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Training Grant-
Biology of Aging

Bruce Barrett

Bruce Barrett

Ph.D., M.D., University of Wisconsin
Professor, Department of Family Medicine & Population Health Sciences

Meditation and Exercise for Prevention of Acute Respiratory Infection

Background: Preliminary evidence suggests that meditation and exercise may work through interacting psychological and physiological pathways to influence the immune system and reduce infectious respiratory disease.

Methods: In this study, women and men aged 50 and older will be randomized to: 1) an 8-week behavioral training program in mindfulness meditation, 2) an intensity, duration and location-matched 8-week exercise training program, or 3) a waiting list control group. Sample size will be N=150 enrolled, with N=50 in each group. The main patient-oriented outcome will be severity-adjusted total days of acute respiratory infection (ARI) illness, as self-reported on the Wisconsin Upper Respiratory Symptom Survey (WURSS-24), a validated questionnaire outcome measure. Nucleic acid based viral identification will verify all symptomatic infections, and the cytokine IL-8 and nasal neutrophil from nasal wash will serve as biomarkers of illness severity. Biomarkers of immune function will include antibody response to influenza immunization (serum IgG, mucosal IgA) and cytokines IFN-? and IL-10 from cultured ex vivo lymphocytes. Questionnaire measures assessing perceived stress, positive and negative emotion, optimism, and anxiety will be analyzed as potential mediators of immunomodulation and illness prevention.

Timeframe / logistics: This will be a 2-year project, with 2 cohorts conducted during a single cold season. The first cohort of N=60 will be randomized and begin interventions in September 2009. The second cohort of N=90 will be randomized and begin interventions in January 2010. Tri-valent influenza vaccination will occur on week 6 of behavioral interventions in both cohorts. Blood for antibody titer and ex vivo cytokine assay will be drawn at baseline, at the end of the 8-week session, and once again 3 months later. Nasal swab for IgA will be done at the same times. Participants will be followed with telephone contact every 2 weeks, with monthly questionnaire instruments, and with daily self-assessments during ARI illness episodes.

Analysis: ANOVA-based models will assess effects of meditation and exercise on immune markers and ARI illness. Psychological measures will be assessed as potential mediators of effects of meditation and exercise on ARI illness. Generalized estimating equations, random-effects pattern-mixture models, and hierarchical linear models will be used to assess longitudinal effects, interactions, and covariate mediation.

Representative Publications
Brown, R., Obasi, C., & Barrett, B. (2016). Rasch analysis of the WURSS-21: Dimensional validation and assessment of invariance. Journal of Lung, Pulmonary & Respiratory Research, 3(2), 00076.
View publication via DOI: DOI:10.15406/jlprr.2016.03.00076

Henriquez, K. M., Hayney, M. S., Rakel, D. P., & Barrett, B. (2016). Procalcitonin levels in acute respiratory infection. Viral Immunology, 29(2), 128-131.
View publication via DOI: DOI:10.1089/vim.2015.0106

Barrett, B., Ricco J., Wallace, M., Kiefer, D., & Rakel, D. (2016). Communicating statin evidence to support shared decision-making. BMC Family Practice 17, 41.
View publication via DOI: DOI:10.1186/s12875-016-0436-9

Dorresteijn, P. M., Muller, D., Xie, Y., Zhang, Z., & Barrett, B. P. (2016). Validation of the Nasal Mucus Index: A novel measure of acute respiratory infection severity. American Journal of Rhinology & Allergy, 30(5), 324-8.
View publication via DOI: DOI:10.2500/ajra.2016.30.4337

Barrett, B., Grabow, M., Middlecamp, C., Mooney, M., Checovich, M. M., Converse, A. K., Gillespie, B., & Yates, J. (2016). Mindful climate action: Health and environmental co-benefits from mindfulness-based behavioral training. Sustainability, 8(10), 1040.
View publication via DOI: DOI:10.3390/su8101040

Maxwell, L., Barrett, B., Chase, J., Brown, R., & Ewers, T. (2015). Self-reported mental health predicts acute respiratory infection. Wisconsin Medical Journal, 114(3), 100-104.

Karsch-Volk, M., Barrett, B., & Linde, K. (2015). Echinacea for preventing and treating the common cold. JAMA, 313(6), 618-619.
View publication via DOI: DOI:10.1001/jama.2014.17145

Barrett, B., Charles, J. W., & Temte, J. L. (2015). Climate change, human health, and epidemiological transition. Preventive Medicine, 70, 69-75.
View publication via DOI: DOI:10.1016/j.ypmed.2014.11.013

Kiefer, D. S., Chase, J. C., Love, G. D., & Barrett, B. P. (2014). The overlap of dietary supplement and pharmaceutical use in the MIDUS national study. Evidence-Based Complementary and Alternative Medicine, 2014(Article ID 823853), 1-6.
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View publication via DOI: DOI:10.1155/2014/823853

Henriquez, K. M., Hayney, M. S., Xie, Y., Zhang, Z, & Barrett, B. (2014). Association of interleukin-8 and neutrophils with nasal symptom severity during acute respiratory infection. Journal of Medical Virology, 87(2), 330-337.
View publication via DOI: DOI:10.1002/jmv.24042

Wallace, M.L., Ricco, J.A., & Barrett, B. (2014). Screening strategies for cardiovascular disease in asymptomatic adults. Primary Care, 41(2), 371-97.
View publication via DOI: DOI:10.1016/j.pop.2014.02.010

Karsh-Volk, M., Barrett, B., Kiefer, D., Bauer, R., Ardjomand-Woelkart, K., & Linde, K. (2014). Echinacea for preventing and treating the common cold. The Cochrane Collaboration, (11), 622-637.
View publication via DOI: DOI:10.1002/14651858.CD000530.pub3

Obasi, C., Barrett, B., Brown, R., Vrtis, R., Barlow, S., Muller, D., & Gern, J (2014). Detection of viral and bacterial pathogens in acute respiratory infections. Journal of Infection, 68(2), 125-130.
View publication via DOI: DOI:10.1016/j.jinf.2013.10.013

Obasi, C. N., Brown, R., Ewers, T., Barlow, S., Gassman, M., Zgierska, A., Coe, C. L., & Barrett, B. (2013). Advantage of meditation over exercise in reducing cold and flu illness is related to improved function and quality of life. Influenza and Other Respiratory Viruses, 7(6), 938-944.
View publication via DOI: DOI:10.1111/irv.12053

Ferreira, M. L., Herbert, R. D., Ferreira, P. H., Latimer, J., Ostelo, R. W., Grotle, M., & Barrett, B. (2013). The smallest worthwhile effect of nonsteroidal anti-inflammatory drugs and physiotherapy for chronic low back pain: A benefit-harm trade-off study. Journal of Clinical Epidemiology, 66(12), 1397-1404.
View publication via DOI: DOI:10.1016/j.jclinepi.2013.02.018

Rakel, D., Mundt, M., Ewers, T., Fortney, L., Zgierska, A., Gassman, M., & Barrett, B. (2013). Value associated with mindfulness meditation and moderate exercise intervention in acute respiratory infection: The MEPARI Study. Family Practice, 30(4), 390-397.
View publication via DOI: DOI:10.1093/fampra/cmt008

Longmier, E., Barrett, B., & Brown, R. (2013). Can patients or clinicians predict the severity or duration of an acute upper respiratory infection? Family Practice, 30(4), 379-385.
View publication via DOI: DOI:10.1093/fampra/cmt006

Zgierska, A., Obasi, C. N., Brown, R., Ewers, T., Muller, D., Gassman, M., . . . Barrett, B. (2013). Randomized controlled trial of mindfulness meditation and exercise for the treatment of acute respiratory infection: Possible mechanisms of action. Evidence-Based Complementary and Alternative Medicine. Advance online publication.
View publication via DOI: DOI:10.1155/2013/952716

Hayney, M. S., Coe, C. L., Muller, D., Obasi, C. N., Backonja, U., Ewers, T., & Barrett, B. (2013). Age and psychological influences on immune responses to trivalent inactivated influenza vaccine in the meditation or exercise for preventing acute respiratory infection (MEPARI) trial. Human Vaccines and Immunotherapeutics, 10(1). Advance online publication.
View publication via DOI: DOI:10.4161/hv.26661

Obasi, C., Brown, R., & Barrett, B. (2013). Item reduction of the Wisconsin upper respiratory symptom survey (wurss-21) leads to the wurss-11. Quality of Life Research. Advance online publication.
View publication via DOI: DOI:10.1007/s11136-013-0561-z

Obasi, C. N., Barrett, B., Brown, R., Vrtis, R., Barlow, S., Muller, D., & Gern, J. (2013). Detection of viral and bacterial pathogens in acute respiratory infections. The Journal of Infection. Advance online publication.
View publication via DOI: DOI:10.1016/j.jinf.2013.10.013

Barrett, B. (2013). Sufficiently important difference: Concepts, caveats, and challenges. Medical Decision Making, 33(6), 869-874.
View publication via DOI: DOI:10.1177/0272989x13476764

Barrett, B., Hayney, M.S., Muller, D., Rakel, D., Ward, A., Obasi, O.N., ... Coe, C.L. (2012). Meditation or Exercise for Preventing Acute Respiratory Infection: A Randomized Controlled Trial. Annals of Family Medicine, 10(4), 337-346.
View publication via DOI: DOI:10.1370/afm.1376

Barrett, B., Stiles, M., & Patterson, J. (2012). Radiation risks: Critical analysis and commentary. Preventive Medicine, 54(3-4), 280-282.
View publication via DOI: DOI:10.1016/j.ypmed.2011.12.017

Husted, C. & Barrett, B. (2010). Therapeutics and safety profile section in monograph: Echinacea angustifolia root: Standards of analysis, quality control and therapeutics. American Herbal Pharmacopoeia and Therapeutic Compendium. A.H.P., Scotts Valley, CA.

Rakel, D.P., Hoeft, T.J., Barrett, B., Chewning, B.A., Craig, B.M., & Niu, M. (2009). Practitioner empathy and the duration of the common cold. Family Medicine, 41(7), 494-50.

Barrett, B., Brown, R.L., Mundt, M.P., Thomas, G.R., Barlow, S.K., Highstrom, A.D., & Bahrainian, M. (2009). Validation of a short form Wisconsin Upper Respiratory Symptom Survey (WURSS-21). Health and Quality of Life Outcomes, 7, 76.
View publication via DOI: DOI:10.1186/1477-7525-7-76

Rakel, D.P., Hoeft, T.J., Barrett, B.P., Chewning, B.A., Craig, B.M., & Niu, M. (2009). Practitioner empathy and the duration of the common cold. Family Medicine, 41(7), 494-501.
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Barrett, B., Mundt, M., & Brown, R. (2008). Comparison of anchor-based and distributional approaches in estimating important difference in common cold. Quality of Life Research, 17(1), 75-85.
View publication via DOI: DOI:10.1007/s11136-007-9277-2

Barrett, B., Harahan, B., Brown, D., Zhang, Z., & Brown, R. (2007). Sufficiently important difference for common cold: Severity reduction. Annals of Family Medicine, 5(4), 216-223.
View publication via DOI: DOI:10.1370/afm.698

Barrett, B., Endrizzi, S., Andreoli, P., Barlow, S., & Zhang, Z. (2007). Clinical significance of common cold treatment: Professionals' opinions. Wisconsin Medical Journal, 106(8), 473-480.

Barrett, B., Rakel, D., Chewning, B., Marchand, L., Rabago, D., Brown, R., Scheder, J., Schmidt, R., Gern, J. E., Bone, K., Thomas, G., & Barlow, S. (2007). Rationale and methods for a trial assessing placebo, echinacea and doctor patient interaction in common cold. Explore: The Journal of Science and Healing, 3(6), 561-572.
View publication via DOI: DOI:10.1016/j.explore.2007.08.001

Linde, K., Barrett, B., Wolkart, K., Bauer, R., & Melchart, D. (2006). Echinacea for preventing and treating the common cold. Cochrane Collaboration Systematic Review.
View publication via DOI: DOI:10.1002/14651858.CD000530.pub2

Barrett, B., Muller, D., Rakel, D., Rabago, D., Marchand, L., & Scheder, J. (2006). Placebo, meaning and health. Perspectives in Biology and Medicine, 49(2), 178-198.
View publication via DOI: DOI:10.1353/pbm.2006.0019

Barrett, B., Brown, R., Voland, R., Maberry, R., & Turner, R. (2006). Relations among questionnaire and laboratory measures of rhinovirus infection. European Respiratory Journal, 28(2), 358-362.
View publication via DOI: DOI:10.1183/​09031936.06.00002606

Barrett, B., Brown, D., Mundt, M. P., & Brown, R. L. (2005). Sufficiently important difference: Expanding the framework of clinical significance. Medical Decision Making, 25(2), 1-11.
View publication via DOI: DOI:10.1177/0272989X05276863

Barrett, B., Marchand, L., Scheder, J., Appelbaum, D., Plane, M. B., Blustein, J., Maberry, R., & Capperino, C. (2004). What complementary and alternative medicine practitioners say about health and health care. Annals of Family Medicine, 2(3), 253-259.
View publication via DOI: DOI:10.1370/afm.81

Barrett, B. (2003). Medicinal properties of echinacea: A critical review. Phytomedicine, 10(1), 66-86.
View publication via DOI: DOI:10.1078/094471103321648692

Barrett, B. (2003). Echinacea: A safety review. HerbalGram: Journal of the American Botanical Council, 57, 36-39.

Barrett, B., Marchand, L., Scheder, J., Plane, M. B., Maberry, R., Appelbaum, D., Rakel, D., & Rabago, D. (2003). Themes of holism, empowerment, access and legitimacy define complementary, alternative and integrative medicine in relation to conventional biomedicine. Journal of Alternative and Complementary Medicine, 9(5), 937-47.
View publication via DOI: DOI:10.1089/107555303771952271

Barrett, B., Locken, K., Maberry, R., Brown, R.L., Bobula, A., & D'Alessio, D. (2002). Treatment of the common cold with unrefined echinacea: A randomized double-blind, placebo-controlled trial. Annals of Internal Medicine, 137(12), 939-946.
View publication via DOI: DOI:10.7326/0003-4819-137-12-200212170-00006

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