Objectives: The objectives of this study were to assess the general acceptability and to assess domains of potential effect of a mindfulness-based stress reduction (MBSR) program for human immunodeficiency virus (HIV)-infected and at-risk urban youth. Methods: Thirteen-to twenty-one-year-old youth were recruited from the pediatric primary care clinic of an urban tertiary care hospital to participate in 4 MBSR groups. Each MBSR group consisted of nine weekly sessions of MBSR instruction. This mixed-methods evaluation consisted of quantitative data-attendance, psychologic symptoms (Symptom Checklist 90-Revised), and quality of life (Child Health and Illness Profile-Adolescent Edition)-and qualitative data-in-depth individual interviews conducted in a convenience sample of participants until interview themes were saturated. Analysis involved comparison of pre-and postintervention surveys and content analysis of interviews. Results: Thirty-three (33) youth attended at least one MBSR session. Of the 33 who attended any sessions, 26 youth (79%) attended the majority of the MBSR sessions and were considered ''program completers.'' Among program completers, 11 were HIV-infected, 77% were female, all were African American, and the average age was 16.8 years. Quantitative data show that following the MBSR program, participants had a significant reduction in hostility ( p ¼ 0.02), general discomfort ( p ¼ 0.01), and emotional discomfort ( p ¼ 0.02). Qualitative data (n ¼ 10) show perceived improvements in interpersonal relationships (including less conflict), school achievement, physical health, and reduced stress. Conclusions: The data suggest that MBSR instruction for urban youth may have a positive effect in domains related to hostility, interpersonal relationships, school achievement, and physical health. However, because of the small sample size and lack of control group, it cannot be distinguished whether the changes observed are due to MBSR or to nonspecific group effects. Further controlled trials should include assessment of the MBSR program's efficacy in these domains.

Epidemiologic studies provide estimates of the scope and distribution of the public health problems posed by migraine. These studies have been facilitated by the development of the International Headache Society criteria for migraine, which have now been used in separate prevalence studies in several countries. In this article, we review some of the methodological challenges in studying migraine epidemiology, report recent results from studies using IHS criteria, and suggest directions for future research.

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The aim of this study was to evaluate the association of parent-reported barriers on the likelihood of attending a mental health evaluation after referral from pediatric primary care. As the part of procedure, parents of children (N = 55) referred for mental health from primary care completed a 23-item questionnaire (three subscales; Cronbach alpha > 0.7): intangible barriers, tangible barriers, and child functioning. Logistic regression examined associations between responses and referral follow-through. The results showed that the high levels of intangible barriers were associated with decreased odds of attending the mental health evaluation (OR = 0.20, 0.06-0.83; P = 0.03). Therefore, we conclude that parental concerns about mental health care may be important for engagement in treatment.