Significant weight loss was documented among participants in mindfulness interventions for 13 of the 19 studies identified for review. However, studies do not clarify the degree to which changes in mindfulness are a mechanism responsible for weight loss in mindfulness interventions. Methodological weaknesses and variability across studies limit the strength of the evidence. Further research is needed to document and evaluate the psychological, behavioral, and biological mechanisms involved in the relationship between mindfulness and weight loss.

Burnout has high costs for pediatricians and their patients. There is increasing interest in educational interventions to promote resilience and minimize burnout among pediatric trainees. This study tested a conceptual model of factors that might promote resilience and protect against burnout, and which could serve as targets for addressing burnout in pediatric residents. Questionnaires were administered in a cross-sectional survey of (n = 45) first-year pediatric and medicine-pediatric residents. A minority (40%) of residents met one or more criteria for burnout. Physician empathy and emotional intelligence were not significantly correlated with burnout or resilience. Self-compassion and mindfulness were positively associated with resilience and inversely associated with burnout. Thus many residents in this sample endorsed burnout; mindfulness and self-compassion were associated with resilience and may promote resilience and protect against burnout in these trainees. Future studies should explore the impact of training in mindfulness and self-compassion in pediatric trainees.

We explored the relationships between potentially modifiable factors (mindfulness and self-compassion), intermediate factors (resilience and stress), and outcomes of interest in a cross-sectional study of medical trainees (compassionate care and clinician well-being). Among the 12 participants, the average age was 27.6 years. Mindfulness and self-compassion were positively associated with confidence in providing calm, compassionate care (r ¼ 0.91 and 0.81, respectively; P < .01); they were also positively correlated with clinician resilience (P < .01), which was correlated with clinician mental health (r ¼ 0.83; P < .01). Perceived stress was strongly and significantly negatively correlated with all measures (rs ranging from -0.62 for flourishing to -0.92 for confidence in delivering calm, compassionate care; P < .05 for all correlations). Given the positive correlations between mindfulness and self-compassion with both clinician well-being and confidence in providing calm, compassionate care, interventional studies are warranted to determine what kind of training most efficiently and effectively improves trainee mindfulness and self-compassion. Effective patient-centered health care relies on the ability to be calm and compassionate, effectively comforting distressed patients in the face of sometimes stressful circumstances. Stress is ubiquitous in health care, particularly in times of rapid change in which physicians experience a diminished sense of control. Stress can increase psychological distress, 1-3 adversely affect attention 4 and concentration, 5 and impair decision making.6,7Stress also may lead to increased burnout, 8 which is associated with poor quality of care. 9,10 To improve the quality of care and clinician well-being, a growing number of programs aim to improve clinician mindfulness and/or compassion for self and others.11-15 An early study by Shapiro and colleagues 13 found that an 8-week mindfulness-based stress reduction program was associated with decreases in anxiety and distress and increases in empathy among premedical and medical students. Another effective mindfulness-based communication program involved an intensive 8-week phase of 2.5-hour weekly in-person group meetings followed by a 10-month maintenance phase of 2.5 hours per month.12 A briefer intervention at the University of Wisconsin was evaluated with 30 primary care clinicians using a pre/post training design; in this pilot study, 18 hours of mindfulness training were followed by significant decreases in burnout, depression, anxiety, and perceived stress, without changes in resilience or compassion. 16 Nurses and psychologists, too, have benefited from mindfulness and self-compassion training in small studies evaluating the effect on burnout. 17,18Before offering in-person or online training to our trainees, we wanted to test a conceptual model relating potentially trainable qualities to stress, resilience, and confidence in the ability to provide calm, comforting care. Were mindfulness and selfcompassion associated ...

BACKGROUND/OBJECTIVES Prior research indicates that features of the home environment (for example, televisions, exercise equipment) may be associated with obesity, but no prior study has examined objective features of the home food environment (for example, location of food) in combination with behavioral (for example, food purchasing), psychological (for example, self-efficacy) and social factors among obese adults. This study identified factors associated with obesity status from measures of home environment, food purchasing behavior, eating behavior and psychosocial functioning. SUBJECTS/METHODS One hundred community-residing obese (mean body mass index (BMI) = 36.8, s.e. = 0.60) and nonobese (mean BMI = 23.7, s.e. = 0.57) adults (mean age = 42.7, s.e. = 1.50; range = 20–78 years) completed an observational study with 2-h home interview/assessment and 2-week follow-up evaluation of food purchases and physical activity. Data were analyzed with analysis of variance and logistic regression, controlling for sex. RESULTS Univariate analyses revealed that homes of obese individuals had less healthy food available than homes of nonobese (F(1,97) = 6.49, P = 0.012), with food distributed across a greater number of highly visible locations (F(1,96) = 6.20, P = 0.01). Although there was no group difference in household income or size, obese individuals reported greater food insecurity (F(1,97) = 9.70, P < 0.001), more reliance on fast food (F(1,97) = 7.63, P = 0.01) and more long-term food storage capacity in number of refrigerators (F(1,97) = 3.79, P = 0.05) and freezers (F(1,97) = 5.11, P = 0.03). Obese individuals also reported greater depressive symptoms (F(1,97) = 10.41, P = 0.002) and lower ability to control eating in various situations (F(1,97) = 20.62, P < 0.001). Multiple logistic regression revealed that obesity status was associated with lower self-esteem (odds ratio (OR) 0.58, P = 0.011), less healthy food consumption (OR 0.94, P = 0.048) and more food available in the home (OR 1.04, P = 0.036). CONCLUSIONS The overall pattern of results reflected that home food environment and psychosocial functioning of obese individuals differed in meaningful ways from that of nonobese individuals. In particular, lower self-esteem may be an important psychosocial aspect of obesity, especially in the context of greater food consumption and food storage/availability.