Internal Awareness Research Articles

Alexithymia, impulsivity and negative mood in relation to internet addiction symptoms in female university students

ABSTRACT Objective Alexithymia has been implicated as a risk factor for problematic substance use and other excessive behaviours including internet addiction . Impulsiveness has also been identified as a likely predisposing factor for excessive behaviours. However, as impulsivity is often elevated in alexithymia, the degree of independence of these factors in relation to excessive internet use is unclear. Method The present study assessed contributions of alexithymia, impulsivity and negative affect to variance in internet addiction symptoms in 116 internet-using female university students. Participants completed the following instruments online: demographics, Toronto Alexithymia Scale-20, Barratt Impulsiveness Scale-11, Internet Addiction Test and the Depression Anxiety Stress Scales-21. Results Measures were significantly intercorrelated in expected directions. Hierarchical regression indicated that although both alexithymia and impulsivity were highly significant predictors of internet addiction symptoms after controlling for demographic covariates, the contribution of alexithymia became nonsignificant after adding impulsivity to the model. The final model explained 37% of variance in internet addiction symptoms. Multiple mediation modelling indicated that both impulsivity and negative affect fully mediated the association of alexithymia with internet addiction symptoms. Conclusions Impulsivity and negative affect may account for the link between alexithymia and internet addiction symptoms in young women at university. KEY POINTS What is already known about this topic: Alexithymia and impulsivity have been linked to a variety of addictive behaviors including internet addiction. Alexithymia and impulsivity have been reported to independently predict excessive alcohol use in regression models. Alexithymia may reflect deficient interoception and corresponding poor internal awareness of overconsumption cues in alcohol use. What this topic adds: In female university students, alexithymia, impulsivity, and negative affect were significant positive predictors of internet addiction symptoms in a regression model. Alexithymia was no longer significant after adding impulsivity to the model. Multiple mediation modelling indicated that impulsivity and negative affect fully mediated the association of alexithymia with internet addiction symptoms.

FORMATION OF PERFORMANCE RELIABILITY OF THE FUTURE TEACHER OF MUSIC ART

The purpose of this study is to highlight the theoretical foundations of the formation of performing reliability of the future music teacher in the process of professional instrumental and performance training. The leading provisions of personality-activity, acmeological, and axiological approaches were chosen as the methodological basis of the study. Based on the study and analysis of scientific and methodological sources, we consider the concept of "performing reliability" as a necessary component of the performing skills of a music teacher, as a relatively stable personal development, established through theacquisition of musical-theoretical knowledge, mastery of musical-performing, interpretive, and stage artistic skills. The results indicate that students who are giving priority to higher motives of musical activity, awareness of the importance of such a personal development as performance reliability, which is a necessary component of professional competence of the future music teacher, stimulate students to expand their own instrumental and performancecapabilities, to self-improvement of personal will and professional qualities. The scientific relevance of this study lies in substantiating of the basics of formation of the musical activity motivation, the conditions which, according to the author, will promote success of this process in the course of instrumental and performing educational activity are outlined. The author offers a general way of forming performing reliability, which consists in the optimal pedagogical interaction in directing the individual to the internal awareness of the purpose of the activity as personally significant ones. This leads to the predominance ofhigher meaning-making motives, such as self-improvement and self-actualization in the modern society.

49-OR: Changes in Regional Cerebral Blood Flow during Hypoglycemia in T1DM

Regulation of cerebral blood flow (CBF) during hypoglycemia (HYPO) is critical for maintaining adequate glucose delivery to the brain; however, specific changes in regional CBF during HYPO are not well defined. We measured CBF in 14 T1DM (mean ± SD age 31 ± 7 yrs, DM duration 16 ± 5 yrs, A1c 7.2 ± 1.0 %) and 13 healthy controls (CON; age 35 ± 11 yrs, A1c 5.2 ± 0.5 %) using 3.0 T MRI continuous arterial spin labeling during fasting baseline (BAS), a hyperinsulinemic (2 mU/kg/min) euglycemic clamp (EUG; 90 mg/dl), followed by a hypoglycemic clamp (HYPO; 50 mg/dl). Global and regional changes in CBF were measured in 15 regions of interest (ROI). At BAS, gray matter CBF was similar in CON and T1DM (58 ± 16 vs. 61 ± 11 ml/100 gm brain/min). No significant changes in CBF were observed from BAS to EUG in any brain region in either CON or T1DM. However, during HYPO in T1DM, CBF increased by 10% in gray matter and 16% in brainstem, both p <0.05. CBF also increased by 10% - 18% in specific ROIs involved in awareness of internal states, reward and emotion (orbitofrontal cortex, insula, anterior cingulate cortex, thalamus, and substantia nigra; p<0.01 to p<0.05). Minimal increases in CBF (1% - 6%) were observed in regions primarily involved in sensory or motor function, (occipital cortex, motor cortex, cerebellum, caudate, putamen) or in the posterior cingulate (all p > 0.30). In CON, no significant global or regional changes in CBF occurred during HYPO. In all subjects, higher A1c correlated with greater increases in CBF during HYPO (p<0.05). Conclusions: 1) Hyperinsulinemia per se does not alter CBF in T1DM or CON, 2) During HYPO, brain blood flow increases more in T1DM vs. CON, especially in regions involved in integration of internal awareness, reward and emotion, compared to sensory or motor function, and 3) Greater increases in CBF in subjects with higher A1c suggest that compensatory physiologic mechanisms enable subjects with chronic exposure to hyperglycemia to maintain adequate cerebral glucose supply when plasma glucose levels are suddenly reduced. Disclosure D. C. Simonson: Stock/Shareholder; Spouse/Partner; Phase V Technologies, Inc. N. R. Bolo: None. J. Theberge: None. G. Musen: None. A. M. Jacobson: None. Funding National Institutes of Health (DK073843)

Relational autonomy: where Confucius and Mencius stand on freedom

ABSTRACT I approach the person in the context of ren (being-humane) and li (ritual propriety) in dialogue with role ethics and the issue of autonomy. The hypotheses are as follows: first, even if the person is committed to dao, the person is to enjoy uncoerced freedom of choice, or at least some measure of it in the case of early Confucianism; second, the sentimental and rational dimensions are unified and make up a judgment as a whole in the Chinese context, whereas the functioning of reason is more elevated in the West; third, ren and li are mutually constitutive, requiring and complementing one another as internal awareness and external practice respectively. Even though ren and li both share an orientation to social order, they differ with respect to internalized recognition and simply following norms. If relationships are constitutive of persons and the focus of relational autonomy is on cultivation, then there is no conflict between self-completion and autonomy.

Accounting for modern slavery risk in the time of COVID-19: challenges and opportunities

PurposeThe purpose of this paper is to examine how the coronavirus disease 2019 (COVID-19) pandemic affects corporate modern slavery accounting, auditing and accountability, and how a business can take advantage of this situation to ensure a more robust and effective modern slavery response in the long-term.Design/methodology/approachDrawing on recent literature and available statistics about modern slavery in the context of COVID-19 comment is provided on the challenges and opportunities for researchers and business.FindingsGiven the additional invisibility of modern slavery in a COVID-19 environment as victims move into unemployment and back into vulnerable positions where they are exploited the challenge is how accounting, auditing and accountability can help business break this cycle. Capabilities for business to track and trace victims of modern slavery will be reduced because of the pandemic. Opportunities exist for gathering data and building internal awareness about the problem of modern slavery in supply chains and to reassess operational risk and investment in modern slavery reduction. With the pause in external reporting opportunity exists to obtain views of external stakeholders.Research limitations/implicationsBecause of the relatively short period of the COVID-19 pandemic to date, numeric data on impacts are largely unavailable.Originality/valueThis is the first paper to consider the challenges and opportunities of COVID-19 on accounting for modern slavery in business. Directions for future research are also considered.

ENVIRONMENTAL RESPONSIBILITY AS A FORM OF MARKETING STRATEGIES, INFLUENCE ON MARKET SHARE

The development witnessed by the world and the changes in the global economy imposed on organizations to adopt environmental responsibility. Therefore, major international organizations seek to develop strategic plans to preserve the environment and reduce the use of polluting resources which led to increasing its profitability, increasing its market share and maximizing its relationship with its competitors and customers. Current study aimed at examining the role of environmental responsibility on increasing organizational market share within four main variables which are (internal operations, values, environmental policies and management awareness). A questionnaire was adopted in order to gather data from a sample of (321) marketing and sales managers within industrial sector in Kuwait. Utilizing descriptive statistics, linear regression and multiple regression through SPSS; results of study accepted the main hypothesis and expressed the ability to environmental responsibility to boost market share. In addition to that, it appeared that among chosen variables internal operations seemed to have the highest influence in terms of decreasing production costs and giving the chance for organizations to increase quality and lower prices in order to attract more customers, meet competitors thus get a higher market share. Study recommended that expecting a higher market share is not unlimited; rather it is dependent on many monopoly laws, so organizations must adopt the foundations for increasing market share in a logical and thoughtful way.

The Efffect of Environmental Management Accounting, Environmental Strategy on Environmental Performance and Financial Performance Moderated By Managerial Commitment

Environmental management (EMA) has been considered as a successful idea to reduce ecological burdens in the form of energy dependence and carbon footprint. In addition to the company's highest emphasis on EMA, the organization's environmental strategy (ENS) is articulated and implemented with ecological motivation. The role of the ENS strengthens the internal awareness of the organization to improve environmental conditions and thereby helps reduce negative environmental stresses. In addition, with increasing environmental regulations in place, the need for sound environmental policies and strategies of the company is essential to protect future growth and market image. Results There is a significant influence of environmental management accounting to encourage environmental performance, there is a significant effect of environmental management accounting to encourage economic performance, there is a significant influence of environmental strategy to encourage environmental performance, there is a significant influence of environmental strategy to encourage economic performance, commitment to moderate management The significant influence of Environmental Management Accounting to encourage Environmental Performance, Management Commitment Cannot Moderate the Effect of Environmental Management Accounting which encourages Economic Performance, Management Commitment to Moderate the significant influence of Environmental Strategy to encourage Environmental Performance and Management Commitment to Moderate the Impact of Environmental Strategy which is significant to encourage Economic Performance .

Creative self-fulfillment and goal commitment of teachers at the stage of entering the profession

Modern education is meant to create conditions for the development and self-development of learners’ personalities. This task can only be achieved by teachers who aim for creative professional self-fulfillment and self-enhancement; therefore, in the context of global changes the issue of self-design carried out by the subject of teaching activity and development of their personal potential is gaining new significance. The prerequisites for this research are determined by the necessity and possibility for involving young teachers in pedagogic creativity, which helps them to enter the profession successfully. Meanwhile, there are quite a few obstacles to teachers’ creative self-fulfillment; at the stage of entering the profession and adaptation to it, there is a gap between the potential and actual action. The objective of this research is to identify the value and conceptual orientation of personality and find out the reasons preventing creative self-fulfillment and goal commitment among teachers at the stage of entering the profession. A total of 30 teachers working at Moscow schools ages 25 to 35 took part in the empirical research. Methods: coaching techniques, written survey (empirical questioning), and content analysis of mini-essays. It has been found that creative self-fulfillment is possible if there is a connection between professional devotion, personal success, and clear goal commitment of a teacher. The obstacles on the way to self-fulfillment include a set of unjustified personal restrictions, “hidden” positive ideas of oneself and one’s individual abilities, misbalance between personal beliefs and value-conceptual orientations as well as inactivity and exaggeration of external, environmental, or interpersonal barriers. “Reloading” of a teacher is possible if they focus their goals on the future and support such commitment with internal freedom and awareness of their potential and creativity.

National clinical programmes in the Republic of Ireland: a qualitative study of acute hospitals.

The national clinical programmes (NCPs) were established in 2010 to achieve three objectives, namely: improve quality, access and cost effectiveness. Limited research exists on their implementation in the Republic of Ireland (ROI). This qualitative study identified key stakeholders' perceptions on (a) implementation thus far, and (b) conditions perceived necessary for implementation in acute hospitals. The overall aim of this research was to undertake an in-depth study to explore from the perspectives of key stakeholders, their perceptions on implementation of the national clinical programmes, thus far, in relation to three overarching objectives (to improve quality, access, cost effectiveness) and what are the conditions necessary for their implementation in the Republic of Ireland's acute hospitals. Twenty participants were interviewed using face-to-face audio-recorded semi-structured interviews. Transcribed data were coded and analysed, and a number of themes emerged from the dataset relating to the study aims. Implementation was perceived as being inconsistent. Outcomes were identified as: best practice guidelines, models of care, protocols, pathways; education & training; new services; improved discharges; improved patient outcomes; reduced length of stay; timely access; reduced waiting lists; cost effectiveness and other intangible outcomes. Sixteen conditions, under four themes, were perceived necessary for implementation, namely: Governance - structure, audit & monitoring, senior management support, accountability, and clear objectives and expectations; Communication - visible face-to-face engagement, internal awareness, and external awareness; Leadership - programme level, national level, hospital level, and professional level; Resources - budget, staff, information technology, training, skills, and competency. This study adds to the existing limited body of knowledge on implementation of the NCPs in the acute hospitals in the ROI while contributing to the wider international literature in this area. The study provides hitherto unreported knowledge on the conditions that are perceived necessary for implementation. Novel in the ROI context is the perceived necessity to condense the number of NCPs, placing greater emphasis on (a) the need to structurally integrate the NCPs across the continuum of care, and (b) the importance of communication through visible face-to-face engagement. This study concludes that significant progress has been made by the NCPs towards meeting the objectives, albeit to varying degrees. There is a strong perception that the NCPs should remain, and that addressing the conditions perceived necessary for implementation in the areas of governance, communications, leadership and resources by both top-down senior health officials and bottom-up front-line hospital staff would significantly enhance the ability of the NCPs to meet objectives and implementation. It provides the ROI health services with valuable information to inform future reform, strategic planning and NCP implementation.

Green Supply Chain Management in Vietnam Industrial Zone: Province-Level Evidence

The main purpose of this paper is to explore how green supply chain management (GSCM) and its evaluative factors have affected green supply chain management practice and performance in industrial zone. This study proposes a structural equation model of the relationships among four factors: internal awareness (IA); suppliers' pressure (SP); customers' awareness (CA); and regulations pressure (RP) and their effect on GSCM practice (PA) and GSCM performance (PE). We used a survey questionnaire to elicit perceptions/opinions about GSCM from three level of managers of 322 companies in Bac Ninh Province's industrial zones, Vietnam. PLS-SEM 3.0 software was applied to analyze and verify the gathered data, and the proposed hypothesis model. The results of path analysis show that internal awareness and customers' awareness are positively related to the GSCM practice and GSCM performance. However, suppliers' pressure and regulations pressure just impacted on GSCM practice. As a result, the testing of the relationship between GSCM practice and GSCM performance has been verified and supported. The findings of this study can help manager of companies in industrial zone understand the structure of GSCM, associate with the green supply chain management practice and green supply chain management performance, and be successful in green management organizations.

Factors to enhance reduction technology development through ETS

Environmental regulations can take many forms, from command and control to market-oriented regulations, but their success commonly depends on the active participation of the target. This study surveyed all companies in the Republic of Korea implementing national level emission trading system (ETS) to examine how external conditions and internal perceptions determine companies' response and technology development as against to ETS. It may be the first study to examine the relationships among the objective data (allocation and emissions), characteristics of company (size, employment, sector, and financials) and person in charge of ETS within company (division and position) and companies' perceptions. The results showed that fine allocation design alone does not lead companies to invest in reduction technology. Rather, companies’ perceptions drive the holistic response to ETS and technology investment. In addition, large emitters engaged more actively in ETS, but their holistic response was far from increasing investment in reduction technology. The goals of ETS—cost-effective reduction and green investment—can be best achieved through policy design that takes into account internal awareness, motivation, technology support, and pricing management.

ПСИХОЛОГІЧНІ ОСОБЛИВОСТІ ЕМОЦІЙНОГО ІНТЕЛЕКТУ ТА САМОРЕГУЛЯЦІЇ МАЙБУТНІХ ПСИХОЛОГІВ

У статті розглянуті основні наукові погляди на проблему емоційного інтелекту, підходи до його розуміння та інтерпретації. Представлені результати емпіричного дослідження динаміки емоційного інтелекту майбутніх психологів та відмінностей системи саморегуляції студентів з низьким та високим рівнем емоційного інтелекту. Досліджена динаміка міжособистісного та внутрішньоособистісного компонентів емоційного інтелекту майбутніх психологів в процесі навчання. Виявлено, що розвиток внутрішньоособистісного емоційного інтелекту виявляється в меншому ступені вираженості ніж міжособистісний емоційний інтелект; динаміка внутрішньоособистісного емоційного інтелекту має тенденцію до збільшення від низьких рівнів розвитку на молодших курсах навчання до нижньої межі високого рівня на старших курсах навчання; ріст відмінностей на рівні середніх значень міжособистісного емоційного інтелекту молодших та старших курсів не є статистично значущими. Міжособистіснийком понент емоційного інтелекту має виражену динаміку в процесі навчання; його рівень змінюється від низького рівня розвитку на молодших курсах навчання до високого рівня на старших курсах навчання; такі відмінності є статистично значущими. Досліджено індивідуальні особливості системи саморегуляції за рівнями емоційного інтелекту. Виявлено значущі відмінності у групах міжособистісного та внутрішньоособистісного емоційного інтелекту. У групі з високим рівнем міжособистісного емоційного інтелекту притаманно більш розвинуті процеси планування, програмування, контролю, гнучкості та самостійності. Група з високим рівнем внутрішньоособистісного емоційного інтелекту характеризується більш розвинутими процесами планування, моделювання та гнучкістю. Такі особливості системи саморегуляції психологів. Перспективами подальших досліджень є виявленні особистісних характеристик майбутніх психологів з різними рівнями емоційного інтелекту та його компонентів.

Integrative Review of Dietary Choice Revealed by fMRI: Considerations for Obesity Prevention and Weight-Loss Education.

Emerging findings from neuroimaging studies investigating brain activity associated with dietary behavior are illuminating the interaction of biological and behavioral mechanisms that have implications for obesity prevention. Globally, A total of 1.9 billion adults are overweight, and 650 million are obese. Obesity and being overweight are major risk factors for chronic illness and death. Behaviorally based health interventions have had limited success in curbing the obesity epidemic. Greater understanding of brain responses to food cues will contribute to new knowledge and shape public health efforts in obesity prevention. However, an integration of this knowledge for obesity prevention education has not been published. This study links evidence generated from brain activation studies generated in response to diet and food images and highlights educational recommendations for nurses engaged in obesity prevention and weight-loss education. An integrative review of the literature was conducted using the MeSH keywords "magnetic resonance imaging," "diet," and "food images" in PubMed, MEDLINE Complete, CINAHL, and Cochrane databases from their first appearance in 2006 through March 2018. Studies published in English and using functional magnetic resonance imaging to measure brain response to diet, and food images were initially identified. Animal models, those whose primary focus was a specific disease, and intervention studies were excluded. Of 159 studies identified, 26 met inclusion criteria. Findings from neuroimaging studies may help explain the relationship between brain mechanisms and behavioral aspects of dietary choice and inform patient education in obesity prevention. Awareness of this evidence is applicable to nursing education efforts. This review contributes several recommendations that should be considered by nurses providing individualized weight-loss education. Nurses engaged in patient education for obesity prevention should consider personalized interventions that cultivate internal awareness for dietary adherence, self-care, exercise, hydration, and mood state; avoid using caloric deprivation approaches, such as skipping breakfast, for weight-loss interventions; and note the importance of individualized obesity prevention and weight-loss education.

Content-Free Awareness: EEG-fcMRI Correlates of Consciousness as Such in an Expert Meditator.

The minimal neural correlate of the conscious state, regardless of the neural activity correlated with the ever-changing contents of experience, has still not been identified. Different attempts have been made, mainly by comparing the normal waking state to seemingly unconscious states, such as deep sleep or general anesthesia. A more direct approach would be the neuroscientific investigation of conscious states that are experienced as free of any specific phenomenal content. Here we present serendipitous data on content-free awareness (CFA) during an EEG-fMRI assessment reported by an extraordinarily qualified meditator with over 50,000 h of practice. We focused on two specific cortical networks related to external and internal awareness, i.e., the dorsal attention network (DAN) and the default mode network (DMN), to explore the neural correlates of this experience. The combination of high-resolution EEG and ultrafast fMRI enabled us to analyze the dynamic aspects of fMRI connectivity informed by EEG power analysis. The neural correlates of CFA were characterized by a sharp decrease in alpha power and an increase in theta power as well as increases in functional connectivity in the DAN and decreases in the posterior DMN. We interpret these findings as correlates of a top-down-initiated attentional state excluding external sensory stimuli and internal mentation from conscious experience. We conclude that the investigation of states of CFA could provide valuable input for new methodological and conceptual approaches in the search for the minimal neural correlate of consciousness.

Pedagogía de la propiocepción corporal en el cantante

Este artículo, derivado del proyecto investigativo Nuevas pedagogías en la enseñanza del canto en el contexto formativo de la Escuela de Artes y Música de la Universidad Sergio Arboleda, tuvo como objetivo indagar sobre los distintos mecanismos propioceptivos y los diferentes grados de conciencia interna desarrollados por cantantes en formación dentro de una experiencia colectiva de aprendizaje. Los resultados, analizados desde una postura hermenéutica, arrojan las reflexiones, dilemas y logros originados en el proceso de construcción de la propia corporalidad y los distintos ajustes y desarrollos perceptivos para una adecuada articulación entre la voz y el cuerpo. Las conclusiones destacan la importancia de la propiocepción como un aprendizaje social e intersubjetivo a través de un proceso de internalización en el cual cobra valor la reivindicación de la subjetividad del cantante para expresar su mundo interior.

Befriending Our Own Mortality: An Innovative Curriculum to Engage with Palliative Care Clinician Countertransference (FR414)

•Define the concept of clinician countertransference, specifically in the area of mortality, and describe how these reactions can impact the delivery of optimal clinical palliative care.•Describe core elements of a curricular model designed to help clinicians understand their own emotional and cultural lens of mortality in order to objectively engage with patients/loved ones facing the end of life.•List key learning takeaways from former Thursdays with Mort (TWM) participants, and identify strategies for adaptation to one's own program or institution. Palliative care clinicians are routinely asked to expertly communicate about serious illness and end of life issues with patients and their loved ones. This information frequently leads patients and their loved ones to reflect on their cultural and existential attitudes toward mortality. Unfortunately medical training and hospital culture discourage engagement with mortality. In addition, deep-seated emotions associated with the clinician's own cultural background and life experience can prompt discomfort and suffering, especially surrounding this issue of mortality. If they go unnoticed and unexplored, these countertransference reactions can significantly interfere with the provision of effective and compassionate patient care as well as the clinician's resiliency and ultimate wellness. Thursdays with Mort (TWM) is a curriculum designed to address palliative medicine fellows' countertransference reactions to mortality in a supportive holding environment' where fellows can feel safe to explore and process their relationship with mortality, allowing for deepened internal awareness and understanding. This concurrent session will review the TWM curriculum, provide attendees with an adapted experiential component of TWM, and engage with former participants of TWM to learn of their TWM experience and its impact in their current practice. Attendees will be encouraged to consider ways they can bring TWM to their home institutions.

Near-Death Experience as a Probe to Explore (Disconnected) Consciousness.

Forty-five years ago, the first evidence of near-death experience (NDE) during comatose state was provided, setting the stage for a new paradigm for studying the neural basis of consciousness in unresponsive states. At present, the state of consciousness associated with NDEs remains an open question. In the common view, consciousness is said to disappear in a coma with the brain shutting down, but this is an oversimplification. We argue that a novel framework distinguishing awareness, wakefulness, and connectedness is needed to comprehend the phenomenon. Classical NDEs correspond to internal awareness experienced in unresponsive conditions, thereby corresponding to an episode of disconnected consciousness. Our proposal suggests new directions for NDE research, and more broadly, consciousness science.

GOVERNANCE OF THE FACEBOOK PRIVACY CRISIS

In November 2018, The New York Times ran a front-page story describing how Facebook concealed knowledge and disclosure of Russian-linked activity and exploitation resulting in Kremlin led disruption of the 2016 and 2018 U.S. elections, through the use of global hate campaigns and propaganda warfare. By mid-December 2018, it became clear that the Russian efforts leading up to the 2016 U.S. elections were much more extensive than previously thought. Two studies conducted for the United States Senate Select Committee on Intelligence (SSCI), by: (1) Oxford University’s Computational Propaganda Project and Graphika; and (2) New Knowledge, provide considerable new information and analysis about the Russian Internet Research Agency (IRA) influence operations targeting American citizens.By early 2019 it became apparent that a number of influential and successful high growth social media platforms had been used by nation states for propaganda purposes. Over two years earlier, Russia was called out by the U.S. intelligence community for their meddling with the 2016 American presidential elections. The extent to which prominent social media platforms have been used, either willingly or without their knowledge, by foreign powers continues to be investigated as this Article goes to press. Reporting by The New York Times suggests that it wasn’t until the Facebook board meeting held September 6, 2017 that board audit committee chairman, Erskin Bowles, became aware of Facebook’s internal awareness of the extent to which Russian operatives had utilized the Facebook and Instagram platforms for influence campaigns in the United States. As this Article goes to press, the degree to which the allure of advertising revenues blinded Facebook to their complicit role in offering the highest bidder access to Facebook users is not yet fully known. This Article can not be a complete chapter in the corporate governance challenge of managing, monitoring, and oversight of individual privacy issues and content integrity on prominent social media platforms. The full extent of Facebook’s experience is just now becoming known, with new revelations yet to come. All interested parties: Facebook users; shareholders; the board of directors at Facebook; government regulatory agencies such as the Federal Trade Commission (FTC) and Securities and Exchange Commission (SEC); and Congress must now figure out what has transpired and what to do about it. These and other revelations have resulted in a crisis for Facebook. American democracy has been and continues to be under attack. This article contributes to the literature by providing background and an account of what is known to date and posits recommendations for corrective action.

Special Issue: Integrating Mindfulness Training with Clinical Biofeedback: Practical Applications

This special issue continues the focus of the spring and summer 2018 issues (Volume 46, Issues 1 and 2) on the benefits of integrating mindfulness and biofeedback approaches and identifies several new areas of application in pediatric biofeedback, the treatment of adults with intellectual disabilities, care for persons with respiratory illness and mechanical ventilation, and the management of chronic multiple sclerosis.The issue opens with an article by two leaders in biofeedback, who argue that mindfulness is as a natural extension of the awareness training inherent in biofeedback and other self-regulation approaches. Eric Peper and Richard Harvey compare mindfulness with other self-regulation strategies, such as progressive muscle relaxation, autogenic training, and transcendental meditation. They identify common elements shared by mindfulness with other self-regulation strategies. They also argue that most of the commonly used self-regulation strategies have comparable efficacy. They suggest mechanisms making many such self-regulation skills effective, including effects on the gamma aminobutyric acid neurotransmitter system. Finally, they call for further research to explore dropout rates, adverse effects, and other dimensions of mindfulness training.Next, Jonathan Sikorski and Olivia Hernandez-Gonzalez address the challenges in applying mindfulness-based interventions with two special populations. They point out that young children often struggle with communicating their needs, feelings, and desires with others. Adults with intellectual disabilities face similar challenges. The authors introduce practical strategies they have developed to introduce mindfulness skills for these two groups. They also use biofeedback as a tool to assist both groups in enhancing internal awareness of the link between emotions and physiological sensations. To illustrate their approach, they present two case narratives, the first a 10-year-old boy with generalized anxiety disorder, and the second a 28-year-old adult with Prader-Willi syndrome and intellectual disabilities.Urszula Klich presents a case study illustrating her clinical approach, which emphasizes teaching self-regulation and compassion. The case example in her article presents a patient with a tracheostomy who is experiencing anxiety related to pain and anxiety about eventual removal of her vent. Mechanical ventilation for acute respiratory insufficiency accounts for approximately 800,000 hospitalizations each year, and discontinuation of mechanical ventilation is challenging for patients and care teams alike. Klich combined compassion-based strategies with biofeedback to reduce anxiety about decannulation (removal of the tracheostomy tube). Her interventions included mindfulness meditation, breath training, heart rate variability training, loving kindness meditation, and the use of mindfulness strategies to ameliorate anxiety.In the final article, Donald Moss discusses the integration of mindfulness training, clinical biofeedback, and lifestyle change in the management of multiple sclerosis (MS). Moss provides a discussion of the medical diagnosis and treatment of MS, a review of the epidemiology and genetics of the condition, and a case narrative describing a 36-year-old woman with a pattern of chronic relapsing MS. This chapter also shows the use of the Pathways Model to organize treatment. The Pathways Model is an overall self-directed program of acquiring self-regulation skills and implementing lifestyle changes as a supplement to professional intervention.

Mindful Adaptations for Young Patients and Adults with Mild Cognitive Disabilities

Young patients often encounter behavioral and communication challenges when interacting with adults. Adults with intellectual disabilities (ID) experience similar difficulties. There is a need to develop strategies that teach young patients and adults with intellectual disabilities practical and applicable mindfulness skills to either augment or support other behavioral or medical interventions. Biofeedback is a useful tool to teach these populations ways to increase their internal awareness of how emotions influence physiological sensations, while mindfulness helps them to focus on the present moment to control their emotions. This article presents the cases of Max and Robin to illustrate how mindfulness and biofeedback interventions can be adapted for younger patients and adults with ID in clinical settings. Clinicians used tangible visuals and overemphasized gestures to facilitate the understanding of our patients. Following these strategies, patients were able to understand changes in their physiological and emotional responses using biofeedback and mindfulness.