BackgroundPractice of meditation or exercise may enhance health to protect against acute infectious illness.ObjectiveTo assess preventive effects of meditation and exercise on acute respiratory infection (ARI) illness.DesignRandomized controlled prevention trial with three parallel groups.SettingMadison, Wisconsin, USA.ParticipantsCommunity-recruited adults who did not regularly exercise or meditate.Methods1) 8-week behavioral training in mindfulness-based stress reduction (MBSR); 2) matched 8-week training in moderate intensity sustained exercise (EX); or 3) observational waitlist control. Training classes occurred in September and October, with weekly ARI surveillance through May. Incidence, duration, and area-under-curve ARI global severity were measured using daily reports on the WURSS-24 during ARI illness. Viruses were identified multiplex PCR. Absenteeism, health care utilization, and psychosocial health self-report assessments were also employed.ResultsOf 413 participants randomized, 390 completed the trial. In the MBSR group, 74 experienced 112 ARI episodes with 1045 days of ARI illness. Among exercisers, 84 had 120 episodes totaling 1010 illness days. Eighty-two of the controls had 134 episodes with 1210 days of ARI illness. Mean global severity was 315 for MBSR (95% confidence interval 244, 386), 256 (193, 318) for EX, and 336 (268, 403) for controls. A prespecified multivariate zero-inflated regression model suggested reduced incidence for MBSR (p = 0.036) and lower global severity for EX (p = 0.042), compared to control, not quite attaining the p<0.025 prespecified cut-off for null hypothesis rejection. There were 73 ARI-related missed-work days and 22 ARI-related health care visits in the MBSR group, 82 days and 21 visits for exercisers, and 105 days and 24 visits among controls. Viruses were identified in 63 ARI episodes in the MBSR group, compared to 64 for EX and 72 for control. Statistically significant (p<0.05) improvements in general mental health, self-efficacy, mindful attention, sleep quality, perceived stress, and depressive symptoms were observed in the MBSR and/or EX groups, compared to control.ConclusionsTraining in mindfulness meditation or exercise may help protect against ARI illness.LimitationsThis trial was likely underpowered.Trial registrationClinicaltrials.gov NCT01654289

Objectives/Hypothesis In vitro modeling of cell-matrix interactions that occur during human vocal fold scarring is uncommon, as primary human vocal fold scar fibroblast cell lines are difficult to acquire. The purpose of this study was to characterize morphologic features, growth kinetics, contractile properties, α-smooth muscle actin (α-SMA) protein expression and gene expression profile of human vocal fold fibroblasts derived from scar (sVFF) relative to normal vocal fold fibroblasts (nVFF). Study Design In vitro. Methods We successfully cultured human vocal fold fibroblasts from tissue explants of scarred vocal folds from a 56-year-old female and compared these to normal fibroblast cells from a 59-year-old female. Growth and proliferation were assessed by daily cell counts and morphology was compared at 60% confluence for 5 days. Gel contraction assays were evaluated after seeding cells within a collagen matrix. Alpha-SMA was measured using western blotting and immunocytochemistry (ICC). Quantitative RT-PCR was used to assess differential extracellular matrix gene expression between the two cell types. Results sVFF were morphologically indistinguishable from nVFF. sVFF maintained significantly lower proliferation rates relative to nVFF on days 3-6 (day 3: p = 0.0138, days 4, 5, and 6: p < 0.0001). There were no significant differences in contractile properties between the two cell types at any time point (0h: p = 0.70, 24h: p = 0.79, 48h: p = 0.58). ICC and western blot analyses revealed increased expression of α-SMA in sVFF as compared with nVFF at passages 4 and 5, but not at passage 6 (passage 4: p = 0.006, passage 5: p = 0.0015, passage 6 = 0.8860). Analysis of 84 extracellular matrix genes using qRT-PCR revealed differential expression of 15 genes (p < 0.01). Conclusions nVFF and sVFF displayed differences in proliferation rates, α-SMA expression, and gene expression, whereas no differences were observed in contractile properties or morphology. Further investigation with a larger sample size is necessary to confirm these findings.

No abstract

Background and Objectives: Resident physicians experience a high level of stress. Mindfulness meditation has been shown to offer medical students and physicians a healthier way to relate to daily stressors. We developed and pilot tested a mindfulness training program and assessed its impact on resident physician burnout and resilience. Methods: The residency program offered 17 family medicine residents a 10-hour mindfulness training over the course of 2 months in 2016. Residents were encouraged, but not mandated, to attend. Experienced Mindfulness-Based Stress Reduction teachers and a family physician/integrative health fellow cotaught the program. A research team qualitatively assessed deidentified, postintervention resident interviews. Residents completed four quantitative questionnaires preintervention, immediately postintervention, and 3 months postintervention. A t score was calculated to assess for statistical significance. Results: Three residents (18%) attended all five training sessions, seven residents (41%) completed at least four sessions, and 16 residents (94%) completed either one or two sessions. Eight residents completed the postintervention interview. Twelve, nine and 14 residents completed the four questionnaires at the three time points, respectively. Qualitative results identified multiple personal/professional benefits of participating in mindfulness training, and we found a statistically significant decrease in perceived stress and increase in mindful awareness from pre- to postintervention (P&lt;.05). Conclusions: A resident physician mindfulness training program can be reasonably integrated into the residency schedule as part of the wellness curriculum required by the Accreditation Council for Graduate Medical Education. Preliminary results show potential for personal growth and positive changes in patient relationships.

No abstract