The Process-Outcome Mindfulness Effects in Trainees (PrOMET) study: protocol of a pragmatic randomized controlled trial

Background Mindfulness has its origins in an Eastern Buddhist tradition that is over 2500 years old and can be defined as a specific form of attention that is non-judgmental, purposeful, and focused on the present moment. It has been well established in cognitive-behavior therapy in the last decades, while it has been investigated in manualized group settings such as mindfulness-based stress reduction and mindfulness-based cognitive therapy. However, there is scarce research evidence on the effects of mindfulness as a treatment element in individual therapy. Consequently, the demand to investigate mindfulness under effectiveness conditions in trainee therapists has been highlighted. Methods/Design To fill in this research gap, we designed the PrOMET Study. In our study, we will investigate the effects of brief, audiotape-presented, session-introducing interventions with mindfulness elements conducted by trainee therapists and their patients at the beginning of individual therapy sessions in a prospective, randomized, controlled design under naturalistic conditions with a total of 30 trainee therapists and 150 patients with depression and anxiety disorders in a large outpatient training center. We hypothesize that the primary outcomes of the session-introducing intervention with mindfulness elements will be positive effects on therapeutic alliance (Working Alliance Inventory) and general clinical symptomatology (Brief Symptom Checklist) in contrast to the session-introducing progressive muscle relaxation and treatment-as-usual control conditions. Treatment duration is 25 therapy sessions. Therapeutic alliance will be assessed on a session-to-session basis. Clinical symptomatology will be assessed at baseline, session 5, 15 and 25. We will conduct multilevel modeling to address the nested data structure. The secondary outcome measures include depression, anxiety, interpersonal functioning, mindful awareness, and mindfulness during the sessions. Discussion The study results could provide important practical implications because they could inform ideas on how to improve the clinical training of psychotherapists that could be implemented very easily; this is because there is no need for complex infrastructures or additional time concerning these brief session-introducing interventions with mindfulness elements that are directly implemented in the treatment sessions.

Achtsamkeitsinterventionen in Ausbildungspsychotherapien: die "Process-Outcome Mindfulness Effects in Trainees (PROMET)-Studie"

Achtsamkeit hat seine Ursprünge in einer über 2500 Jahre alten, östlich-buddhistischen Tradition und kann konzeptualisiert werden als eine spezifische Form der Aufmerksamkeit, die nicht-bewertend, absichtsvoll und auf den aktuellen Moment fokussiert ist. Zentrale Ziel dieser Studie zu identifizieren, ob Übungen mit Achtsamkeitselementen, die zu Beginn von Therapiesitzungen durchgeführt werden, helfen können, den therapeutischen Prozess zu verbessern. Spezifischer werden die Effekte einer kurzen Übung mit Achtsamkeitselementen auf den therapeutischen Prozess und Behandlungserfolg unter Effectiveness-Bedingungen untersucht, die von ambulanten Patienten und Therapeuten gemeinsam zu Beginn jeder Therapiestunde durchgeführt wird. Dabei werden 150 Patienten vor dem Start ihrer therapeutischen Behandlung und nach Abschluss einer sechs Sitzungen andauernden diagnostischen Phase randomisiert auf entweder eine Achtsamkeitsinterventionsgruppe (AIG), eine Kontrollgruppe (KG), die eine Kurzversion von Progressiver Muskelrelaxation (PMR) durchführt, oder auf eine Treatment As Usual (TAU)-Gruppe. Das Studiendesign und erste Ergebnisse einer Vorstudie werden skizziert.

Measurement and correlates of physical activity behavior among older minority women

Research has shown that physical activity serves a preventive function against the development of several major chronic diseases. However, studying physical activity and its health benefits is difficult due to the complexity of measuring physical activity. The overall aim of this research is to contribute to the knowledge of both correlates and measurement of physical activity. Data from the Women On The Move study were used for this study (n = 260), and the results are presented in three papers. The first paper focuses on the measurement of physical activity and compares an alternate coding method with the standard coding method for calculating energy expenditure from a 7-day activity diary. Results indicate that the alternative coding scheme could produce similar results to the standard coding in terms of total activity expenditure. Even though agreement could not be achieved by dimension, the study lays the groundwork for a coding system that saves considerable amount of time in coding activity and has the ability to estimate expenditure more accurately for activities that can be performed at varying intensity levels. The second paper investigates intra-day variability in physical activity by estimating the variation in energy expenditure for workers and non-workers and identifying the number of days of diary self-report necessary to reliably estimate activity. The results indicate that 8 days of activity are needed to reliably estimate total activity for individuals who don't work and 12 days of activity are needed to reliably estimate total activity for those who work. Days of diary self-report required by dimension for those who don't work range from 6 to 16 and for those who work from 6 to 113. The final paper presents findings on the relationship between daily living activity and Type A behavior pattern. Significant findings are observed for total activity and leisure activity with the Temperament Scale summary score. Significant findings are also observed for total activity, household chores, work, leisure activity, exercise, and inactivity with one or more of the individual items on the Temperament Scale. However, even though some significant findings were observed, the overall models did not reveal meaningful associations. ^

Racial Bias in Motor Vehicle Searches: Additional Theory and Evidence

Knowles, Persico, and Todd (2001) develop a model of police search and offender behavior. Their model implies that if police are unprejudiced the rate of guilt should not vary across groups. Using data from Interstate 95 in Maryland, they find equal guilt rates for African-Americans and whites and conclude that the data is not consistent with racial prejudice against African-Americans. This paper generalizes the model of Knowles, Persico, and Todd by accounting for the fact that potential offenders are frequently not observed by the police and by including two different levels of offense severity. The paper shows that for African-American males the data is consistent with prejudice against African-American males, no prejudice, and reverse discrimination depending on the form of equilibria that exists in the economy. Additional analyses based on stratification by type of vehicle and time of day were conducted, but did not shed any light on the form of equilibria that best represents the situation in Maryland during the sample period.

Understanding Racial Segregation: What is known about the Effect of Housing Discrimination

A central purpose of this chapter is to assess whether the available empirical evidence supports the view that current levels of housing discrimination are a significant contributor to residential segregation in U.S. cities and metropolitan areas. Through the course of this chapter, the reader will find that the empirical patterns of racial segregation in the U.S. are often inconsistent the available evidence on housing discrimination. Admittedly, strong evidence exists that both housing discrimination exists today and that housing discrimination throughout much of the Twentieth Century was central to creating the high levels of segregation that we observe in U.S. metropolitan areas today, but the appropriate policy responses may differ dramatically depending upon how these two phenomena are currently interrelated.

Prostate cancer in Texas: Addressing racial and ethnic disparities

Racial disparities in prostate cancer are of public health concern. This dissertation used Texas Cancer Registry data to examine racial disparities in prostate cancer incidence for Texas over the period 1995–1998 and subsequent mortality through the year 2001. Incidence, mortality, treatment, and risk factors for survival were examined. It was found that non-Hispanic blacks have higher incidence and mortality from prostate cancer than non-Hispanic whites, and that Hispanics and non-Hispanic Asians are roughly similar to non-Hispanic whites in cancer survival. The incidence rates in non-Hispanic whites were spread more evenly across the age spectrum compared to other racial and ethnic groups. Non-Hispanic blacks were more often diagnosed at a higher stage of disease. All racial and ethnic groups in the Registry had lower death rates from non-prostate cancer causes than non-Hispanic whites. Age, stage and grade all conferred about the same relative risks of all-cause and prostate cancer survival within each racial and ethnic group examined. Radiation treatment for non-Hispanic blacks and Hispanics did not confer a relative risk of survival statistically significantly different from surgery, whereas it conferred greater survival in non-Hispanic whites. However, non-Hispanic blacks were statistically significantly less likely to have received radiation treatment, while controlling for age, stage, and grade. Among only those who died of prostate cancer, non-Hispanic blacks were less likely to have received radiation than were non-Hispanic whites, whereas among those who had not died, non-Hispanic blacks were more likely to have received this treatment. Hispanics were less likely to have received radiation whether they died from prostate cancer or not. All racial and ethnic groups were less likely than Non-Hispanic whites to have received surgery. Non-Hispanic blacks and Hispanics were more likely than non-Hispanic whites to have received hormonal treatment. The findings are interpreted with caution with regard to the limitations of data quality and missing information. Results are discussed in the context of previous work, and public health implications are pondered. This study confirms some earlier findings, identifies treatment as one possible source of disparity in prostate cancer mortality, and contributes to understanding the epidemiology of prostate cancer in Hispanics. ^

Beyond Racial Precedents: Loving v. Virginia as an Appropriate Legal Model and Strategy for Same-Sex Marriage Litigation

This thesis explores how LGBT marriage activists and lawyers have employed a racial interpretation of due process and equal protection in recent same-sex marriage litigation. Special attention is paid to the Supreme Court's opinion in Loving v. Virginia, the landmark case that declared anti-miscegenation laws unconstitutional. By exploring the use of racial precedent in same-sex marriage litigation and its treatment in state court cases, this thesis critiques the racial interpretation of due process and equal protection that became the basis for LGBT marriage briefs and litigation, and attempts to answer the question of whether a racial interpretation of due process and equal protection is an appropriate model for same-sex marriage litigation both constitutionally and strategically. The existing scholarly literature fails to explore how this issue has been treated in case briefs, which are very important elements in any legal proceeding. I will argue that through an analysis of recent state court briefs in Massachusetts and Connecticut, Loving acts as logical precedent for the legalization of same-sex marriage. I also find, more significantly, that although this racial interpretation of due process and equal protection represented by Loving can be seen as an appropriate model for same-sex marriage litigation constitutionally, questions remain about its strategic effectiveness, as LGBT lawyers have moved away from race in some arguments in these briefs. Indeed, a racial interpretation of Due Process and Equal Protection doctrine imposes certain limits on same-sex marriage litigation, of which we are warned by some Critical Race theorists, Latino Critical Legal theorists, and other scholars. In order to fully incorporate a discussion of race into the argument for legalizing same-sex marriage, the dangers posed by the black/white binary of race relations must first be overcome.

Racial Differences in Homeownership: The Effect of Residential Location

The rate of homeownership among African-American households is considerably lower than white households in American urban areas. This paper examines whether racial differneces in residential location outcomes are among the factors that contribute to the large racial differences in homeownership rates in major US metropolitan areas. Based on the 1985 metropolitan sample of the American Housing Survey for Philadelphia, the paper does not find any evidence that existing racial differences in residential location in Philadelphia decrease the homeownership rate among African Americans. Rather, the empirical evidence suggests that African-American residential location outcomes are associated with lower than expected racial differences in homeownership. Therefore, after controlling for neighborhood, racial differences in homeownership are larger than originally believed, and the ability of racial differences in endowments to explain hoeownership differences is more limited.

Schools and Housing Markets: An Examination of School Segregation and Performance in Connecticut

This paper examines the relationship between house price levels, school performance, and the racial and ethnic composition of Connecticut school districts between 1995 and 2000. A panel of Connecticut school districts over both time and labor market areas is used to estimate a simultaneous equations model describing the determinants of these variables. Specifically, school district changes in price level, school performance, and racial and ethnic compositions depend upon each other, labor market wide changes in these variables, and the deviation of each school district from the overall metropolitan area. The specification is based on the differencing of dependent variables, as opposed to the use of level or fixed effects models and lagging level variables beyond the period over which change is considered; as a result the model is robust to persistence in the sample. Identification of the simultaneous system arises from the presence of multiple labor market areas in the sample, and the assumption that labor market changes in a variable due not directly influence the allocation of households across towns within a labor market area. We find that towns in labor markets that experience an inflow of minority households have greater increases in percent minority if those towns already ahve a substantial minoritypopulation. We find evidence that this sorting proces is reflected in housing price changes in the low priced segment of the housing market, not in the middle and upper segments.

The Continuing Practice and Impact of Discrimination

This chapter provides a detailed discussion of the evidence on housing and mortgage lending discrimination, as well as the potential impacts of such discrimination on minority outcomes like homeownership and neighborhood environment. The paper begins by discussing conceptual issues surrounding empirical analyses of discrimination including explanations for why discrimination takes place, defining different forms of discrimination, and the appropriate interpretation of observed racial and ethnic differences in treatment or outcomes. Next, the paper reviews evidence on housing market discrimination starting with evidence of segregation and price differences in the housing market and followed by direct evidence of discrimination by real estate agents in paired testing studies. Finally, mortgage market discrimination and barriers in access to mortgage credit are discussed. This discussion begins with an assessment of the role credit barriers play in explaining racial and ethnic differences in homeownership and follows with discussions of analyses of underwriting and the price of credit based on administrative and private sector data sources including analyses of the subprime market. The paper concludes that housing discrimination has declined especially in the market for owner-occupied housing and does not appear to play a large role in limiting the neighborhood choices of minority households or the concentration of minorities into central cities. On the other hand, the patterns of racial centralization and lower home ownership rates of African-Americans appear to be related to each other, and lower minority homeownership rates are in part attributable to barriers in the market for mortgage credit. The paper presents considerable evidence of racial and ethnic differences in mortgage underwriting, as well as additional evidence suggesting these differences may be attributable to differential provision of coaching, assistance, and support by loan officers. At this point, innovation in loan products, the shift towards risk based pricing, and growth of the subprime market have not mitigated the role credit barriers play in explaining racial and ethnic differences in homeownership. Further, the growth of the subprime lending industry appears to have segmented the mortgage market in terms of geography leading to increased costs of relying on local/neighborhood sources of mortgage credit and affecting the integrity of many low-income minority neighborhoods through increased foreclosure rates.

Redlining, the Community Reinvestment Act, and Private Mortgage Insurance

This paper examines whether neighborhood racial or income composition influences a lender's treatment of mortgage applications. Recent studies have found little evidence of differential treatment based on either the racial or income composition of the neighborhood, once the specification accounts for neighborhood risk factors. This paper suggests that lenders may favor applicants from CRA-protected neighborhoods if they obtain Private Mortgage Insurance (PMI) and that this behavior may mask lender redlining of low income and minority neighborhoods. For loan applicants who are not covered by PMI, this paper finds strong evidence that applications for units in low-income neighborhoods are less likely to be approved, and some evidence that applications for units in minority neighborhoods are less likey to be approved, regardless of the race of the applicant. This pattern is not visible in earlier studies because lenders appear to treat applications from these neighborhoods more favorably when the applicant obtains PMI.

Na 1 Nachlass Max Horkheimer, 687 - "Experimental Movie Project", "The Police and Minority Groups" u.a. (p. IX 150.1-17 - IX 152.1-2)

"Experimental Movie Project" (1945-46):; 1. "Below the Surface", Drehbuch des Testfilms, a) als Typoskript vervielfältigt, 46 Blatt, b) als Typoskript vervielfältigt, 26 Blatt, c) als Typoskript vervielfältigt, 26 Blatt, d) als Typoskript vervielfältigt, 26 Blatt "Experimental Movie Project" (1945-46): Memoranden zum Test; 2. 'Notes' 25.4.1946, Typoskript, 1 Blatt; 3. "Memorandum on Experimental Movie Project", 19.4.1946. Typoskript, 3 Blatt; 4. "Memorandum re: 'Below the Surface" (Juli 1945). Typoskript, 2 Blatt; 5. Dore Schary und Allen Rivkin: 'Memorandum, Subject: New Suggested Treatment for 'Below the Surface'", 13.7.1945. Typoskript, 2 Blatt; 6. Hans Richter: "Report about the film script 'Below the surface'", 7. u. 8.7.1945, a) Typoskript, 1 Blatt, b) Typoskript, 1 Blatt; 7. Hans Richter: Bestätigung der Vereinbarung mit dem American Jewish Committee, 3.7.1945. Typoskript, 1 Blatt; 8. "Notes and Suggestions re Experimental Motion Picture", Juni 1945. Typoskript, 2 Blatt; 9. Siegfried Kracauer; "Suggestions for the Dialogue" (4.4.1945). Typoskript, 3 Blatt; 10. "Motion Picture", März 1945. Typoskript, 5 Blatt; 11. "Project on a Test film", a) Typoskript, 4 Blatt, b) Typoskript, 5 Blatt; 12. "Memorandum re: 'Below the Surface'", a) Typoskript, 3 Blatt, b) Typoskript mit eigenhändigen Korrekturen von Theodor W. Adorno, 3 Blatt; "Experimental Movie Project" (1945-46): Korrespondenz zum Test-Film-Projekt:; 13. Friedrich Pollock: 1 Brief an Max Horkheimer, Santa Monica, California, 12.10.1945; 14. Theodor W. Adorno: 2 Briefe an Max Horkheimer, Los Angeles und Santa Monica, California, 1945; 15. Joseph M. Proskauer: 1 Brief von Max Horkheimer, o.O., 29.6.1945, 1 Brief mit Unterschrift an Max Horkheimer, o.O., o.D., 3 Blatt; 16. Alexander Hackenschmied, 1 Brief mit Unterschrift an Max Horkheimer, New York, 19.6.1945, 1 Blatt; 17. Gilbert Gabriel: 1 Brief von John Slawson, o.O., 22.3.1945, 2 Blatt; "The Police and Minority Groups" (1946):; 1. "The Police and Minority Groups". Typoskript, 2 Blatt; 2. Robert W. Kenny: "Police and Minority Groups - an Experiment". Als Typoskript vervielfältigt, 17 Blatt; 3. Davis McEntire, Robert B. Powers: "Police Training Bulletin. A Guide to Race Relations for Police Officers", State of California, 1946, 38 Seiten; Max Horkheimer: "Memorandum on a Study of Race Hatred in Post-War Germany" (1946):; 1. Memorandum, a) Typoskript, 8 Blatt, b) Typoskript mit eigenhändigen und handschriftlichen Korrekturen, 6 Blatt, c) Typoskript, 5 Blatt, d) Teilstück, Typoskript mit eigenhändigen Korrekturen, 1 Blatt e) Typoskript mit eigenhändigen Korrekturen, 5 Blatt, f) Teilstück, Typoskript mit handschriftlichen Korrekturen, 2 Blatt, g) Typoskript mit eigenhändigen Korrekturen, 7 Blatt, h) Teilstück, Typoskript mit eigenhändigen Korrekturen und Ergänzungen, 1 Blatt, i) Typoskript, 2 Blatt; 2. Theodor W. Adorno: "Ad Memorandum Neumann", Manuskript, 3 Blatt;