Effectiveness of Mindfulness-Based Relapse Prevention Program as an Adjunct to the Standard Treatment for Smoking: A Pragmatic Design Pilot Study.

INTRODUCTION: Posttreatment relapse is a major roadblock to stemming the global epidemic of tobacco-related illness. This article presents results from a pilot trial evaluating the feasibility and initial efficacy of Mindfulness-Based Relapse Prevention (MBRP) as an adjunct to standard relapse prevention treatment (ST) for smoking cessation. AIMS AND METHODS: Smokers (n = 86) in the maintenance phase of treatment were randomized to receive either ST plus MBRP (MBRP) (n = 44) or ST alone (ST) (n = 42). Data were collected at baseline and at 4-, 12-, and 24-week follow-up points. We evaluated the feasibility of the protocol with frequency analysis, and the efficacy with both intention to treat and complete case analyses of the effects of MBRP on abstinence. Secondary outcomes included mindfulness, craving, depression, anxiety, and positive/negative affect. RESULTS: High adherence suggested MBRP is acceptable and feasible. Participants in the MBRP group reported increases in mindfulness (M = -7.833, p = .016), and reductions in craving (M = 17.583, p = .01) compared with the ST group. Intention to treat analysis found that, compared with MBRP (36.4%), ST (57.1%) showed trend-level superiority in abstinence at Week 4 (Prevalence Ratio = 0.63, p = .06); however at Week 24, the ST group (14.3%) demonstrated a twofold greater decrease in abstinence, compared with the MBRP group (20.1%) (Prevalence Ratio = 2.25, p = .08). Therefore, the MBRP group maintained a higher abstinence rate for longer. Reported effects were greater in the complete case analysis. CONCLUSIONS: MBRP holds promise for preventing relapse after aided tobacco quit attempts. IMPLICATIONS: Findings suggest that MBRP is acceptable, feasible, and valued by participants. At 24-week follow-up, there was a large effect size and a statistical trend toward fewer MBRP patients relapsing compared with ST patients. MBRP conferred ancillary benefits including reductions in craving and increases in levels of mindfulness. MBRP for tobacco cessation is highly promising and merits further research. TRIAL REGISTRATION: clinicaltrials.gov. IDENTIFIER: NCT02327104.

The effects of perceived chronic stress on the fMRI correlates of attentional control in women managers.

The aims of the current study were to examine differences in brain responses to cognitive control in stressed and non-stressed women managers. Stress complaints are highly prevalent among active workers and play an important role in women managers mental health and cognitive functioning. Psychosocial stress has been associated with differential executive functions in this population, but little is known about the neural correlates underlying such differences. We examined brain responses of a particular group of workers that has been proposed to have a different response to stress as a function of their status (i.e., managers). Stressed (n = 19) and non-stressed women managers (n = 21) were scanned using functional magnetic resonance imaging (fMRI) during the performance of a cognitively demanding task. We used the Stroop color-word task to compare neural activation associated with the suppression of a predominant response tendency (i.e., word reading) and the initiation of an appropriate behavior alternative (i.e., naming word color). Despite similar behavioral performances, stressed managers exhibited increased activation in the occipital cortex during response inhibition. No regions were more activated in the non-stressed relative to the stressed group. This finding of greater activation has been interpreted as compensatory brain response to maintain performance in front of cognitive challenge.

A New Mental Health Mobile App for Well-Being and Stress Reduction in Working Women: Randomized Controlled Trial.

BACKGROUND: Although the availability and use of mobile mental health apps has grown exponentially in recent years, little data are available regarding their efficacy. OBJECTIVE: This study aimed to evaluate the effectiveness of an app developed to promote stress management and well-being among working women compared with a control app. METHODS: Female employees at a private hospital were invited to participate in the study via mailing lists and intranet ads. A total of 653 individuals self-enrolled through the website. Eligible participants were randomized between control (n=240) and intervention (n=250) groups. The well-being mobile app provides an 8-week program with 4 classes per week (including a brief theoretical portion and a 15-min guided practice). The active control app also provided 4 assessments per week that encouraged participants to self-observe how they were feeling for 20 min. We also used the app to conduct Web-based questionnaires (10-item Perceived Stress Scale and 5-item World Health Organization Well-Being Index) and ask specific questions to assess subjective levels of stress and well-being at baseline (t1), midintervention (t4=4 weeks after t1) and postintervention (t8=8 weeks after t1). Both apps were fully automated without any human involvement. Outcomes from the control and intervention conditions at the 3 time points were analyzed using a repeated measures analysis of variance. RESULTS: Among the randomized participants (n=490), 185 participants were excluded at the 4-week follow-up and another 79 at the 8-week follow-up because of noncompliance with the experimental protocol. Participants who did not complete t4 and t8 assessments were equally distributed between groups (t4: control group=34.6% [83/240] and intervention group=40.8% [102/250]; P=.16; t8: control group=29.9% [47/157] and intervention group=21.6% [32/148]; P=.10). Both groups showed a significant increase in general well-being as a function of time (F2,426=5.27; P=.006), but only the intervention group presented a significant increase in work-related well-being (F2,426=8.92; P<.001), as well as a significant reduction in work-related and overall stress (F2,426=5.50; P=.004 and F2,426=8.59; P<.001, respectively). CONCLUSIONS: The well-being mobile app was effective in reducing employee stress and improving well-being. TRIAL REGISTRATION: Clinicaltrials.gov NCT02637414; https://clinicaltrials.gov/ct2/show/NCT02637414.

Psychoeducation versus psychoeducation integrated with yoga for family caregivers of people with Alzheimer's disease: a randomized clinical trial.

We evaluate and compare the effectiveness of two psychoeducation programs on the burden and quality of life of family caregivers of people with Alzheimer's disease: one of psychoeducation alone and the other integrated with yoga. Forty-nine participants were randomly allocated to two groups, 25 to the psychoeducation integrated with yoga group (G1) and 24 to the psychoeducation group (G2). The programs took place online through Google Meet and consisted of eight weekly meetings, lasting 30 min for psychoeducation and 30 min for yoga. Participants were evaluated by the Burden Interview Scale (BI-Zarit), Quality of Life Scale in Alzheimer's Disease-Caregiver Version (CQOL-AD), Depression, Anxiety and Stress Scale (DASS-21), Mindfulness and Awareness Scale (MAAS) and a satisfaction survey. Both groups showed reduced overload according to the BI-Zarit scale (F(1) = 4.435, p = 0.041, η2p = 0.086) and improvement in the domains of physical health (F(1) = 4.881, p = 0.032, η2p = 0.094), memory (F(1) = 4.192, p = 0.046, η2p = 0.082) and money (F(1) = 4.862, p = 0.032, η2p = 0.094) in the CQOL-AD. We detected a significantly higher improvement of G1 in memory (F(1) = 4.192, p = 0.046 η2p = 0.082), money (F(1) = 7.147, p = 0.010, η2p = 0.132) and friends (F(1) = 4.828, p = 0.033, η2p = 0.093). The G1 when compared to the G2 did not demonstrate significant effects of the BI-Zarit, in the total scores CQOL-AD, MAAS and DASS-21. The study showed that both psychoeducation alone and integrated with yoga reduced the burden of family caregivers of people with Alzheimer's disease, and that the integration of online yoga practice with psychoeducation potentiated the improvement only in some aspects of the quality of life and subjective perception of burden reduction.Clinical trial registration https://ensaiosclinicos.gov.br/ , identifier RBR-794593r, retrospectively registered.

Baseline emotional state influences on the response to animated short films: A randomized online experiment.

Introduction: Considering the relevance of the emotional state, it is necessary to understand how daily stimuli can modulate the emotions. Animated short films are common stimuli, but it is unknown how they can modulate the emotional state. The study aimed to evaluate: how participants' emotional state changed after watching animated short films with positive or negative emotional valence in an online experiment; the relationship between participants' baseline score on an Emotional Intensity Scale and their potential change in the main emotion after watching the films; and the association between the initial main emotion valence and the potential change in this emotion with participants' sociodemographic information. Methods: A sample of 2,269 participants recruited during COVID-19 pandemic were randomly assigned to either watch a negative or positive animated short film. Results: The results showed that, after watching a film with negative valence, participants were in a more negative emotional state than at baseline and compared with those who watched the film with positive valence. Also, individuals who had a negative baseline emotion and maintained the same emotion after the film had presented higher baseline emotional state scores (more negative emotion) than those who changed their emotions. In addition, the individuals who kept the baseline emotion had an association with age, marital status, level of education and psychiatric disorders, use of medication, and emotional awareness, while the individuals who changed the baseline emotion had an association with age, gender, and following or not social distancing recommendations. Conclusion: Baseline emotional state may influence the response to animated short films and sociodemographic characteristics are associated with the initial main emotion valence and its potential change in this emotion.

The use of functional near infrared spectroscopy and gait analysis to characterize cognitive and motor processing in early-stage patients with multiple sclerosis.

Background: Dual-task paradigms are a known tool to evaluate possible impairments in the motor and cognitive function in patients with multiple sclerosis (MS). A technique to evaluate the cortical function during movement is functional near-infrared spectroscopy (fNIRS). The evaluation of the MS course or its treatment by associating fNIRS with gait measurements may be flexible and low-cost; however, there are no feasibility studies in the literature using these combined techniques in early-stage patients with MS. Objective: To evaluate cortical hemodynamics using fNIRS and gait parameters in patients at early stages of MS and in healthy controls during a dual-task paradigm. Methods: Participants performed cognitive tasks while walking to simulate daily activities. Cortical activation maps and gait variability were used to evaluate differences between 19 healthy controls and 20 patients with MS. Results and conclusion: The results suggest an enhanced cortical activation in the motor planning areas already at the early stages of MS when compared to controls. We have also shown that a systematic analysis of the spatiotemporal gait variability parameters indicates differences in the patient population. The association of cortical and gait parameters may reveal possible compensatory mechanisms related to gait during dual tasking at the early stages of the disease.

COVID-19 news valence effects on emotion and its modulation by a relaxation: A randomized online experiment during COVID-19 pandemic.

This study evaluated how news with positive and negative content about COVID-19, as well as a relaxation pause, affect the emotional state. We also investigated the association between emotional state and practicing meditation/yoga, physical activity or having a mental disease. For that, a sample of 717 participants, recruited through social media, were randomly assigned to listen to negative or positive news about COVID-19. After that, both groups were guided through a short relaxation pause. Their emotional state was measured before they listened to the audios and after each audio. Mixed linear models were used to evaluate the effects of news group, relaxation pause, mental health and well-being practices. Negative news worsened their emotional state, whereas positive news improved it. A brief relaxation pause improved the effects of negative news content and may mitigate the effects of this valence of information. Practicing physical activity, meditation/yoga was associated with better emotional responses.

Can news with positive or negative content affect and a relaxation pause improve the emotional state of health care professionals? A randomized online experiment during COVID-19 pandemic.

A cause of mental distress during the COVID-19 pandemic is media exposure, which can impact health care professionals (HCPs) who must keep up to date with the statistics and procedures to fight the outbreak. This study aimed to evaluate the effects of listening to negative and positive news about COVID-19 pandemic and a relaxation pause audio. For that, we measured the emotional state through Likert items in a scale developed to assess how anxious, stressed, hopeful, conscious about emotions, irritated, despondent, joyful, optimistic, and preoccupied, he or she was feeling in the moment of evaluation. In an online experiment, an HCPs sample of 245 participants were randomly assigned to either listen to negative or positive news contents about COVID-19. After that, both groups were guided by a relaxation pause activity in which they paid attention to the body and breath. They were assessed before and after listening to each audio. After listening to negative news, participants entered in a more negative emotional state than at baseline (p < 0.001) and compared with participants who listened to positive news (p < 0.001). Both groups improved their emotional state after performing the proposed brief relaxation (p < 0.001). These results show the importance of HCPs being aware and controlling the content of consumed news. A brief relaxation practice can mitigate the negative effects of consuming information with negative content.

The Child Emotion Facial Expression Set: A Database for Emotion Recognition in Children.

Background: This study developed a photo and video database of 4-to-6-year-olds expressing the seven induced and posed universal emotions and a neutral expression. Children participated in photo and video sessions designed to elicit the emotions, and the resulting images were further assessed by independent judges in two rounds. Methods: In the first round, two independent judges (1 and 2), experts in the Facial Action Coding System, firstly analysed 3,668 emotions facial expressions stimuli from 132 children. Both judges reached 100% agreement regarding 1,985 stimuli (124 children), which were then selected for a second round of analysis between judges 3 and 4. Results: The result was 1,985 stimuli (51% of the photographs) were produced from 124 participants (55% girls). A Kappa index of 0.70 and an accuracy of 73% between experts were observed. Lower accuracy was found for emotional expression by 4-year-olds than 6-year-olds. Happiness, disgust and contempt had the highest agreement. After a sub-analysis evaluation of all four judges, 100% agreement was reached for 1,381 stimuli which compound the ChildEFES database with 124 participants (59% girls) and 51% induced photographs. The number of stimuli of each emotion were: 87 for neutrality, 363 for happiness, 170 for disgust, 104 for surprise, 152 for fear, 144 for sadness, 157 for anger 157, and 183 for contempt. Conclusions: The findings show that this photo and video database can facilitate research on the mechanisms involved in early childhood recognition of facial emotions in children, contributing to the understanding of facial emotion recognition deficits which characterise several neurodevelopmental and psychiatric disorders.

Quantitative assessment of pilot-endured workloads during helicopter flying emergencies: an analysis of physiological parameters during an autorotation.

The procedures to be performed after sudden engine failure of a single-engine helicopter impose high workload on pilots. The maneuver to regain aircraft control and safe landing is called autorotation. The safety limits to conduct this maneuver are based on the aircraft height versus speed diagram, which is also known as "Dead Man's Curve". Flight-test pilots often use subjective methods to assess the difficulty to conduct maneuvers in the vicinity of this curve. We carried out an extensive flight test campaign to verify the feasibility of establishing quantitative physiological parameters to better assess the workload endured by pilots undergoing those piloting conditions. Eleven pilots were fully instrumented with sensors and had their physiological reactions collected during autorotation maneuvers. Our analyses suggested that physiological measurements (heart rate and electrodermal activity) can be successfully recorded and useful to capture the most effort-demanding effects during the maneuvers. Additionally, the helicopter's flight controls displacements were also recorded, as well as the pilots' subjective responses evaluated by the Handling Qualities Rate scale. Our results revealed that the degree of cognitive workload was associated with the helicopter's flight profile concerning the Height-Speed diagram and that the strain intensity showed a correlation with measurable physiological responses. Recording flight controls displacement and quantifying the pilot's subjective responses show themselves as natural effective candidates to evaluate the intensity of cognitive workload in such maneuvers.

Mind-body interventions for the treatment of insomnia: a review.

OBJECTIVE: As insomnia is highly prevalent, and side effects of medication are well-known, mind-body interventions are increasingly being sought. The objective of this study is to present a narrative review regarding the effects of mind-body interventions for the treatment of insomnia. METHOD: A PubMed search was conducted including only randomized, controlled trials in which the main objective was to treat insomnia. DISCUSSION: Twelve studies were selected. In three of the studies, objective parameters (polysomnography) were analyzed. Mind-body interventions were able to improve sleep efficiency and total sleep time. Most can ameliorate sleep quality; some can reduce the use of hypnotic drugs in those who are dependent on these drugs. CONCLUSION: According to the studies we selected, self-reported sleep was improved by all mind-body treatments, among them yoga, relaxation, Tai Chi Chih and music. Cognitive behavioral therapy seems to be the most effective mind-body intervention. Cognitive behavioral therapy was the only intervention that showed better results than medication. However, considering that only five of the twelve studies chosen reached a score of 3 in the Jadad scale, new studies with a higher methodological quality have to be conducted especially in mind-body interventions that belong to the complementary or alternative medicine field.

Effect of progressive self-focus meditation on attention, anxiety, and depression scores.

This study evaluated the effects of Progressive Self-focus Meditation with 42 volunteers (M age = 46.0 yr., SD = 14.1) allocated to two groups: one that had weekly 1-hr. training sessions in the practice for 5 wk. and one waiting-list group. Participants were evaluated before and after 5 wk. on the Beck Anxiety Inventory, Beck Depression Inventory, the Digit Symbol subtest of the Wechsler Adult Intelligence Scale, and the Mindfulness Attention Awareness Scale. After 5 wk., a significant reduction in scores on depression was found in the Meditation group as well as an increase in attention in comparison with the waiting-list Control group.

Neural correlates of meditation: a review of structural and functional MRI studies.

Here, we review the neurophysiological and neuroimaging changes that mediation induces in structural and functional MRI. The available evidence from structural studies suggests that mediation impacts neuronal plasticity and the functional MRI suggest that there are changes in gray and white matter in subjects who meditate. FMRI studies show that meditation is associated with decreased activity of default mode network and activation of brain regions involved in cognitive and emotional control. Together, the available imaging techniques have revealed that rather than impacting specific brain regions, meditation causes structural and functional changes in large-scale brain networks.

A Critical Analysis on Characterizing the Meditation Experience Through the Electroencephalogram.

Meditation practices, originated from ancient traditions, have increasingly received attention due to their potential benefits to mental and physical health. The scientific community invests efforts into scrutinizing and quantifying the effects of these practices, especially on the brain. There are methodological challenges in describing the neural correlates of the subjective experience of meditation. We noticed, however, that technical considerations on signal processing also don't follow standardized approaches, which may hinder generalizations. Therefore, in this article, we discuss the usage of the electroencephalogram (EEG) as a tool to study meditation experiences in healthy individuals. We describe the main EEG signal processing techniques and how they have been translated to the meditation field until April 2020. Moreover, we examine in detail the limitations/assumptions of these techniques and highlight some good practices, further discussing how technical specifications may impact the interpretation of the outcomes. By shedding light on technical features, this article contributes to more rigorous approaches to evaluate the construct of meditation.

COVID-19 information exposure in digital media and implications for employees in the health care sector: findings from an online survey.

OBJECTIVE: To estimate coronavirus disease 2019-related information consumption and related implications for health care professionals (medical and nonmedical personnel) during the pandemic. METHODS: A cross-sectional on-line survey was distributed to employees of a major health care institution located in São Paulo, Brazil between April 3 and April 10, 2020. Data were analyzed using descriptive statistics. RESULTS: The sample comprised 2,646 respondents. Most participants (44.4%) reported excessive or almost excessive access to information about the novel coronavirus and 67.6% reported having increased their average time spent on social media. When asked how frequently they consider it was easy to determine the reliability of information, "sometimes" corresponded to 43.2% of the answers in contrast to 14.6% responding "always". Answers related to potential signs of information overload associated with the pandemic indicated that 31% of respondents felt stressed by the amount of information they had to keep up with almost every day or always. Overall, 80.0% of respondents reported having experienced at least one of the following symptoms: headache, eye twitching, restlessness or sleeping difficulty. The frequency of symptoms was higher among participants with a more negative information processing style regarding when dealing with large volumes of information relative to those with a positive information processing style. Likewise, symptoms were more frequently reported by participants who had increased their social media access relative to those reporting reduced access during the pandemic. CONCLUSION: Our survey provides a description of how health professionals consume COVID-19 related information during the pandemic, and suggests that excessive information exposure and high processing demands may impose psychological distress and affect mental health.

Quality of life is related to the functional connectivity of the default mode network at rest.

Quality of life is an important issue concerning people all over the world and affecting patients in the mental health field. When considering the potential neural links between quality of life and the brain, a brain network that comes into mind is the default mode network (DMN). Its architecture and function has been investigated in relation to various research fields including social and emotional cognition, meditation and neuropsychiatric disorders as well as happiness. In this cross-sectional study we investigated the relationship between various quality of life domains (physiological, psychological, social and environmental) and the functional connectivity of the default mode network at rest in a sample of 42 healthy working female managers. The results indicate that there is a significant association between the social quality of life domain and the functional connectivity of the default mode network. Post-hoc analysis revealed that high social quality of life scores were associated with right-left lateral parietal hypoconnectivity. By adopting a wide ranging perspective, our study approaches to fundamental research about quality of life but so far only applied on a female subgroup. As far as we know, it is the first to analyze the neuronal correlates of quality of life in the brain and therefore sets an initial step in its investigation.

Dispositional mindfulness, affect and tobacco dependence among treatment naive cigarette smokers in Brazil.

INTRODUCTION: The current study examined associations between affective and smoking-related factors, and dispositional mindfulness among smokers seeking enrollment in a cessation program in Brazil. METHODS: Participants were first-time treatment seeking adult smokers (N=90) on a waiting list for a government-sponsored cessation program. Pearson's bivariate correlations assessed relationships between the primary outcome variable (dispositional mindfulness) and each explanatory variable (nicotine dependence, depression, anxiety, and state positive/negative affect). Linear regression analyses evaluated the unique contribution of each explanatory variable when controlling for the others. RESULTS: The sample (N=90) was predominantly female (n=71) and most (79%) had 11 or fewer years of education. In the final regression model, a total of 36.2% of the variance in dispositional mindfulness was accounted for by positive affect (B=0.81, p<0.001), negative affect (B= -0.44, p=0.02), and level of nicotine dependence (B=1.48, p=0.007). CONCLUSIONS: Positive and negative affect, as well as nicotine dependence, account for a significant and sizable amount of the variance in dispositional mindfulness. Future mindfulness interventions for smoking cessation should be designed to address individual differences in affect, as well as nicotine dependence, in order to better tailor treatment to address baseline differences in mindfulness.

Evaluation of Siddha Samadhi Yoga for anxiety and depression symptoms: a preliminary study.

Siddha Samadhi Yoga is a program in which meditation is associated with pranayama (breathing exercises). 22 volunteers with anxiety complaints (M age = 42.8 yr., SD = 10.3) were assigned to two groups: 14 attended the yoga group, and 8 attended a waiting-list or control group. They were evaluated before the intervention and 1 month after it on the State-Trait Anxiety Inventory, the Beck Depression Inventory, Tension Feelings Self-evaluation Scales, and the Well-being Self-evaluation Scales. A significant reduction in scores on anxiety, depression, and tension was found in yoga group, as well as an increase in well-being in comparison with the control group.

Perceived stress among Primary Health Care Professionals in Brazil. / Estresse percebido em profissionais da Estratégia Saúde da Família.

OBJECTIVE:: To evaluate the perceived stress (PS) of professionals in Primary Health Care and its association with the characteristics of the teams in the Family Health Program (FHP). The association between PS and self-referred morbidity was also investigated. METHODS:: This is a cross-sectional study conducted with 450 employees from 60 teams in 12 Basic Health Units (BHUs) in a region of São Paulo. The differences in the total score in the Perceived Stress Scale were evaluated through multiple linear regression models. RESULTS:: Higher levels of PS were observed in those who had been working for one year or more in the same team, in the categories of doctors, nurses and community health workers, females, non-religious, and in BHU professionals in incomplete teams (absence of a physician). Lower perceived stress was found in widowers. It was observed that individuals with higher levels of PS have higher chances of reporting chronic health problems. CONCLUSION:: It can be concluded that the perception of stress in this population is associated with individual, professional factors, and the composition of teams in healthcare units.