Objective Study the effect of participation in a mindfulness training program (Mindfulness Based Stress Reduction) on degree of bother from hot flashes and night sweats. Methods Randomized trial of 110 late perimenopausal and early post-menopausal women experiencing average of ≥5 moderate or severe hot flashes (including night sweats)/day. A wait list control was used, with three-month post-intervention follow-up. Main outcome was degree of bother from hot flashes and night sweats in previous 24 hours. Secondary measures: hot flash intensity, quality of life, insomnia, anxiety, perceived stress. Results Baseline average hot flash frequency was 7.87 (SD 3.44) and 2.81 night sweats (SD 1.76)/day. Mean bothersomeness score was 3.18 (SD 0.55) (‘moderately bothered/extremely bothered’). All analyses were intent to treat, and controlled for baseline values. Within-woman changes in bother from hot flashes differed significantly by treatment arm (week × treatment arm interaction P=0.042). At completion of intervention, bother in the MBSR arm decreased on average by 14.77% versus 6.79% for WLC. At 20 weeks total reduction in bother for MBSR was 21.62% and 10.50% for WLC. Baseline-adjusted changes in hot flash intensity did not differ between treatment arms (week × treatment arm interaction P=0.692). The MBSR arm made clinically significant improvements in quality of life (P=0.022), subjective sleep quality (p=0.009), anxiety (P=0.005), and perceived stress (P=0.001). Improvements were maintained 3 months post-intervention. Conclusions Our data suggest that MBSR may be a clinically significant resource in reducing the degree of bother and distress women experience from hot flashes and night sweats.

Background-The effect of dietary carbohydrate on blood lipids has received considerable attention in light of the current trend in lowering carbohydrate intake for weight loss.

Recruiting participants for research studies is often a challenging task. Recruitment requires careful planning, collaboration, and flexibility on the part of researchers and health care providers at the recruitment sites. This article describes six major barriers to recruiting study participants as identified from a review of the literature and from the coauthors' research experiences. These barriers include challenges related to regulations of the Health Insurance Portabililty and Accountability Act (HIPAA), health care providers' work burden, providers' financial disincentives, competition, health care provider concerns regarding research, and provider protection of patients. Each barrier is described, and specific strategies are suggested based on the empirical literature. In some instances, the coauthors' experiences are also shared.

Inconsistencies exist in the current literature regarding hypothalamic-pituitary-adrenal (HPA) regulation following exposure to repeated stressful events. These inconsistencies stem, in part, from the limitations imposed by measuring cortisol in saliva or plasma (i.e. "point measures" of HPA activity). The present study used a cross-sectional, correlational design to examine the relationship between childhood stress (assessed using the adverse childhood experiences [ACEs] questionnaire) and hair cortisol (a biomarker of chronic HPA activity) in 55 healthy 18-24-year-old college students. Dichotomous ACE score for two models using different cut-points was significantly, inversely related to hair cortisol level (B = 1.03, p = 0.046 and B = 1.09, p = 0.031). These results are consistent with theoretical models where exposure to repeated stressful events results in chronic HPA dysregulation, which may include down-regulation under certain conditions.

Mothers in the experimental arm valued the mentors' help in adjusting to the diagnosis, but this value was not measured by the study instruments. Focus group research is under way to clarify the concept of parent mentor social support and to develop a social support measurement tool.