Buddhist yoga encompasses an extensive variety of methods that aim to develop key virtues or qualities known as the 37 aids to awakening. The ultimate goal of Buddhist yoga is bodhi (awakening) or nirvana (cessation), which is traditionally seen as the permanent end of suffering (dukkha) and rebirth.[note 20] Buddhist texts use numerous terms for spiritual praxis besides yoga, such as bhāvanā ("development")[note 21] and jhāna/dhyāna.[note 22]
The tantra yoga practices include asanas and breathing exercises. The Nyingma tradition practices Yantra yoga (Tib. "Trul khor"), a discipline that includes breath work (or pranayama), meditative contemplation and other exercises. In the Nyingma tradition, the path of meditation practice is divided into further stages, such as Kriya yoga, Upa yoga, Yoga yana, Mahā yoga, Anu yoga and Ati yoga. The Sarma traditions also include Kriya, Upa (called "Charya"), and Yoga, with the Anuttara yoga class substituting for Mahayoga and Atiyoga.
The spiritual sense of the word yoga first arises in Epic Sanskrit, in the second half of the 1st millennium BCE, and is associated with the philosophical system presented in the Yoga Sutras of Patanjali, with the chief aim of "uniting" the human spirit with the Divine. The term kriyāyoga has a technical meaning in the Yoga Sutras (2.1), designating the "practical" aspects of the philosophy, i.e. the "union with the supreme" due to performance of duties in everyday life.
Since the late 1970s, the federal Healthy People Initiative has been a visible component of the United States’ approach to improving population health. In each decade, a new version of Healthy People is issued, featuring updated goals and identifying topic areas and quantifiable objectives for health improvement during the succeeding ten years, with assessment at that point of progress or lack thereof. Progress has been limited to many objectives, leading to concerns about the effectiveness of Healthy People in shaping outcomes in the context of a decentralized and uncoordinated US health system. Healthy People 2020 gives more prominence to health promotion and preventive approaches and adds a substantive focus on the importance of addressing social determinants of health. A new expanded digital interface facilitates use and dissemination rather than bulky printed books as produced in the past. The impact of these changes to Healthy People will be determined in the coming years.