Abstract Background Evidence for the longer-term benefits of online mindfulness training for medical students, including in the reduction of stress and improved wellbeing, is limited. This study aimed to evaluate the impact of a novel online mindfulness training program on trait mindfulness, wellbeing and study engagement of medical students at program completion and 6-month follow-up. Methods This was a randomised waitlist control study of an 8-week, online, mindfulness-based intervention versus normal curriculum alone for medical students (N = 114). The primary outcome measures were the changes from baseline to program completion at Week 8 for self-reported trait mindfulness (Freiburg Mindfulness Inventory), perceived stress (Perceived Stress Scale), self-compassion (Self-Compassion Scale) and study engagement scores (Utrecht Work Engagement Scale for Students). The secondary outcome measures were these score changes from baseline to 6-month follow up. Intervention and control students completed surveys at all three time points. Program adherence (Mindfulness Adherence Questionnaire) was also measured in the intervention group. Results The intervention group experienced modest but statistically significant improvements in mindfulness (9%, p = 0.0002), self-compassion (5%, p = 0.026), and study engagement (4%, p = 0.035) from baseline to Week 8. They also reported a sustained improvement of 5% (p = 0.017) in mindfulness scores at 6 months. The control group reported no significant changes at Week 8 or 6 Months. Between-group comparisons showed that compared to the control group, the intervention group improved significantly more in mindfulness (p = 0.0076), and statistically marginally more in study engagement (p = 0.0534) at Week 8. No statistically significant between-group differences were observed at 6 months. Conclusions These results add to the small but growing body of evidence suggesting that online mindfulness-based interventions with minimal contact can improve, albeit in modest magnitude, mindfulness and possibly study engagement in medical students for the duration of a mindfulness program. Further refinements to the program may be important to maintain improvements in the longer-term. Trial registration Registration number ACTRN12624000783527.

Introduction: Student wellbeing is a growing concern for physiotherapy and other health professional students, with potential impacts on academic success, patient care and future personal wellbeing. The purpose of this study was to determine the predictors of future stress, anxiety, depression, study engagement and academic performance in physiotherapy students, including a subgroup who undertook a mindfulness training program. Methods: Predictors of outcome were obtained from a prospective cohort study involving 83 penultimate-year physiotherapy students, who could volunteer to participate in a 6-week mindfulness training program during semester (n = 17) or complete outcome measures without mindfulness training (n = 66). Baseline predictors of outcome were obtained at the start of Semester 1: age, gender, trait mindfulness, study engagement, training (mindfulness training or no training), stress, anxiety and depression. Outcomes were measured at the end of Semester 1 (study engagement, stress, anxiety, depression, grade point average) and at the end of the course (grade point average). Multiple regression was used to determine the ability of baseline characteristics to predict outcomes. Results: Psychological distress (stress, anxiety and depression) increased across the full study cohort between the start and end of the semester as exams approached (p <.05). Completion of mindfulness training was significantly associated with better academic performance and lower levels of depression at follow-up. Female gender, lower baseline depression scores and higher study engagement were also significant predictors of superior academic performance, while older age and higher trait mindfulness predicted greater study engagement at end of semester (p <.05). Conclusions: Potentially modifiable factors (study engagement, depression and mindfulness training) were associated with future wellbeing and academic success in physiotherapy students. Further research is warranted to explore interventions to address these outcomes in randomised controlled trials.

Anger is a common behaviour exhibited by road users when one's goals are perceived to have been blocked by another. Recent research has demonstrated that, generally, cyclists tend to deal with anger in constructive ways. However, when anger does manifest, it can result in behaviours that increase their crash risk. Amongst motor vehicle drivers, mindfulness levels have been associated with less anger and appear to mediate anger and associated aggression. The current study sought to understand whether mindfulness has similar associations with anger and aggression in a sample of cyclists. A total of 583 cyclists (males = 68 %) completed an online questionnaire that sought information on their levels of mindfulness, current mindfulness practices and tendencies for anger and aggression while cycling. The relationships between these were then examined using structural equation modelling. The results showed that cyclists with higher mindfulness levels tended to report less anger across a range of situations (e.g., interactions with pedestrians, cyclists, motor vehicle drivers and police). Both direct and indirect (through anger) relationships were found between mindfulness and aggression, again showing that more mindful cyclists tended to engage in less frequent aggression. These findings align with recent research investigating this relationship amongst motor vehicle drivers and suggest that mindfulness may be a promising strategy to reduce or avoid anger and aggression in cyclists.

Introduction: Medical students experience high levels of psychological distress and are at risk for depression, burnout and suicidal ideation. To address these issues, the mindfulness-based Health Enhancement Program (HEP) forms part of the MBBS (Bachelor of Medicine) at Monash University. This pilot study investigated the relationship between amount of mindfulness practice and measures of mental health, study engagement and dispositional mindfulness. We also sought to understand how "Big Five" personality traits predicted engagement with the intervention. Methods: From an eligible cohort of 322 MBBS students, 37 (24 females, 13 males; aged 17 to 20) provided pre-and post-intervention responses. Participants completed the International Personality Item Pool (IPIP-100) pre-intervention and the Freiburg Mindfulness Inventory (FMI), Depression and Anxiety Scale Stress Scale (DASS-21) and the student version of the Utrecht Work Engagement Scale (UWES-S) pre-and post-intervention. Evaluation: Results indicated that both dispositional mindfulness and study engagement increased from pre-to post-intervention. Results also indicated no increase in depression, anxiety and stress from mid-semester to exam periods. Amount of mindfulness meditation was positively related to agreeableness. Conclusions: These results suggest that individuals who score higher in agreeableness may engage most with mindfulness programs, which may be protective for mental health. However, the conclusions of the study are limited by a small sample size and lack of control group.

Anger and aggression on the roads is associated with how drivers evaluate the driving situation and the behaviour of other drivers. Consequently, both can be exacerbated when these evaluations are made superficially and/or when drivers have pre-existing negative schemas regarding certain types of road situations or users. Mindfulness is likely to have negative associations with anger and aggression because it promotes opposing appraisals. That is, it encourages emotion-regulation and involves acceptance of, but not reaction to, the current situation. To examine these associations, a total of 309 drivers responded to an online questionnaire assessing mindfulness, driving anger and aggressive driving. The results showed that mindfulness shared negative relationships with driving anger and self-reported aggressive driving. However, when these relationships were examined simultaneously using Structural Equation Modelling, mindfulness was found to relate only to anger and this, in turn, predicted aggressive driving. Further analysis showed that driving anger mediates the relationship between mindfulness and aggressive driving. These results suggest that mindfulness training may provide a promising intervention for drivers prone to driving anger and subsequent aggression. (C) 2018 Elsevier Ltd. All rights reserved.

BACKGROUNDSleep disorders represent an under-recognised public health problem and are reported to be under-diagnosed in general practices.AIMSTo examine general practitioners' (GPs) attitude, knowledge and practice behaviour and identify barriers to detection, diagnosis and treatment of sleep disorders encountered in the Australian primary care setting.METHODUsing mixed methods, quantitative data from the Dartmouth Sleep Knowledge Questionnaire (DSKQ) were analysed using MS Excel 2007. Qualitative data were obtained from one focus group and eight interviews. Data were thematically analysed.RESULTS15 GPs participated; seven in a focus group and eight in interviews. Scores from DSKQ suggest gaps in GPs' knowledge. Qualitative analysis revealed that patients frequently presented with sleep disorders underpinned by mental health disorders. GPs agreed that prescribing pharmacological interventions was undesirable and behavioural interventions were preferred. Barriers included limited training for GPs, lack of resources, patient expectations and willingness to engage in lifestyle changes, and consultation time constraints.DISCUSSIONGreater flexibility to investigate sleep related problems within the standard consultation and improved access to educational activities could assist GPs. Patient factors, such as adherence to management strategies, are paramount to successful management of sleep disorders; however, these obstacles to clinical practice may be difficult to overcome.CONCLUSIONProviding education for GPs about sleep disorders, greater flexibility within consultations may improve patient care and patient engagement in management strategies may assist, yet a critical success factor in disease management includes patient engagement in management strategies.

Caring for the environment is not usually seen as the core business of a medical practitioner but 'doctors for the environment' disagree. It seems that the laws that rule the planet are the same as those that rule our health. (non-author abstract)

The author discusses the topic of gender related response to stress and the questions: Is the fight-or-flight response the only stress response? Who would say that ?submissiveness? is good for the health of a woman? Are the biological and behavioural natures of men and women competitive or complementary? (non-author abstract)

The author discusses the different forms of scepticism and the importance of a healthy form of scepticism. (non-author abstract)

The author discusses the notion of moderation and the concept of balance in the environment and the individual. (non-author abstract)

The discussion starts with a consideration of the management of infertility and finishes with a consideration about what life is and where it begins. (non-author abstract)

The author asks that maybe we could consider the possibility that true ethical principles do not conflict with each other but rather our limited and superficial understanding creates conflict where it does not exist. (non-author abstract)

BACKGROUND:The beneficial effect of humour on health has long been recognised anecdotally and intuitively but studying and quantifying that effect is difficult. 'Studying humour is like dissecting a frog--you may know a lot but you end up with a dead frog.' (Mark Twain)OBJECTIVE:To describe some of the psychological and physiological effects of laughter and the health benefits of humour.DISCUSSION:Stress reduction has been shown to improve outcomes in the treatment of many health problems. While there are inherent difficulties in structuring studies to assess the impact of humour and laughter on health, positive psychological and physiological responses to laughter have been demonstrated in a variety of settings. In particular, laughter has a role in stress hormone reduction, improving mood, enhancing creativity, pain reduction, improving immunity and reducing blood pressure.