Mindfulness-based programs (MBPs) are increasingly utilized to improve mental health. Interest in the putative effects of MBPs on cognitive function is also growing. This is the first meta-analysis of objective cognitive outcomes across multiple domains from randomized MBP studies of adults. Seven databases were systematically searched to January 2020. Fifty-six unique studies (n = 2,931) were included, of which 45 (n = 2,238) were synthesized using robust variance estimation meta-analysis. Meta-regression and subgroup analyses evaluated moderators. Pooling data across cognitive domains, the summary effect size for all studies favored MBPs over comparators and was small in magnitude (g = 0.15; [0.05, 0.24]). Across subgroup analyses of individual cognitive domains/subdomains, MBPs outperformed comparators for executive function (g = 0.15; [0.02, 0.27]) and working memory outcomes (g = 0.23; [0.11, 0.36]) only. Subgroup analyses identified significant effects for studies of non-clinical samples, as well as for adults aged over 60. Across all studies, MBPs outperformed inactive, but not active comparators. Limitations include the primarily unclear within-study risk of bias (only a minority of studies were considered low risk), and that statistical constraints rendered some p-values unreliable. Together, results partially corroborate the hypothesized link between mindfulness practices and cognitive performance. This review was registered with PROSPERO [CRD42018100904].

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Women face greater challenges than men in accessing water, sanitation, and hygiene (WASH) resources to address their daily needs, and may respond to these challenges by adopting unsafe practices that increase the risk of reproductive tract infections (RTIs). WASH practices may change as women transition through socially-defined life stage experiences, like marriage and pregnancy. Thus, the relationship between WASH practices and RTIs might vary across female reproductive life stages. This cross-sectional study assessed the relationship between WASH exposures and self-reported RTI symptoms in 3,952 girls and women from two rural districts in India, and tested whether social exposures represented by reproductive life stage was an effect modifier of associations. In fully adjusted models, RTI symptoms were less common in women using a latrine without water for defecation versus open defecation (Odds Ratio (OR) = 0.69; Confidence Interval (CI) = 0.48, 0.98) and those walking shorter distances to a bathing location (OR = 0.79, CI = 0.63, 0.99), but there was no association between using a latrine with a water source and RTIs versus open defecation (OR = 1.09; CI = 0.69, 1.72). Unexpectedly, RTI symptoms were more common for women bathing daily with soap (OR = 6.55, CI = 3.60, 11.94) and for women washing their hands after defecation with soap (OR = 10.27; CI = 5.53, 19.08) or ash/soil/mud (OR = 6.02; CI = 3.07, 11.77) versus water only or no hand washing. WASH practices of girls and women varied across reproductive life stages, but the associations between WASH practices and RTI symptoms were not moderated by or confounded by life stage status. This study provides new evidence that WASH access and practices are associated with self-reported reproductive tract infection symptoms in rural Indian girls and women from different reproductive life stages. However, the counterintuitive directions of effect for soap use highlights that causality and mechanisms of effect cannot be inferred from this study design. Future research is needed to understand whether improvements in water and sanitation access could improve the practice of safe hygiene behaviors and reduce the global burden of RTIs in women.

We examined the effectiveness of a heads-up Forward Collision Warning (FCW) system in 39 younger to middle aged drivers (25-50, mean = 35 years) and 37 older drivers (66-87, mean = 77 years). The warnings were implemented in a fixed based, immersive, 180 degree forward field of view simulator. The FCW included a visual advisory component consisting of a red horizontal bar which flashed in the center screen of the simulator that was triggered at time-to-collision (TTC) 4 seconds. The bar roughly overlapped the rear bumper of the lead vehicle, just below the driver's line-of-sight. A sustained auditory tone (~80 dB) was activated at TTC=2 to alert the driver to an imminent collision. Hence, the warning system differed from the industry standard in significant ways. 95% Confidence intervals for the safety gains ranged from −.03 to .19 seconds in terms of average correction time across several activations. Older and younger adults did not differ in terms of safety gains. Closer inspection of data revealed that younger to middle aged drivers were already braking (42%) on a larger proportion of FCW activations than older drivers (26%), p < .001. Conversely, older drivers were still accelerating (38%) on a larger proportion of FCW activations than younger to middle aged drivers (23%) at the time FCW was activated, p < .009. There were no differences in the proportion of activations when drivers were coasting at the time FCW was activated, p = .240. Furthermore, large individual differences in basic visual, motor, and cognitive function predicted the tendency to brake prior to FCW activation. Those who tended to be better functioning in each of these domains were more likely to be already braking prior to FCW activation at the fixed threshold of TTC=4. These findings suggest optimal timing for advisory alerts for forward events may need to be larger than TTC=4.