Combining mindfulness and cognitive training in children with attention deficit hyperactivity disorder: study protocol of a pilot randomized controlled trial (the NeuroMind study).

Introduction: Attention Deficit Hyperactivity Disorder (ADHD) has a global mean prevalence of 5%. Cognitive Training (CT) and Mindfulness-Based Interventions (MBIs) have shown promising results in managing ADHD symptoms, but they are not its Treatment-As-Usual (TAU). The NeuroMind Study aims to evaluate the preliminary effectiveness and feasibility of three interventions: Mindfulness for Health (M4H), CT using the NeuronUP® platform (CT), and a combination of both, Mindfulness Cognitive Training (MCT). There is empirical evidence supporting the effectiveness of the M4H and NeuronUP® platform; however, this study explores for the first time the effectiveness of MCT and CT, as well as the integration of M4H into TAU. The objectives of this 5-month Randomized Controlled Trial (RCT) are: (1) To analyze the preliminary effectiveness and feasibility of M4H, CT or a combination of both (MCT) added to TAU for children with ADHD; (2) To evaluate the role of psychological process variables (mindfulness and emotional regulation) as mediators of 5-month follow-up clinical outcomes; (3) To preliminarily explore whether specific sociodemographic and clinical characteristics can predict the short-and medium-term clinical response to the specific treatments. Methods and analysis: Participants will be 120 children (7 to 12 years) with ADHD recruited at Child and Adolescent Mental Health Service (CAMHS) Sant Joan de Déu Terres de Lleida (Spain) randomly allocated to one of the four study arms: TAU vs. TAU + CT vs. TAU + M4H vs. TAU + MCT. An assessment to collect ADHD symptoms, Executive Functions (EF), comorbid symptoms and global functioning will be conducted pre-intervention, post-intervention (2 months after baseline) and at the 5-month follow-up. Linear mixed models and mediational models will be computed. Discussion: If the preliminary effectiveness and feasibility of the MCT are demonstrated, this study could be a preliminary basis to do a full RCT with a larger sample to definitively validate the intervention. The MCT could be applied in clinical practice if it is definitively validated.Clinical trial registration:ClinicalTrials.gov, identifier, NCT05937347. https://clinicaltrials.gov/study/NCT05937347?locStr=Spain&country=Spain&cond=ADHD&intr=Mindfulness&rank=1.

Mindfulness-Based Intervention Effect on the Psychophysiological Marker of Self-Regulation in Women With Endometriosis-Related Chronic Pain.

Endometriosis is a gynecological disease that involves a broad biopsychosocial compromise with the potential to create a negative vicious cycle. Despite the complexity of factors influencing women's improvement, most interventions investigated target just the peripheral nociceptive sources of endometriosis-related pain. An alternative is intervening in self-regulation, which can potentially influence multiple domains of the illness experience. The present study examines the effect of a brief Mindfulness-Based Intervention (bMBI) on attention and autonomic nervous system regulation in women with endometriosis-related pain. Also, explore the interaction between these self-regulation domains and the affective pain dimension. An exploratory analysis of the secondary outcomes of a pilot randomized controlled trial was performed. The vagally-mediated Heart Rate Variability (vmHRV) at rest, cognitive stress, and recovery was employed to measure autonomic regulation. The Flanker and Stroop tasks were used to estimate the attention domains. Results showed that bMBI (n = 26) significantly improved Flanker accuracy and Flanker and Stroop reaction time compared to the control group (n = 28). bMBI significantly increased vmHRV at rest and recovery after cognitive stress. Attention mediated the bMBI effect on affective pain improvement. Results suggest that bMBI improves self-regulation domains with the potential to develop a broad biopsychosocial benefit in the endometriosis context. PERSPECTIVE: This article demonstrates the positive impact of a brief Mindfulness-Based Intervention on attention and parasympathetic regulation in women suffering from endometriosis-related pain. This mindfulness-induced self-regulation improvement can benefit affective pain and potentially multiple psychophysiological processes relevant to endometriosis.

The effectiveness of rational emotive behavior therapy (REBT) and mindfulness-based intervention (MBI) on psychological, physiological and executive functions as a proxy for sports performance.

BACKGROUND: In the current study, we conducted a comparative analysis involving three distinct groups: one receiving group-based rational emotive behavior therapy (REBT), another undergoing a mindfulness-based intervention (MBI), and a third group serving as the control. The aim of the study was to explore the effectiveness of the two interventions on specific psychological (competitive anxiety, perfectionism, irrational beliefs), physiological (salivary cortisol levels), and neurocognitive (executive functions: working memory, inhibition, cognitive flexibility) functions in Hungarian junior ice hockey players. METHODS: The participants consisted of 10 females and 36 males (NREBT=12, NMINDFULNESS=14, NCONTROL=20). We used questionnaires to assess competitive anxiety, perfectionism, and irrational beliefs. The components of executive functions were measured using a computerized testing system, while cortisol levels were examined through salivary samples. Prior to and after the interventions, each participant underwent all measurements, after which we conducted repeated measures ANOVA on our data. RESULTS: We found REBT to be an effective intervention for the regulation of competitive anxiety, perfectionism, and irrational beliefs as well as for improving some components of executive functions (inhibition and cognitive flexibility). Mindfulness was found to improve athletes' processing speed and set-shifting abilities, which are related to cognitive flexibility and metacognitive processes. CONCLUSION: In conclusion, we explore implications of these findings regarding how each approach is posited to enhance sports performance, using neurocognitive functions as a proxy. These findings are useful for further research and practical implications.

Multimodal Physical Exercise Affects Visuo-Spatial Working Memory: Preliminary Evidence from a Descriptive Study on Tai-Chi Practitioners and Runners.

Recent evidence has shown a relationship between physical exercise (PE) and cognitive functioning. However, it is unknown if unimodal and multimodal modalities of PE affect cognitive abilities in different ways. To fill this gap, we analyzed the effects of unimodal PE (running) and multimodal PE (Tai Chi) on specific cognitive abilities. A sample of 33 participants (mean age = 52.6 ± 7.2) divided into eleven runners, eleven Tai Chi practitioners, and eleven age-matched sedentary individuals were subjected to a neuropsychological tests battery to assess shifting and problem solving abilities (Rule Shift Cards, BADS-RS, and Key Search tasks), verbal fluency (semantic and phonemic verbal fluency tasks), verbal memory (Rey's 15 words test), visuo-spatial working memory (Corsi test), and global cognitive functioning (clock-drawing test). The results showed significantly higher BADS-RS scores in runners and Tai Chi practitioners in comparison to the sedentary participants, thus evidencing improved shifting abilities for active individuals. Interestingly, post hoc analysis showed significantly higher span scores of Corsi test only in Tai Chi practitioners as compared to sedentary participants, suggesting how multimodal PE facilitates the visuo-spatial working memory processes. Although preliminary, our descriptive study indicates that the type of PE could modulate specific cognitive domains, even if the practice of motor activity favors a global cognitive improvement.

Effects of short mindful breathing meditations on executive functioning in two randomized controlled double-blinded experiments.

While current models of mindfulness propose benefits to the executive functions of inhibition, updating and shifting through mindful breathing meditations, empirical findings on the effects of short mindful breathing meditations are inconclusive regarding their specificity and dose-response relations. Therefore, we compared short mindful breathing meditations (Experiment 1, 45 min over three sessions; Experiment 2, 80 min over four sessions) with relaxation trainings (progressive muscle relaxation; active control) and listening to podcasts (passive control) in two randomized controlled double-blinded trials. Reaction time tasks were used to assess the executive functions of updating (N-Back), inhibition (CPT-II), and shifting (Number-Letter Task). Results of both experiments suggest no mindfulness-specific improvements in executive functions. We conclude that effects following the first stages of mindfulness training may not be specific to the practice or too transient to be reliably measured in pre-post intervention designs. Implications for research in the field are discussed.

Attachment and emotional regulation: examining the role of prefrontal cortex functions, executive functions, and mindfulness in their relationship.

Attachment is a prominent area of psychological research, with its relevance linked to executive functions, mindfulness, and emotional regulation. The purpose of this study is to examine this relationship among these aforementioned four constructs and propose a model to be tested in the future. Based on the current trends using the Interpersonal Neurobiology approach, which assumes prefrontal cortex functions to include other socioemotional resources such as empathy, morality, insight, behavior, and body regulation. Our study included prefrontal cortical functions alongside executive functions. The assessment instruments used were Attachment-Based Cognitive Representations Scale, Prefrontal Cortex Functions Scale, Webexec, Five Facet Mindfulness Scale, and Difficulties in Emotion Regulation Scale. We hypothesized that attachment would be the strongest predictor of emotional regulation. The participants in the study were 539 college students (mean = 20.21; sd = 1.57); (68% female and 32%, male). Our a priori research hypothesis was supported, with an additional finding that trait mindfulness was also a significant predictor. The strongest correlations with attachment styles were with trait mindfulness and emotional regulation. We conducted path analyses of two different models for secure and insecure attachment. The path analyses showed that secure attachment scores were negatively related, and insecure attachment scores were positively related to difficulties in emotional regulation scores. Furthermore, trait mindfulness and prefrontal cortex functions also mediated this relationship. However, there was no significant relationship between executive functions and difficulties in emotional regulation scores, even though it was significantly related to attachment. Results and implications are discussed.

Cognitive and Mood Effect of Alpha-Lipoic Acid Supplementation in a Nonclinical Elder Sample: An Open-Label Pilot Study.

BACKGROUND: Memory disorders are common among elder people, and nonclinical cognitive decline is commonly experienced with age. Preclinical investigations have explored the possible role of alpha-lipoic acid (ALA), a known antioxidant compound abundant in vegetables and animal tissues, in reducing oxidative stress in the aging brain and preventing cognitive decline. However, clinical evidence is limited, and the few existing results are contrasting. In addition, while most of the existing trials have been focused on the effects of ALA administration in Alzheimer's disease (AD) or other types of dementia, studies evaluating its effects on nonclinical elder population are still missing. METHODS: In the present open-label, pilot study, fifteen elder patients (mean age: 84.5 ± 5.77) received ALA at a daily dose of 600 mg/day for 12 weeks. General cognitive function, executive function, and mood symptom assessment were carried out at baseline and at the endpoint. RESULTS: Overall, ALA administration was generally well-tolerated (only one dropout due to gastrointestinal side effects). However, no statistically significant effects either on cognitive function, executive function, or mood were found. CONCLUSIONS: Despite several limitations, our study found no evidence of positive effects on cognition and mood after ALA administration in elder people without the diagnosis of AD or cognitive impairment. Further clinical trials are needed to better investigate ALA effectiveness on cognition and mood in elder subjects.

Autobiographical memory impairment in chronic schizophrenia: Significance and clinical correlates.

Previous studies of autobiographical memory (AM) in schizophrenia yielded a reduction of specificity, richness of details and conscious recollection, which indicate both, quantitative and qualitative AM changes. However, their associations with psychopathological symptoms and neuropsychological deficits were not resolved. Therefore, we sought to investigate AM with respect to psychopathology and neuropsychology in patients with chronic schizophrenia to rule out the influence of different courses of the disease. AM of four lifetime periods was examined in 75 patients and 50 healthy controls by using a semi-structured interview. The recalled episodes were rated for memory specificity. Subsequently, one single event of each period of life was rated for details and experiential aspects of reliving (originality, vividness/visual imagery, emotional re-experiencing and emotional valence). When contrasted with healthy controls, patients recalled a significantly reduced number of episodes and personal semantic facts; moreover, memory specificity of AM was significantly lower in patients than controls. While the richness of details calculated for single events showed only minor, non-significant group differences, vividness and emotional re-experiencing were significantly less pronounced in the patient group. Along with this, AM performance correlated significantly with negative symptoms including apathy as well as verbal memory and executive functions. Our results underline the significance of overgenerality as a key feature of AM in schizophrenia as well as a dissociation between intact number of details of single events and reduced vividness and emotional re-experiencing. The extent of negative symptoms including apathy and impairments of verbal memory/executive functions may explain AM deficits in chronic schizophrenia.

TMS over dorsolateral prefrontal cortex affects the timing of motor imagery but not overt action: Further support for the motor-cognitive model.

The Motor-Cognitive model suggests a functional dissociation between motor imagery and overt action, in contrast to the Functional Equivalence view of common processes between the two behaviours. According to the Motor-Cognitive model, motor imagery differs from overt action primarily through the use of executive resources to monitor and elaborate a motor image during execution, which can result in a lack of correspondence between motor imagery and its overt action counterpart. The present study examined the importance of executive resources in motor imagery by using TMS to impair the function of the dorsolateral prefrontal cortex while measuring the time to complete imagined versus overt actions. In two experiments, TMS over the dorsolateral prefrontal cortex slowed motor imagery but did not affect overt actions. TMS over the same region also interfered with performance of a mental calculation task, though it did not reliably affect less demanding cognitive tasks also thought to rely on executive functions. Taken together, these results were consistent with the Motor-Cognitive model but not with the idea of functional equivalence. The implications of these results for the theoretical understanding of motor imagery, and potential applications of the Motor-Cognitive model to the use of motor imagery in training and rehabilitation, are discussed.

The effectiveness of child-centered play therapy for executive functions in children with attention-deficit/hyperactivity disorder.

INTRODUCTION: Child-centered play therapy (CCPT) is a practical and recommended non-medication intervention for children with Attention-deficit/hyperactivity disorder (ADHD) but the mechanism in between is unclear. AIM: This study proposed to examine the effectiveness of CCPT on neuropsychological deficits and behavioral symptoms in ADHD. METHODS: Participants with ADHD diagnosis were referred from senior child and adolescent psychiatrists, and typical developmental children (TD) were recruited from community as a control group. All participants' executive functions were evaluated using Cambridge Neuropsychological Test Automated Battery. First of all, the participants were evaluated using Child Behavior Checklist (CBCL) by their parents. The ADHD participants were assigned into CCPT (ADHDc) and waitlist (ADHDw) group; and the ADHDc group then received CCPT weekly for 12 sessions, while the ADHDw continuously received their regular treatment (i.e., medication treatment or other alternative treatments) as usual. RESULTS: Total 52 participants were recruited (17 with ADHD and 35 typically developed children, TD). The results showed that overall the ADHD groups had worse neuropsychological performance and more behavioural disturbance than did the TD (ps < .05). After receiving the CCPT, the results showed that the ADHDc group had significant improvement in the cognitive flexibility (p < .05); while the ADHDw group had no changes.

Systematic Review of Mindfulness-Based Interventions in Child-Adolescent Population: A Developmental Perspective.

Human development implies deep changes in cognitive, attentional, emotional, and behavioral skills. Therefore, Mindfulness-Based Interventions (MBIs) should be adapted in terms of dose, frequency, kind of exercises, assessment methods, and expected effects regarding the abilities and limitations of each developmental period. The present review seeks to describe and compare MBIs characteristics, assessment methods, and effects in youth between 3 and 18 years old considering four developmental periods. A systematic review was carried out including experimental primary studies published during the last five years. Results show that the frequency of the sessions and program duration varies widely. Differences were observed in instructors' training and in assessment strategies. Discrepancies were observed regarding the effects of MBIs both within and between periods in cognitive, socio-emotional, symptoms, and mindfulness variables. Consistency was observed in prosocial behaviors for preschoolers, and in emotional and behavioral problems and hyperactivity in ages between preschool and early adolescence. Nevertheless, it was impossible to compare most results and determine consistency or discrepancy due to the lack of studies. Regarding mindfulness, it is defined and assessed in different ways in each period. Orientations are suggested to move from a compartmentalized view of isolated MBIs, towards an integrative perspective that allows tracing developmental trajectories for mindfulness and other key cognitive and socioemotional skills for children and adolescents.

Effects of Hatha yoga on cognitive functions in the elderly: a cross-sectional study.

This study aimed to investigate the effects of Hatha yoga practice on cognitive functions in the elderly. Thirty healthy older men participated in this study. They belonged to 2 groups. The first group included 15 Hatha yoga practitioners for at least 2 years. The control group involved 15 male older adults who shared the same characteristics (age, years of formal education, and level of physical activity) as the Hatha yoga group but were naive to yoga, meditation, or any mind-body intervention. Neuropsychological tests were applied to measure selective attention, sustained attention, episodic memory, and processing speed. The following tests were administered: The French adaptation of the Victoria Stroop test, the Zazzo's Cancellation Task, the Five Word Test, and a battery of computerized tests to evaluate reaction time. Long-term Hatha yoga practice showed promising results related to executive functions and reaction time, but no significant difference was found between the two groups in episodic memory and sustained attention although a trend of improvement was observed in favor of Hatha yoga practitioners. In conclusion, long-term Hatha yoga practitioners have better cognitive abilities compared to the control group in certain aspects of cognitive functions. Further physiological and psychological variables need to be examined in order to highlight the correlation between yoga intervention and cognitive performance.

Inhibition of the ventral midline thalamus does not alter encoding, short-term holding or retrieval of spatial information in rats performing a water-escape working memory task.

Working memory (WM) is a function operating in three successive phases: encoding (sample trial), holding (delay), and retrieval (test trial) of information. Studies point to a possible implication of the thalamic reuniens nucleus (Re) in spatial WM (SWM). In which of the aforementioned 3 phases the Re has a function is largely unknown. Recently, in a delayed SWM water-escape task, we found that performance during the retrieval trial correlated positively with c-Fos expression in the Re nucleus, suggesting participation in retrieval. Here, we used the same task and muscimol (MUSC) inhibition or DREADD(hM4Di)-mediated inhibition of the Re during information encoding, right thereafter (thereby affecting the holding phase), or during the retrieval trial. A 6-hour delay separated encoding from retrieval. Concerning SWM, MUSC in the Re nucleus did not alter performance, be it during or after encoding, or during evaluation. CNO administered before encoding in DREADD-expressing rats was also ineffective, although CNO-induced inhibition disrupted set shifting performance, as found previously (Quet et al., Brain Struct Function 225, 2020), thereby validating DREADD efficiency. These findings are the first that do not support an implication of the Re nucleus in SWM. As most previous studies used T-maze alternation tasks, which carry high proactive interference risks, an important question to resolve now is whether the Re nucleus is required in (T-maze alternation) tasks using very short information-holding delays (seconds to minutes), and less so in other short-term spatial memory tasks with longer information holding intervals (hours) and therefore reduced interference risks.

Neural correlates of expectations-induced effects of caffeine intake on executive functions.

Placebo effects are defined as the beneficial subjective or behavioral outcomes of an intervention that are not attributable to its inherent properties; Placebo effects thus follow from individuals' expectations about the effects of the intervention. The present study aimed at examining how expectations influence neurocognitive processes. We addressed this question by contrasting three double-blinded within-subjects experimental conditions in which participants were given decaffeinated coffee, while being told they had received caffeinated (condition i) or decaffeinated coffee (ii), and given caffeinated coffee while being told they had received decaffeinated coffee (iii). After each of these three interventions, performance and electroencephalogram was recorded at rest as well as during sustained attention Rapid Visual Information Processing task (RVIP) and a Go/NoGo motor inhibitory control task. We first aimed to confirm previous findings for caffeine-induced enhancement on these executive components and on their associated electrophysiological indexes (The Attention-P3 component, response conflict NoGo-N2 and inhibition NoGo-P3 components (ii vs iii contrast); and then to test the hypotheses that expectations also induce these effects (i vs ii), although with a weaker amplitude (i vs iii). We did not confirm any of our hypotheses for caffeine-induced behavioral improvements and thus did not test the effect of caffeine-related expectations. At the electrophysiological level, however, we confirmed that caffeine increased the Attention-P3 and NoGo-P3 components amplitude but did not confirm an effect on the response-conflict N2 component. We did not confirm that expectations influence any of the investigated electrophysiological indices, but we confirmed that the Attention-P3 Global Field Power values were larger for the caffeine compared to the expectations conditions. We conclude that previously identified behavioral effect size of caffeine and of the related expectations for sustained attention and inhibitory control may have been overestimated, and that caffeine primarily influences the cognitive processes and brain areas supporting attention allocation. Finally, we confirm that caffeine-related expectations induce smaller effects than the substance itself.

Adolescents' executive functions: Links to inattention, hyperactivity-impulsivity, trait mindfulness, and attachment relationships with fathers and mothers.

BACKGROUND AND OBJECTIVES: Considering the important role of executive functions (EF) for adjustment across the lifespan, this study aimed to deepen understanding of protective/risk factors for EF in a potentially vulnerable population: adolescents with ADHD. This study compared adolescents with versus without ADHD for differences in EF, attachment relationships with fathers/mothers, and trait mindfulness and investigated these possible protective/risk factors' contributions to EF in both adolescent groups. METHODS: Ninth graders (N = 91; 49 boys, 42 girls) ages 14-15 years (M = 14.50, SD = 0.50) comprised 45 with ADHD and 46 with typical development (TD). Adolescents completed three self-reports (trait mindfulness, attachment to mother/father). Mothers rated their adolescents' ADHD symptoms and EF. RESULTS AND CONCLUSION: Significantly more maladaptive outcomes emerged for adolescents with ADHD than TD in their EF, attachment with mothers, and mindfulness. Regression analyses demonstrated the significant risk posed by ADHD symptoms and the protection offered by trait mindfulness and attachment with fathers in explaining EF. Discussion focused on understanding these protective/risk factors' possibly unique and complementary roles, suggesting interventions for adolescents with ADHD in family and school settings.

School-based mindfulness intervention for depressive symptoms in adolescence: For whom is it most effective?

INTRODUCTION: There is accumulating evidence for the effectiveness of mindfulness-based interventions in alleviating depressive symptoms. A crucial question is, however, whether mindfulness interventions are more effective for some individuals than others, depending on individual characteristics before a mindfulness intervention. We exploratorily investigated whether the effectiveness of school-based mindfulness intervention against depressive symptoms is modified by executive functions, rumination, and emotion regulation among adolescents. METHODS: The longitudinal data included adolescents with at least mild depressive symptoms at the baseline (n = 369, at the 6th-8th grade, 68.4% female) who were randomized into a 9-week school-based mindfulness intervention group, into an active control group receiving relaxation program, or into an inactive control group. Adolescents' executive functions, rumination, and emotion regulation (i.e., acceptance, catastrophizing, and positive reappraisal) were assessed at the baseline; and depressive symptoms at three time points (at the baseline and at 9-week and 6-month follow-ups). RESULTS AND CONCLUSIONS: In adolescents with at least mild depressive symptoms at the baseline, high catastrophizing, high acceptance, and low executive functions were found to increase the effectiveness of mindfulness-based intervention against depressive symptoms. There seemed to be some sex differences. Thus, when aiming to alleviate depressive symptoms, mindfulness-based intervention may possibly be more effective for adolescents with high catastrophizing, high acceptance, and low executive functioning (than for adolescents with the opposite dispositions). However, as this study was exploratory by nature and corrections for multiple testing were not used, the findings must be regarded as preliminary and need confirmation in further studies.

Short Mindfulness-Based Relaxation Training Has No Effects on Executive Functions but May Reduce Baseline Cortisol Levels of Boys in First Grade: A Pilot Study.

(1) Background: Executive functions are important for academic performance and school readiness. Children's executive function skills are found to be improved by mindfulness-based interventions, and these programs are also effective in stress reduction. The aim of this study was to evaluate the feasibility and the effects of a short mindfulness-based relaxation training compared to a passive control condition right before school entry on executive function skills and cortisol levels. (2) Methods: The feasibility and the effects of the intervention before school entry were tested with 61 preschoolers. The final sample consisted of 51 participants (Mage = 81.90 months, SD = 5.45; 41% male). Short-term memory, executive function skills and cortisol levels before and after the intervention were assessed. Additionally, cortisol levels were assessed one week and one month after school entry. (3) Results: There was a significant sex difference in the effects of the intervention on children's cortisol levels (p = 0.026, η2 = 0.134). The mindfulness-based relaxation training applied before school entry prevented a rise in boys' cortisol levels one week after starting school. (4) Conclusion: A short mindfulness-based intervention before starting school could be effective in fostering physiological stress management in boys.

Mindfulness Practice with a Brain-Sensing Device Improved Cognitive Functioning of Elementary School Children: An Exploratory Pilot Study.

This is the first pilot study with children that has assessed the effects of a brain-computer interface-assisted mindfulness program on neural mechanisms and associated cognitive performance. The participants were 31 children aged 9-10 years who were randomly assigned to either an eight-session mindfulness training with EEG-feedback or a passive control group. Mindfulness-related brain activity was measured during the training, while cognitive tests and resting-state brain activity were measured pre- and post-test. The within-group measurement of calm/focused brain states and mind-wandering revealed a significant linear change. Significant positive changes were detected in children's inhibition, information processing, and resting-state brain activity (alpha, theta) compared to the control group. Elevated baseline alpha activity was associated with less reactivity in reaction time on a cognitive test. Our exploratory findings show some preliminary support for a potential executive function-enhancing effect of mindfulness supplemented with EEG-feedback, which may have some important implications for children's self-regulated learning and academic achievement.

Can the practice of mindfulness reduce medical errors?

Purpose: In this article we consider the impact of mindfulness as an effective method of coping with stress and review the available literature on this topic; in addition, we share our 5 years of experience working with final year medical students. Views: Working in a hospital is a demanding and stressful job. Despite the rapid development of new technologies, the number of medical errors is not decreasing. In this paper we look for effective methods to improve medical education with a focus on the effects of stress on situational awareness (SA) and executive functions (EF). This study provides information on the beneficial effects of mindfulness techniques that, by influencing EF and SA, can directly reduce physicians' errors. Conclusions: The authors of this paper contend that effective methods of coping with stress, including mindfulness, should be considered as an additional subject in the final years of medical education.