, including mindfulness, physical activity and sleep hygiene, can reduce psychological distress in university students. However, it is unclear which intervention is most effective. Artificial intelligence (AI)-driven adaptive trials may be an efficient method to determine what works best and for whom. The primary purpose of the study is to rank the effectiveness of mindfulness, physical activity, sleep hygiene and an active control on reducing distress, using a multiarm contextual bandit-based AI-adaptive trial method. Furthermore, the study will explore which interventions have the largest effect for students with different levels of baseline distress severity. METHODS AND ANALYSIS: The Vibe Up study is a pragmatically oriented, decentralised AI-adaptive group sequential randomised controlled trial comparing the effectiveness of one of three brief, 2-week digital self-guided interventions (mindfulness, physical activity or sleep hygiene) or active control (ecological momentary assessment) in reducing self-reported psychological distress in Australian university students. The adaptive trial methodology involves up to 12 sequential mini-trials that allow for the optimisation of allocation ratios. The primary outcome is change in psychological distress (Depression, Anxiety and Stress Scale, 21-item version, DASS-21 total score) from preintervention to postintervention. Secondary outcomes include change in physical activity, sleep quality and mindfulness from preintervention to postintervention. Planned contrasts will compare the four groups (ie, the three intervention and control) using self-reported psychological distress at prespecified time points for interim analyses. The study aims to determine the best performing intervention, as well as ranking of other interventions. ETHICS AND DISSEMINATION: Ethical approval was sought and obtained from the UNSW Sydney Human Research Ethics Committee (HREC A, HC200466). A trial protocol adhering to the requirements of the Guideline for Good Clinical Practice was prepared for and approved by the Sponsor, UNSW Sydney (Protocol number: HC200466_CTP). TRIAL REGISTRATION NUMBER: ACTRN12621001223820.

Systemic Sclerosis Patients Experiencing Mindfulness-Based Stress Reduction Program: The Beneficial Effect on Their Psychological Status and Quality of Life.

Psychological concerns in Systemic Sclerosis (SSc) patients represent an important issue and should be addressed through non-pharmacological treatments. Thus, the aim of the present study was to assess the effects of the Mindfulness-Based Stress Reduction (MBSR) program on psychological variables and the perspectives and experiences of patients with an SSc diagnosis. Notably, 32 SSc patients were enrolled and assigned to either the intervention (MBSR) group or the waitlist group. Inclusion criteria were (i) age ≥ 18 years, SSc diagnosis according to EULAR/ACR diagnostic criteria and informed consent. Exclusion criteria were previous participation in any Mind-Body Therapy or psychiatric diagnosis. Quantitative and qualitative outcomes were investigated through clinometric questionnaires and individual interviews. MBSR did not significantly impact outcomes such as physical functionality, anxiety, hopelessness, depression, physical health status, perceived stress, mindfulness and mental health status. For the anger evaluation, statistically significant differences are found for both controlling and expressing anger, indicating that the MBSR program had a favorable impact. As for qualitative results, more awareness of daily activities, stress reduction in terms of recognizing the causes and implementing self-strategies to prevent them, adherence to therapy, and recognition of the effect of medication on their bodies were reported. In conclusion, it is important to highlight the absence of negative or side effects of the MBSR program and the positive impact on patients' experience and perspective; thus, we suggest this approach should be taken into account for SSc patients.

The effects of short interventions of focused-attention vs. self-compassion mindfulness meditation on undergraduate students: Evidence from self-report, classroom performance, and ERPs.

Mindfulness-based stress reduction (MBSR) training has been shown to improve cognitive processing, wellbeing, and academic performance. However, mindfulness interventions that are integrated into non-mindfulness related courses have not been well-investigated. Further, the unique effects of different aspects of MBSR training are not as well understood. This paper examines the effects that are uniquely associated with focused-attention versus self-compassion mindfulness practices utilizing a multi-method approach. Event-related potentials (ERPs) were recorded during an Emotional Flanker task, and self-report measures of wellbeing and measures of classroom performance were collected before and after training. Participants were students in two sections of the same undergraduate course and either completed 10 weeks of focused-attention practice or self-compassion practice that was built into their class sessions. Students in the focused-attention group (mean age = 22.08) had reduced interference effects on their reaction times following the training. Students in the self-compassion group (mean age = 23.91) showed altered processing of conflict on negative trials via the N2 and P3 ERP amplitudes after the training. This group also reported significant improvements in wellbeing and performed significantly better on more class tests compared to the focused-attention group. These data support the effectiveness of incorporating brief, simplified mindfulness practices in any classroom as an intervention to improve attention, wellbeing and classroom performance.