Objective:Because evidence-based psychotherapies of 12 to 20 sessions can be perceived as too lengthy and time intensive for the treatment of depression in primary care, a number of studies have examined abbreviated psychotherapy protocols. The purpose of this study was to conduct a systematic review and meta-analysis to determine the efficacy of brief psychotherapy (i.e., < 8 sessions) for depression.
Methods:
We used combined literature searches in PubMed, EMBASE, PsycINFO, and an Internet-accessible database of clinical trials of psychotherapy to conduct two systematic searches: one for existing systematic reviews and another for randomized controlled trials (RCTs). Included studies examined evidence-based psychotherapy(s) of eight or fewer sessions, focused on adults with depression, contained an acceptable control condition, were published in English, and used validated measures of depressive symptoms.
Results:
We retained 2 systematic reviews and 15 RCTs evaluating cognitive behavioral therapy, problem-solving therapy, and mindfulness-based cognitive therapy. The systematic reviews found brief psychotherapies to be more efficacious than control, with effect sizes ranging from −0.33 to −0.25. Our meta-analysis found six to eight sessions of cognitive behavioral therapy to be more efficacious than control (ES −0.42, 95% CI −0.74 to −0.10, I2 = 56%). A sensitivity analysis controlled for statistical heterogeneity but showed smaller treatment effects (ES −0.24, 95% CI −0.42 to −0.06, I2 = 0%).
Conclusions:
Depression can be efficaciously treated with six to eight sessions of psychotherapy, particularly cognitive behavioral therapy and problem-solving therapy. Access to non-pharmacologic treatments for depression could be improved by training healthcare providers to deliver brief psychotherapies.
EcoBuddhism represents a modern American attempt to articulate an authentically Buddhist response to present environmental problems. This article isolates the basic features of the movement and notes a substantial shift away from traditional Buddhist cosmology. Most notably, ecoBuddhism constructs a picture of the world that is intrinsically teleologic. The factors that have given rise to this reworking of tradition are analysed and the question of authenticity is tested against a variety of critical methodologies. The ‘protestant Buddhism’ thesis, in particular, is examined and found wanting. The conclusion drawn is that ecoBuddhism should be classed as a form of reflexive apologetics generated primarily by forces originating from within the Buddhist tradition itself.
Cancer is the uncontrolled growth of cells, which damages healthy tissue and causes disease. The American Cancer Society differentiates more than 100 types of cancers that manifest in diverse ways throughout the human body. Treatment of cancer can vary from local to systemic and from mildly invasive to radical depending on the type of cancer and the extent of disease.
In this paper I challenge and attempt to correct conclusions about Classical Yoga philosophy drawn by traditional and modern interpretations of Patañjali's Yoga‐sūtras. My interpretation of Patañjali's Yoga—which focuses on the meaning of “cessation” (nirodha) as given in Patañjali's central definition of Yoga (YS 1.2)—counters the radically dualistic and ontologically‐oriented interpretations of Yoga presented by many scholars, and offers an open‐ended, epistemologically‐oriented hermeneutic which, I maintain, is more appropriate for arriving at a genuine assessment of Patañjali's system (darśana) of Yoga.
Objective: To investigate the chemical constituent from the roots of Gentiana straminea.; Methods: The constituents were separated by microporous resin,silica gel,Sephadex LH-20 and preparative column chromatography and their structures were elucidated by NMR and MS spectral methods.; Results: Twelve chemical constituents were isolated from the roots of Gentiana straminea and their structures were identified as daucosterol( 1),β-sitosterol( 2),ursolic acid( 3),sweroside( 4),swertiamarin( 5),gentiopicroside( 6),6’-O-acetyl-gentiopicroside( 7),6’-O-β-D-glucopyranosyl-sweroside( 8),protocatech uic aldehyde( 9),protocatechuic acid( 10),methyl gallate( 11) and dibutyl phthalate( 12).; Conclusion: The compounds 8,9,10,11 and 12 are obtained from this plant for the first time.;
This study evaluated the effectiveness of an eight-session mindfulness-based cognitive therapy (MBCT) group intervention programme for treating depression in coronary heart disease (CHD) patients. Thirty-two depressed CHD patients were assigned to an MBCT treatment group, and a demographically and clinically similar group of 30 cases were assigned to a waiting list control group. Participants were evaluated at baseline, 8 weeks, and 6-month follow-up with the Hospital Anxiety and Depression Scale (HADS), Brief Symptom Inventory (BSI), Profile of Mood States (POMS), Psychosocial Adjustment to Illness Scale (PAIS) and the Mindful Attention Awareness Scale (MAAS). After each session, MBCT participants completed the post-session Questionnaire on helpful aspects of therapy and after the programme, completed the Client Satisfaction Questionnaire. At follow-up, 71 % of the MBCT group was clinically recovered from depression compared with 50 % of the control group. The MBCT group showed significantly greater improvement than the control group on all measures with effect sizes at follow-up of d = 0.43–1.0. Increases in mindfulness on the MAAS correlated significantly with improvements on the HADS, BSI, POMS and PAIS. Key helpful aspects of therapy identified by MBCT participants included learning meditation, obtaining group support and developing optimism. There was a high level of satisfaction with the MBCT programme. These results indicate that a randomized controlled trial of MBCT for depressed CHD patients is now warranted.
The locus coeruleus (LC) has established functions in both attention and respiration. Good attentional performance requires optimal levels of tonic LC activity, and must be matched to task consistently. LC neurons are chemosensitive, causing respiratory phrenic nerve firing to increase frequency with higher CO2 levels, and as CO2 level varies with the phase of respiration, tonic LC activity should exhibit fluctuations at respiratory frequency. Top-down modulation of tonic LC activity from brain areas involved in attentional regulation, intended to optimize LC firing to suit task requirements, may have respiratory consequences as well, as increases in LC activity influence phrenic nerve firing. We hypothesize that, due to the physiological and functional overlaps of attentional and respiratory functions of the LC, this small neuromodulatory nucleus is ideally situated to act as a mechanism of synchronization between respiratory and attentional systems, giving rise to a low-amplitude oscillation that enables attentional flexibility, but may also contribute to unintended destabilization of attention. Meditative and pranayama practices result in attentional, emotional, and physiological enhancements that may be partially due to the LC's pivotal role as the nexus in this coupled system. We present original findings of synchronization between respiration and LC activity (via fMRI and pupil dilation) and provide evidence of a relationship between respiratory phase modulation and attentional performance. We also present a mathematical dynamical systems model of respiratory-LC-attentional coupling, review candidate neurophysiological mechanisms of changes in coupling dynamics, and discuss implications for attentional theory, meditation, and pranayama, and possible therapeutic applications.
Ecological Intelligence defines a new way of thinking about the unprecedented environmental pressures of our day. Ian McCallum offers a compelling argument: that we must think differently about ourselves and the earth if we are to take seriously the survival of wilderness areas, wild animals and the human race. He explores the relationship between humans and nature from both a biological and poetic perspective, articulating a wild and ethical imperative—an urgent reminder that we are inextricably linked to the land and that we must not be the creatures of our own undoing.
Science tells us that a new and dangerous stage in planetary evolution has begun—the Anthropocene, a time of rising temperatures, extreme weather, rising oceans, and mass species extinctions. Humanity faces not just more pollution or warmer weather, but a crisis of the Earth System. If business as usual continues, this century will be marked by rapid deterioration of our physical, social, and economic environment. Large parts of Earth will become uninhabitable, and civilization itself will be threatened. Facing the Anthropocene shows what has caused this planetary emergency, and what we must do to meet the challenge. Bridging the gap between Earth System science and ecological Marxism, Ian Angus examines not only the latest scientific findings about the physical causes and consequences of the Anthropocene transition, but also the social and economic trends that underlie the crisis. Cogent and compellingly written, Facing the Anthropocene offers a unique synthesis of natural and social science that illustrates how capitalism's inexorable drive for growth, powered by the rapid burning of fossil fuels that took millions of years to form, has driven our world to the brink of disaster. Survival in the Anthropocene, Angus argues, requires radical social change, replacing fossil capitalism with a new, ecosocialist civilization.
Using data for 25,780 species categorized on the International Union for Conservation of Nature Red List, we present an assessment of the status of the world’s vertebrates. One-fifth of species are classified as Threatened, and we show that this figure is increasing: On average, 52 species of mammals, birds, and amphibians move one category closer to extinction each year. However, this overall pattern conceals the impact of conservation successes, and we show that the rate of deterioration would have been at least one-fifth again as much in the absence of these. Nonetheless, current conservation efforts remain insufficient to offset the main drivers of biodiversity loss in these groups: agricultural expansion, logging, overexploitation, and invasive alien species.Though the threat of extinction is increasing, overall declines would have been worse in the absence of conservation.
Though the threat of extinction is increasing, overall declines would have been worse in the absence of conservation.
Maintains that the Yoga-Sutras do not advocate abandonment of the world, but rather support a stance that enables one to live more fully in the world without being enslaved by worldly identification.The Integrity of the Yoga Darsana centers on the thought of Patanjali, the great exponent of the authoritative and Classical Yoga school of Hinduism and the reputed author of the Yoga-Sutras. In this textual, historical, and interpretive study, Whicher offers a plausible and innovative reading of the "intention" of the Yoga-Sutras, namely that Yoga does not advocate the abandonment or condemnation of the world, but rather supports a stance that enables one to live more fully in the world without being enslaved by worldly identification. Challenging and correcting misperceptions about Yoga drawn by traditional and modern interpretations of the Yoga-Sutras, the author argues for a fresh vision of the spiritual potential present in this seminal text, thereby contributing to our understanding of the meaning and practical relevance of Yoga and its reception today.
In classical Yoga every action (karman) leaves an impression(sam: skara ) in the deeper structure of the mind (citta) where it awaits
its fruition in the form of volitional activity. The most general
meaning of sam: skara is ‘‘ritual’’ or ‘‘forming well, ... making ready,
preparation’’;1 but in addition it also conveys the idea of
‘‘embellishment,’’ ‘‘purification,’’ ‘‘making sacred,’’ ‘‘any purificatory
ceremony.’’2 The root sam: s-kr: means to cleanse and perfect.3 In
Hindu tradition sam: skaras refer to the rites of passage such as birth
rites (jatakarma ), marriage rites (vivaha ) and death rites (antyes:t:i),
rites which are all intended to purify and transform the individual at
specific phases in life. In the context of the YS, however, the most
significant translation which can be extracted from Monier-Williams
list of meanings on the term sam: skara is ‘‘mental impression or recollection, impression on the mind of acts done in a former state of
existence.’’4 Thus, in the context of Yoga sam: skara is often translated
as ‘‘impression’’5 and in more recent scholarship as ‘‘karmic
impulse,’’6 ‘‘subliminal impression,’’7 and ‘‘subliminal activator.’’8 In
this study, I have translated the term sam: skara as ‘‘impression’’/
‘‘mental impression.’’
Zotero Collections:
Human influences on the planet's atmosphere, hydrosphere and biosphere are of such magnitude as to justify naming a new geological epoch, the Anthropocene. Different starting dates and phases have been proposed for this epoch, depending on the criteria used. Recent advances in microbial genomics and ecology show that human perturbations to microbial populations correspond closely to the proposed phases of the Anthropocene: the ‘paleoanthropocene’ which began with the rise of agriculture; the industrial revolution, from the late 1700s; and the ‘Great Acceleration’ from the 1950s to the present day. As the Anthropocene unfolds, environmental instability will trigger episodes of directional natural selection in microbial populations, adding to contemporary effects that already include changes to the human microbiome; intense selection for antimicrobial resistance; alterations to microbial carbon and nitrogen cycles; accelerated dispersal of microorganisms and disease agents; and selection for altered pH and temperature tolerance. Microbial evolution is currently keeping pace with the environmental changes wrought by humanity. It remains to be seen whether organisms with longer generation times, smaller populations and larger sizes can do the same.
Objective: We compared mindfulness-based cognitive therapy (MBCT) with both cognitive psychological education (CPE) and treatment as usual (TAU) in preventing relapse to major depressive disorder (MDD) in people currently in remission following at least 3 previous episodes. Method: A randomized controlled trial in which 274 participants were allocated in the ratio 2:2:1 to MBCT plus TAU, CPE plus TAU, and TAU alone, and data were analyzed for the 255 (93%; MBCT = 99, CPE = 103, TAU = 53) retained to follow-up. MBCT was delivered in accordance with its published manual, modified to address suicidal cognitions; CPE was modeled on MBCT, but without training in meditation. Both treatments were delivered through 8 weekly classes. Results: Allocated treatment had no significant effect on risk of relapse to MDD over 12 months follow-up, hazard ratio for MBCT vs. CPE = 0.88, 95% CI [0.58, 1.35]; for MBCT vs. TAU = 0.69, 95% CI [0.42, 1.12]. However, severity of childhood trauma affected relapse, hazard ratio for increase of 1 standard deviation = 1.26 (95% CI [1.05, 1.50]), and significantly interacted with allocated treatment. Among participants above median severity, the hazard ratio was 0.61, 95% CI [0.34, 1.09], for MBCT vs. CPE, and 0.43, 95% CI [0.22, 0.87], for MBCT vs. TAU. For those below median severity, there were no such differences between treatment groups. Conclusion: MBCT provided significant protection against relapse for participants with increased vulnerability due to history of childhood trauma, but showed no significant advantage in comparison to an active control treatment and usual care over the whole group of patients with recurrent depression.
Objective: We compared mindfulness-based cognitive therapy (MBCT) with both cognitive psychological education (CPE) and treatment as usual (TAU) in preventing relapse to major depressive disorder (MDD) in people currently in remission following at least 3 previous episodes. Method: A randomized controlled trial in which 274 participants were allocated in the ratio 2:2:1 to MBCT plus TAU, CPE plus TAU, and TAU alone, and data were analyzed for the 255 (93%; MBCT = 99, CPE = 103, TAU = 53) retained to follow-up. MBCT was delivered in accordance with its published manual, modified to address suicidal cognitions; CPE was modeled on MBCT, but without training in meditation. Both treatments were delivered through 8 weekly classes. Results: Allocated treatment had no significant effect on risk of relapse to MDD over 12 months follow-up, hazard ratio for MBCT vs. CPE = 0.88, 95% CI [0.58, 1.35]; for MBCT vs. TAU = 0.69, 95% CI [0.42, 1.12]. However, severity of childhood trauma affected relapse, hazard ratio for increase of 1 standard deviation = 1.26 (95% CI [1.05, 1.50]), and significantly interacted with allocated treatment. Among participants above median severity, the hazard ratio was 0.61, 95% CI [0.34, 1.09], for MBCT vs. CPE, and 0.43, 95% CI [0.22, 0.87], for MBCT vs. TAU. For those below median severity, there were no such differences between treatment groups. Conclusion: MBCT provided significant protection against relapse for participants with increased vulnerability due to history of childhood trauma, but showed no significant advantage in comparison to an active control treatment and usual care over the whole group of patients with recurrent depression.
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