RESUMEN
BACKGROUND/AIMS: Age-related cognitive decline is a pervasive problem in our aging population. To date, no pharmacological treatments to halt or reverse cognitive decline are available. Behavioral interventions, such as physical exercise and Mindfulness-Based Stress Reduction, may reduce or reverse cognitive decline, but rigorously designed randomized controlled trials are needed to test the efficacy of such interventions. METHODS: Here, we describe the design of the Mindfulness, Education, and Exercise study, an 18-month randomized controlled trial that will assess the effect of two interventions-mindfulness training plus moderate-to-vigorous intensity exercise or moderate-to-vigorous intensity exercise alone-compared with a health education control group on cognitive function in older adults. An extensive battery of biobehavioral assessments will be used to understand the mechanisms of cognitive remediation, by using structural and resting state functional magnetic resonance imaging, insulin sensitivity, inflammation, and metabolic and behavioral assessments. RESULTS: We provide the results from a preliminary study (n = 29) of non-randomized pilot participants who received both the exercise and Mindfulness-Based Stress Reduction interventions. We also provide details on the recruitment and baseline characteristics of the randomized controlled trial sample (n = 585). CONCLUSION: When complete, the Mindfulness, Education, and Exercise study will inform the research community on the efficacy of these widely available interventions improve cognitive functioning in older adults.
Asunto(s)
Disfunción Cognitiva/terapia , Ejercicio Físico , Educación en Salud/métodos , Atención Plena/métodos , Ensayos Clínicos Controlados Aleatorios como Asunto/métodos , Anciano , Cognición , Envejecimiento Cognitivo , Disfunción Cognitiva/psicología , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Memoria , Proyectos Piloto , Resultado del TratamientoRESUMEN
BACKGROUND: Mindfulness-based stress reduction (MBSR) has the potential to reduce worry and improve cognitive functioning. OBJECTIVES: In this treatment development project, we examined MBSR in older adults with worry symptoms and co-occurring cognitive dysfunction. We examined (i) acceptability of MBSR, (ii) whether MBSR needs to be lengthened providing more repetition, (iii) MBSR's benefits for worry reduction and cognitive improvements, and (iv) continued use of MBSR techniques during follow-up. METHODS: Two sites (St. Louis and San Diego) enrolled individuals aged 65 years or older with significant anxiety-related distress plus subjective cognitive dysfunction, into traditional 8-session MBSR groups and 12-session groups that had the same content but more repetition of topics and techniques. We examined measures of mindfulness, worry, and a neuropsychological battery focused on memory and executive function before and after the MBSR program, and we followed up participants for 6 months after the completion of MBSR regarding their continued use of its techniques. RESULTS: Participants (N = 34) showed improvements in worry severity, increases in mindfulness, and improvements in memory as measured by paragraph learning and recall after a delay, all with a large effect size. Most participants continued to use MBSR techniques for 6 months post-instruction and found them helpful in stressful situations. There was no evidence that the extended 12-week MBSR produced superior cognitive or clinical outcomes, greater satisfaction, or greater continuation of MBSR techniques than 8-week MBSR. CONCLUSIONS: These preliminary findings are promising for the further testing and use of MBSR in older adults suffering from clinical worry symptoms and co-occurring cognitive dysfunction. These are common problems in a broad range of older adults, many of whom have anxiety and mood disorders; therefore, stress reduction intervention for them may have great public health value.
Asunto(s)
Ansiedad/terapia , Trastornos del Conocimiento/terapia , Trastorno Depresivo/terapia , Meditación/métodos , Atención Plena , Estrés Psicológico/terapia , Anciano , Anciano de 80 o más Años , Trastornos de Ansiedad/psicología , Ejercicio Físico/psicología , Estudios de Factibilidad , Femenino , Humanos , Masculino , Yoga/psicologíaRESUMEN
Importance: Quality of life (QOL) of patients with atopic dermatitis (AD) is reported to be the lowest among skin diseases. To our knowledge, mindfulness and self-compassion training has not been evaluated for adults with AD. Objective: To evaluate the efficacy of mindfulness and self-compassion training in improving the QOL for adults with AD. Design, Setting, and Participants: This randomized clinical trial conducted from March 2019 through October 2022 included adults with AD whose Dermatology Life Quality Index (DLQI) score, a skin disease-specific QOL measure, was greater than 6 (corresponding to moderate or greater impairment). Participants were recruited from multiple outpatient institutes in Japan and through the study's social media outlets and website. Interventions: Participants were randomized 1:1 to receive eight 90-minute weekly group sessions of online mindfulness and self-compassion training or to a waiting list. Both groups were allowed to receive any dermatologic treatment except dupilumab. Main Outcomes and Measures: The primary outcome was the change in the DLQI score from baseline to week 13. Secondary outcomes included eczema severity, itch- and scratching-related visual analog scales, self-compassion and all of its subscales, mindfulness, psychological symptoms, and participants' adherence to dermatologist-advised treatments. Results: The study randomized 107 adults to the intervention group (n = 56) or the waiting list (n = 51). The overall participant mean (SD) age was 36.3 (10.5) years, 85 (79.4%) were women, and the mean (SD) AD duration was 26.6 (11.7) years. Among participants from the intervention group, 55 (98.2%) attended 6 or more of the 8 sessions, and 105 of all participants (98.1%) completed the assessment at 13 weeks. The intervention group demonstrated greater improvement in the DLQI score at 13 weeks (between-group difference estimate, -6.34; 95% CI, -8.27 to -4.41; P < .001). The standardized effect size (Cohen d) at 13 weeks was -1.06 (95% CI, -1.39 to -0.74). All secondary outcomes showed greater improvements in the intervention group than in the waiting list group. Conclusions and Relevance: In this randomized clinical trial of adults with AD, integrated online mindfulness and self-compassion training in addition to usual care resulted in greater improvement in skin disease-specific QOL and other patient-reported outcomes, including eczema severity. These findings suggest that mindfulness and self-compassion training is an effective treatment option for adults with AD. Trial Registration: https://umin.ac.jp/ctr Identifier: UMIN000036277.
Asunto(s)
Dermatitis Atópica , Eccema , Atención Plena , Humanos , Adulto , Femenino , Masculino , Dermatitis Atópica/tratamiento farmacológico , Calidad de Vida , Autocompasión , Resultado del TratamientoRESUMEN
We report an approach that extends the applicability of ultrasensitive force-gradient detection of magnetic resonance to samples with spin-lattice relaxation times (T (1)) as short as a single cantilever period. To demonstrate the generality of the approach, which relies on detecting either cantilever frequency or phase, we used it to detect electron spin resonance from a T (1) = 1 ms nitroxide spin probe in a thin film at 4.2 K and 0.6 T. By using a custom-fabricated cantilever with a 4 microm-diameter nickel tip, we achieve a magnetic resonance sensitivity of 400 Bohr magnetons in a 1 Hz bandwidth. A theory is presented that quantitatively predicts both the lineshape and the magnitude of the observed cantilever frequency shift as a function of field and cantilever-sample separation. Good agreement was found between nitroxide T (1) 's measured mechanically and inductively, indicating that the cantilever magnet is not an appreciable source of spin-lattice relaxation here. We suggest that the new approach has a number of advantages that make it well suited to push magnetic resonance detection and imaging of nitroxide spin labels in an individual macromolecule to single-spin sensitivity.
Asunto(s)
Óxidos N-Cíclicos/química , Espectroscopía de Resonancia por Spin del Electrón/métodos , Marcadores de Spin , Fenómenos Biofísicos , Espectroscopía de Resonancia por Spin del Electrón/instrumentación , Espectroscopía de Resonancia por Spin del Electrón/estadística & datos numéricos , Diseño de Equipo , Espectroscopía de Resonancia Magnética , Microondas , Estructura Molecular , TermodinámicaRESUMEN
There are few materials that are broadly used for fabricating optical metasurfaces for visible light applications. Gallium phosphide (GaP) is a material that, due to its optical properties, has the potential to become a primary choice but due to the difficulties in fabrication, GaP thin films deposited on transparent substrates have never been exploited. In this article we report the design, fabrication, and characterization of three different amorphous GaP metasurfaces obtained through sputtering. Although the material properties can be further optimized, our results show the potential of this material for visible applications making it a viable alternative in the material selection for optical metasurfaces.
RESUMEN
OBJECTIVE: To determine whether neurocognitive performance and clinical outcomes can be enhanced by a mindfulness intervention in older adults with stress disorders and cognitive complaints. To explore decreased hypothalamic-pituitary-adrenal (HPA) axis activity as a possible mechanism. METHODS: 103 adults aged 65 years or older with an anxiety or depressive disorder (diagnosed according to DSM-IV criteria) and subjective neurocognitive difficulties were recruited in St. Louis, Missouri, or San Diego, California, from September 2012 through August 2013 and randomly assigned in groups of 5-8 to mindfulness-based stress reduction (MBSR) or a health education control condition matched for time, attention, and credibility. The primary outcomes were memory (assessed by immediate and delayed paragraph and list recall) and cognitive control (Delis-Kaplan Executive Function System Verbal Fluency Test and Color Word Interference Test). Other outcomes included clinical symptoms (worry, depression, anxiety, and global improvement). HPA axis activity was assessed using peak salivary cortisol. Outcomes were measured immediately post-intervention and (for clinical outcomes only) at 3- and 6-month follow up. RESULTS: On the basis of intent-to-treat principles using data from all 103 participants, the mindfulness group experienced greater improvement on a memory composite score (P = .046). Groups did not differ on change in cognitive control. Participants receiving MBSR also improved more on measures of worry (P = .042) and depression (P = .049) at posttreatment and on worry (P = .02), depression (P = .002), and anxiety (P = .002) at follow-up and were more likely to be rated as much or very much improved as rated by the Clinical Global Impressions-Improvement scale (47% vs 27%, χ² = 4.5, P = .03). Cortisol level decreased to a greater extent in the mindfulness group, but only among those participants with high baseline cortisol. CONCLUSIONS: In this population of older adults with stress disorders and neurocognitive difficulties, a mindfulness intervention improves clinical outcomes such as excessive worry and depression and may include some forms of immediate memory performance. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01693874.
Asunto(s)
Trastornos de Ansiedad/psicología , Trastornos de Ansiedad/terapia , Trastorno Depresivo/psicología , Trastorno Depresivo/terapia , Atención Plena , Trastornos Neurocognitivos/psicología , Trastornos Neurocognitivos/terapia , Estrés Psicológico/complicaciones , Estrés Psicológico/psicología , Anciano , Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/fisiopatología , Nivel de Alerta/fisiología , Trastorno Depresivo/diagnóstico , Trastorno Depresivo/fisiopatología , Femenino , Estudios de Seguimiento , Educación en Salud , Humanos , Hidrocortisona/sangre , Sistema Hipotálamo-Hipofisario/fisiopatología , Masculino , Memoria a Corto Plazo/fisiología , Trastornos Neurocognitivos/diagnóstico , Trastornos Neurocognitivos/fisiopatología , Pruebas Neuropsicológicas , Sistema Hipófiso-Suprarrenal/fisiopatología , Retención en Psicología/fisiología , Estrés Psicológico/fisiopatología , Aprendizaje Verbal/fisiologíaRESUMEN
The ability to pay close attention to the present moment can be a crucial factor for performing well in a competitive situation. Training mindfulness is one approach to potentially improve elite athletes' ability to focus their attention on the present moment. However, virtually nothing is known about whether these types of interventions alter neural systems that are important for optimal performance. This pilot study examined whether an intervention aimed at improving mindfulness [Mindful Performance Enhancement, Awareness and Knowledge (mPEAK)] changes neural activation patterns during an interoceptive challenge. Participants completed a task involving anticipation and experience of loaded breathing during functional magnetic resonance imaging recording. There were five main results following mPEAK training: (1) elite athletes self-reported higher levels of interoceptive awareness and mindfulness and lower levels of alexithymia; (2) greater insula and anterior cingulate cortex (ACC) activation during anticipation and post-breathing load conditions; (3) increased ACC activation during the anticipation condition was associated with increased scores on the describing subscale of the Five Facet Mindfulness Questionnaire; (4) increased insula activation during the post-load condition was associated with decreases in the Toronto Alexithymia Scale identifying feelings subscale; (5) decreased resting state functional connectivity between the PCC and the right medial frontal cortex and the ACC. Taken together, this pilot study suggests that mPEAK training may lead to increased attention to bodily signals and greater neural processing during the anticipation and recovery from interoceptive perturbations. This association between attention to and processing of interoceptive afferents may result in greater adaptation during stressful situations in elite athletes.
RESUMEN
OBJECTIVE: This pilot study reports the findings of a randomized controlled trial (RCT) investigating the feasibility, tolerability, acceptability, and initial estimates of efficacy of mindfulness-based cognitive therapy (MBCT) compared to a delayed treatment (DT) control for headache pain. It was hypothesized that MBCT would be a viable treatment approach and that compared to DT, would elicit significant improvement in primary headache pain-related outcomes and secondary cognitive-related outcomes. MATERIALS AND METHODS: RCT methodology was employed and multivariate analysis of variance models were conducted on daily headache diary data and preassessment and postassessment data for the intent-to-treat sample (N=36), and on the completer sample (N=24). RESULTS: Patient flow data and standardized measures found MBCT for headache pain to be feasible, tolerable, and acceptable to participants. Intent-to-treat analyses showed that compared to DT, MBCT patients reported significantly greater improvement in self-efficacy (P=0.02, d=0.82) and pain acceptance (P=0.02, d=0.82). Results of the completer analyses produced a similar pattern of findings; additionally, compared to DT, MBCT completers reported significantly improved pain interference (P<0.01, d=-1.29) and pain catastrophizing (P=0.03, d=-0.94). Change in daily headache diary outcomes was not significantly different between groups (P's>0.05, d's≤-0.24). DISCUSSION: This study empirically examined MBCT for the treatment of headache pain. Results indicated that MBCT is a feasible, tolerable, acceptable, and potentially efficacious intervention for patients with headache pain. This study provides a research base for future RCTs comparing MBCT to attention control, and future comparative effectiveness studies of MBCT and cognitive-behavioral therapy.
Asunto(s)
Terapia Cognitivo-Conductual/métodos , Trastornos de Cefalalgia/psicología , Trastornos de Cefalalgia/terapia , Atención Plena , Adulto , Estudios de Factibilidad , Femenino , Trastornos de Cefalalgia/tratamiento farmacológico , Humanos , Masculino , Persona de Mediana Edad , Motivación , Dimensión del Dolor , Aceptación de la Atención de Salud , Cooperación del Paciente , Satisfacción del Paciente , Proyectos Piloto , Tamaño de la Muestra , Autoeficacia , Factores Socioeconómicos , Resultado del TratamientoRESUMEN
We measure the spin-lattice relaxation time as a function of sample temperature in GaAs in a real-time single-shot inversion recovery experiment using spin force gradients acting on a magnetic tipped cantilever. After inverting 69Ga spins localized near the magnet with a single 20 ms adiabatic rapid passage sweep, the spins' magnetization recovery was passively tracked by recording the cantilever's frequency change, which is proportional to the longitudinal component of the spins' magnetization. The cantilever's frequency was recorded for a time 3*T1 for sample temperatures ranging from 4.8 to 25 K. The temperature dependence was observed for the 69Ga quadrupolar relaxation interaction.
RESUMEN
In-plane to out-of-plane magnetization switching in a single nickel nanorod affixed to an attonewton-sensitivity cantilever was studied at cryogenic temperatures. We observe multiple sharp, simultaneous transitions in cantilever frequency, dissipation, and frequency jitter associated with magnetic switching through distinct intermediate states. These findings suggest a new route for detecting magnetic fields at the nanoscale.
RESUMEN
In spite of the existence of good empirically supported treatments for posttraumatic stress disorder (PTSD), consumers and providers continue to ask for more options for managing this common and often chronic condition. Meditation-based approaches are being widely implemented, but there is minimal research rigorously assessing their effectiveness. This article reviews meditation as an intervention for PTSD, considering three major types of meditative practices: mindfulness, mantra, and compassion meditation. The mechanisms by which these approaches may effectively reduce PTSD symptoms and improve quality of life are presented. Empirical evidence of the efficacy of meditation for PTSD is very limited but holds some promise. Additional evaluation of meditation-based treatment appears to be warranted.
Asunto(s)
Meditación/métodos , Trastornos por Estrés Postraumático/terapia , Humanos , Meditación/psicologíaRESUMEN
Thermotropic liquid crystal (LC)-based inks are combined with patterned anchoring stamps to deposit organic monolayer films with simultaneous control over positional and molecular orientational order in a single step.
RESUMEN
We introduce and demonstrate a method of measuring small force gradients acting on a harmonic oscillator in which the force-gradient signal of interest is used to parametrically up-convert a forced oscillation below resonance into an amplitude signal at the oscillator's resonance frequency. The approach, which we demonstrate in a mechanically detected electron spin resonance experiment, allows the force-gradient signal to evade detector frequency noise by converting a slowly modulated frequency signal into an amplitude signal.
RESUMEN
We have batch-fabricated cantilevers with â¼100 nm diameter nickel nanorod tips and force sensitivities of a few attonewtons at 4.2 K. The magnetic nanorods were engineered to overhang the leading edge of the cantilever, and consequently the cantilevers experience what we believe is the lowest surface noise ever achieved in a scanned probe experiment. Cantilever magnetometry indicated that the tips were well magnetized, with a ≤ 20 nm dead layer; the composition of the dead layer was studied by electron microscopy and electron energy loss spectroscopy. In what we believe is the first demonstration of scanned probe detection of electron-spin resonance from a batch-fabricated tip, the cantilevers were used to observe electron-spin resonance from nitroxide spin labels in a film via force-gradient-induced shifts in cantilever resonance frequency. The magnetic field dependence of the magnetic resonance signal suggests a nonuniform tip magnetization at an applied field near 0.6 T.
Asunto(s)
Imagen por Resonancia Magnética/métodos , Magnetismo , Fenómenos Mecánicos , Nanotecnología/métodos , Espectroscopía de Resonancia por Spin del Electrón , Estudios de Factibilidad , Microscopía Electrónica , Níquel/química , Silicio/química , Espectroscopía de Pérdida de Energía de ElectronesRESUMEN
The invention and initial demonstration of magnetic resonance force microscopy (MRFM) in the early 1990s launched a renaissance of mechanical approaches to detecting magnetic resonance. This article reviews progress made in MRFM in the last decade, including the demonstration of scanned probe detection of magnetic resonance (electron spin resonance, ferromagnetic resonance, and nuclear magnetic resonance) and the mechanical detection of electron spin resonance from a single spin. Force and force-gradient approaches to mechanical detection are reviewed and recent related work using attonewton sensitivity cantilevers to probe minute fluctuating electric fields near surfaces is discussed. Given recent progress, pushing MRFM to single proton sensitivity remains an exciting possibility. We will survey some practical and fundamental issues that must be resolved to meet this challenge.