Please select the eligibility criteria that correspond to the clinical trial below.
Title: Mindfulness Training to Improve Mental Health, Stress and Performance In Physicians
Brief Summary: Background:

Burnout and overwhelming stress are growing issues among surgeons and are associated with mental illness, attrition and diminished patient care. Among surgical trainees, burnout and distress are alarmingly prevalent but high inherent mindfulness has been shown to decrease the risk of depression, suicidal ideation, burnout and overwhelming stress by more than 75%. In other high-stress populations formal mindfulness training has been shown to improve mental health and buffer overwhelming stress and yet this approach has not been tried in surgery.

The aim of this study is to evaluate feasibility and acceptability of modified mindfulness-based stress reduction (MBSR) training among PGY-1 surgery residents and to obtain initial evidence of efficacy in regard to well-being and performance.

Design: A pilot randomized clinical trial of modified MBSR versus an active control.

Setting: Residency training program, tertiary academic medical center.

Participants: PGY-1 surgery residents.

Intervention:

Weekly two-hour modified MBSR classes (compared to an active control) and 20 minutes of suggested daily home practice over an eight-week period.

Main Outcomes and Measures:

Primary outcome is feasibility, assessed along six domains (demand, implementation, practicality, acceptability, adaptation and integration), using focus groups, interviews, surveys, attendance, daily practice time and subjective self-report of experience.

Secondary outcomes include perceived stress, mindfulness and executive function (specifically working memory capacity), followed by psychosocial well-being (burnout, depression, resilience), performance (motor skills testing) and functional brain scans focused on areas associated with reappraisal as a surrogate for emotional control.

This study seeks to demonstrate the feasibility of mindfulness training in surgery PGY-1s while simultaneously providing preliminary quantitative data on the effects of mindfulness training in a randomized, controlled setting. Data will inform modifications to the MBSR curriculum that enhance feasibility and inform sample size calculations for subsequent, adequately-powered RCTs which will likely need to be multi-center trials.

Results could potentially impact formal medical training, the mental health of providers at every level, and the overall quality of patient care.


Options:
A: Inclusion Criteria:

* aged 18 years and older
* currently smoking at least one cigarette per day in the past 30 days
* Hong Kong residents
* able to communicate in Cantonese
* currently residing in Hong Kong and expecting to continue to do so for the next 6 months
* have access to a telephone

Exclusion Criteria:

* currently undergoing another smoking cessation or similar program
B: Inclusion Criteria:

* Smoke 5+ cigarettes/day
* \< 3 months abstinence in the past year
* Have a smartphone
* Score greater than or equal to 8 of 10 on the Contemplation Ladder (Biener \& Abrams, 1991)

Exclusion Criteria:

* None
C: Inclusion Criteria:

* UCSF surgical interns entering training. Do not meet exclusion criteria.

Exclusion Criteria:

* Current personal mindfulness practice, medications with CNS effects, lifetime history of a mental disorder, acute or chronic immune or inflammatory disorders, pregnancy, breast-feeding or implanted MRI-incompatible metal.
D: Inclusion Criteria:

1. aged 18 years or above;
2. diagnosed with schizophrenia;
3. referred by medical doctors;
4. currently smoking, i.e. have at least one cigarette per day in the past month,
5. willing to take part in a face-to-face individual intervention program in changing smoking behaviors such as smoking cessation, reduction of cigarette consumed, or the relief of withdrawal symptoms.
6. able to communicate in Cantonese.

Exclusion Criteria:

1. disorientation, developmental disabilities, and/or organic conditions that will inhibit his/her understanding and participation in the therapeutic process,
2. diagnosis of alcohol or drug dependence in the preceding year of recruitment or,
3. medication regime revised in the last 3 months or,
4. current participation in another smoking cessation program.

Answer: C