Comparison of mindfulness interventions for healthcare professionals: A mixed-methods study

ObjectivesBurnout is increasingly a concerning problem in US Healthcare systems. Although the causes of burnout are not predominantly due to individual factors, mindfulness instruction is an evidence-based approach to counteracting burnout. Our health system initiated a multi-pronged approach to mindfulness instruction for our employees and community. We aimed to assess the impact of these varied programs.MethodsSeveral mindfulness courses of different lengths were employed. Validated survey instruments were administered to participants before and after the courses to assess stress, mindfulness and burnout. Pre-course and post-course results were compared for each intervention. Free-text responses were also captured and analyzed in a qualitative fashion.ResultsParticipants in MBIs demonstrated statistically significant improvement in burnout and perceived stress on post-course survey results. Several mindfulness domains also showed statistically significant improvement (awareness, non-react and observe). There was no difference in the observed results between the mindfulness interventions. Qualitative analysis yielded three themes: seeking help, symptoms, and changes in mindfulness practice.ConclusionsMBIs designed for employees of an academic medical center were associated with positive quantitative and qualitative results. All MBI participants achieved improvement in perceived stress and mindfulness as well as reduction in burnout, regardless of course length.     

Trends in Cervical Cancer Mortality in Brazilian Women who are Screened and Not Screened

Objective: This study aimed to analyze the trend in cervical cancer (ICD C53) mortality in Brazilian regions in women who are who are screened and not screened from 1996 to 2015. Methods: An epidemiological study, of time series of mortality from cervical cancer performed in 90,856 women under 24 years old (343 women), between 25 and 64 years old (32,703 women), and over 65 years old (10,909 women). The data from this research were collected from the DATASUS, from the SIM Health Surveillance Secretariat files, captured through TABNET selecting the resident population by gender and age group and ICD 10 C53 from 1996 to 2015. Results: Among women, 43.8% were white, and 76% had less than eight years of formal education. Polynomial regression showed an increasing trend in cervical cancer mortality in Brazil for women aged 15 - 24 years (p=0.01). Between 25 - 64 and 65 years or older it remained constant, but high (p=0.07; 0.99). The Northeast region pointed a growing trend in women aged 15 to 24 (p=0.01), 25 to 64 years (p=0.01) and 65 or older (p=0.001). The Northeast presented the highest average growth per year. In the Southeast, South and Midwest regions, decreasing trends were observed despite the high rates. The Joinpoint regression showed a 95% confidence interval, and that mortality from cervical cancer in the North region increased throughout the period analyzed. an increasing trend was observed from 1996 to 1998, whereas in the Midwest region, the trend remained stable throughout the period analyzed. The Federal District presented an upward trend from 1996 to 2015. In Brazil, an upward trend was observed throughout the whole period analyzed. Conclusions: Cervical cancer mortality in younger women is becoming more predominant, in addition to the high rate observed for women aged 65 or older.     

Implicit and explicit self-concept of neuroticism in borderline personality disorder

Purpose: In the past, research on personality in borderline personality disorder (BPD) used primarily questionnaires suggesting heightened neuroticism in BPD. Self-report instruments inform about the conscious or explicit self-concept. BPD patients are known to show negative distortion with exaggeration of negative affect in the self-report. Neuroticism represents a risk factor for mental disorders. Indirect measures are available that tap into the implicit self-concept of neuroticism. The implicit self-concept refers to individual differences in associative representations of the self. The present study examined for the first time the implicit in addition to the explicit self-concept of neuroticism in BPD.

Materials and methods: Female BPD patients (N?=?35) and healthy women (N?=?39) completed an implicit association test and the NEO-FFI personality inventory.

Results: BPD patients showed higher implicit and explicit neuroticism compared to controls. The group difference for explicit neuroticism was four times larger than that for implicit neuroticism. Presence of comorbid depressive disorder was positively correlated with implicit neuroticism. The IAT neuroticism showed excellent split-half reliability for BPD patients.

Conclusions: The present data suggest that BPD patients with comorbid clinical depression but not those without clinical depression differ from healthy individuals in their implicit self-concept of neuroticism. In the associative network, BPD patients with comorbid clinical depression exhibit stronger associations of the self with neuroticism-related characteristics, such as nervousness, fearfulness, and uncertainty than healthy individuals. Regardless of depression, BPD patients show increased explicit neuroticism. Our findings provide evidence that the IAT neuroticism can be applied reliably to BPD patients.