Background-This research examines student evaluations of their experience and attitudes in an 11 week mind-body skills course for first year medical students.Aims-The aim is to understand the impact of this course on students' self-awareness, selfreflection, and self-care as part of their medical education experience.Methods-This study uses a qualitative content analysis approach to data analysis. The data are 492 verbatim responses from 82 students to six open-ended questions about the students' experiences and attitudes after a mind-body skills course. These questions queried students' attitudes about mind-body medicine, complementary medicine, and their future as physicians using these approaches.Results-The data revealed five central themes in students' responses: connections, self discovery, stress relief, learning, and medical education.Conclusions-Mind-body skills groups represent an experiential approach to teaching mindbody techniques that can enable students to achieve self-awareness and self-reflection in order to engage in self-care and to gain exposure to mind-body medicine while in medical school. IntroductionMedical school is a challenging environment in which students are confronted with multiple psychological and physical stressors; teaching students how to deal with these stressors is important for their health and well-being. Training physicians to focus on self-awareness, self-reflection and self-care may produce more reflective and well balanced doctors who may provide better patient care. HHS Public Access Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptOne approach to helping students to deal with the stressors of medical school focuses on teaching mind-body skills (MBS) that promote self-awareness, self-reflection and self-care. While medical teaching on self-reflection and professionalism is more wide spread in the UK (Maudsley & Fryer-Edwards 2003), curricula focusing on MBS and the promotion of self-awareness and self-reflection is less well established in medical schools in the United States (Dannoff & Corbet 2005). The learning objectives of self-awareness and reflection are often challenging to integrate into a medical school curriculum and equally difficult to assess (Boenink et al. 2004). There have been a variety of interventions employed to help students alleviate stress, promote well-being and self-reflection, this paper describes the results of an experiential intervention focusing on MBS techniques to achieve these outcomes.Medical students have been surveyed about the physical and psychological challenges of medical school since the early 1970s (Pitts et al. 1961;Linn & Zeppa 1984;Firth 1986;Wolf 1989;Mosley et al. 1994;Stewart et al. 1997). Findings of increased stress levels have motivated a variety of interventions designed to provide sensitivity training (Dashef et al. 1974;Hilberman et al. 1975), self-awareness (Cadden et al. 1969), self-reflection (Killion & Todnem 1991;Maudsley & Fryer-Edwards 2003;Boenink et al. 2004), sharing of feeli...

Neuropeptide Y (NPY) has recently been localized in the rat hypothalamus. We have evaluated the effects of NPY on hypothalamic and pituitary function by injecting NPY into the third ventricle in vivo and by examining its action on perifused pituitary cells in vitro. Injection of NPY into the third ventricle of conscious ovariectomized rats led to a dramatic and highly significant reduction in plasma luteinizing hormone (LH) relative to pretreatment levels in these animals or to those of controls injected with physiological saline. Significant inhibition was obtained with doses ranging from 0.02 to 5.0 1Ag (4.7-1175 pmol) Neuropeptide Y (NPY) was isolated from porcine brain by Tatemoto and co-workers (1, 2). It contains 36 amino acids and displays marked sequence homology to avian and bovine pancreatic polypeptide (APP and BPP). NPY-like immunoreactivity has been localized throughout the brain (3, 4, t, t), and especially high concentrations (5, 6) have been measured in the hypothalamus of the rat and human by RIA. NPY appears to be located in certain brainstem noradrenergic and adrenergic nuclei that project to the hypothalamus and also in intrinsic hypothalamic neurons (3, 4, t, t (225-250 g) were bilaterally ovariectomized while they were under ether anesthesia, 3-5 weeks before implantation of a 3V cannula or before decapitation for collection of anterior pituitary glands. The animals were housed in group cages under controlled conditions of temperature (23-25°C) and illumination (lights on 0500-1900) and were provided food and water ad lib.Jugular Cannulation. Twenty-four hours prior to 3V injection of NPY or saline (0.9% NaCl), a cannula was inserted into the right external jugular vein by using an established procedure (7). On the day of the experiment, the cannula was connected to a longer flexible tube (PE-50, Clay Adams) containing heparin and saline. This system allowed rapid collection of blood samples (0.6 ml) and replacement of blood volume with 0.9% NaCl without disturbing the animal. Rats were acclimated to these conditions for at least 1 hr prior to 3V injection of NPY.Ventricular Injections and Blood Sampling. A stainless steel cannula (23 gauge) was implanted into the third ventricle 7-10 days before the experiment (8). Various doses of synthetic porcine NPY (lots 003778 and 004219, Peninsula Laboratories, Belmont, CA) or an equal volume (2 ,u) of diluent (0.9% NaCl) was injected into the third ventricle of conscious, unrestrained animals after withdrawal of a preinjection blood sample (0.6 ml) through the jugular cannula. This blood sample was designated the 0-min sample and subsequent samples were obtained at various times after 3V injection. Samples were stored on ice and later spun at low speed at 4°C, the supernatant was removed, and plasma was divided into aliquots immediately or stored frozen for RIA to determine the concentrations of luteinizing hormone (LH) and growth hormone (GH) as well as follicle-stimulating hormone (FSH) in one experiment.Anterior Pituitary Cell Perif...

The presence of oxytocin (OT) in neuronal elements of the external layer of the median eminence and in hypophysial portal plasma suggests a role for the peptide in the control of anterior pituitary function. We have reported previously that OT stimulates PRL release in vitro; therefore, we attempted to establish evidence for a physiological PRL-releasing role for OT. Plasma OT levels rose significantly just before the PRL surges occurring during a suckling stimulus in lactating rats (10 min after pup reinstatement vs. 15 min for PRL) and 48 h after estrogen injection in ovariectomized (OVX) rats (at 1200 h vs. 1300 h). Dispersed anterior pituitary cells harvested from lactating female rats and OVX estrogen-primed rats released PRL in a specific, significant, and dose-related fashion when perifused in vitro with incubation medium containing 10(-7)-10(-9) M OT, doses similar to levels found previously in hypophysial portal plasma. Infusion of antiserum specific for OT into lactating females before pup reinstatement and into estrogen-primed OVX rats 2 h before the expected release of endogenous OT delayed and significantly reduced subsequent PRL surges compared to levels in saline-or normal rabbit serum-infused rats; however, PRL release was not completely abolished. These data indicate that OT plays a physiological role in the hypothalamic control of PRL secretion and further suggest the importance of multiple factors in coordinated regulation of PRL release.

To determine whether oxytocin (OT) could alter the release of PRL and other hormones from the anterior pituitary gland, the effects of OT were examined in two in vitro and two in vivo test systems. Cells dispersed from anterior pituitary glands of intact adult male rats were incubated in medium containing OT at doses of 10(-8), 10(-7), 10(-6), and 10(-5) M in two trials. OT stimulated PRL release 1.5-fold (P less than 0.01) and 2- to 3-fold (P less than 0.001) above control levels at 10(-8) and 10(-7) M doses, respectively, thus indicating a dose-dependent relationship. Higher doses did not produce a further elevation above that obtained with 10(-7) M OT. Arginine vasopressin (AVP) caused a slight decrease in PRL release from dispersed cells while TRH produced a small (25%), significant, but nondose-related increase in PRL release. Hemipituitary glands from adult male rats, incubated with 10(-6) and 10(-5) M OT, released twice as much PRL (P less than 0.01) into the medium as paired controls, but 10(-7) M OT was ineffective. The iv injection of 1 or 10 micrograms OT into conscious male rats elevated plasma PRL by 50% (P less than 0.05) or 500% (P less than 0.001), respectively, above basal values at 5 min only. Vehicle or 0.1 microgram OT were without effect. When 0.1 microgram OT was microinjected into the third ventricle (3V) of conscious male rats, it paradoxically reduced plasma PRL by 40% at 30 min (P less than 0.05), whereas 1 microgram OT significantly lowered PRL at 5-60 min, with the maximum suppression (60%, P less than 0.001) occurring at 30 min. These latter findings may indicate that an ultrashort loop feedback mechanism exists whereby exogenous OT decreases hypothalamic OT secretion, thereby reducing the OT stimulus for PRL release. The specificity of the OT effect on PRL was attested to by the failure of OT to alter significantly FSH, LH, and TSH in each system. GH was unchanged except that 3V-injected OT (1 microgram only) elevated (P less than 0.001) plasma GH at 15-30 min. These results support the view that OT acts directly on the cells of the anterior pituitary gland at low to high doses to release PRL specifically and in a dose-related fashion. In contrast, 3V injection of OT reduces PRL secretion, thereby suggesting that OT may decrease its own neurosecretion by ultrashort loop feedback and thus reduce an OT stimulus for PRL release.

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