1 2235 86 THE IMPACT OF YOGA UPON FEMALE PATIENTS SUFFERING FROM HYPOTHYROIDISM. OBJECTIVE: TO STUDY THE EFFECT OF YOGA ON THE QUALITY OF LIFE OF FEMALE HYPOTHYROID PATIENTS. DESIGN: THE WHO QUALITY OF LIFE SCALE(22) WAS USED TO ASSESS THE QUALITY OF LIFE OF 20 FEMALE HYPOTHYROID PATIENTS. SUBJECTS ATTENDED ONE HOUR YOGA SESSIONS DAILY FOR A PERIOD OF ONE MONTH. A PRETEST-POST-TEST RESEARCH DESIGN WAS USED FOR DATA ANALYSIS. RESULTS: PATIENTS' QUALITY OF LIFE SCORES FOLLOWING THE YOGA PROGRAM WERE GREATER THAN SCORES OBTAINED PRIOR TO UNDERTAKING YOGA (P < 0.01). PATIENTS ALSO REPORTED SIGNIFICANT IMPROVEMENT IN THEIR PERCEPTION OF THE OVERALL QUALITY OF LIFE AND OF THEIR HEALTH POST YOGA INTERVENTION. CONCLUSIONS: IT CAN BE CONCLUDED THAT YOGA IS VALUABLE IN HELPING THE HYPOTHYROID PATIENTS TO MANAGE THEIR DISEASE-RELATED SYMPTOMS. YOGA MAY BE CONSIDERED AS SUPPORTIVE OR COMPLEMENTARY THERAPY IN CONJUNCTION WITH MEDICAL THERAPY FOR THE TREATMENT OF HYPOTHYROID DISORDER. 2011 2 115 28 A PILOT STUDY OF A YOGA INTERVENTION FOR THE TREATMENT OF ANXIETY IN YOUNG PEOPLE WITH EARLY PSYCHOSIS. BACKGROUND: ANXIETY IS COMMON IN YOUNG PEOPLE WITH EARLY PSYCHOSIS AND TREATMENT OPTIONS FOR THIS CO-MORBIDITY REMAIN LIMITED. YOGA IS A PROMISING ADJUNCT INTERVENTION THAT HAS BEEN SHOWN TO REDUCE ANXIETY FOR ADULTS WITH SCHIZOPHRENIA, THEREFORE THIS PILOT STUDY EVALUATED THE ACCEPTABILITY AND POTENTIAL EFFECTIVENESS OF YOGA FOR ANXIETY IN EARLY PSYCHOSIS. METHODS: A PROSPECTIVE SINGLE ARM PILOT STUDY OF A YOGA INTERVENTION WAS CONDUCTED WITHIN AN EARLY INTERVENTION FOR PSYCHOSIS SERVICE. RATES OF ATTENDANCE, AS WELL AS SYMPTOMS OF ANXIETY PRE AND POST YOGA SESSION WERE MEASURED. RESULTS: A TOTAL OF 14 YOUNG PEOPLE PARTICIPATED IN THE STUDY AND OVER 70% ATTENDED HALF OR MORE OF THE YOGA SESSIONS OFFERED. SIGNIFICANT TRANSIENT REDUCTION IN STATE ANXIETY AFTER A SINGLE SESSION OF YOGA WAS OBSERVED (P < 0.01). CONCLUSIONS: YOGA WAS FOUND TO BE AN ACCEPTABLE AND POTENTIALLY EFFECTIVE ADJUNCTIVE TREATMENT FOR ANXIETY IN EARLY PSYCHOSIS AND THE RESULTS WARRANT FURTHER CLINICAL TRIALS. 2022 3 159 34 A RANDOMISED COMPARATIVE TRIAL OF YOGA AND RELAXATION TO REDUCE STRESS AND ANXIETY. OBJECTIVE: TO COMPARE YOGA AND RELAXATION AS TREATMENT MODALITIES AT 10 AND 16 WEEKS FROM STUDY BASELINE TO DETERMINE IF EITHER OF MODALITY REDUCES SUBJECT STRESS, ANXIETY, BLOOD PRESSURE AND IMPROVE QUALITY OF LIFE. DESIGN: A RANDOMISED COMPARATIVE TRIAL WAS UNDERTAKEN COMPARING YOGA WITH RELAXATION. PARTICIPANTS: ONE HUNDRED AND THIRTY-ONE SUBJECTS WITH MILD TO MODERATE LEVELS OF STRESS WERE RECRUITED FROM THE COMMUNITY IN SOUTH AUSTRALIA. INTERVENTIONS: TEN WEEKLY 1- H SESSIONS OF RELAXATION OR HATHA YOGA. MAIN OUTCOME MEASURES: CHANGES IN THE STATE TRAIT PERSONALITY INVENTORY SUB-SCALE ANXIETY, GENERAL HEALTH QUESTIONNAIRE AND THE SHORT FORM-36. RESULTS: FOLLOWING THE 10 WEEK INTERVENTION STRESS, ANXIETY AND QUALITY OF LIFE SCORES IMPROVED OVER TIME. YOGA WAS FOUND TO BE AS EFFECTIVE AS RELAXATION IN REDUCING STRESS, ANXIETY AND IMPROVING HEALTH STATUS ON SEVEN DOMAINS OF THE SF-36. YOGA WAS MORE EFFECTIVE THAN RELAXATION IN IMPROVING MENTAL HEALTH. AT THE END OF THE 6 WEEK FOLLOW-UP PERIOD THERE WERE NO DIFFERENCES BETWEEN GROUPS IN LEVELS OF STRESS, ANXIETY AND ON FIVE DOMAINS OF THE SF-36. VITALITY, SOCIAL FUNCTION AND MENTAL HEALTH SCORES ON THE SF-36 WERE HIGHER IN THE RELAXATION GROUP DURING THE FOLLOW-UP PERIOD. CONCLUSION: YOGA APPEARS TO PROVIDE A COMPARABLE IMPROVEMENT IN STRESS, ANXIETY AND HEALTH STATUS COMPARED TO RELAXATION. 2007 4 1076 25 EFFECTS OF YOGA ON PHYSIOLOGICAL INDICES, ANXIETY AND SOCIAL FUNCTIONING IN MULTIPLE SCLEROSIS PATIENTS: A RANDOMIZED TRIAL. INTRODUCTION: MULTIPLE SCLEROSIS (MS) AS A CHRONIC DISEASE COULD AFFECT PATIENTS' VARIOUS DOMAINS OF LIFE. AIM: THIS STUDY WAS CONDUCTED TO STUDY THE EFFECT OF YOGA ON THE PHYSIOLOGICAL INDICES, ANXIETY AND SOCIAL FUNCTIONING OF PATIENTS WITH MS IN SOUTHWEST, IRAN. MATERIALS AND METHODS: IN THIS CLINICAL TRIAL STUDY, 60 MS PATIENTS WERE ENROLLED ACCORDING TO INCLUSION CRITERIA AND RANDOMLY ASSIGNED TO TWO GROUPS OF 30 EACH. PRIOR TO AND AFTER INTERVENTION, THE PATIENTS' VITAL SIGNS WERE MEASURED. FOR CASE GROUP YOGA EXERCISES WERE PERFORMED THREE SESSIONS A WEEK FOR 12 WEEKS WHILE CONTROL GROUP PERFORMED NO EXERCISE. THE DATA WERE GATHERED BY QUESTIONNAIRE AND ANALYSED BY DESCRIPTIVE AND ANALYTICAL STATISTICS IN SPSS. RESULTS: PRIOR TO INTERVENTION, THERE WAS NO SIGNIFICANT DIFFERENCE IN FATIGUE SEVERITY AND PAIN BETWEEN THE TWO GROUPS BUT THE MEAN FATIGUE SEVERITY AND PAIN IN CASE GROUP DECREASED COMPARED TO THE CONTROL GROUP AFTER THE INTERVENTION. PRIOR TO INTERVENTION, THERE WAS NO SIGNIFICANT DIFFERENCE IN MEAN PHYSIOLOGICAL INDICES BETWEEN THE TWO GROUPS BUT THE MEAN PHYSIOLOGICAL INDICES IN CASE GROUP DECREASED SIGNIFICANTLY AFTER THE INTERVENTION (P<0.05). CONCLUSION: YOGA IS LIKELY TO INCREASE SELF-EFFICACY OF MS PATIENTS THROUGH ENHANCING PHYSICAL ACTIVITY, INCREASING THE STRENGTH OF LOWER LIMBS AND BALANCE, AND DECREASING FATIGUE AND PAIN, AND FINALLY TO PROMOTE SOCIAL FUNCTIONING AND TO RELIEVE STRESS AND ANXIETY IN THESE PATIENTS. 2016 5 1732 41 PERSPECTIVE OF PATIENTS REFERRED TO YOGA CENTER IN A TERTIARY NEUROPSYCHIATRIC HOSPITAL: A CROSS-SECTIONAL RETROSPECTIVE STUDY. BACKGROUND: YOGA HAS BEEN EXTENSIVELY USED AS AN ALTERNATIVE OR COMPLEMENTARY THERAPY IN PSYCHIATRIC DISORDERS DEPENDING ON THE TYPE AND SEVERITY OF THE DISORDERS. HOWEVER, DATA RELATED TO PERSPECTIVE ON YOGA SERVICES AND THE BENEFITS AND ADVERSE EFFECTS ATTRIBUTED TO YOGA BY PATIENTS WITH MAJOR PSYCHIATRIC DISORDERS IS LACKING. AIM: THE AIM OF THE STUDY WAS TO ASSESS FEEDBACK OF THE PATIENTS WHO ATTENDED YOGA SESSIONS AT A YOGA CENTER IN A TERTIARY NEUROPSYCHIATRIC HOSPITAL. MATERIALS AND METHODS: THIS WAS A CROSS-SECTIONAL RETROSPECTIVE STUDY USING A SPECIFIC QUESTIONNAIRE TO GET FEEDBACK FROM PATIENTS REFERRED TO THE NIMHANS INTEGRATED CENTER FOR YOGA, AT THE END OF THEIR YOGA TRAINING. RESULTS: TWO HUNDRED AND ONE PATIENTS' DATA WERE INCLUDED IN THIS RETROSPECTIVE STUDY. MOST OF THE PATIENTS WERE REFERRED BY THE DOCTORS. THE YOGA MODULE FOR SCHIZOPHRENIA WAS MOST COMMONLY UTILIZED, FOLLOWED BY DEPRESSION. ON AN AVERAGE, PATIENTS ATTENDED 13 SESSIONS. MOST OF THEM PRACTICED YOGA FOR 1-2 WEEKS AND HAD MISSED LESS THAN 2 SESSIONS. THE GREAT MAJORITY OF THE PATIENTS REPORTED THAT PRACTICING YOGA HELPED THEM. SPEARMAN CORRELATION ANALYSIS REVEALED POSITIVE ASSOCIATIONS BETWEEN IMPROVEMENT ATTRIBUTED TO YOGA AND VARIABLES AFFECTING QUALITY OF YOGA SERVICES AT THE CENTER, INCLUDING THE QUALITY OF YOGA SESSIONS ATTENDED. OVERALL HEALTH AND SLEEP IMPROVEMENT ALSO POSITIVELY CORRELATED WITH IMPROVEMENT ATTRIBUTED TO YOGA. A MINORITY OF PATIENTS REPORTED ADVERSE EFFECTS, ALTHOUGH THESE DID NOT LEAD TO DISCONTINUATION. CONCLUSION: IN THIS RETROSPECTIVE STUDY OF PATIENTS REFERRED TO A YOGA CENTER IN A TERTIARY PSYCHIATRIC FACILITY, THE MAJORITY OF PATIENTS WITH MAJOR MENTAL DISORDERS WERE ABLE TO PRACTICE YOGA UNDER SUPERVISION AND REPORTED SIGNIFICANT IMPROVEMENT IN SYMPTOMS WITH MINIMAL ADVERSE EFFECTS. 2021 6 2080 34 THE EFFECT OF GROUP MINDFULNESS - BASED STRESS REDUCTION PROGRAM AND CONSCIOUS YOGA ON THE FATIGUE SEVERITY AND GLOBAL AND SPECIFIC LIFE QUALITY IN WOMEN WITH BREAST CANCER. BACKGROUND: CANCER IS NOT MERELY AN EVENT WITH A CERTAIN END, BUT IT IS A PERMANENT AND VAGUE SITUATION THAT IS DETERMINED BY DELAYED EFFECTS DUE TO THE DISEASE, ITS TREATMENT AND ITS RELATED PSYCHOLOGICAL ISSUES. THE AIM OF THIS STUDY WAS TO EXAMINE THE EFFECTIVENESS OF THE MINDFULNESS-BASED STRESS REDUCTION PROGRAM AND CONSCIOUS YOGA ON THE MENTAL FATIGUE SEVERITY AND LIFE QUALITY OF WOMEN WITH BREAST CANCER. METHODS: THIS WAS A QUASI-EXPERIMENTAL STUDY WITH A PRE-TEST, POST-TEST AND CONTROL GROUP. IN THIS STUDY, 24 PATIENTS WITH THE DIAGNOSIS OF BREAST CANCER WERE SELECTED AMONG THE PATIENTS WHO REFERRED TO THE DIVISION OF ONCOLOGY AND RADIOTHERAPY OF IMAM HOSSEIN HOSPITAL IN TEHRAN USING AVAILABLE SAMPLING METHOD, AND WERE RANDOMLY ASSIGNED INTO THE EXPERIMENTAL AND CONTROL GROUPS. ALL THE PARTICIPANTS COMPLETED THE FATIGUE SEVERITY SCALE, GLOBAL LIFE QUALITY OF CANCER PATIENT AND SPECIFIC LIFE QUALITY OF CANCER PATIENT QUESTIONNAIRES. DATA WERE ANALYZED BY MULTIVARIATE REPEATED MEASUREMENT VARIANCE ANALYSIS MODEL. RESULTS: FINDINGS REVEALED THAT THE MINDFULNESS-BASED STRESS REDUCTION TREATMENT SIGNIFICANTLY IMPROVED THE OVERALL QUALITY OF LIFE, ROLE, COGNITIVE, EMOTION, SOCIAL FUNCTIONS AND PAIN AND FATIGUE SYMPTOMS IN GLOBAL LIFE QUALITY IN THE EXPERIMENTAL GROUP. IT ALSO SIGNIFICANTLY IMPROVED THE BODY IMAGE, FUTURE FUNCTIONS AND THERAPY SIDE EFFECTS IN SPECIFIC LIFE QUALITY OF THE EXPERIMENTAL GROUP COMPARED TO THE CONTROL GROUP. IN ADDITION, FATIGUE SEVERITY CAUSED BY CANCER WAS REDUCED SIGNIFICANTLY. CONCLUSION: THE RESULTS SHOWED THAT THE MINDFULNESS - BASED STRESS REDUCTION TREATMENT CAN BE EFFECTIVE IN IMPROVING GLOBAL AND SPECIFIC LIFE QUALITY AND FATIGUE SEVERITY IN WOMEN WITH BREAST CANCER. 2015 7 976 31 EFFECTS OF AN INTERVENTION PROGRAM WITH HEALTH EDUCATION AND HATHA YOGA ON THE HEALTH OF PROFESSIONALS WITH MUSCULOSKELETAL SYMPTOMS. INTRODUCTION: MUSCULOSKELETAL AND MENTAL DISORDERS ARE RELEVANT IN THE WORKERS' DISEASE PROCESS, AND ERGONOMIC INTERVENTIONS THAT INCLUDE GUIDANCE AND PHYSICAL EXERCISE CONSIST OF STRATEGIES OF HEALTH PROMOTION. INTEGRATIVE AND COMPLEMENTARY PRACTICES ARE PRESENTED AS A POSSIBILITY OF PROMOTING COMPREHENSIVE CARE AND YOGA CONSISTS OF A THERAPEUTIC ALTERNATIVE. OBJECTIVE: TO EVALUATE THE EFFECTS OF AN INTERVENTION INCLUDING EDUCATIONAL MEASURES AND HATHA YOGA IN MUSCULOSKELETAL PAIN, DISABILITY, AND STRESS IN PROFESSIONALS OF A UNIVERSITY HOSPITAL. METHODS: WE SELECTED 125 PROFESSIONALS WITH MUSCULOSKELETAL SYMPTOMS OF INTENSITY >/= 1 WHO DID NOT PRACTICE YOGA AND RANDOMLY ASSIGNED THEM TO INTERVENTION (N = 63) AND CONTROL (N = 62) GROUPS, REQUESTING ANSWERS TO THE FOLLOWING QUESTIONNAIRES: INITIAL CHARACTERIZATION, THE NORDIC MUSCULOSKELETAL QUESTIONNAIRE AND A NUMERIC SCALE, THE PAIN DISABILITY QUESTIONNAIRE, AND THE PERCEIVED STRESS SCALE. THE INTERVENTION GROUP WENT THROUGH A 12-WEEK PROGRAM WITH EDUCATIONAL MEASURES AND HATHA YOGA. AT THE END OF THE STUDY PERIOD, BOTH GROUPS ANSWERED TO THE QUESTIONNAIRES ONCE AGAIN. WE COMPARED DATA BEFORE AND AFTER THE INTERVENTION AND BETWEEN GROUPS. RESULTS: BOTH GROUPS PRESENTED IMPROVEMENTS AFTER 12 WEEKS, BUT THE DIFFERENCE BETWEEN MEAN RESULTS OBTAINED IN THE FIRST AND SECOND DATA COLLECTIONS REVEALED THAT THE LEVELS OF PAIN, DISABILITY, AND STRESS DECREASED MORE STRONGLY IN THE INTERVENTION GROUP THAN IN THE CONTROL GROUP. CONSIDERING THAT THE INTERVENTION GROUP BEGAN THE PROGRAM IN WORSE CLINICAL CONDITIONS, THE PROGRAM LED TO A REDUCTION IN THE DIFFERENCE BETWEEN GROUPS, BUT THIS WAS NOT ENOUGH FOR THE INTERVENTION GROUP TO REACH BETTER RESULTS THAN THE CONTROL. CONCLUSIONS: THE INTERVENTION PROMOTED IMPROVEMENTS IN THE INTENSITY OF PAIN, DISABILITY, AND STRESS AMONG THE PARTICIPANTS OF THE INTERVENTION GROUP. SIMILAR PROGRAMS COULD BE EXPLORED IN THE PROMOTION OF OCCUPATIONAL HEALTH. 2020 8 1846 27 QUALITY OF LIFE AND MENTAL HEALTH IN PATIENTS WITH CHRONIC DISEASES WHO REGULARLY PRACTICE YOGA AND THOSE WHO DO NOT: A CASE-CONTROL STUDY. WHILE CLINICAL TRIALS HAVE SHOWN EVIDENCE OF EFFICACY OF YOGA IN DIFFERENT CHRONIC DISEASES, SUBJECTIVE HEALTH BENEFITS ASSOCIATED WITH YOGA PRACTICE UNDER NATURALISTIC CONDITIONS HAVE NOT YET BEEN INVESTIGATED. THE AIM OF THIS STUDY WAS TO INVESTIGATE ASSOCIATIONS OF REGULAR YOGA PRACTICE WITH QUALITY OF LIFE AND MENTAL HEALTH IN PATIENTS WITH CHRONIC DISEASES. USING A CASE-CONTROL DESIGN, PATIENTS WITH CHRONIC DISEASES WHO REGULARLY PRACTICED YOGA WERE SELECTED FROM A LARGE OBSERVATIONAL STUDY AND COMPARED TO CONTROLS WHO DID NOT REGULARLY PRACTICE YOGA AND WHO WERE MATCHED INDIVIDUALLY TO EACH CASE ON GENDER, MAIN DIAGNOSIS, EDUCATION, AND AGE (WITHIN 5 YEARS). PATIENTS' QUALITY OF LIFE (SF-36 QUESTIONNAIRE), MENTAL HEALTH (HOSPITAL ANXIETY AND DEPRESSION SCALE), LIFE SATISFACTION, AND HEALTH SATISFACTION (QUESTIONNAIRE FOR LIFE SATISFACTION) WERE ASSESSED. PATIENTS WHO REGULARLY PRACTICED YOGA (N = 186) HAD A BETTER GENERAL HEALTH STATUS (P = 0.012), A HIGHER PHYSICAL FUNCTIONING (P = 0.001), AND PHYSICAL COMPONENT SCORE (P = 0.029) ON THE SF-36 THAN THOSE WHO DID NOT (N = 186). NO GROUP DIFFERENCES WERE FOUND FOR THE MENTAL SCALES OF THE SF-36, ANXIETY, DEPRESSION, LIFE SATISFACTION, OR HEALTH SATISFACTION. IN CONCLUSION, PRACTICING YOGA UNDER NATURALISTIC CONDITIONS SEEMS TO BE ASSOCIATED WITH INCREASED PHYSICAL HEALTH BUT NOT MENTAL HEALTH IN CHRONICALLY DISEASED PATIENTS. 2013 9 1707 29 PATTERNS OF YOGA PRACTICE AND PHYSICAL ACTIVITY FOLLOWING A YOGA INTERVENTION FOR ADULTS WITH OR AT RISK FOR TYPE 2 DIABETES. BACKGROUND: THE CURRENT STUDY DESCRIBED PATTERNS OF YOGA PRACTICE AND EXAMINED DIFFERENCES IN PHYSICAL ACTIVITY OVER TIME BETWEEN INDIVIDUALS WITH OR AT RISK FOR TYPE 2 DIABETES WHO COMPLETED AN 8-WEEK YOGA INTERVENTION COMPARED WITH CONTROLS. METHODS: A LONGITUDINAL COMPARATIVE DESIGN MEASURED THE EFFECT OF A YOGA INTERVENTION ON YOGA PRACTICE AND PHYSICAL ACTIVITY, USING DATA AT BASELINE AND POSTINTERVENTION MONTHS 3, 6, AND 15. RESULTS: DISPARATE PATTERNS OF YOGA PRACTICE OCCURRED BETWEEN INTERVENTION AND CONTROL PARTICIPANTS OVER TIME, BUT THE SUBJECTIVE DEFINITION OF YOGA PRACTICE LIMITS INTERPRETATION. MULTILEVEL MODEL ESTIMATES INDICATED THAT TREATMENT GROUP DID NOT HAVE A SIGNIFICANT INFLUENCE IN THE RATE OF CHANGE IN PHYSICAL ACTIVITY OVER THE STUDY PERIOD. WHILE AGE AND EDUCATION WERE NOT SIGNIFICANT INDIVIDUAL PREDICTORS, THE INCLUSION OF THESE VARIABLES IN THE MODEL DID IMPROVE FIT. CONCLUSIONS: FINDINGS INDICATE THAT AN 8-WEEK YOGA INTERVENTION HAD LITTLE EFFECT ON PHYSICAL ACTIVITY OVER TIME. FURTHER RESEARCH IS NECESSARY TO EXPLORE THE INFLUENCE OF YOGA ON BEHAVIORAL HEALTH OUTCOMES AMONG INDIVIDUALS WITH OR AT RISK FOR TYPE 2 DIABETES. 2012 10 2883 29 YOGA: A TOOL FOR IMPROVING THE QUALITY OF LIFE IN CHRONIC PANCREATITIS. AIM: TO DETERMINE THE EFFECTIVENESS OF YOGA ON IMPROVING THE QUALITY OF LIFE IN PATIENTS OF CHRONIC PANCREATITIS. METHODS: THE PATIENTS WERE RANDOMIZED TO TWO GROUPS. THE CONTROL GROUP CONTINUED THEIR USUAL CARE AS DIRECTED BY THEIR PHYSICIANS. PATIENTS IN THE YOGA GROUP, IN ADDITION, RECEIVED BIWEEKLY YOGA SESSIONS FOR 12 WK. THE PATIENTS' DEMOGRAPHIC AND HEALTH BEHAVIOUR VARIABLES WERE ASSESSED BEFORE AND AFTER THE YOGA PROGRAMME USING MEDICAL OUTCOMES SHORT FORM (SF-36) FOR QUALITY OF LIFE, PROFILE OF MOOD STATES FOR ASSESSING MOOD AND SYMPTOMS OF STRESS INVENTORY FOR MEASURING STRESS. RESULTS: A TOTAL OF 60 PATIENTS WERE ENROLLED, WITH 8 DROP-OUTS. THIRTY PATIENTS WERE RANDOMIZED TO THE YOGA GROUP AND 30 TO THE CONTROL GROUP. SIGNIFICANT IMPROVEMENTS WERE SEEN IN OVERALL QUALITY OF LIFE, SYMPTOMS OF STRESS, MOOD CHANGES, ALCOHOL DEPENDENCE AND APPETITE AFTER THE 12 WK PERIOD APART FROM THE GENERAL FEELING OF WELL-BEING AND DESIRE TO CONTINUE WITH THE PROGRAMME IN FUTURE IN THE YOGA GROUP, WHILE THERE WAS NO DIFFERENCE IN THE CONTROL GROUP. CONCLUSION: YOGA IS EFFECTIVE ON IMPROVING THE QUALITY OF LIFE IN PATIENTS OF CHRONIC PANCREATITIS. 2007 11 2673 27 YOGA IN PRIMARY HEALTH CARE: A QUASI-EXPERIMENTAL STUDY TO ACCESS THE EFFECTS ON QUALITY OF LIFE AND PSYCHOLOGICAL DISTRESS. BACKGROUND: AND PURPOSE: YOGA IS GROWING IN POPULARITY, BUT ITS BENEFITS AND INTEGRATION INTO PRIMARY CARE REMAIN UNCERTAIN. HERE, WE DETERMINE YOGA EFFECTS ON QUALITY OF LIFE AND PSYCHOLOGICAL DISTRESS, AND EVALUATE THE FEASIBILITY OF INTRODUCING YOGA AT PRIMARY CARE LEVEL. MATERIALS AND METHODS: THIS IS A PROSPECTIVE, LONGITUDINAL, QUASI-EXPERIMENTAL STUDY, WITH AN INTERVENTION (N=49) AND A CONTROL GROUP (N=37). YOGA GROUP UNDERWENT 24-WEEKS PROGRAM OF ONE-HOUR SESSIONS. OUR PRIMARY ENDPOINT WAS QUALITY OF LIFE AND PSYCHOLOGICAL DISTRESS, AS WELL AS SATISFACTION LEVEL AND ADHERENCE RATE. RESULTS: PARTICIPANTS REPORTED A SIGNIFICANT IMPROVEMENT IN ALL DOMAINS OF QUALITY OF LIFE AND A REDUCTION OF PSYCHOLOGICAL DISTRESS. LINEAR REGRESSION ANALYSIS SHOWED THAT YOGA SIGNIFICANTLY IMPROVES PSYCHOLOGICAL QUALITY OF LIFE (P=0.046). CONCLUSION: YOGA IN PRIMARY CARE IS FEASIBLE, SAFE AND HAS A SATISFACTORY ADHERENCE, AS WELL AS A POSITIVE EFFECT ON PSYCHOLOGICAL QUALITY OF LIFE OF PARTICIPANTS. 2019 12 1091 40 EFFECTS OF YOGA ON THE QUALITY OF LIFE IN CANCER PATIENTS. OBJECTIVE: THIS STUDY SOUGHT TO INVESTIGATE THE EFFECTS OF YOGA ON THE QUALITY OF LIFE IN PATIENTS WITH BREAST CANCER. DESIGN: TWENTY PATIENTS BETWEEN 30 AND 50 YEARS OF AGE PRESENTLY UNDER TREATMENT FOR BREAST CANCER WERE INCLUDED IN THE STUDY. THE PHYSICAL CHARACTERISTICS OF THE PATIENTS WERE RECORDED AND GENERAL PHYSIOTHERAPY ASSESSMENTS PERFORMED. EIGHT SESSIONS OF A YOGA PROGRAM INCLUDING WARMING AND BREATHING EXERCISES, ASANAS, RELAXATION IN SUPINE POSITION, AND MEDITATION WERE APPLIED TO PARTICIPANTS. MAIN OUTCOME MEASURES: THE PRE- AND POST-YOGA QUALITY OF LIFE ASSESSMENTS FOR THE PATIENTS WERE CONDUCTED USING THE NOTTINGHAM HEALTH PROFILE (NHP). PATIENTS' STRESS LEVELS WERE ASSESSED USING THE STAI-I AND STAI-II ANXIETY INVENTORY. THEIR SATISFACTION LEVELS ABOUT THE YOGA PROGRAM WAS EVALUATED USING THE VISUAL ANALOG SCALE (VAS). RESULTS: IT WAS FOUND THAT PATIENTS' QUALITY OF LIFE SCORES AFTER THE YOGA PROGRAM WERE BETTER THAN SCORES OBTAINED BEFORE THE YOGA PROGRAM (P < 0.05). AFTER SESSIONS, THERE WAS A STATISTICALLY SIGNIFICANT DECREASE IN THEIR STAI-I (MEASURING THE REACTIONS OF ANXIETY) SCORES AND STAI-II (MEASURING THE PERMANENCE OF ANXIETY) SCORES (P < 0.05). IT WAS FOUND OUT THAT THE SATISFACTION SCORE CONCERNING THE YOGA PROGRAM WAS CONSIDERABLY INCREASED AFTER THE YOGA PROGRAM (P < 0.05). CONCLUSIONS: IT CAN BE CONCLUDED THAT YOGA IS VALUABLE IN HELPING TO ACHIEVE RELAXATION AND DIMINISH STRESS, HELPS CANCER PATIENTS PERFORM DAILY AND ROUTINE ACTIVITIES, AND INCREASES THE QUALITY OF LIFE IN CANCER PATIENTS. THIS RESULT WAS POSITIVELY REFLECTED IN PATIENTS SATISFACTION WITH THE YOGA PROGRAM. 2010 13 2864 31 YOGA-BASED INTERVENTION FOR CAREGIVERS OF OUTPATIENTS WITH PSYCHOSIS: A RANDOMIZED CONTROLLED PILOT STUDY. PURPOSE OF THE STUDY: THE USE OF YOGA AS AN INTERVENTION FOR CAREGIVERS OF PATIENTS WITH PSYCHOSIS HAS BEEN POORLY STUDIED. THE CURRENT STUDY AIMED TO TEST THE EFFICACY OF A BRIEF YOGA PROGRAM AS AN INTERVENTION IN CAREGIVERS OF OUTPATIENTS WITH FUNCTIONAL PSYCHOTIC DISORDERS USING A RANDOMIZED CONTROLLED RESEARCH DESIGN. MATERIALS AND METHODS: CAREGIVERS WHO AGREED TO PARTICIPATE IN THE STUDY (N=29) WERE RANDOMIZED INTO YOGA (N=15) OR WAIT-LIST GROUP (N=14). THEY WERE ASSESSED AT BASELINE AND AT THE END OF 3 MONTHS. PATIENTS WHO WERE RANDOMIZED INTO THE YOGA GROUP WERE OFFERED SUPERVISED YOGA TRAINING THRICE A WEEK FOR 4 WEEKS, AFTER WHICH THEY WERE INSTRUCTED TO PRACTICE AT HOME FOR THE NEXT 2 MONTHS. DUE TO THE SMALL SAMPLE SIZE AND SOME VARIABLES NOT BEING NORMALLY DISTRIBUTED, NON-PARAMETRIC STATISTICAL ANALYSIS WAS USED. RESULTS: RESULTS SHOWED SIGNIFICANTLY REDUCED BURDEN SCORES AND IMPROVED QUALITY OF LIFE SCORES IN THE YOGA GROUP AS COMPARED TO THE WAIT-LIST GROUP AT THE END OF 3 MONTHS. THERE WERE NO SIGNIFICANT CHANGES IN ANXIETY AND DEPRESSION SCORES IN CAREGIVERS, OR PSYCHOPATHOLOGY SCORES IN PATIENTS. CONCLUSION: IN CAREGIVERS OF OUTPATIENTS WITH FUNCTIONAL PSYCHOSIS, 4 WEEKS OF TRAINING FOLLOWED BY 3 MONTHS OF HOME PRACTICE OF A YOGA MODULE OFFERED SIGNIFICANT ADVANTAGE OVER WAITLIST. YOGA CAN BE OFFERED AS AN INTERVENTION FOR CAREGIVERS OF PATIENTS WITH SEVERE MENTAL DISORDERS. METHODS OF PROVIDING YOGA INTERVENTION CLOSER TO THE COMMUNITY OR USE OF FLEXIBLE MODULES AT HOSPITALS NEEDS FURTHER STUDY. 2013 14 428 27 CAN YOGA HAVE ANY EFFECT ON SHOULDER AND ARM PAIN AND QUALITY OF LIFE IN PATIENTS WITH BREAST CANCER? A RANDOMIZED, CONTROLLED, SINGLE-BLIND TRIAL. OBJECTIVE: TO EXAMINE THE EFFECTS OF YOGA ON SHOULDER AND ARM PAIN, QUALITY OF LIFE (QOL), DEPRESSION, AND PHYSICAL PERFORMANCE IN PATIENTS WITH BREAST CANCER. METHODS: THIS PROSPECTIVE, RANDOMIZED STUDY INCLUDED 42 PATIENTS. THE PATIENTS IN GROUP 1 UNDERWENT A 10-WEEK HATHA YOGA EXERCISE PROGRAM. THE PATIENTS IN GROUP 2 WERE INCLUDED IN A 10-WEEK FOLLOW-UP PROGRAM. OUR PRIMARY ENDPOINT WAS ARM AND SHOULDER PAIN INTENSITY. RESULTS: THE GROUP RECEIVING YOGA SHOWED A SIGNIFICANT IMPROVEMENT IN THEIR PAIN SEVERITY FROM BASELINE TO POST-TREATMENT, AND THESE BENEFITS WERE MAINTAINED AT 2.5 MONTHS POST-TREATMENT. WHEN COMPARED TO THE CONTROL GROUP, THERE WERE NO STATISTICALLY SIGNIFICANT DIFFERENCES BETWEEN THE 2 GROUPS WITH RESPECT TO THE PARAMETERS ASSESSED AT THE END OF WEEK 10. CONCLUSION: YOGA WAS AN EFFECTIVE AND SAFE EXERCISE FOR ALLEVIATING SHOULDER AND ARM PAIN, WHICH IS A COMPLICATION WITH A HIGH PREVALENCE IN PATIENTS WITH BREAST CANCER. 2018 15 2119 27 THE EFFECT OF YOGA THERAPY ON SELECTED PSYCHOLOGICAL VARIABLES AMONG MALE PATIENTS WITH INSOMNIA. BACKGROUND: AN ESTIMATED 30-50% OF THE GENERAL POPULATION IS AFFECTED BY INSOMNIA AND 10% HAVE CHRONIC INSOMNIA. YOGA THERAPY IS BENEFICIAL IN SUCH DISORDERS AND IT HAS FEWER SIDE EFFECTS. AIM: THE AIM OF THIS STUDY WAS TO FIND OUT THE EFFECT OF YOGA THERAPY ON SELECTED PSYCHOLOGICAL VARIABLES AMONG MEN WITH INSOMNIA. METHODS: FORTY MALES WITH INSOMNIA WERE DIVIDED RANDOMLY INTO 2 GROUPS (THE EXPERIMENTAL AND THE CONTROL GROUPS). THE EXPERIMENTAL GROUP RECEIVED EIGHT WEEKS OF YOGA THERAPY, WHILE THE CONTROL GROUP DID NOT RECEIVE ANY THERAPY. THE PRE AND POST TREATMENT STRESS AND THE SELF CONFIDENCE SCORES WERE TAKEN. RESULTS: THERE WAS A SIGNIFICANT IMPROVEMENT IN THE STRESS SCORES AND THE SELF CONFIDENCE SCORES IN THE EXPERIMENTAL GROUP. THERE WERE NEITHER ANY SIDE EFFECTS NOR ANY DROP OUTS. CONCLUSION: WE CONCLUDE THAT YOGA IS AN EFFECTIVE TREATMENT OPTION FOR THE PATIENTS WITH INSOMNIA. THERE ARE NO MAJOR SIDE EFFECTS. 2013 16 2000 28 STRESS MANAGEMENT: A RANDOMIZED STUDY OF COGNITIVE BEHAVIOURAL THERAPY AND YOGA. IN THIS STUDY, A STRESS MANAGEMENT PROGRAM BASED ON COGNITIVE BEHAVIOURAL THERAPY PRINCIPLES WAS COMPARED WITH A KUNDALINIYOGA PROGRAM. A STUDY SAMPLE OF 26 WOMEN AND 7 MEN FROM A LARGE SWEDISH COMPANY WERE DIVIDED RANDOMLY INTO 2 GROUPS FOR EACH OF THE DIFFERENT FORMS OF INTERVENTION; A TOTAL OF 4 GROUPS. THE GROUPS WERE INSTRUCTED BY TRAINED GROUP LEADERS AND 10 SESSIONS WERE HELD WITH EACH OF GROUPS, OVER A PERIOD OF 4 MONTHS. PSYCHOLOGICAL (SELF-RATED STRESS AND STRESS BEHAVIOUR, ANGER, EXHAUSTION, QUALITY OF LIFE) AND PHYSIOLOGICAL (BLOOD PRESSURE, HEART RATE, URINARY CATECHOLAMINES, SALIVARY CORTISOL) MEASUREMENTS OBTAINED BEFORE AND AFTER TREATMENT SHOWED SIGNIFICANT IMPROVEMENTS ON MOST OF THE VARIABLES IN BOTH GROUPS AS WELL AS MEDIUM-TO-HIGH EFFECT SIZES. HOWEVER, NO SIGNIFICANT DIFFERENCE WAS FOUND BETWEEN THE 2 PROGRAMS. THE RESULTS INDICATE THAT BOTH COGNITIVE BEHAVIOUR THERAPY AND YOGA ARE PROMISING STRESS MANAGEMENT TECHNIQUES. 2006 17 500 26 COMBINING GROUP PSYCHOTHERAPY AND YOGA EXERCISES IMPROVES QUALITY OF LIFE IN MENTAL HEALTH PROFESSIONALS: A CONTROLLED RANDOMIZED CLINICAL TRIAL. PURPOSE: THIS STUDY AIMS TO INVESTIGATE THE EFFECTS OF COMBINING 12-WEEK GROUP PSYCHOTHERAPY WITH YOGA EXERCISES ON STRESS PERCEPTION AND QUALITY OF LIFE IN MENTAL HEALTH PROFESSIONALS. DESIGN/METHODOLOGY/APPROACH: THIS STUDY WAS A PARALLEL-ARM RANDOMIZED CONTROLLED TRIAL, IN WHICH THE PARTICIPANTS WAS UNAWARE OF WHICH GROUP WAS THE EXPERIMENTAL ONE. PARTICIPANTS INVOLVED IN OUR RESEARCH WERE ASSIGNED TO TWO GROUPS OF SEPARATE TREATMENT THAT FOLLOWED FOR THREE MONTHS GROUP PSYCHOTHERAPY COMBINED WITH YOGA PROGRAM FOR STRESS MANAGEMENT OR USUAL STRESS COPING STRATEGIES. FINDINGS: THE FINDINGS DID NOT REVEAL A SIGNIFICANT DIFFERENCE IN STRESS PERCEPTION ASSESSED IN THE TWO GROUPS EITHER BEFORE OR AFTER INTERVENTION BUT REVEAL A SIGNIFICANT DIFFERENCE IN THE QUALITY OF LIFE IN THE TWO GROUPS BEFORE AND AFTER THE PSYCHO BEHAVIORAL INTERVENTIONS. ORIGINALITY/VALUE: THE FINDINGS DID NOT REVEAL A SIGNIFICANT DIFFERENCE IN STRESS PERCEPTION ASSESSED IN THE TWO GROUPS EITHER BEFORE OR AFTER INTERVENTION BUT REVEAL A SIGNIFICANT DIFFERENCE IN THE QUALITY OF LIFE IN THE TWO GROUPS BEFORE AND AFTER THE PSYCHO BEHAVIORAL INTERVENTIONS. 2019 18 2222 41 THE IMPACT OF MODIFIED HATHA YOGA ON CHRONIC LOW BACK PAIN: A PILOT STUDY. PURPOSE: THE PURPOSE OF THIS RANDOMIZED PILOT STUDY WAS TO EVALUATE A POSSIBLE DESIGN FOR A 6-WEEK MODIFIED HATHA YOGA PROTOCOL TO STUDY THE EFFECTS ON PARTICIPANTS WITH CHRONIC LOW BACK PAIN. PARTICIPANTS: TWENTY-TWO PARTICIPANTS (M = 4; F = 17), BETWEEN THE AGES OF 30 AND 65, WITH CHRONIC LOW BACK PAIN (CLBP) WERE RANDOMIZED TO EITHER AN IMMEDIATE YOGA BASED INTERVENTION, OR TO A CONTROL GROUP WITH NO TREATMENT DURING THE OBSERVATION PERIOD BUT RECEIVED LATER YOGA TRAINING. METHODS: A SPECIFIC CLBP YOGA PROTOCOL DESIGNED AND MODIFIED FOR THIS POPULATION BY A CERTIFIED YOGA INSTRUCTOR WAS ADMINISTERED FOR ONE HOUR, TWICE A WEEK FOR 6 WEEKS. PRIMARY FUNCTIONAL OUTCOME MEASURES INCLUDED THE FORWARD REACH (FR) AND SIT AND REACH (SR) TESTS. ALL PARTICIPANTS COMPLETED OSWESTRY DISABILITY INDEX (ODI) AND BECK DEPRESSION INVENTORY (BDI) QUESTIONNAIRES. GUIDING QUESTIONS WERE USED FOR QUALITATIVE DATA ANALYSIS TO ASCERTAIN HOW YOGA PARTICIPANTS PERCEIVED THE INSTRUCTOR, GROUP DYNAMICS, AND THE IMPACT OF YOGA ON THEIR LIFE. ANALYSIS: TO ACCOUNT FOR DROP OUTS, THE DATA WERE DIVIDED INTO BETTER OR NOT CATEGORIES, AND ANALYZED USING CHI-SQUARE TO EXAMINE DIFFERENCES BETWEEN THE GROUPS. QUALITATIVE DATA WERE ANALYZED THROUGH FREQUENCY OF POSITIVE RESPONSES. RESULTS: POTENTIALLY IMPORTANT TRENDS IN THE FUNCTIONAL MEASUREMENT SCORES SHOWED IMPROVED BALANCE AND FLEXIBILITY AND DECREASED DISABILITY AND DEPRESSION FOR THE YOGA GROUP BUT THIS PILOT WAS NOT POWERED TO REACH STATISTICAL SIGNIFICANCE. SIGNIFICANT LIMITATIONS INCLUDED A HIGH DROPOUT RATE IN THE CONTROL GROUP AND LARGE BASELINE DIFFERENCES IN THE SECONDARY MEASURES. IN ADDITION, ANALYSIS OF THE QUALITATIVE DATA REVEALED THE FOLLOWING FREQUENCY OF RESPONSES (1) GROUP INTERVENTION MOTIVATED THE PARTICIPANTS AND (2) YOGA FOSTERED RELAXATION AND NEW AWARENESS/LEARNING. CONCLUSION: A MODIFIED YOGA-BASED INTERVENTION MAY BENEFIT INDIVIDUALS WITH CLB, BUT A LARGER STUDY IS NECESSARY TO PROVIDE DEFINITIVE EVIDENCE. ALSO, THE IMPACT ON DEPRESSION AND DISABILITY COULD BE CONSIDERED AS IMPORTANT OUTCOMES FOR FURTHER STUDY. ADDITIONAL FUNCTIONAL OUTCOME MEASURES SHOULD BE EXPLORED. THIS PILOT STUDY SUPPORTS THE NEED FOR MORE RESEARCH INVESTIGATING THE EFFECT OF YOGA FOR THIS POPULATION. 2004 19 198 28 A REGULAR YOGA INTERVENTION FOR STAFF NURSE SLEEP QUALITY AND WORK STRESS: A RANDOMISED CONTROLLED TRIAL. AIMS AND OBJECTIVES: ALTHOUGH MANY STUDIES HAVE ASSESSED THE EFFICACY OF YOGA IN OLDER INDIVIDUALS, MINIMAL RESEARCH HAS FOCUSED ON HOW NURSES USE YOGA TO IMPROVE SLEEP QUALITY AND TO REDUCE WORK STRESS AFTER WORK HOURS. WE USED THE PITTSBURGH SLEEP QUALITY INDEX IN CHINESE AND THE QUESTIONNAIRE ON MEDICAL WORKER'S STRESS IN CHINESE TO DETERMINE THE IMPACT OF YOGA ON THE QUALITY OF SLEEP AND WORK STRESS OF STAFF NURSES EMPLOYED BY A GENERAL HOSPITAL IN CHINA. BACKGROUND: DISTURBANCES IN THE CIRCADIAN RHYTHM INTERRUPT AN INDIVIDUAL'S PATTERN OF SLEEP. STUDY DESIGN: CONVENIENT SAMPLING METHOD. METHODS: ONE HUNDRED AND TWENTY NURSES WERE RANDOMISED INTO TWO GROUPS: A YOGA GROUP AND A NON-YOGA GROUP. THE YOGA GROUP PERFORMED YOGA MORE THAN TWO TIMES EVERY WEEK FOR 50-60 MINUTES EACH TIME AFTER WORK HOURS. THE NG GROUP DID NOT PARTICIPATE IN YOGA. AFTER SIX MONTHS, SELF-REPORTED SLEEP QUALITY AND WORK STRESS WERE COMPARED BETWEEN THE TWO GROUPS, AND THEN WE USED LINEAR REGRESSION TO CONFIRM THE INDEPENDENT FACTORS RELATED TO SLEEP QUALITY. RESULTS: NURSES IN THE YOGA GROUP HAD BETTER SLEEP QUALITY AND LOWER WORK STRESS COMPARED WITH NURSES IN THE NON-YOGA GROUP. THE LINEAR REGRESSION MODEL INDICATED THAT NURSING EXPERIENCE, AGE AND YOGA INTERVENTION WERE SIGNIFICANTLY RELATED TO SLEEP QUALITY. CONCLUSION: REGULAR YOGA CAN IMPROVE SLEEP QUALITY AND REDUCE WORK STRESS IN STAFF NURSES. RELEVANCE TO CLINICAL PRACTICE: THIS STUDY PROVIDES EVIDENCE THAT HOSPITAL MANAGEMENT SHOULD PAY ATTENTION TO NURSE SLEEP QUALITY AND WORK STRESS, THEREBY TAKING CORRESPONDING MEASURES TO REDUCE WORK PRESSURE AND IMPROVE HEALTH OUTCOMES. 2015 20 901 35 EFFECTIVENESS OF A BRIEF ADJUNCTIVE YOGA INTERVENTION FOR SHORT-TERM MOOD AND PSYCHIATRIC SYMPTOM CHANGE DURING PARTIAL HOSPITALIZATION. OBJECTIVE: EVIDENCE CONCERNING THE EFFECTIVENESS OF YOGA IN PARTIAL HOSPITAL PROGRAMS IS LIMITED. YET, PARTIAL HOSPITALS PROVIDE TREATMENT AT A CRITICAL JUNCTURE BY BRIDGING INPATIENT AND OUTPATIENT CARE. THE PRESENT STUDY TESTED THE EFFECTIVENESS OF A SINGLE-SESSION GROUP YOGA INTERVENTION FOR SHORT-TERM MOOD AND PSYCHIATRIC SYMPTOM CHANGE IN PARTICIPANTS ATTENDING A 1- TO 2-WEEK PARTIAL HOSPITAL PROGRAM. METHOD: PARTICIPANTS INCLUDED 104 PARTIAL HOSPITAL PATIENTS WHO PARTICIPATED IN THE SINGLE-SESSION YOGA INTERVENTION AND COMPLETED A MEASURE OF POSITIVE/NEGATIVE AFFECT BEFORE AND AFTER THE GROUP. PARTICIPANTS, AS WELL AS PARTIAL HOSPITAL PATIENTS WHO DID NOT ATTEND THE YOGA INTERVENTION (N = 438), COMPLETED MEASURES OF DEPRESSION AND ANXIETY SYMPTOMS AT ADMISSION AND DISCHARGE FROM THE PROGRAM. AT DISCHARGE, THEY ALSO RATED THEIR PERCEIVED IMPROVEMENT AND THE OVERALL QUALITY OF THE CARE THEY RECEIVED. RESULTS: PARTICIPANTS WHO ATTENDED THE YOGA INTERVENTION EXPERIENCED SIGNIFICANT IMPROVEMENTS IN POSITIVE AND NEGATIVE AFFECT DURING THE GROUP. THEY DID NOT SHOW GREATER IMPROVEMENTS IN SYMPTOMS OF ANXIETY OR DEPRESSION OVER THE COURSE OF TREATMENT COMPARED TO INDIVIDUALS WHO DID NOT ATTEND THE GROUP. YOGA INTERVENTION PARTICIPANTS NONETHELESS GAVE HIGHER RATINGS TO THE QUALITY OF THE CARE THEY RECEIVED. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: FINDINGS DEMONSTRATED THAT ATTENDING A SINGLE YOGA SESSION DURING PARTIAL HOSPITALIZATION WAS ASSOCIATED WITH SHORT-TERM MOOD BENEFITS, AND WITH ENHANCED OVERALL PERCEPTIONS OF TREATMENT. FURTHER RESEARCH IS NEEDED TO DETERMINE THE CONDITIONS UNDER WHICH PARTICIPATION IN YOGA DURING PARTIAL HOSPITALIZATION COULD CONTRIBUTE TO SYMPTOM CHANGE IN THIS CONTEXT. (PSYCINFO DATABASE RECORD (C) 2019 APA, ALL RIGHTS RESERVED). 2019