Stress and stress‐related mental health problems are major causes of illness and disability. Mindfulness‐based stress reduction (‘MBSR’) is a group‐based health promotion intervention to improve health and the way people deal with stress and life?s challenges. The core ingredient is mindfulness training through physical and mental exercises practiced daily for eight weeks. The mindful non‐judgmental attitude of being present with what arises is practiced in the formal exercises and in everyday situations. This review assesses the effect of MBSR programs on outcome measures of mental and physical health, quality of life and social functioning in adults. MBSR has a moderately large effect on outcome measures of mental health, somatic health, and quality of life including social function at post‐intervention when compared to an inactive control. If 100 people go through the MBSR program, 21 more people will have a favourable mental health outcome compared to if they had been put on a wait‐list or gotten only the usual treatment. These results may be inflated by underreporting of negative trials and moderate heterogeneity (indicating differences between the trials). MBSR has a small but significant effect on improving mental health at post‐intervention compared to other active treatments. MBSR has the same effect as other active interventions on somatic health, and quality of life (including social function). There was no underreporting of negative trials, and heterogeneity (differences between trials) were small for mental health, moderate for quality of life and large for somatic health. The effects were similar across all target groups and were generally maintained at follow‐up (1?34 months). The effects were largely independent of gender and study sample. The effects seemed also largely independent of duration and compliance with the MBSR intervention. No studies report results regarding side‐effects or costs. Effects were strongly correlated to the effects on measures of mindfulness, indicating that the effects may be related to the increase in self‐reported mindfulness. Two thirds of the included studies showed a considerable risk of bias, which was higher among studies with inactive than active control groups. Studies of higher quality reported lower effects than studies with low quality. The overall quality of the evidence was moderate, indicating moderate confidence in the reported effect sizes. Further research may change the estimate of effect. Plain language summary Mindfulness training improves health and quality of life for adultsMindfulness‐based stress reduction (MBSR) is used to improve health, quality of life and social functioning. MBSR has a positive effect on mental health outcomes measured right after the intervention and at follow up. It also improves personal development, quality of life, and self‐reported mindfulness. What is this review about?Stress and stress‐related mental health problems are major causes of illness and disability. MBSR is a group‐based health promotion intervention to imp...

ObjectiveTo identify and describe the content of templates for reporting prehospital major incident medical management.DesignSystematic literature review according to PRISMA guidelines.Data sourcesPubMed/MEDLINE, EMBASE, CINAHL, Scopus and Web of Knowledge. Grey literature was also searched.Eligibility criteria for selected studiesTemplates published after 1 January 1990 and up to 19 March 2012. Non-English language literature, except Scandinavian; literature without an available abstract; and literature reporting only psychological aspects were excluded.ResultsThe main database search identified 8497 articles, among which 8389 were excluded based on title and abstract. An additional 96 were excluded based on the full-text. The remaining 12 articles were included in the analysis. A total of 107 articles were identified in the grey literature and excluded. The reference lists for the included articles identified five additional articles. A relevant article published after completing the search was also included. In the 18 articles included in the study, 10 different templates or sets of data are described: 2 methodologies for assessing major incident responses, 3 templates intended for reporting from exercises, 2 guidelines for reporting in medical journals, 2 analyses of previous disasters and 1 Utstein-style template.ConclusionsMore than one template exists for generating reports. The limitations of the existing templates involve internal and external validity, and none of them have been tested for feasibility in real-life incidents.Trial registrationThe review is registered in PROSPERO (registration number: CRD42012002051).

BackgroundStructured reporting of major incidents has been advocated to improve the care provided at future incidents. A systematic review identified ten existing templates for reporting major incident medical management, but these templates are not in widespread use. We aimed to address this challenge by designing an open access template for uniform reporting of data from pre-hospital major incident medical management that will be tested for feasibility.MethodsAn expert group of thirteen European major incident practitioners, planners or academics participated in a four stage modified nominal group technique consensus process to design a novel reporting template. Initially, each expert proposed 30 variables. Secondly, these proposals were combined and each expert prioritized 45 variables from the total of 270. Thirdly, the expert group met in Norway to develop the template. Lastly, revisions to the final template were agreed via e-mail.ResultsThe consensus process resulted in a template consisting of 48 variables divided into six categories; pre-incident data, Emergency Medical Service (EMS) background, incident characteristics, EMS response, patient characteristics and key lessons.ConclusionsThe expert group reached consensus on a set of key variables to report the medical management of pre-hospital major incidents and developed a novel reporting template. The template will be freely available for downloading and reporting on http://www.majorincidentreporting.org. This is the first global open access database for pre-hospital major incident reporting. The use of a uniform dataset will allow comparative analysis and has potential to identify areas of improvement for future responses.