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Mindfulness in Higher Education: Awareness and Attention in University Students Increase During and After Participation in a Mindfulness Curriculum Course

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This study assessed the effects of a mindfulness course in the curriculum of international students (n = 104) from 16 different countries at the University of Amsterdam. The curriculum consisted of seven weekly lectures, as well as studying scientific articles on mindfulness research and gaining some experiential learning in meditating. The primary goal of this course was not to become more mindful, but to learn about the origins and the applications of mindfulness in (child) psychiatry. Students filled in the Five Facet Mindfulness Questionnaire (FFMQ) at “wait-list,” pre-course, post-course, and at 7 weeks follow-up. Multilevel analyses showed that mindful awareness decreased during wait-list (d = −0.11), increased from pre-course to post-course (d = 0.36), and even more so from pre-course to follow-up (d = 0.53). Differential effects for students from within and outside the Netherlands are discussed as well as for “meditator” versus “novice” students. International students and meditators showed an increase in mindfulness already during the course, whereas Dutch students and novices only reported an increase in mindfulness at follow-up. Overall, participation in a low-intensity mindfulness course in a university’s curriculum leads to an increased non-judgmental and non-reactive stance towards student’s thoughts, feelings, and emotions, during the course period, and their mindfulness increased even further after the course period. This increased mindfulness may help them in coping with stress given the pressure they are under and may improve their performance and their quality of life.
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ORIGINAL PAPER
Mindfulness in Higher Education: Awareness and Attention
in University Students Increase During and After Participation
in a Mindfulness Curriculum Course
Esther I. de Bruin & Renée Meppelink & Susan M. Bögels
#
Springer Science+Business Media New York 2014
Abstract This study assessed the effects of a mindfulness
course in the curriculum of international students (n=104)
from 16 different countries at the University of Amsterdam.
The curriculum consisted of seven weekly lectures, as well as
studying scientific articles on mindfulness research and
gaining some experiential learning in meditating. The primary
goal of this course was not to become more mindful, but to
learn about the origins and the applications of mindfulness in
(child) psychiatry. Students filled in the Five Facet
Mindfulness Questionnaire (FFMQ) at wait-list, pre-course,
post-course, and at 7 weeks follow-up. Multilevel analyses
showed that mindful awareness decreased during wait-list (d=
0.11), increased from pre-course to post-course (d=0.36),
and even more so from pre-course to follow-up (d=0.53).
Differential effects for students from within and outside the
Netherlands are discussed as well as for meditator versus
novic e students. Int erna tional s tudents and meditators
showed an increase in mindfulness already during the course,
whereas Dutch students and novices only reported an increase
in mindfulness at follow-up. Overall, participation in a low-
intensity mindfulness course in a universityscurriculumleads
to an increased non-judgmental and non-reactive stance to-
wards students thoughts, feelings, and emotions, during the
course period, and their mindfulness increased even further
after the course period. This increased mindfulness may help
them in coping with stress given the pressure they are under
and may improve their performance and their quality of life.
Keywords Mindfulness
.
University students
Introduction
University students show a very high rate of stress, anxiety,
and depression. For instance, at the University of Michigan,
the estimated prevalence of a depressive or anxiety disorder
was 15.6 % for undergraduates and 13 % for graduate students
(Eisenberg, Gollust, Golberstein, and Hefner 2007). To com-
pare, major depressive disorder has a 12-month prevalence of
6.7 % in the US general adult population (Kessler, Chiu,
Demler, and Walters 2005). According to a national survey
by the American College Health Association, 10 % of the
students reported to seriously consider attempting suicide. It
is clear that (university) students face a high stress load which
creates a need for time-out moments, for calm, for relaxation,
and for present-moment awareness in their hectic lives.
Mindfulness could be a helping aid for surviving in this frantic
world of a twenty-first century student. This study assessed
the effects of a mindfulness curriculum course on the mindful
awareness and attention of university students.
Despite the plethora of studies into the effects of mindful-
ness training in clinical and non-clinical populations, only a
few studies of mindfulness in higher education are available.
Collard, Avny, and Boniwell (2009)includedan8-weekex-
periential mindfulness-based cognitive therapy (MBCT)
course in the curriculum of psychotherapy students (n=15)
of the University of East London. A pre-post test design
showed a significant increase in mindfulness after the course.
Further, the 8-week Mindf ulness-Based Coping with
University Life (MBCUL) was developed for stressed stu-
dents at the University of Northampton and a pilot study
E. I. de Bruin (*)
:
R. Meppelink
:
S. M. Bögels
Research Institute of Child Development and Education (RICDE),
Research Priority Area Yield, University of Amsterdam, Nieuwe
Achtergracht 127, 1018 WS Amsterdam, The Netherlands
e-mail: e.i.debruin@uva.nl
Mindfulness
DOI 10.1007/s12671-014-0364-5
showed lowered stress, anxiety, and depression as well as an
increase in mindfulness in students that took part in this course
(n=10) as compared to those who were on the wait-list (n=6)
(Lynch, Gander, Kohls, Kudielka, and Walach 2011). A recent
RCT in a sample of stressed university students and young
adults (n=76) showed that 6 weeks of daily meditations, daily
physical exercises, or daily biofeedback were equally effective
in the reduction of stress, anxiety, and depression and in the
improvement of psychological well-being and sleep quality
(Van der Zwan, de Vente, Huizink, Bögels, and de Bruin
2014).
Apart from these mindfulness-related interventions for
(stressed) students, we are aware of a few universities where
the study and practice of mindfulness is actually integrated in
the curriculum. At the University of Oxford, UK, a 2 year
masters degree is offered in MBCT. In line, at the Lesley
University of Massachusetts, USA, a 2 year master of arts in
mindfulness studies is offered. And at the University of
Sapienza, Rome, Italy, a 1-year curriculum that fully focuses
on different aspects of mindfulness is available. These three
examples are high-intensity courses. In the current study, we
assessed the effects of a low-intensity 7-week mindfulness
curriculum course (in which students mainly attended lectures
about mindfulness, not an experiential course such as
mindfulness-based stress reduction (MBSR) or MBCT) for
international university students on their level of mindful
awareness and attention.
Method
Participants
Bachelor students from the University of Amsterdam were the
participants in this study (n=104,n=92 females). Average age
of the students was 22.5 years (SD=2.8). Since the mindful-
ness course was an international course in the curriculum,
students from 16 different countries participated: Bulgaria,
n =1; China, n =2; Costa Rica, n =2; Curacao, n =2;
Denmark, n=2; Germany, n=3, Great Britain, n=1; Greece,
n=1; Hungary, n=1; Iceland, n=1; Italy, n=2; Norway, n=1;
South-Africa, n=3; the Netherlands, n=66; Turkey, and n=1;
USA, n=15. Overall, 63.5 % of the students were of Dutch
origin.
Procedure
Six weeks before the course started, a wait-list (T0) mea-
surement took place, 1 week before start of the mindfulness
course pre-course assessment (T1) took place, immediately
after the 7-week course post-course test (T2), and follow-up
measurement (T3) took place 6 weeks after post-cours e.
Students were blind with respect to the number of
measurements that were coming, and they were not aware of
the purpose of filling in the questionnaire. During their course,
they also learned about mindfulness measurements and filling
out the Five Facet Mindfulness Questionnaire (FFMQ) was
presented as being part of the curriculum to learn about
mindfulness measurements and questionnaires. Students gave
consent to participate, and the Ethics Committee of the
University of Amsterdam approved the study.
The mindfulness course was a third-year elective bachelor
course of 6 ECTS. The course consisted of seven weekly 2-h
lectures by qualified and highly experienced mindfulness
trainers and researchers. Lectures were accompanied by video
lectures of Mark Williams and Jon Kabat-Zinn, and students
watched two mindfulness documentaries (Be Still and the
Dhamma Brothers). In addition, they studied 13 scientific
articles about mindfulness as well as the book by Segal,
Williams, and T easdale (2013). According to the study man-
ual, the goals of this part of the curriculum for students were as
follows: (1) to acquire knowledge about the historical per-
spective and development of mindfulness-based interven-
tions, (2) to learn about the most common MBSR and
MBCT trainings, (3) to become familiar with mindfulness
interventions in child psychiatry, (4) to learn about the relation
between mindfulness-based interventions and more classical-
ly known forms of psychotherapy, and (5) to practice a little
with different forms of meditation themselves.
The following topics were part of the mindfulness course:
history of MBSR and MBCT, differences between mindful-
ness training and cognitive behavior training (CBT), mindful-
ness and depression (i.e., Hofmann et al. 2010; Segal et al.
2013), mindful parenting (i.e., Bögels, Lehtonen, and Restifo
2010), mindfulness in pregnancy and childbirth (i.e., Duncan
and Bardacke 2010), mindfulness for children and teenagers
with ADHD (i.e., Van der Oord, Bögels, and Peijnenburg
2012), mindfulness for children and teenagers with autism
(i.e., Singh, Lancion i, Singh, Winton, Singh, and Singh
2011), and mindfulness interventions at schools (i.e., van de
Weijer-Bergsma, Langenberg, Brandsma, Oort, and Bögels
2012). Each of these main themes was studied from three
perspectives: a clinical perspective, actual training protocols
and patient groups were discussed and viewed in different
videos; a resear ch perspec tive, scienti fic studie s were
discussed; and an experiential perspective, during the lectures,
several meditations were practiced with the students, for in-
stance the raisin meditation, the breath meditation, the 3-min
breathing space, the body scan, and the thoughts meditation.
Further, they were given meditation ex ercises during the
course to practice them at home. For instance, they practiced
the .b exercise. That is, subgroups of two students exchanged
mobile phone numbers for this exercise. Once a day, each of
the two students would send the other, at a random moment, a
so-called .b message by W hatsApp (Kuyken, Weare,
Ukoumunne, Vicary, Motton, Burnett, et al. 2013). At the
Mindfulness
moment of either sending or receiving a .b, they would need to
stop whatever they were doing and take a 3-min breathing
space (.b=stop and breathe). Students final grade for the
course was based on multiple-choice questions (i.e., MBCT
was originally developed in order to prevent relapse of: A.
Alcohol and substance abuse; B. Major depressive episodes;
C. Generalized anxiety episodes or Full Catastrophe Living
is a famous book in the literature around mindfulness by Jon
Kabat-Zinn. With your current knowledge of mindfulness,
what is the most likely meaning of this title? To learn: A.
How to have less catastrophes happening in your life; B. How
to accept and embrace catastrophes in your life; C. Not to
worry so much about catastrophes in your life) and open-
ended essay style questions (i.e., With respect to your own
practice of the meditations during this course, either at home
or during the lectures, please describe your experiences, re-
flections and discoveries in a maximum of 200 words).
Measures
FFMQ
The FFMQ is a 39-item self-reported questionnaire that con-
sists of five facets of mindfulness: observing, describing,
acting with awareness, non-judging, and non-reactivity
(Baer, Smith, Hopk ins, Kriete meyer, and Toney 20 06).
Items are scored on a 5-point scale where 1=never or very
rarely true and 5=very often or always true. Observing reflects
the tendency to notice or attend to internal and external expe-
riences (i.e., When I take a shower or bath, I stay alert to the
sensations of water on my body). Describing reflects the
tendency to describe and label these experiences with words
(i.e., Im good at finding the words to describe my feelings).
Acting with awareness refers to directing undivided attention
to ones current activity (i.e., I rush through activities without
being really attentive to them). Non-judging reflects a non-
evaluative attitude towards inner experiences (i.e., Ithink
some of my emotions are bad or inappropriate and I shouldnt
feel them). Non-reactivity is the tendency to allow thoughts
and feelings to come and go, without getting caught up in
them or react instantly to them (i.e., Iperceivemyfeelings
and emotions withou t having to react to them). Internal
consistency of the FFMQ varies between .75 and .90 for the
Dutch population (de Bruin, Topper, Muskens, gels, and
Kamphuis 2012). In the current sample, internal consistencies
were the following: T0: α =0.78, T1: α =0.87, T2: α =0.80,
and T3: α=0.90.
Data Analyses
The effectiveness of the mindfulness university course on
students own level of mindful awareness and attention was
examined by multilevel analyses because these analyses
account for dependencies in nested data. In this study, mea-
surements were nested in respondents (i.e., students reported
four times about the same behaviors, namely at wait-list, pre-
course, post-course, and follow-up course measurement).
Depen dent variables w ere the outcome measures (FFMQ
subscales) while time was entered as predictor. Standardized
scores of the FFMQ were used (with a mean of 0 and standard
deviation of 1). This way, the parameter estimates can be
interpreted as a measure of effect (Cohens d). An effect size
of 0.3 was considered small, of 0.5 medium, and an effect size
of 0.8 was considered large (Cohen 1988). Because significant
effects of time (p<0.05) were found on the total FFMQ score,
additional analyses were conducted on the five subscales.
Results
Attendance rate of students at the seven lectures was high,
considering being present was not compulsory. Around 10 %
of the students attended a maximum of three lectures; the other
90 % attended four or more of the lectures, with over 30 %
attending six to seven lectures.
Students rated their level of affinity with mindfulness in
general on a 110-point scale. This affinity showed a border-
line significant increase during wait-list period (from T0 to T1,
parameter estimate=0.13) and a significant increase after the
mindfulness course (from T1 to T2, parameter estimate=
0.49).
Students also reported on the extent to which they practiced
the meditation exercises at home. Between T1 and T2, course-
related meditations (e.g., breathing space, sitting meditation,
.b exercise) were practiced with the following frequencies: not
at all (8.9 %), less than once a week (29.1 %), about once or
twice a week (43 %), about three to five times a week
(16.5 %), and daily (2.5 %). One of the students from China
reported that even though she did not pass the exam, she felt it
was a life-changing course for her. She had no prior experi-
ence with meditation, but since the course, she felt she was
able to observe her emotions more and learned to accept them
in a calmer way (cited with students permission).
In Table 1, the means and standard deviations on the
FFMQ subscales and total score are presented for the different
measurement occasions. Subsequently, in Table 2,itcanbe
seen that a significant effect was found at pre-course assess-
ment for FFMQ total score indicating that during the wait-list
period (from T0 to T1), self-rated mindful awareness had
significantly decreased with a parameter estimate (interpret-
able as Cohens d)of0.11. From pre-course to post-course
meas urement (T1 to T2), total FFMQ score significantly
increased (parameter estimate=0.36). Students rated them-
selves as being more mindful after the course. This effect
lasted into follow-up. From pre-course to follow-up
Mindfulness
assessment (T1 to T3), total FFMQ score significantly in-
creased (parameter estimate=0.53). When post-course assess-
ment was compared to follow-up (T2 to T3), it was found that
effects increased even further after the mindfulness course
(parameter estimate=0.17). For FFMQ subscale effects, see
further Table 2.
To further disentangle the findings, the factors nationality
and meditator were added to the model as fixed effects.
Furthermore, the unstandardized total score of the FFMQ was
analyzed to improve interpretability. When students from the
Netherlands (n=66) were compared with those from other
countries (n=38), it was found that there was no main effect
of the course for nationality, indicating that overall Dutch and
inte rnational studen ts had similar results on self-reported
mindfulness. However, looking at the post hoc pairwise com-
parisons, adjusted for multiple testing by the Bonferroni pro-
cedure (Aickin and Gensler 1996), differences between Dutch
and international students were found. Both for Dutch and
international students, no change occurred during wait-list in
FFMQ total score. In Dutch students, mindfulness increased
significantly from pre-course to follow-up (mean difference=
0.18) and mindfulness increased with marginal significance
from post-course to follow-up (mean difference=0.10). From
pre-course to post-course, however, no change was found in
Dutch students. Subsequently, for the international students,
mindfulness significantly increased from pre-course to post-
course and from pre-course to follow-up (respectively, mean
difference=0.22 and 0.24). From post-course to follow-up,
mindfulness did not further increase in international students.
In sum, the beneficial effects of the course already became
visible for the international students during the course and
were maintained after the course, whereas Dutch students
mostly benefited from the lectures and mindfulness practices
after the course ended. A graphical display of these results can
be found in Fig. 1.
When students were dichotomized into meditators (n=61)
and novices (n=42), no main effect of the course for medita-
tors and novices occurred, indicating that overall meditators
did not differ from novices in their self-reported mindfulness
scores. However, looking at the post hoc pairwise compari-
sons, differences during the course between meditators and
novices were present. During the wait-list period, total FFMQ
scores did not change for both meditators and novices. The
novices reported a significant increase in total FFMQ from
pre-course to follow-up (mean difference=0.20), but not from
pre-course to post-course, nor from post-course to follow-up.
The meditators reported a significant increase in FFMQ total
score from pre-course to post-course and from pre-course to
follow-up (respectively, mean difference=0.21 and 0.23). The
effect remained stable from post-course to follow-up.
Therefore, results indicate that the meditators already benefit-
ed to the utmost from the lectures and mindfulness practice
during the course, while for the novices, becoming more
mindful seemed to be a more gradual process, during and after
the course. A graphical display of these results can be found in
Fig. 2. Important to note, however, is that meditators in this
study were defined as students who meditated in the past (n=
27) or were currently meditating on a daily (n=5), weekly (n=
11), monthly (n=5), or less than monthly (n=10) basis, or
Table 1 Means and standard deviations on the FFMQ at wait-list (T0), pre-course (T1), post-course (T2), and follow-up assessment (T3)
Wait-list Pre-course Post-course Follow-up
M SD M SD M SD M SD
FFMQ total 3.17 0.37 3.13 0.38 3.28 0.42 3.38 0.39
Observing 3.38 0.62 3.34 0.61 3.44 0.66 3.39 0.71
Describing 3.45 0.62 3.37 0.64 3.59 0.62 3.59 0.58
Act. awareness 3.04 0.65 2.95 0.70 2.97 0.63 3.14 0.61
Non-judging 3.12 0.79 3.10 0.84 3.39 0.88 3.62 0.89
Non-reactivity 2.83 0.51 2.86 0.52 2.99 0.51 3.11 0.51
The FFMQ was filled out by 90 % of the students at wait-list, by 89 % at pre-course, by 75 % at post-course, and by 49 % at follow-up assessment
Table 2 Parameter estimates of multilevel analyses evaluating the effects
of a mindfulness course for (international) students on their level of
mindful awareness (FFMQ)
Parameter estimates
wl-pre pre-post pre-fu post-fu
FFMQ total 0.11* 0.36*** 0.53*** 0.17*
Observing 0.09 0.13 0.07 0.06
Describing 0.11
#
0.32*** 0.29** 0.03
Acting with awareness 0.12 0.00 0.16 0.16
Non-judging 0.04 0.35*** 0.56*** 0.21
#
Non-reactivity 0.04 0.22* 0.43*** 0.21*
Parameter estimates can be interpreted as Cohens d effect sizes, since
results were standardized into Z-scores
Fu follow-up (T3), post post-course (T2), pre pre-course (T2), wl wait-list
(T0)
#p<0.10; *p<0.05; **p<0.01; ***p<0.001
Mindfulness
those who classified themselves as other (n=3). Novices
were those who had never meditated in their lives. One person
preferred not to answer this question and was, therefore, not
included in these analyses.
Meditators and international students seem to develop the
same during the course, as do novices and Dutch students,
who also seem to develop similarly. However, no interaction
effect was found between nationality and being a meditator or
a novice. This indicates that meditators are not necessarily
international students and novices are not necessarily Dutch
students.
Discussion
This was the first study in which the effects of a low-intensity
7-week mindfulness course in the curriculum of undergradu-
ate international students were assessed. In the group as a
whole, it was found that although overall mindfulness de-
creased in the weeks before the course started, level of mindful
awareness increased during the curriculum course and
increased even further after the course. More specifically,
improvement was mainly seen in being less judgmental and
less reactive towards thoughts, feelings, and emotions of
others and particularly of oneself.
Taking into account the factors nationality (Dutch or inter-
national) and meditator (meditatorornovice),amorefine-tuned
picture became apparent. Dutch students seemed to be the
slow bloomers whoshowednoeffectontheirmindfulaware-
ness during the course; however , after the course was closed,
positive effects on mindful awareness became apparent 6 weeks
later. Whereas for the international students, the effect took
place right away during the course and remained stable until
6 weeks after the course. So although in the long run both
groups increased their mindfulness, the Dutch students seem to
take somewhat longer. This might be related to the higher
internal motivation of the foreign students. This mindfulness
course was elective; it was not a compulsory part of the curric-
ulum. Whereas for Dutch students this choice might have been
partly driven by simply obtaining a few more credit points,
some foreign students specifically came from abroad to the
University of Amsterdam to attend this course driven by their
specific interest (and obtaining the study credit points might not
have been their prior motivation). As far as we are aware, other
European universities do not offer a low-intensity course on
mindfulness as part of their curriculum this way, apart from the
tree examples as mentioned in the In troduction section of 1
2 year masters degrees but they have a different focus.
In addition, just like the Dutch students seemed to be the
late bloomers, so were the novices. Whereas the meditators
showed an instant increase in their mindful awareness after the
course, for the novices, students who had never meditated in
their lives, no short-term effects were found. However, 6 weeks
after the course had ended, they found themselves being less
judgmental and reactive, more aware and awake, and better
able to observe and describe sensations within and outside
themselves. In other words, they were more mindful in their
daily lives. A delayed effect seemed to have taken place. For
students who had (at least minimal) experience with meditating
(the meditators in this study), the effects were substantial,
during and after the course. An explanation for this faster effect
of the course on (at least minimal) meditators mindfulness is
that some seeds of mindfulness had already been planted in the
past, and they had already practiced some meditation before,
which allowed them to pick up the psycho-education about
mindfulness and the invitation to practice faster. In contrast,
the novices may have needed a warm-up period to learn and
feel comfortable with a new field to them, and therefore, the
effects only became apparent at a later stage .
Overall, the increased mindful awareness is an interesting
finding considering that these students only attended relatively
brief lectures in which the goals simply were to get acquainted
with the origins and applications of mindfulness in (child)
psychiatry and to experience some meditation for oneself.
Fig. 1 Self-reported mindfulness scores (FFMQ) of Dutch students
versus international students. T0=wait-list, T1=pre-course, T2=post-
course, T3=follow-up. The mindfulness course took place between T1
and T2
Fig. 2 Self-reported mindfulness scores (FFMQ) of meditators versus
novices. T0=wait-list, T1 =pre-course, T2=post-course, T3=follow-up.
The mindfulness course took place between T1 and T2
Mindfulness
Mindfulness scores have been shown to increase in students
after a mindfulness training before (Collard et al. 2009; Lynch
et al. 2011), but the intervention in this study by no means
compares to a standard MBSR- or MBCT-related course in
which for instance daily 3045-min practice is very common.
Also remarkable was the actual decline in mindful awareness
before the course started (although this was not visible when
the two factors were included). This might be due to that in the
six pre-course weeks, students were still occupied with (the
stress of) exams from other courses. Alternatively, it might be
that students have answered the questions about how mindful
they are too positive, and if they think about it a second time,
they may become more mindful about their lack of
mindfulness.
Limitations in this study were the inclusion of only one
outcome variable and the high drop-out at follow-up. It is
known that mindfulness is a predictor of psychological well-
being (Baer, Lykins, and Peters 2012; Lykins and Baer 2009)
and that an increase in mindfulness is related to improved
well-being and quality of life and lowered stress experience
(e.g., Brown and Ryan 2003), constructs that were not mea-
sured in this study. Further, at follow-up assessment 6 weeks
after the course, only about half of the students filled out the
questionnaire. It is possible that these were mainly the highly
motivated students, which might, as a result, present an overly
positive picture. However, multilevel analyses showed there
was no main effect for filling out the follow-up measurement.
Students who did complete T3 did not differ from those who
did not. Further, there were no significant correlations be-
tween whether the follow-up assessment was filled out and
the extent of meditation experience (meditator or novice) or
the nationality of the student.
In future research on the effects of mindfulness courses on
students own mindful awareness, the influence of increased
mindfulness on personal well-being, study stress, and study
performance could be assessed. If such effects are found, it
could be considered to give low-dose mindfulness training
to university students, already at the beginning of their study,
so that the benefits of increased mindfulness can be used
throughout the study.
Acknowledgments We would like to thank all the students of the
University of Amsterdam that took part in this course, the management
for including this course in the curriculum, and Irena Veringa, Rachel van
der Meulen, and George Langenberg for giving wonderful guest lectures.
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Mindfulness
... Mindfulness-based skills may foster the development of professional resilience [4], benefiting the clinician, the patient, and the healthcare community. Abilities such as mindful awareness, decentering, and psychological flexibility have been associated with general well-being in patient and nonpatient populations [5][6][7][8][9][10][11][12][13][14]. The development of these skills may also contribute to increased professionalism by cultivating focus and improving communication [7,15]. ...
... This context has contributed to the risk for a "parallel pandemic" related to fear, anxiety, worry, and the declining well-being of those providing patient care [27]. Many educational institutions, from primary to higher education, are recognizing the benefit of prevention strategies to promote and sustain well-being and have developed self-care instruction, founded on mindfulness-based skills and principles, to effectively incorporate into existing curricula [7,8,22,28]. ...
... Some institutions are electing to require well-being content within programs of study and core courses, while other universities are choosing to offer instruction as an elective course [4,7,22]. While there are a variety of pedagogical approaches to well-being content, only a few education programs have attempted to incorporate mindfulness-based instruction into existing curriculums [7,8,22]. ...
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Purpose: To promote well-being, healthcare education programs have incorporated mindfulness-based skills and principles into existing curriculums. Pandemic-related restrictions have compelled programs to deliver content virtually. Study objectives were to determine (1) whether teaching mindfulness-based skills within physician assistant (PA) programs can promote well-being and (2) whether delivery type (virtual vs. in-person) can impact the effectiveness. Methods: During this 2-year study, a brief mindfulness-based curriculum was delivered to incoming first-year students at six PA programs, while students at two programs served as controls. The curriculum was delivered in-person in year one and virtually in year two. Validated pre- and post-test survey items assessed mindfulness (decentering ability, present moment attention and awareness, and psychological flexibility) and well-being (perceived stress and life satisfaction). Results: As expected, coping abilities and well-being were adversely impacted by educational demands. The mindfulness-based curriculum intervention was effective in increasing mindfulness and life satisfaction, while decreasing perceived stress when delivered in-person. Virtual curricular delivery was effective in decreasing perceived stress but not improving life satisfaction. Over half of the participants receiving the curriculum reported positive changes on mindfulness measures with approximately 14-38% reporting a change of greater than one standard deviation. Changes on mindfulness measures explained 30-38% of the reported changes in perceived stress and 22-26% of the changes in life satisfaction. Therefore, the mindfulness curriculum demonstrated statistically significant improvements in measures of mindfulness and mitigated declines in life satisfaction and perceived stress. Conclusion: Mindfulness-based skills effectively taught in-person or virtually within PA programs successfully promote well-being.
... While some mindfulness-based interventions have shown to be effective in reducing stress and anxiety among university students in general (Bamber & Schneider, 2016), there remains a paucity of studies that specifically focus on the efficacy of mindfulness practices among international students attending U.S. universities (Ching et al., 2015). A perusal of the literature indicates only two studies that recruited international students at the University of Amsterdam, the Netherlands (Altinyelken et al., 2020;de Bruin et al., 2015). One study investigated a 6-week mindfulness-based class (de Bruin et al., 2015) and the other used a modified mindfulnessbased cognitive therapy (MBCT; Altinyelken et al., 2020). ...
... A perusal of the literature indicates only two studies that recruited international students at the University of Amsterdam, the Netherlands (Altinyelken et al., 2020;de Bruin et al., 2015). One study investigated a 6-week mindfulness-based class (de Bruin et al., 2015) and the other used a modified mindfulnessbased cognitive therapy (MBCT; Altinyelken et al., 2020). Both studies indicated that mindfulness-based interventions help improve international students' well-being by increasing their mindful awareness (de Bruin et al., 2015), managing stress and anxiety, cultivating self-awareness, and regulating difficult emotions (Altinyelken et al., 2020). ...
... One study investigated a 6-week mindfulness-based class (de Bruin et al., 2015) and the other used a modified mindfulnessbased cognitive therapy (MBCT; Altinyelken et al., 2020). Both studies indicated that mindfulness-based interventions help improve international students' well-being by increasing their mindful awareness (de Bruin et al., 2015), managing stress and anxiety, cultivating self-awareness, and regulating difficult emotions (Altinyelken et al., 2020). ...
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With an increasing number of international students enrolled in U.S. higher education, they were reported to have severe mental health issues, especially during the coronavirus disease (COVID‐19) pandemic. It is critical to provide evidence‐based mental health services to help them cope with those issues and promote mental health and the overall well‐being of international students. In this article, we utilized a randomized controlled trial to pilot‐test the effectiveness of a mindfulness‐based well‐being group for international students (MBWIS) in improving participants’ overall well‐being and mental health. The results indicated that the MBWIS not only improves international students’ trait mindfulness but also increases positive mental health as well as decreases their overall psychological distress and perceived discrimination. Related findings and implications for counselors and university personnel, including how to implement MBWIS in mental health facilities, are discussed within the existing literature.
... Some studies have shown that mindfulness training could increase awareness and attention in students. 45 Among clinical populations, such as breast cancer patients, only the educated could increase the performance of this instrument. In other words, present-moment attention and acting with awareness have been more prominent in educated people. ...
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Background: Breast cancer is now the most significant health issue in women, threatening diverse aspects of human health, including mental health and cognitive function. This research aimed to validate the Persian version of Mindful Attention Awareness Scale (MAAS) in Iranian women with breast cancer. Methods: We gathered data on 229 women with breast cancer in Tehran through convenience sampling. They completed a demographic questionnaire, the Persian version of MAAS, the General Self-Efficacy Scale, and DASS-21. SPSS-22 analyzed the Pearson correlation between the Persian version of MAAS, general self-efficacy, and DASS-21. Also, LISREL 8.8 was used to analyze the internal structure of the MAAS. Results: Findings from the confirmatory factor analysis (CFA) showed that the model with one factor fits well with the data (sbχ2=4.29 (P=0.36); SRMR=0.058; CFI=1.0; NFI=0.91; IFI=0.95; RFI=0.97; GFI=0.90; RMSEA=0.069). Significant negative correlations were found between MAAS and DASS-21 scores for anxiety (r=-0.51), depression (r=-0.48) and stress (r=-0.49), indicating an acceptable divergent validity. There was also a positive relationship between MAAS and general self-efficacy (r=0.37; P<0.01). Conclusion: The Persian version of MAAS seems to be a valid scale for evaluating the extent of mindfulness of Iranian women with breast cancer.
... [34][35][36][37] There are very few studies that examined the implications of a mindfulness course that students may enroll in for university credit. [38][39][40][41] The present study offered a unique opportunity to investigate the psychological and physiological effects of a full semester (15-week) mindfulness course offered to students for college credit at a mid-size public university (Bowling Green State University). This mindfulness course was offered for two consecutive semesters (i.e., fall 2018 and spring 2019), with two different groups of students completing the course each semester (two independent "trials"). ...
Article
Objective: This study examined the effects of a college mindfulness course on vital-signs and Five Facet Mindfulness Questionnaire (FFMQ) scores. Participants: Two independent groups of 20 students were enrolled in the mindfulness course during the Fall 2018 (Trial 1) and Spring 2019 (Trial 2) semesters. Methods: Blood pressure, heart rate, and respiration rate were recorded before and after in-class mindfulness meditations several times throughout each semester. FFMQ scores were recorded at the beginning and conclusion of each semester. Results: Statistical analyses indicated that 20minutes of mindfulness meditation significantly decreased respiration rate (both trials) and heart rate (Trial 2) for female students. There were significant changes in the FFMQ mean scores for “non-react,” “observe,” “act aware,” and “non-judge.” Conclusions: These results suggest that mindfulness meditation may be beneficial for students to enhance their well-being. Recommendations are provided to further examine the implications of consistent mindfulness practices for college students.
... From a theoretical perspective, our study strengthens the postulation of mindfulness in self-determination theory. In line with existing proposition that mindfulness helps to bring about autonomous form of motivation (Ryan et al., 2021), our study gives evidence that students with higher mindfulness tend to be more aware of their internal phenomena such as needs and emotions and external phenomena such as conflicts and pressure, and are less likely to get influenced by automatic responses (de Bruin et al., 2015). As such, they are at a better position to engage in choices that are reflective and actions that are congruent with their self (Donald et al., 2020). ...
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The aim of the present study was to examine the mediation effects of resilience and stress, two perceived opposite constructs, in the relationship between mindfulness and happiness. Mindful Attention Awareness Scale, Connor-Davidson Resilience Scale, Subjective Happiness Scale, Depression Anxiety Stress Scales short version-21 were administered to 523 undergraduate university students in India. Structural Equation Modeling with bootstrapping was applied to test the mediating effects of resilience and stress. Results showed that resilience and stress partially mediated the mindfulness-happiness relationship. In addition, resilience partially mediated the relationship of mindfulness to stress. Findings suggest that mindfulness may play an influential role in enhancing happiness through the mediating effects of resilience and stress.
... A study by Bamber and Morpeth (2019) concluded that MBI with a focus on relationships/loving-kindness and insightful meditations were shown to have no significant effect on anxiety. However, students who participated in brief focused breathing exercises reported increased performances in difficult arithmetic tests, due to a reduction in anxiety after the exercises (de Bruin et al., 2015). When students participated in MBI, a reduction of anxiety symptoms was reported (Potek, 2011;Stein, 2016). ...
Article
Background : With the onset of the COVID-19 pandemic, many have experienced drastic changes in their academic and social lives with ensuing consequences towards their physical and mental well-being. The purpose of this systematic review is to identify virtual mindfulness-based interventions for the well-being of adults aged 19 to 40 years in developed countries and examine the efficacy of these techniques/exercises. Methods : This mixed-methods systematic review follows the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines with a registered PROSPERO protocol. With a convergent integrated synthesis approach, IEEE Xplore, PsychInfo, Web of Science and OVID were searched with a predetermined criteria and search strategy employing booleans and filters for peer-reviewed and grey literature. Data screening and extraction were independently performed by two authors, with a third author settling disagreements after reconciliation. Study quality of selected articles was assessed with two independent authors using the Mixed Methods Appraisal Tool (MMAT). Studies were analyzed qualitatively (precluding meta and statistical analysis) due to the heterogeneous study results from diverse study designs in present literature. Results : Common mindfulness-based interventions used in the appraised studies included practicing basic mindfulness, Mindfulness-Based Stress Reduction (MBSR) programs, Mindfulness-Based Cognitive Therapy programs (MBCT) and the Learning 2 BREATHE (L2B) program. Conclusion : Studies implementing mindfulness interventions demonstrated an overall improvement in well-being. Modified versions of these interventions can be implemented in a virtual context, so adults can improve their well-being through an accessible format.
... Although mindfulness is practiced in most universities' well-being or life centers, it is also an accredited course in some universities' curricula, such as Brown University in the United States and Monash University in Australia [16][17][18]. Moreover, Oxford University in the United Kingdom and the Lesley University in the United States have integrated mindfulness in their 2-year master's degree course [19]. Existing research highlights that highly competitive students-such as medical students-also benefit from mindfulness practices [20]. ...
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Mindfulness-based interventions (MBIs) have been applied in many contexts, including educational sectors of K-12 and various graduate schools, such as medical and law schools. Research shows that highly competitive students are likely to benefit from mindfulness practices. However, few STEM-focused colleges have been able to assess its value and apply mindfulness practices. This study presents a case report of an MBI course offered by the Korea Advanced Institute of Science and Technology (KAIST). We devised eight questions in three categories to investigate how each individual experiences the MBI course, how they enjoy the academic course, and the suitability of the MBI curriculum in STEM education. Qualitative assessments of feedback featuring questions and answers were analyzed using grounded theory. The results demonstrate three central phenomena: a) gradual changes and development in students’ emotional intelligence, b) development in physical awareness, and c) enhanced sense of joy during the session. These results imply that even during the COVID-19 pandemic, international students—being isolated in their home countries and taking the course online—would likely still benefit from the intrinsic effect of MBIs. It also implies that MBI courses could be recommended as mandatory classes for all KAIST students, where feasible. Nevertheless, further research is needed to fully explore the impact of such programs, both online and in-person, including the use of self-report scales of common measures of mental health to contribute empirical data to the literature.
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The aim of this study was to explore the role of gender, age, and academic year in shaping dispositional mindfulness (DM) and the association between DM facets and empathy dimensions in a sample of undergraduate nursing students. In a multicenter cross-sectional study design, the Five Facet Mindfulness Questionnaire (FFMQ), the Interpersonal Reactivity Index (IRI), and socio-demographic questions were administrated to a convenience sample of Italian nursing students. 622 nursing students (82.2% female) participated in the study (response rate = 86.15%). Females had higher levels of Acting with Awareness ( p < .001, d = .54) and lower levels of Non-reacting ( p < .001, d = .52) facets of DM than males. Older students displayed higher scores on the Observing ( r = .112, p = .005) and on the Non-reacting ( r = .187, p < .001) FFMQ subscales than younger ones. No statistically significant differences in DM levels between the three academic years were found ( p s > .202). After controlling for socio-demographic factors, DM facets were generally positively related to Perspective Taking ( β s from .131 to .208, p s < .007) and Empathic Concern ( β s from −.156 to .189, p s < .001), whereas negatively related to Personal Distress ( β s from −.141 to −.261, p s < .001). Nursing students with higher levels of DM were more able to consider others’ cognitive perspective and to feel compassion, and were less emotionally distressed when facing tense interpersonal situations. Tailored mindfulness interventions might be useful to foster functional empathy within nursing undergraduate programs.
Article
Mindfulness-based interventions have been shown to impact a broad range of outcomes including enhanced attention, memory, and self-regulation. Previously, mindfulness training has been negatively correlated with brain activity across the default mode network nodes following mindfulness-based practice. Currently, little research has been done to understand the neural basis of differences in mindfulness levels in untrained individuals. In this study, we explored the relationship between the amplitude of low-frequency fluctuation (ALFF) and fractional ALFF (fALFF) during the resting state and the level of dispositional mindfulness, which was measured by using the Five Facet Mindfulness Questionnaire (FFMQ). The results showed that the total scores on the FFMQ were negatively correlated with the spontaneous activation of left premotor cortex. This indicates that individuals with higher levels of dispositional mindfulness might require less effort to control their irrelevant motor responses.
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In contemporary western societies stress is highly prevalent, therefore the need for stress-reducing methods is great. This randomized controlled trial compared the efficacy of self-help physical activity (PA), mindfulness meditation (MM), and heart rate variability biofeedback (HRV-BF) in reducing stress and its related symptoms. We randomly allocated 126 participants to PA, MM, or HRV-BF upon enrollment, of whom 76 agreed to participate. The interventions consisted of psycho-education and an introduction to the specific intervention techniques and 5 weeks of daily exercises at home. The PA exercises consisted of a vigorous-intensity activity of free choice. The MM exercises consisted of guided mindfulness meditation. The HRV-BF exercises consisted of slow breathing with a heart rate variability biofeedback device. Participants received daily reminders for their exercises and were contacted weekly to monitor their progress. They completed questionnaires prior to, directly after, and 6 weeks after the intervention. Results indicated an overall beneficial effect consisting of reduced stress, anxiety and depressive symptoms, and improved psychological well-being and sleep quality. No significant between-intervention effect was found, suggesting that PA, MM, and HRV-BF are equally effective in reducing stress and its related symptoms. These self-help interventions provide easily accessible help for people with stress complaints.
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Mindfulness training has well-documented effects on psychological health. Recent findings suggest that increases in both mindfulness and self-compassion may mediate these outcomes; however, their separate and combined effects are rarely examined in the same participants. This study investigated cross-sectional relationships between self-reported mindfulness, self-compassion, meditation experience, and psychological wellbeing in 77 experienced meditators and 75 demographically matched nonmeditators. Most mindfulness and self-compassion scores were significantly correlated with meditation experience and psychological wellbeing. Mindfulness and self-compassion accounted for significant independent variance in wellbeing. A significant relationship between meditation experience and wellbeing was completely accounted for by a combination of mindfulness and self-compassion scores. Findings suggest that both mindfulness and self-compassion skills may play important roles in the improved wellbeing associated with mindfulness training; however, longitudinal studies are needed to confirm these findings.
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Mindfulness-based approaches for adults are effective at enhancing mental health, but few controlled trials have evaluated their effectiveness among young people. To assess the acceptability and efficacy of a schools-based universal mindfulness intervention to enhance mental health and well-being. A total of 522 young people aged 12-16 in 12 secondary schools either participated in the Mindfulness in Schools Programme (intervention) or took part in the usual school curriculum (control). Rates of acceptability were high. Relative to the controls, and after adjusting for baseline imbalances, children who participated in the intervention reported fewer depressive symptoms post-treatment (P = 0.004) and at follow-up (P = 0.005) and lower stress (P = 0.05) and greater well-being (P = 0.05) at follow-up. The degree to which students in the intervention group practised the mindfulness skills was associated with better well-being (P<0.001) and less stress (P = 0.03) at 3-month follow-up. The findings provide promising evidence of the programme's acceptability and efficacy.
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Although mindfulness meditation traditionally is viewed as a lifelong practice, much current knowledge about its effects is based on short-term practitioners who have participated in mindfulness-based treatment. In the current study, long-term meditators and demographically similar nonmeditators completed self-report measures of constructs expected to be related to the practice of mindfulness meditation. Extent of meditation experience was correlated in the expected directions with levels of mindfulness and with many other variables. Mean differences between meditators and nonmeditators were significant in most cases. Mediation analyses were consistent with the hypothesis that practicing meditation is associated with increased mindfulness in daily life, which is related to decreased rumination, decreased fear of emotion, and increased behavioral self-regulation. These mechanisms appear partially responsible for the relationships between mindfulness skills and psychological adjustment. Overall, the current study suggests that the long-term practice of mindfulness meditation may cultivate mindfulness skills and promote adaptive functioning.
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The factor structure, internal consistency, construct validity, and predictive validity of the Dutch version of the Five Facet Mindfulness Questionnaire (FFMQ-NL) were studied in a sample of meditators (n = 288) and nonmeditators (n = 451). A five-factor structure was demonstrated in both samples, and the FFMQ-NL and its subscales were shown to have good internal consistencies. Meditators scored higher on all facets of the FFMQ-NL than the participants in the nonmeditating sample. For both samples, expected negative correlations between most mindfulness facets (all except for the Observing facet) and the constructs of alexithymia, thought suppression, rumination, worry, and dissociation were found. The Observing facet of the FFMQ-NL showed an unexpected positive correlation with thought suppression in the nonmeditating sample. Furthermore, as expected, mindfulness facets were negatively related to psychological symptoms, and all mindfulness facets except for Observing and Describing significantly predicted psychological symptoms. Overall, the Dutch FFMQ demonstrated favorable psychometric properties, commensurate with its (original) English language version.
Article
Studies on the effects of mindfulness interventions on mental health and behavioral problems in children show promising results, but are primarily conducted with selected samples of children. The few studies investigating school-based interventions used self-selected samples, provided training outside of the classroom, and did not report longer-term effects. The immediate and longer-term effects of a class-based mindfulness intervention for elementary school children were investigated as a primary prevention program (MindfulKids) to reduce stress and stress-related mental health and behavioral problems. Children (8–12 years) from three elementary schools participated. Classes were randomized to an immediate-intervention group (N = 95) or a waitlist-control group (N = 104), which received the intervention after a waitlist period. Twelve 30-min sessions were delivered in 6 weeks. At baseline, pretest, posttest, and follow-up, variables indicative of stress and metal well-being were assessed with children, variables indicative of mental health problems were assessed with parents, and teachers reported on class climate. Multilevel analysis revealed that there were no significant changes from baseline to pretest. Some primary prevention effects on stress and well-being were found directly after training and some became more apparent at follow-up. Effects on mental health problems also became apparent at follow-up. MindfulKids seems to have a primary preventive effect on stress, well-being, and behavior in schoolchildren, as reported by children and parents. Exploratory analysis revealed that children who ruminate more are affected differently by the intervention than children who ruminate less. It is concluded that mindfulness training can be incorporated in elementary schools at the class level, letting all children benefit from the intervention.
Article
Children and adolescents with Asperger syndrome occasionally exhibit aggressive behavior against peers and parents. In a multiple baseline design across subjects, three adolescents with Asperger syndrome were taught to use a mindfulness-based procedure called Meditation on the Soles of the Feet to control their physical aggression in the family home and during outings in the community. They were taught to shift the focus of their attention from the negative emotions that triggered their aggressive behavior to a neutral stimulus, the soles of their feet.Prior to training in the mindfulness-based procedure the adolescents had moderate rates of aggression. During mindfulness practice, which lasted between 17 and 24 weeks, their mean rates of aggression per week decreased from 2.7, 2.5 and 3.2 to 0.9, 1.1, and 0.9, respectively, with no instances observed during the last 3 weeks of mindfulness practice. No episodes of physical aggression occurred during a 4-year follow-up. This study suggests that adolescents with Asperger syndrome may successfully use a mindfulness-based procedure to control their aggressive behavior.
Article
This study aimed to address the gap in the literature considering empirical evidence in support of the assumption that Mindfulness is the mediating factor in the positive outcomes of Mindfulness Based Cognitive Therapy (MBCT) and Mindfulness Based Stress Reduction (MBSR) programmes, and to further examine the link between Mindfulness and Subjective Well Being. The research question was whether MBCT would increase participants’ levels of Mindfulness and Satisfaction with Life and decrease participants’ level of Negative Affect. A Repeated Measures (Test–Retest) within participants design was employed and fifteen Counselling students at the University of East London provided data anonymously at the beginning and end of MBCT programme by completing the Freiburg Mindfulness Inventory (FMI) (Walach, Buchheld, Buttenmuller, Kleinknecht, & Schmidt, 2006), Satisfaction With Life Scale (SWLS) (Diener, Emmons, Larsen & Griffin, 1985) and Positive and Negative Affect Schedule (PANAS) (Watson, Clark & Tellegen, 1988). The results indicated that by the end of the MBCT programme: participants’ level of Mindfulness significantly increased; Positive Affect remained unchanged; Negative Affect significantly decreased; a strong trend in the data indicated an increase in participants’ Satisfaction With Life but failed to reach a statistically significant level; Mindfulness and Negative Affect were significantly negatively correlated, while Mindfulness and Satisfaction With Life were not found to be associated. A longer practice time of Mindfulness during the programme was found to be significantly correlated with a higher level of Mindfulness at the end of the programme. The results were interpreted in support of the assumption that Mindfulness has an important role as a mediating factor in symptoms relief and positive outcomes following participation on Mindfulness programmes. The results also support of Brown and Ryan's (2003) conclusion regarding the role of Mindfulness in enhancing Well Being. A Positive Psychology framework was applied in interpreting the data and it was suggested that there was ground to believe that Mindfulness can be integrated well, as a concept and as a therapeutic intervention, into the field of Positive Psychology.
Article
The aim of this study was to explore the feasibility of implementing a new 8-week mindfulness-based programme, ‘Mindfulness-Based Coping with University Life’ (MBCUL), specifically tailored to the needs and demand of students and to explore its impact in a pilot evaluation. Participants were drawn from the University of Northampton (MBCUL N = 10; control N = 6). A non-randomized wait-list-controlled design was employed. Measures examined anxiety and depression, perceived stress, mindfulness and personally relevant change before and immediately after the programme. The diurnal profile of salivary cortisol and alpha-amylase level was collected for two consecutive days. No significant intergroup differences were observed on any of the measures at either time point. However, significant change was observed for the MBCUL group in terms of perceived stress (d = 1.06; z = −2.25, p = 0.03), anxiety (d = 1.04; z = −2.14, p = 0.03), depression (d = 0.52; z = −0.69, p = 0.5) and personally relevant change (d = 2.63; z = −2.68, p = 0.01), along with an increase in mindfulness (d = 1.06; z = −1.89, p = 0.06). In contrast, no significant change was found in the daily profiles of cortisol and alpha-amylase. The data from this pilot tentatively suggest that MBCUL appears to be a promising programme that warrants further evaluation using a randomized study with a larger sample size. Copyright © 2011 John Wiley & Sons, Ltd.