Religion/Spirituality Overall Increases HIV Prevention Behaviors

Religion/Spirituality Overall Increases HIV Prevention Behaviors

 

By John M. de Castro, Ph.D.

 

“spirituality plays a critical role in the prognosis of HIV in many patients. The type of spiritual beliefs and practices determines whether spirituality is a protective or risk factor to the progression of HIV.” – Joni Utley

 

More than 35 million people worldwide and 1.2 million people in the United States are living with HIV infection. These include a significant number of children and adolescents. In 1996, the advent of the protease inhibitor and the so-called cocktail changed the prognosis for HIV. Since this development a 20-year-old infected with HIV can now expect to live on average to age 69. Even with these treatment advances it is still essential to prevent the transmission of HIV in the first place. There are a number of prevention techniques including drugs, condom use, HIV testing, reducing the number of sexual partners, and reducing intravenous drug use. But, in order for these activities to be effective, the individual must actively engage in them.

 

Spirituality is defined as “one’s personal affirmation of and relationship to a higher power or to the sacred. There have been a number of studies of the influence of spirituality on the physical and psychological well-being of practitioners mostly showing positive benefits, with spirituality encouraging personal growth and mental health. Spirituality and religion, however, have a complex relationship with HIV prevention activities. It can be supportive in encouraging morals, norms, structures and institutions that can positively affect the individual’s behavior. On the other hand, religious strictures regarding sexuality can interfere with HIV prevention by discouraging behaviors such as condom use.

 

A number of research studies have been conducted on the effects of religion/spirituality on HIV prevention behaviors. So, it makes sense to step back and review what has been learned about the effects of religion/spirituality on the prevention of HIV transmission. In today’s Research News article “Religion, faith, and spirituality influences on HIV prevention activities: A scoping review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7297313/) Vigliotti and colleagues review and summarize the published scientific research on the effects of religion/spirituality on HIV prevention. They identified 29 published peer-reviewed research studies.

 

They report that the majority of studies found that attendance at religious services, religiosity/spirituality, and religion were significantly associated with increased use of condoms and increased HIV testing except in the cases where their religious beliefs and values related to sex and sexuality were against it. Hence, the published research supports the contention that for the most part religion/spirituality improves the likelihood that the individual will engage in behaviors that contribute to the prevention of HIV transmission. This is tempered, however, with the facts that some forms of religion/spirituality incorporate norms and values regarding sexuality that tend to interfere with engaging in behaviors that reduce the prevention of HIV transmission.

 

These findings were correlative and as such no conclusions about causation can be reached. It is difficult to perform manipulative studies to determine causation so this correlative evidence may be the best available. In addition, many of the studies employed weak designs that included the possibility of confounding. As a result, care must be taken in reaching conclusions regarding the effects of religion/spirituality on HIV prevention.

 

So, religion/spirituality overall increases HIV prevention behaviors.

 

overcoming spiritual guilt” is a factor in helping HIV-positive people stay healthy, widespread stigma and condemnation may have ushered those people more quickly toward death.” – Emma Green

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Vigliotti, V., Taggart, T., Walker, M., Kusmastuti, S., & Ransome, Y. (2020). Religion, faith, and spirituality influences on HIV prevention activities: A scoping review. PloS one, 15(6), e0234720. https://doi.org/10.1371/journal.pone.0234720

 

Abstract

Introduction

Strategies to increase uptake of next-generation biomedical prevention technologies (e.g., long-acting injectable pre-exposure prophylaxis (PrEP)) can benefit from understanding associations between religion, faith, and spirituality (RFS) and current primary HIV prevention activities (e.g., condoms and oral PrEP) along with the mechanisms which underlie these associations.

Methods

We searched PubMed, Embase, Academic Search Premier, Web of Science, and Sociological Abstracts for empirical articles that investigated and quantified relationships between RFS and primary HIV prevention activities outlined by the United States (U.S.) Department of Health and Human Services: condom use, HIV and STI testing, number of sexual partners, injection drug use treatment, medical male circumcision, and PrEP. We included articles in English language published between 2000 and 2020. We coded and analyzed studies based on a conceptual model. We then developed summary tables to describe the relation between RFS variables and the HIV prevention activities and any underlying mechanisms. We used CiteNetExplorer to analyze citation patterns.

Results

We identified 2881 unique manuscripts and reviewed 29. The earliest eligible study was published in 2001, 41% were from Africa and 48% were from the U.S. RFS measures included attendance at religious services or interventions in religious settings; religious and/or spirituality scales, and measures that represent the influence of religion on behaviors. Twelve studies included multiple RFS measures. Twenty-one studies examined RFS in association with condom use, ten with HIV testing, nine with number of sexual partners, and one with PrEP. Fourteen (48%) documented a positive or protective association between all RFS factors examined and one or more HIV prevention activities. Among studies reporting a positive association, beliefs and values related to sexuality was the most frequently observed mechanism. Among studies reporting negative associations, behavioral norms, social influence, and beliefs and values related to sexuality were observed equally. Studies infrequently cited each other.

Conclusion

More than half of the studies in this review reported a positive/protective association between RFS and HIV prevention activities, with condom use being the most frequently studied, and all having some protective association with HIV testing behaviors. Beliefs and values related to sexuality are possible mechanisms that could underpin RFS-related HIV prevention interventions. More studies are needed on PrEP and spirituality/subjective religiosity.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7297313/

 

Improve the Quality of Life of Patients Living with HIV with Yoga

Improve the Quality of Life of Patients Living with HIV with Yoga

 

By John M. de Castro, Ph.D.

 

yoga can have positive impact on mental health for people living with HIV,” – Eugene Dunne

 

More than 35 million people worldwide and 1.2 million people in the United States are living with HIV infection. These include a significant number of children and adolescents. In 1996, the advent of the protease inhibitor and the so-called cocktail changed the prognosis for HIV. Since this development a 20-year-old infected with HIV can now expect to live on average to age 69. Hence, living with HIV is a long-term reality for a very large group of people.

 

People living with HIV infection experience a wide array of physical and psychological symptoms which decrease their perceived quality of life. The symptoms include chronic pain, muscle aches, anxiety, depression, weakness, fear/worries, difficulty with concentration, concerns regarding the need to interact with a complex healthcare system, stigma, and the challenge to come to terms with a new identity as someone living with HIV. Mindfulness training has been shown to improve psychological well-being, lower depression and strengthen the immune system of patients with HIV infection. Yoga practice has also been found to be effective in treating HIV.

 

In today’s Research News article “Feasibility and Impact of a Yoga Intervention on Cognition, Physical Function, Physical Activity, and Affective Outcomes among People Living with HIV: A Randomized Controlled Pilot Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7318828/) Quigley and colleagues recruited patients living with HIV infection who were over the age of 35 years and randomly assigned them to receive 12 weeks of 3 times per week 1-hour Hatha yoga practice or to a no treatment control condition. They were measured before and after the practice period for cognitive ability, HIV-specific cognitive difficulties, balance, physical activity, medication adherence, HIV medical outcomes, quality of life, anxiety, depression, and mental health.

 

They found that the yoga classes were well attended, 82% of all classes and all participants reported satisfaction with the intervention. They also found that the yoga group had a significant improvement in health-related quality of life for cognitive function, and trends toward significance for depression and health -related quality of life for health transitions.

 

This was a small pilot study that did not have an active control condition and was not powered to detect small differences. As such, conclusions must be limited. But the study was successful in establishing that yoga practice for patients living with HIV is feasible and acceptable and appreciated by the participants, and that improvement in quality of life occurred with the yoga practice. These results are promising and thus strongly suggest that a large randomized controlled clinical trial with an active control condition be conducted in the future.

 

So, improve the quality of life of patients living with HIV with yoga

 

“Yoga quiets the mind, improves breathing and circulation, and reduces stress. Daily practice can help support the immune system in conjunction with a comprehensive HIV treatment program.” – Jon Kaiser

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Quigley, A., Brouillette, M. J., Gahagan, J., O’Brien, K. K., & MacKay-Lyons, M. (2020). Feasibility and Impact of a Yoga Intervention on Cognition, Physical Function, Physical Activity, and Affective Outcomes among People Living with HIV: A Randomized Controlled Pilot Trial. Journal of the International Association of Providers of AIDS Care, 19, 2325958220935698. https://doi.org/10.1177/2325958220935698

 

Abstract

The purpose of this pilot randomized controlled trial is to assess the feasibility and impact of a triweekly 12-week yoga intervention among people living with HIV (PLWH). Additional objectives included evaluating cognition, physical function, medication adherence, health-related quality of life (HRQoL), and mental health among yoga participants versus controls using blinded assessors. We recruited 22 medically stable PLWH aged ≥35 years. A priori feasibility criteria were ≥70% yoga session attendance and ≥70% of participants satisfied with the intervention using a postparticipation questionnaire. Two participants withdrew from the yoga group. Mean yoga class attendance was 82%, with 100% satisfaction. Intention-to-treat analyses (yoga n = 11, control n = 11) showed no within- or between-group differences in cognitive and physical function. The yoga group improved over time in HRQoL cognition (P = .047) with trends toward improvements in HRQoL health transition (P =.063) and depression (P = .055). This pilot study provides preliminary evidence of feasibility and benefits of yoga for PLWH.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7318828/

 

Improve the Psychological Well-Being of Patients Living with HIV/AIDS with Mindfulness

Improve the Psychological Well-Being of Patients Living with HIV/AIDS with Mindfulness

 

By John M. de Castro, Ph.D.

 

Given the stress-reduction benefits of mindfulness meditation training, these findings indicate there can be health protective effects not just in people with HIV but in folks who suffer from daily stress,” – – David Creswell

 

More than 35 million people worldwide and 1.2 million people in the United States are living with HIV infection. These include a significant number of children and adolescents. In 1996, the advent of the protease inhibitor and the so-called cocktail changed the prognosis for HIV. Since this development a 20-year-old infected with HIV can now expect to live on average to age 69. Hence, living with HIV is a long-term reality for a very large group of people.

 

People living with HIV infection experience a wide array of physical and psychological symptoms which decrease their perceived quality of life. The symptoms include chronic pain, muscle aches, anxiety, depression, weakness, fear/worries, difficulty with concentration, concerns regarding the need to interact with a complex healthcare system, stigma, and the challenge to come to terms with a new identity as someone living with HIV. Mindfulness training has been shown to improve psychological well-being, lower depression and strengthen the immune system of patients with HIV infection. Yoga practice has also been found to be effective in treating HIV.

 

The research is accumulating. So, it makes sense to step back and review what has been learned about the effectiveness of mindfulness training for the treatment of the symptoms of living with HIV/AIDS. In today’s Research News article “Mindfulness-Based Interventions for Adults Living with HIV/AIDS: A Systematic Review and Meta-analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6344266/), Scott-Sheldon and colleagues review, summarize, and perform a meta-analysis of the effectiveness of Mindfulness-Based Interventions (MBIs) for the treatment of the symptoms experienced by people living with HIV/AIDS.

 

They identified 16 published research studies containing a total of 1059 participants. Of these studies 11 employed Mindfulness-Based Stress Reduction (MBSR) while 5 studies employed Mindfulness-Based Cognitive Therapy (MBCT). All studies compared pre- to post-treatment measures while 9 of these studies also had a control comparison group.

 

They report that the published research found that in comparison to baseline after treatment with Mindfulness-Based Interventions (MBIs) there were significant improvements in quality of life and positive emotions and significant reductions in anxiety and depression. The reductions in depression were significantly greater for those participants who received Mindfulness-Based Cognitive Therapy (MBCT). No significant effects were reported for improvements in immune system function (CD4 counts).

 

This analysis of the available research suggests that Mindfulness-Based Interventions (MBIs) are a safe and effective treatment to improve the psychological health of patients diagnosed with HIV/AIDS. The fact that Mindfulness-Based Cognitive Therapy (MBCT) was more effective for depression was not surprising as MBCT was specifically developed to treat depression. It has been well established the Mindfulness-Based Interventions (MBIs) are effective in reducing anxiety and depression and improving positive emotions and quality of life in a wide variety of patients. The present analysis simply extends types of patients for which Mindfulness-Based Interventions (MBIs)are beneficial to patients diagnosed with HIV/AIDS.

 

So, improve the psychological well-being of patients living with HIV/AIDS with mindfulness.

 

mindfulness-based therapies . . . had a long-term effect on stress and both a short- and long-term effect on depression in people living with an HIV infection.” – Xu Tian

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Scott-Sheldon, L., Balletto, B. L., Donahue, M. L., Feulner, M. M., Cruess, D. G., Salmoirago-Blotcher, E., … Carey, M. P. (2019). Mindfulness-Based Interventions for Adults Living with HIV/AIDS: A Systematic Review and Meta-analysis. AIDS and behavior, 23(1), 60–75. doi:10.1007/s10461-018-2236-9

 

Abstract

This meta-analysis examined the effects of mindfulness-based interventions (MBIs) on stress, psychological symptoms, and biomarkers of disease among people living with HIV/AIDS (PLWHA). Comprehensive searches identified 16 studies that met the inclusion criteria (N = 1,059; M age = 42 years; 20% women). Participants had been living with HIV for an average of 8 years (range = <1 to 20 years); 65% were currently on antiretroviral therapy. Between-group analyses indicated that depressive symptoms were reduced among participants receiving the MBIs compared to controls (d+ = 0.37, 95% CI = 0.03, 0.71). Within-group analyses showed reductions in psychological symptoms (i.e., less anxiety, fewer depressive symptoms) and improved quality of life over time among MBI participants (d+s = 0.40–0.85). No significant changes were observed for immunological outcomes (i.e., CD4 counts) between- or within- groups. MBIs may be a promising approach for reducing psychological symptoms and improving quality of life among PLWHA. Studies using stronger designs (i.e., randomized controlled trials) with larger sample sizes and longer follow-ups are needed to clarify the potential benefits of MBIs for PLWHA.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6344266/

 

Reduce Stress and Substance Abuse in Ex-Prisoner HIV Patients with Yoga

Reduce Stress and Substance Abuse in Ex-Prisoner HIV Patients with Yoga

 

By John M. de Castro, Ph.D.

 

“Yoga is an ideal exercise for people with HIV. It not only helps build muscle and energy, but also reduces stress.” – Matt McMillen

 

More than 35 million people worldwide and 1.2 million people in the United States are living with HIV infection. These include a significant number of children and adolescents. In 1996, the advent of the protease inhibitor and the so-called cocktail changed the prognosis for HIV. Since this development a 20-year-old infected with HIV can now expect to live on average to age 69. Hence, living with HIV is a long-term reality for a very large group of people. People living with HIV infection experience a wide array of physical and psychological symptoms which decrease their perceived quality of life. The symptoms include chronic pain, muscle aches, anxiety, depression, weakness, fear/worries, difficulty with concentration, concerns regarding the need to interact with a complex healthcare system, stigma, and the challenge to come to terms with a new identity as someone living with HIV.

 

Incarcerated people are 5 times more likely to have HIV infection and also are much more likely to suffer from substance abuse problems. Dealing with these issues upon release from prison is essential for successful reintegration into society. Mindfulness training has been shown to improve psychological well-being, lower depression and strengthen the immune system of patients with HIV infection. Yoga practice has also been found to be effective in treating HIV and with substance abuse.  It is not known whether yoga can help with these HIV patients with substance abuse upon release from prison.

 

In today’s Research News article “A randomized trial of yoga for stress and substance use among people living with HIV in reentry.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6397425/), Wimberly and colleagues recruited adult HIV patients who had a history of substance abuse and who were recently released from prison. The participants were randomly assigned to either treatment as usual or to treatment as usual plus once a week for 12 weeks, 90-minute yoga practice. They were measured before and after training for perceived stress and substance abuse.

 

They found that in comparison to baseline and treatment as usual the patients who practiced yoga had significant reductions in perceived stress and the percentage of days with substance abuse (20% for yoga participants vs. 41% for treatment as usual). The patients had difficulty attending yoga classes with an average attendance of 35% of the classes.

 

It is well documented that yoga practice reduces stress and is helpful in controlling substance abuse. The present results are encouraging in that they suggest that yoga practice may be helpful in reducing stress and substance abuse in this vulnerable group of HIV patients who had a history of substance abuse and who were recently released from prison. Finding ways to improve attendance would seem important, perhaps online yoga classes would help. Regardless, participation in yoga appears to improve the likelihood that these ex-prisoners will be able to deal with HIV infection and life outside of prison.

 

So, reduce stress and substance abuse in ex-prisoner HIV patients with yoga.

 

Drugs, I believe, are keeping me alive. But yoga,” he says, “keeps my spirit alive.” – Ken Lowstetter

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Wimberly, A. S., Engstrom, M., Layde, M., & McKay, J. R. (2018). A randomized trial of yoga for stress and substance use among people living with HIV in reentry. Journal of substance abuse treatment, 94, 97–104. doi:10.1016/j.jsat.2018.08.001

 

Highlights

– Compared stress and substance use outcomes of yoga versus treatment as usual.

– Participants included returning citizens with HIV and substance use problems.

– At three-months, the yoga group had reduced stress and slightly reduced substance use.

– Future research with this population can compare yoga with an active intervention.

Abstract

Background:

People in reentry from prison or jail (returning citizens) living with HIV and substance use problems often experience numerous stressors and are at high risk for resumed substance use. Interventions are needed to manage stress as a pathway to reduced substance use.

Objective:

This study explored the effect of a Hatha yoga intervention as compared to treatment as usual on stress and substance use among returning citizens living with HIV and substance use problems.

Methods:

Participants were randomized to either a 12-session, 90-minute weekly yoga intervention or treatment as usual. All participants were clients of a service provider for returning citizens that offered case management, health care, and educational classes. Outcomes included stress as measured by the Perceived Stress Scale at the completion of the yoga intervention (three-months) and substance use as measured by the Timeline Followback at one-month, two- months, and three-months.

Results:

Seventy-five people were enrolled, two of whom were withdrawn from the study because they did not have HIV. Of the 73 remaining participants, 85% participated in the three- month assessment. At three-months, yoga participants reported less stress than participants in treatment as usual [F (1,59)=9.24, p<.05]. Yoga participants reported less days of substance use than participants in treatment as usual at one-month, two-months, and three-months [X2 (1)= 11.13, p<.001].

Conclusion:

Yoga interventions for returning citizens living with HIV and substance use problems may reduce stress and substance use. This finding is tentative because the control group did not receive an intervention of equal time and intensity.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6397425/

 

Improve the Symptoms of HIV Infection in Children with Yoga

Improve the Symptoms of HIV Infection in Children with Yoga

 

By John M. de Castro, Ph.D.

 

“It’s about going deep under the waves—the hurricane that’s HIV—and finding a stillness. As debilitating and emotional as HIV is, yoga helps me transcend it so that I can rediscover myself. Then I remember I am not HIV; I am not the face of AIDS. I am me.” – River Huston

 

More than 35 million people worldwide and 1.2 million people in the United States are living with HIV infection. These include a significant number of children and adolescents. In 1996, the advent of the protease inhibitor and the so-called cocktail changed the prognosis for HIV. Since this development a 20-year-old infected with HIV can now expect to live on average to age 69. Hence, living with HIV is a long-term reality for a very large group of people. People living with HIV infection experience a wide array of physical and psychological symptoms which decrease their perceived quality of life. The symptoms include chronic pain, muscle aches, anxiety, depression, weakness, fear/worries, difficulty with concentration, concerns regarding the need to interact with a complex healthcare system, stigma, and the challenge to come to terms with a new identity as someone living with HIV.

 

Mindfulness training has been shown to improve psychological well-being, lower depression and strengthen the immune system of patients with HIV infection. Yoga practice has also been found to be effective in treating HIV. Most studies, however, focus on adult patients with HIV. There are, however, a large number of children and adolescents who are infected with HIV. Hence it makes sense to examine the ability of yoga training to treat HIV infection in children and adolescents.

 

In today’s Research News article “Effect of Yoga on Immune Parameters, Cognitive Functions, and Quality of Life among HIV-Positive Children/Adolescents: A Pilot Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6521755/), Chandra and colleagues recruited children and adolescents (aged 8 to 18 years) who had HIV infection from a HIV/AIDS rehabilitation center. Treatment as usual was continued while they were provided with daily 1-hour yoga practice sessions for 6 months. They were measured before and after training for immune system function, health-related quality of life, fatigue-related quality of life, depression, and cognitive function.

 

They found that in comparison to baseline, yoga practice produced a significant decrease in in HIV viral load and a significant increase in plasma CD4 counts. There was also a significant increase in health-related quality of life, including the health and general activities, feelings, getting along with others, and about school subscales, and fatigue-related quality of life, including general fatigue (b) sleep fatigue, and (c) cognitive fatigue. After yoga practice the children and adolescents had significant improvements in cognitive function and increases in depression.

 

The observed effectiveness of yoga practice for the treatment of HIV infected children and adolescents, parallels that observed in prior studies with adults. These include reducing the presence of the virus in the blood, improvement of immune system function, quality of life, and mental abilities. This was a pilot study and did not have a control condition, so conclusions need to be tempered. The results, though are encouraging and should motivate conducting a large randomized controlled trial. Regardless, the results are very encouraging and suggest that yoga practice is beneficial for the health and well-being of youths infected with HIV.

 

So, improve the symptoms of HIV infection in children with yoga.

 

“Yoga is an ideal exercise for people with HIV. It not only helps build muscle and energy, but also reduces stress. . .  stress greatly increases the risk that HIV will progress to AIDS.” – Matt McMillen

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Hari Chandra, B. P., Ramesh, M. N., & Nagendra, H. R. (2019). Effect of Yoga on Immune Parameters, Cognitive Functions, and Quality of Life among HIV-Positive Children/Adolescents: A Pilot Study. International journal of yoga, 12(2), 132–138. doi:10.4103/ijoy.IJOY_51_18

 

Abstract

Context:

HIV/AIDS individuals have problems relating to immune system, quality of life (QOL), and cognitive functions (CFs). Yoga is found to be useful in similar conditions. Hardly, any work is reported on yoga for HIV-positive adults/adolescents. Hence, this study is important.

Aim:

The aim of the study is to determine the effect of yoga on immune parameters, CFs, and QOL of HIV-positive children/adolescents.

Settings and Design:

Single-group, pre–post study with 4-month yoga intervention.

Methods:

The study had 18 children from an HIV/AIDS rehabilitation center for children/adolescents. CD4, CD8, CD4/CD8 ratio, and viral loads were studied. CF tests included six letter cancellation test, symbol digit modalities test, digit-span forward backward test, and Stroop tests. QOL was assessed using PedsQL-QOL and fatigue questionnaire. Depression was assessed using CDI2-SR.

Statistical Analysis Used:

t-test and Wilcoxon signed-rank tests, as applicable.

Results:

The study included 18 children/adolescents. There was improvement in general health of the participants. There was statistically significant increase in CD4 cells counts (p = 0.039) and significant decrease in viral load (p = 0.041). CD4/CD8 ratio moved to normal range. QOL significantly improved. CFs had mixed results with improved psychomotor performance (PP) and reduced executive functions.

Conclusions:

There was improvement in general health and immune parameters. While depression increased, QOL improved. CFs showed mixed results with improved PP and reduced executive functions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6521755/

 

Improve Physical and Psychological Symptoms and Quality of Life in People Living with HIV with Mind-Body Practices

Improve Physical and Psychological Symptoms and Quality of Life in People Living with HIV with Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

“Our bodies and minds are intimately connected. Living with HIV can be stressful and can challenge our emotional well-being. Similarly, stress and anxiety can affect our bodies. So maintaining “a healthy mind in a healthy body” is key.” – CATIE

 

More than 35 million people worldwide and 1.2 million people in the United States are living with HIV infection. In 1996, the advent of the protease inhibitor and the so-called cocktail changed the prognosis for HIV. Since this development a 20-year-old infected with HIV can now expect to live on average to age 69. Hence, living with HIV is a long-term reality for a very large group of people. People living with HIV infection experience a wide array of physical and psychological symptoms which decrease their perceived quality of life. The symptoms include chronic pain, muscle aches, anxiety, depression, weakness, fear/worries, difficulty with concentration, concerns regarding the need to interact with a complex healthcare system, stigma, and the challenge to come to terms with a new identity as someone living with HIV.

 

Mindfulness training has been found to be effective in treating chronic pain conditions. In addition, mindfulness training has been shown to improve psychological well-being, lower depression and strengthen the immune system of patients with HIV infection. The research and evidence is accumulating. Hence it makes sense to stop and summarize the research on the ability of mind-body practices to help relieve the symptoms of patients living with HIV.

 

In today’s Research News article “Mind-body practices for people living with HIV: a systematic scoping review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6560810/ ), Ramirez-Garcia and colleagues review and summarize the published research studies of the effectiveness of mind-body practices for the treatment of the symptoms of HIV infection. “Mind-body practices include Tai Chi, Qigong, yoga, meditation, and all types of relaxation” training. They identified 84 published research studies.

 

They report that these studies found that for patients with HIV, Mindfulness-Based Stress Reduction (MBSR) decrease the physical symptoms and the side effects of the drug treatment, and improves the patient’s psychological state. They also report that Cognitive Behavioral Therapy and the combining at least three relaxation techniques decreases the patient’s physical and psychological symptoms, and increase quality of life and health. Yoga practice was also found to lower the patient’s blood pressure. Tai Chi, Qigong, and relaxation techniques were found to improve the patient’s physical and psychological condition.

 

Hence the accumulated research suggests that mind-body therapies in addition to antiretroviral treatment are safe and effective treatments to improve the health, well-being, and quality of life of patients living with HIV. This is important as these patients will be living for many years with the symptoms of HIV and the side effects of its treatment. The addition of mind-body practices can help make living with HIV more tolerable and improve the patients’ lives.

 

So, improve physical and psychological symptoms and quality of life in people living with HIV with Mindbody practices.

 

“Living a healthy lifestyle can help you better control HIV and prevent the progression to AIDS. Eating a healthy diet and maintaining a healthy body weight, exercising regularly, practicing safe sex, and following your medicine regimen are all important steps in managing HIV.” – Johns Hopkins Health

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Ramirez-Garcia, M. P., Gagnon, M. P., Colson, S., Côté, J., Flores-Aranda, J., & Dupont, M. (2019). Mind-body practices for people living with HIV: a systematic scoping review. BMC complementary and alternative medicine, 19(1), 125. doi:10.1186/s12906-019-2502-z

 

Abstract

Background

Mind-body practices are frequently used by people living with HIV to reduce symptoms and improve wellbeing. These include Tai Chi, Qigong, yoga, meditation, and all types of relaxation. Although there is substantial research on the efficacy of mind-body practices in people living with HIV, there is no summary of the available evidence on these practices. The aim of this scoping review is to map available evidence of mind-body practices in people living with HIV.

Methods

The Arksey and O’Malley (Int J Soc Res Methodol 8:19-32, 2005) methodological framework was used. A search of 16 peer-review and grey literature databases, websites, and relevant journals (1983–2015) was conducted. To identify relevant studies, two reviewers independently applied the inclusion criteria to all abstracts or full articles. Inclusion criteria were: participants were people living with HIV; the intervention was any mind-body practice; and the study design was any research study evaluating one or several of these practices. Data extraction and risk of bias assessment were performed by one reviewer and checked by a second, as needed, using the criteria that Cochrane Collaboration recommends for systematic reviews of interventions (Higgins and Green, Cochrane handbook for systematic reviews of intervention. 2011). A tabular and narrative synthesis was carried out for each mind-body practice.

Results

One hundred thirty-six documents drawing on 84 studies met the inclusion criteria. The most widely studied mind-body practice was a combination of least three relaxation techniques (n = 20), followed in declining order by meditation (n = 17), progressive muscle relaxation (n = 10), yoga (n = 9) and hypnosis (n = 8). Slightly over half (47/84) of studies used a RCT design. The interventions were mainly (46/84) conducted in groups and most (51/84) included daily individual home practice. All but two studies were unblinded to participants.

Conclusion

The amount of available research on mind-body practices varies by practice. Almost half of the studies in this review were at high risk of bias. However, mindfulness, a combination of least three relaxation techniques and cognitive behavioral strategies, and yoga show encouraging results in decreasing physical and psychological symptoms and improving quality of life and health in people living with HIV. More rigorous studies are necessary to confirm the results of Tai Chi, Qigong, and some relaxation techniques.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6560810/

 

Decrease Chronic Pain with HIV Infection with Mindfulness

Decrease Chronic Pain with HIV Infection with Mindfulness

 

By John M. de Castro, Ph.D.

 

“When it came to processing my HIV diagnosis, meditation offered me a framework for reflection, self-forgiveness, forgiving others and moving toward a place of acceptance.” – Seb Stuart

 

More than 35 million people worldwide and 1.2 million people in the United States are living with HIV infection. In 1996, the advent of the protease inhibitor and the so-called cocktail changed the prognosis for HIV. Since this development a 20-year-old infected with HIV can now expect to live on average to age 69. Hence, living with HIV is a long-term reality for a very large group of people. People living with HIV infection experience a wide array of physical and psychological symptoms which decrease their perceived quality of life. The symptoms include chronic pain, muscle aches, anxiety, depression, weakness, fear/worries, difficulty with concentration, concerns regarding the need to interact with a complex healthcare system, stigma, and the challenge to come to terms with a new identity as someone living with HIV.

 

Mindfulness training has been found to be effective in treating chronic pain conditions. In addition, mindfulness training has been shown to improve psychological well-being, lower depression and strengthen the immune system of patients with HIV infection. Hence it makes sense to examine the ability of mindfulness training to help relieve the chronic pain associated with HIV infection.

 

In today’s Research News article “A Mixed-Methods Pilot Study of Mindfulness Based Stress Reduction for HIV-Associated Chronic Pain.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6005203/ ), George and colleagues recruited  HIV-infected adults who had been experiencing neuropathic and/or musculoskeletal pain for at least 3 months. They were randomly assigned to receive either an 8-week program of Mindfulness-Based Stress Reduction (MBSR) or health education. The MBSR program was comprised of guided meditations, gentle movement exercises, and group discussion. Health education concerned HIV-related pain topics. The participants were measured before and after training and 3 months later for pain intensity, pain interference with activities, HIV symptoms, perceived stress, and autonomic nervous system function.

 

They found that both groups improved modestly on all measures after training. But at the 3-month follow-up the Mindfulness-Based Stress Reduction (MBSR) had a further significant decline in pain intensity while the health education group reverted to pretreatment levels. At the follow-up 79% of the MBSR patients were still practicing which may account for the continued improvements. MBSR is composed of an array of different practices and it cannot be determined here which or which combination of components were necessary and sufficient for the benefits.

Regardless, MBSR appears to help in all areas of HIV symptoms but particularly with HIV-related pain and it is not only lasting but appears to continue producing reductions in pain intensity over time. This is a blessing for the patients as the torment of the pain produces suffering and reduces the quality of their lives.

 

So, decrease chronic pain with HIV infection with mindfulness.

 

“Given the stress-reduction benefits of mindfulness meditation training, these findings indicate there can be health protective effects not just in people with HIV but in folks who suffer from daily stress,” – David Creswell

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

George, M. C., Wongmek, A., Kaku, M., Nmashie, A., & Robinson-Papp, J. (2017). A Mixed-Methods Pilot Study of Mindfulness Based Stress Reduction for HIV-Associated Chronic Pain. Behavioral Medicine (Washington, D.C.), 43(2), 108–119. http://doi.org/10.1080/08964289.2015.1107525

 

Abstract

Treatment guidelines for chronic pain recommend non-pharmacologic modalities as part of a comprehensive management plan. Chronic pain is common among people living with HIV/AIDS, but there is little data to guide the choice of non-pharmacologic therapies in this complex population. We performed a mixed-methods feasibility study of Mindfulness Based Stress Reduction (MBSR) versus health education control with 32 inner city, HIV-infected participants. Outcome measures included: the Brief Pain Inventory, Perceived Stress Scale, HIV Symptoms Index, autonomic function testing, and audiotaped focus groups. Post-intervention, participants reported modest improvements in pain measures and perceived stress, but no effect of group assignment was observed. At 3-month follow-up, 79% of MBSR participants were still practicing, and pain intensity was improved, whereas in the control group pain intensity had worsened. Qualitative analysis revealed a strong sense of community in both groups, but only MBSR was perceived as useful for relaxation and pain relief.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6005203/

 

Improve the Physical and Psychological State of HIV-Infected Youth with Mindfulness

Improve the Physical and Psychological State of HIV-Infected Youth with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Even in the midst of this stressful experience of testing positive for HIV, coaching people to feel happy, calm and satisfied — what we call positive affect — appears to influence important health outcomes,” – Judith Moskowitz

 

More than 35 million people worldwide and 1.2 million people in the United States are living with HIV infection. HIV is a virus that gradually attacks the immune system. It destroys a type of white blood cell called a T-helper cell (CD4 Cell). This isn’t a problem unto itself, but the immune system is our body’s natural defense against illness. Hence, HIV infection makes it harder to combat other infections and diseases. If HIV is untreated, these secondary infections produce chronic illness and eventually death. It is important, then, in treating HIV infection to strengthen the immune system and increase the levels of CD4 in the blood to fight off disease.

 

In 1996, the advent of the protease inhibitor and the so-called cocktail changed the prognosis for HIV. Since this development a 20 year-old infected with HIV can now expect to live on average to age 69. Hence, living with HIV is a long-term reality for a very large group of people. People living with HIV infection experience a wide array of physical and psychological symptoms which decrease their perceived quality of life. The symptoms include muscle aches, anxiety, depression, weakness, fear/worries, difficulty with concentration, concerns regarding the need to interact with a complex healthcare system, stigma, and the challenge to come to terms with a new identity as someone living with HIV. Hence, patients with HIV infection, even when controlled with drugs, have a reduction in their quality of life.

 

Mindfulness has been shown to strengthen the immune system. It also improve psychological and physical well-being in people suffering from a wide range of disorders including depression and anxiety. It has also been shown that mindfulness is associated with psychological well-being and lower depression in patients with HIV infection. Hence, it makes sense to further study the ability of mindfulness training as a treatment for the physical and psychological issues associated with living with HIV.

 

In today’s Research News article “Mindfulness instruction for HIV-infected youth: a randomized controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5987527/ ), Webb and colleagues recruited HIV infected youths 14-22 aged years who were being treated with drugs. They were randomly assigned to receive a Mindfulness-Based Stress Reduction (MBSR) program or health education program. Both the MBSR and health education programs were presented for 2.5 hours, once a week, for 8 weeks. MBSR consisted of discussion and meditation, body scan, and yoga practices and included 30-minute daily home practice. They were measured before and after training and 3-months later for mindfulness, perceived stress, cognitive self-regulation, emotional attention, coping, life satisfaction, problem solving, aggression, HIV drug regimen adherence, HIV viral load, and CD4 counts.

 

At the 3-month follow-up, the youths who received the MBSR program had significantly higher levels of mindfulness, life satisfaction, problem solving, and lower levels of aggression. MBSR participants were significantly more likely to have markedly improved HIV viral loads after treatment. These results are potentially very important and demonstrate that mindfulness training improves the psychological state of HIV infected youths. But significantly appeared to also improve their physiological state, lowing the levels of virus in their blood.

 

This suggests that the Mindfulness-Based Stress Reduction (MBSR) program may be an effective treatment for HIV infected youths. MBSR was designed to and has been repeatedly been shown to improve the individual’s ability to cope with the physiological and psychological effect of stress. Since stress is known to worsen the symptoms of HIV, it would seem reasonable to speculate that the improved stress coping underlies the ability of MBSR to improve the physical and psychological state of HIV sufferers.

 

So, improve the physical and psychological state of HIV-infected youth with mindfulness.

 

“mindfulness meditation stress-management training can have a direct impact on slowing HIV disease progression. . . . it’s possible that such training can be used as a powerful complementary treatment for HIV disease, alongside medications.” – David Creswell

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Webb, L., Perry-Parrish, C., Ellen, J., & Sibinga, E. (2018). Mindfulness instruction for HIV-infected youth: a randomized controlled trial. AIDS Care, 30(6), 688–695. http://doi.org/10.1080/09540121.2017.1394434

 

Abstract

HIV-infected youth experience many stressors, including stress related to their illness, which can negatively impact their mental and physical health. Therefore, there is a significant need to identify potentially effective interventions to improve stress management, coping, and self-regulation. The object of the study was to assess the effect of a mindfulness-based stress reduction (MBSR) program compared to an active control group on psychological symptoms and HIV disease management in youth utilizing a randomized controlled trial. Seventy-two HIV-infected adolescents, ages 14–22 (mean age 18.71 years), were enrolled from two urban clinics and randomized to MBSR or an active control. Data were collected on mindfulness, stress, self-regulation, psychological symptoms, medication adherence, and cognitive flexibility at baseline, post-program, and 3-month follow-up. CD4+ T lymphocyte and HIV viral load (HIV VL) counts were also pulled from medical records. HIV-infected youth in the MBSR group reported higher levels of mindfulness (P = .03), problem-solving coping (P = .03), and life satisfaction (P = .047), and lower aggression (P = .002) than those in the control group at the 3-month follow-up. At post-program, MBSR participants had higher cognitive accuracy when faced with negative emotion stimuli (P = .02). Also, those in the MBSR study arm were more likely to have or maintain reductions in HIV VL at 3-month follow-up than those in the control group (P = .04). In our sample, MBSR instruction proved beneficial for important psychological and HIV-disease outcomes, even when compared with an active control condition. Lower HIV VL levels suggest improved HIV disease control, possibly due to higher levels of HIV medication adherence, which is of great significance in both HIV treatment and prevention. Additional research is needed to explore further the role of MBSR for improving the psychological and physical health of HIV-positive youth.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5987527/

 

Improve Loneliness and Quality of Life with Women with HIV with Mindfulness

Improve Loneliness and Quality of Life with Women with HIV with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness-Based Therapies had a long-term effect on stress and both a short- and long-term effect on depression in people living with an HIV infection.” – Yang Yang

 

More than 35 million people worldwide and 1.2 million people in the United States are living with HIV infection. In 1996, the advent of the protease inhibitor and the so-called cocktail changed the prognosis for HIV. Since this development, a 20-year-old individual, infected with HIV, can now expect to live on average to age 69. Hence, living with HIV is a long-term reality for a very large group of people.

 

People living with HIV infection experience a wide array of physical and psychological symptoms which decrease their perceived quality of life. The symptoms include muscle aches, anxiety, depression, weakness, fear/worries, difficulty with concentration, concerns regarding the need to interact with a complex healthcare system, stigma, loneliness, and the challenge to come to terms with a new identity as someone living with HIV. Hence, patients with HIV infection, even when controlled with drugs, have a reduction in their quality of life.  There is thus a need to find methods to improve the quality of life in people who are living with HIV infection.

 

Mindfulness has been shown to improve psychological and physical well-being in people suffering from a wide range of disorders including depression and anxiety. It has also been shown that mindfulness is associated with psychological well-being and lower depression in patients with HIV infection. Integrated Yoga is a contemplative practice is a mindfulness practice that includes postures, breathing practices, relaxation techniques, and meditation. It has been shown to reduce anxiety and depression in in patients with HIV infection. So, it would stand to reason that other mindfulness practices would be beneficial for people who are living with HIV infection.

 

In today’s Research News article “The effectiveness of mindfulness-based cognitive therapy on quality of life and loneliness of women with HIV.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5319288/

Samhkaniyan and colleagues recruited women infected with HIV and randomly assigned them to a no-treatment control or to receive 8 weeks of Mindfulness-Based Cognitive Therapy (MBCT), administered once weekly for 2 hours. They were measured before and after the 8-week intervention for loneliness and quality of life, including body health, emotional care, community relationships, and environmental health.

 

They found that the Mindfulness-Based Cognitive Therapy (MBCT) group had significant improvements in all measure in comparison to baseline and the control group, with significant improvements in loneliness, overall quality of life and each quality of life component, body health, emotional care, community relationships, and environmental health. Hence, MBCT appears to be an effective treatment for the psychological issues of loneliness and perceived quality of life in women diagnosed with HIV.

 

MBCT contains both mindfulness practice and also cognitive therapy that is designed to change faulty thought processes. Mindfulness training has been shown to relieve loneliness and lead to improvement in quality of life with a myriad of different conditions. Also, loneliness is an interpretation of the environmental conditions and the altered thinking produced by MBCT may well be responsible for the effect. A more mundane explanation is that the social contacts involved in receiving MBCT by themselves relieve loneliness and improve quality of life. A randomized controlled clinical trial with an active control group is needed to distinguish between these alternative explanations.

 

So, improve loneliness and quality of life with women with HIV with mindfulness.

 

“Given the stress-reduction benefits of mindfulness meditation training, there can be health protective effects not just in people with HIV but in folks who suffer from daily stress,” – David Creswell

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

Samhkaniyan, E., Mahdavi, A., Mohamadpour, S., & Rahmani, S. (2015). The effectiveness of mindfulness-based cognitive therapy on quality of life and loneliness of women with HIV . Journal of Medicine and Life, 8(Spec Iss 4), 107–113.

 

Abstract

Objective: The present study investigated the performance of Mindfulness according to the Cognitive approach on the Quality of Life and Loneliness of women with HIV.

Methods: This research is a semi-experimental with pretest-posttest and check team, which was conducted in winter, 2014. In this research, 24 positive HIV women in Tehran were selected by volunteers sampling method and were stochastically related to either the control team (n = 12) or the MBCT groups (n = 12) and, the World Health Organization quality of life survey and the University of California Los Angeles loneliness scale were administrated as pretest. The MBCT team got eight sessions of mindfulness according to the cognitive theory and the check team got no intervention. At the end, the post-test was administrated to two groups and, covariance method was used for data analysis by SPSS-20 software.

Findings: The results of the present study indicated that there were clear variations among the test groups check group and MBCT (p < 0.001). Therefore, Mindfulness-based Cognitive theory increased the mean quality of life and decreased loneliness.

Conclusion: The findings indicated that the Mindfulness-based Cognitive therapy increased the quality of life and decreased loneliness in positive HIV women. Therefore, in order to modify the quality of life and loneliness in these cases, attention to these variables during clinical trials with the goal of an appropriate intervention, will be beneficial.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5319288/

 

Improve Psychological and Physical Effects of HIV with Yoga

By John M. de Castro, Ph.D.

 

“Yoga is not just about the physical side, it’s also about the mind-body connection. I think having that awareness and accepting their condition can help them when they go out into the world, and lift up their self-esteem. Life is fast – yoga can help them be calm and still.” – Surang Sengsamran

 

HIV is a virus that gradually attacks the immune system. It destroys a type of white blood cell called a T-helper cell (CD4 Cell). This isn’t a problem unto itself, but the immune system is our body’s natural defense against illness. Hence, HIV infection makes it harder to combat other infections and diseases. If HIV is untreated, these secondary infections produce chronic illness and eventually death. It is important, then, in treating HIV infection to strengthen the immune system and increase the levels of CD4 in the blood to fight off disease.

 

More than 35 million people worldwide and 1.2 million people in the United States are living with HIV infection. In 1996, the advent of the protease inhibitor and the so-called cocktail changed the prognosis for HIV. Since this development a 20 year-old infected with HIV can now expect to live on average to age 69. Hence, living with HIV is a long-term reality for a very large group of people.

 

People living with HIV infection experience a wide array of physical and psychological symptoms which decrease their perceived quality of life. The symptoms include muscle aches, anxiety, depression, weakness, fear/worries, difficulty with concentration, concerns regarding the need to interact with a complex healthcare system, stigma, and the challenge to come to terms with a new identity as someone living with HIV. Hence, patients with HIV infection, even when controlled with drugs, have a reduction in their quality of life.  There is thus a need to find methods to improve the quality of life in people who are living with HIV infection.

 

Mindfulness has been shown to strengthen the immune system. It also improve psychological and physical well-being in people suffering from a wide range of disorders including depression and anxiety. It has also been shown that mindfulness is associated with psychological well-being and lower depression in patients with HIV infection. Integrated Yoga is a contemplative practice that includes postures, breathing practices, relaxation techniques, and meditation. It has been shown to increase mindfulness, and reduce anxiety and depression. So, it would stand to reason that Integrated Yoga would be beneficial for people who are living with HIV infection.

 

In today’s Research News article “Effect of Integrated Yoga (IY) on psychological states and CD4 counts of HIV-1 infected patients: A randomized controlled pilot study”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1183625434994714/?type=3&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4728960/

Naoroibam and colleagues randomly assigned patients with HIV infection to either a one-hour per day, six-days per week Integrated Yoga practice for one-month or to a treatment as usual condition. Compared to before treatment and the control group, they found that the Integrated Yoga practice produced a significant reduction in anxiety and depression levels and an increase in T-helper cell (CD4 Cell) counts in the blood. It should be kept in mind that there was not an active control condition. So, it is unclear if the effectiveness of Integrated Yoga practice was due to exercise effects or perhaps to expectancy effects, researcher bias effects, etc. It will remain for future research to sort out exactly what is responsible to the improvement in the HIV patients.

 

Regardless, these are exciting and potentially important results suggesting that Integrated Yoga practice may not only improve the psychological well-being of HIV infected patients but also strengthen the immune system. This would make them better able to combat other infections and diseases.

 

So, improve psychological and physical effects of HIV with yoga.

 

“As you become more adept at yoga, you learn which poses can help you, depending on how you are feeling physically. There are certain poses that assist in relieving fatigue, diarrhea, anxiety, depression. You do learn about the nature of self, but you also learn that so much is beyond your control. It helps you realize, somehow, to trust in a higher being.” – Steve McCeney

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are available at the Contemplative Studies Blog http://contemplative-studies.org/wp/