PURPOSE This study was designed to evaluate potential preventive effects of meditation or exercise on incidence, duration, and severity of acute respiratory infection (ARI) illness.METHODS Community-recruited adults aged 50 years and older were randomized to 1 of 3 study groups: 8-week training in mindfulness meditation, matched 8-week training in moderate-intensity sustained exercise, or observational control. The primary outcome was area-under-the-curve global illness severity during a single cold and infl uenza season, using the Wisconsin Upper Respiratory Symptom Survey (WURSS-24) to assess severity. Health care visits and days of missed work were counted. Nasal wash collected during ARI illness was assayed for neutrophils, interleukin-8, and viral nucleic acid. RESULTSOf 154 adults randomized into the study, 149 completed the trial (82% female, 94% white, mean age 59.3 ± 6.6 years). There were 27 ARI episodes and 257 days of ARI illness in the meditation group (n = 51), 26 episodes and 241 illness days in the exercise group (n = 47), and 40 episodes and 453 days in the control group (n = 51). Mean global severity was 144 for meditation, 248 for exercise, and 358 for control. Compared with control, global severity was signifi cantly lower for meditation (P = .004). Both global severity and total days of illness (duration) trended toward being lower for the exercise group (P = .16 and P = .032, respectively), as did illness duration for the meditation group (P = .034). Adjusting for covariates using zero-infl ated multivariate regression models gave similar results. There were 67 ARI-related days of-work missed in the control group, 32 in the exercise group (P = .041), and 16 in the meditation group (P <.001). Health care visits did not differ signifi cantly. Viruses were identifi ed in 54% of samples from meditation, 42% from exercise, and 54% from control groups. Neutrophil count and interleukin-8 levels were similar among intervention groups. CONCLUSIONSTraining in meditation or exercise may be effective in reducing ARI illness burden.
High doses of psilocybin elicited subjective effects at least as strong as the lower doses and resulted in positive persisting subjective effects 30 days after, indicating that a complete mystical experience was not a prerequisite for positive outcomes.
Purpose To examine whether apparent advantages following training in meditation over exercise can be attributed to specific symptoms, functional impairments, or quality of life indicators assessed by the Wisconsin Upper Respiratory Symptom Survey (WURSS-24). Methods Results from the randomized controlled trial “Meditation or Exercise for Preventing Acute Respiratory Illness” (MEPARI) showed mean global severity and total days of illness were worse in Control (358, 8.9) compared to Exercise (248, 5.1) or Meditation (144, 5.0). Global severity of illness was estimated using area-under-the-curve from daily self-reported severity scores on the WURSS-24. For the current project, we estimated within-group WURSS item-level severity and between-group effect sizes (Cohen's “d” statistic) relative to control. The item-level effect sizes were grouped into 1) symptoms and 2) function and quality of life domains. Results Among the 3 groups, mediators showed the lowest severity estimates for 21 of 22 WURSS items. Item-level Cohen's “d” indicated most benefit was evident in WURSS items representing function and quality of life. Compared to exercise, meditation fostered larger reductions in illness severity, although due mostly to improved function and the quality of life domain (d = − 0.33, p<0.001) compared to symptom domain (d = − 0.22, p<0.001). Conclusions The apparent advantage of training in meditation over exercise for reducing cold and flu illness is explained more by improved function and quality of life than by a reduction in symptom severity.
Background Injectable naltrexone for alcohol use disorders (AUDs) has been efficacious in several studies. It has not been (1) compared head-to-head with oral naltrexone, or (2) examined in the hospital setting as an intervention that might facilitate treatment attendance after hospital discharge. Methods Fifty-four hospitalized veterans identified as having DSM-IV alcohol dependence were randomized to receive: (1) a 50 mg oral naltrexone plus a 30-day prescription, or (2) a 380 mg intramuscular naltrexone injection prior to discharge. Of 113 veteran inpatients deemed eligible based on screening criteria, 54 met final eligibility criteria and were enrolled and randomized. Baseline data included demographics, alcohol consumption and co-morbidity. Measures of treatment initiation and engagement and alcohol consumption were reassessed at 14-day and 45-day follow ups. Results Thirty-five participants (64.8%) completed the entire study protocol (received a study medication and completed 14- and 45-day follow ups). Among those who received a study medication (n=45), 77.8% completed all follow-up interviews. This pilot study was not designed to have sufficient statistical power for hypothesis testing, and thus, as expected, there were no significant differences between groups in medication adherence (self-report of > 80% of daily doses taken in oral group; receipt of second injection in the injection group), treatment engagement (at least treatment 3 visits in the 30 days post-discharge, and 2 or more visits per month in each of the 3 months following discharge) or alcohol consumption at 14 or at 45 days (p>0.05). The median number of drinks among the entire cohort in the two weeks prior to hospitalization (128 drinks) was significantly higher than at Day 14 (0 drinks, p<0.001) or Day 45 (0 drinks, p<0.001). Rates of medication adherence were 62% in the oral group and 61% in the injection group Conclusions Results indicate feasibility for larger, more definitive study. Both groups had significant reductions in alcohol consumption over time and high treatment engagement rates. Both oral and injectable formulations are feasible to initiate prior to discharge for hospital inpatients identified as having an AUD.
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