Salivary Cortisol Analysis Research Articles

Koncentrace kortizolu ve slinách v průběhu zátěžových situací u úzkostných a neúzkostných adolescentů

Objectives. We investigated the biological response of organism to stress in real situations at school in adolescents. We were interested in how stress is manifested in adolescents without anxiety and in adolescents with a tendency to anxiety experiencing. The aim of the study is to analyse changes in salivary cortisol levels during stressful situation at school. Hypotheses. The analyses verified how cortisol levels change in situations associated with the threat of social assessment in the school environment in individuals without anxiety and anxious; H1a–c: Anxiety individuals will have higher cortisol levels in all monitored situations compared to adolescentswithout anxiety. We also focused on the possible links between an individual’s tendency to experience anxiety and the type of stress response; H2: Anxiety individuals will show a different development of cortisol levels between situations A, B and C compared to adolescents without anxiety. We also examined the relationships between cortisol levels and cognitive and emotional fear. H3: Anxiety individuals will show significant links between cortisol levels and cognitive and emotional fear in the achievement situation. Methods. The research group was comprised of 238 adolescents in the first phase of the study. The final sample for salivary cortisol analysis was comprised of 38 participants aged 12−14 years. The questionnaires battery contains Piers-Harris II, B-JEPI and TAI. Results. The results show that in both groups of adolescents without anxiety and anxious adolescents, cortisol has a demonstrably different development trend during the day. Furthermore, anxious adolescents showed demonstrably lower cortisol levels at school compared to adolescents without anxiety, in adolescents without anxiety, we observed higher cortisol levels and fall of cortisol level during the day. Our analyses showed that stronger relationships between cortisol and test anxiety are shown especially by anxiety adolescents compared to adolescents without anxiety. Limitations. The limitation is a smaller research sample and the selection of situations in which the level of salivary cortisol was evaluated. The important limitation is the fact that the first sampling was taken at different times after awakening, because the cortisol levels change more dynamically in this part of the day.

Salivary Cortisol Analysis In Collegiate Female Lacrosse Athletes

Cortisol is a hormone that corresponds to physiological and emotional stress. The purpose of this study was to 1) evaluate the changes in cortisol in female Division I collegiate lacrosse players (n = 15) throughout the competitive season, and 2) evaluate the correlation between cortisol and athlete wellness and workload. Salivary cortisol samples were collected weekly in the morning throughout the entirety of the 2021 competitive season (12 weeks). Subjective athlete total wellness scores and sub-scores (muscle soreness, sleep quality, fatigue, and stress) were taken on the same days. Objective total weekly Athlete Load (AL, an amalgam workload metric) were tabulated from the previous training week. A significant effect of time was found on wellness (p < 0.001) and AL (p < 0.001) over the twelve weeks with weekly differences, such as weeks with more than one game, weeks with no games, weeks with students in quarantine (not competing), or weeks with academic stressors such as final exams. There were no weekly differences in cortisol (p = 0.058). Cortisol had negligible correlations with wellness (r = -0.010, p = 0.889) and AL (r = 0.083, p = 0.272) during the competitive season. These findings suggest that cortisol changed little for athletes throughout the season although training volume and wellness did. Thus, assessing acute responses of cortisol may prove to be more beneficial to evaluating athletes' stress.

A complete lab-made point of care device for non-immunological electrochemical determination of cortisol levels in salivary samples

In this work, we describe a portable and microfluidic electrochemical device for cortisol determination in saliva samples. The non-immunological methodology was developed using a nickel modified screen-printed electrode coupled to a microfluidic platform obtained by 3D printing. The lab-made screen-printed electrodes were based on a conductive ink obtained from nail polish and graphite, in an optimized proportion of 70:30 % (w / w), and appropriate solvent. Amperometric measurements were performed by a lab-made portable electrochemical device, PotSensE, based on the Texas Instruments LMP91000 chip as a front-end analog device and the Raspberry Pi as a controller. Under optimized conditions, an analytical curve with a linear dynamic range from 0.25 to 25.0 μmol L−1 of cortisol was obtained, with the calculated limits of detection and quantification of 74.0 and 240 nmol L-1, respectively. Analysis of salivary cortisol from artificial and natural spiked samples was possible, ranging from good recovery values. As a proof-of-concept, the lab-made setup was employed as a POC-like device, showing the application potential with good recovery values for the adopted methodology.

Risk and Resilience in an Acute Stress Paradigm: Evidence From Salivary Cortisol and Time-Frequency Analysis of the Reward Positivity

Both abnormal stress and reward responsivity are consistently linked to multiple forms of psychopathology; however, the nature of the associations between stress and reward sensitivity remains poorly understood. In the present study, we examined associations between the hypothalamic-pituitary-adrenal-axis stress response and event-related potentials sensitive to the receipt of reward-related feedback in a pre–post experimental paradigm. Neural responses were recorded while male participants completed a simple monetary-reward guessing task before and after the Montreal Imaging Stress Task. Results demonstrated that acute psychosocial stress significantly reduced the magnitude of neural responses to feedback in the reward-sensitive delta-frequency band but not the loss-sensitive theta-frequency band. In addition, a larger delta-frequency response to rewards at baseline predicted reduced overall cortisol response in the stress condition. These findings suggest, therefore, that neural reward circuitry may be associated with both risk for and resilience to stress-related psychopathology.

Hyper-realistic and immersive surgical simulation training environment will improve team performance

BackgroundSurgical trauma care requires excellent multidisciplinary team skills and communication to ensure the highest patient survival rate. This study investigated the effects of Hyper-realistic immersive surgical team training to improve...

Effects of smelling amniotic fluid on preterm infant's pain and stress during peripheral cannulation: A randomized controlled trial.

To investigate the effect of smelling amniotic fluid on preterm infants' pain and stress caused by peripheral cannulation. This was a randomized controlled trial. The study sample consisted of 80 preterm infants meeting the case selection criteria and infants were randomly assigned to each group. However, in addition to the infants excluded from the study, total number of the infants in all the groups was 61. Infants in the amniotic fluid group smelled amniotic fluid for 15 min before, during, and after the application of peripheral cannulation while those in the control group received routine care during the procedure. The Premature Infant Pain Profile was used to assess their pain levels, and salivary cortisol analysis was performed to evaluate stress levels. Preterm infants in the amniotic fluid and control groups had similar baseline characteristics. However, the pain levels of infants in the amniotic fluid group were significantly lower than of those in the control group during and after the procedure. After the procedure, cortisol levels of the infants in the amniotic fluid group were lower than of those in the control group, although this difference was not significant. The intervention of smelling amniotic fluid is a practice that can be used for reducing pain and stress of preterm infants during peripheral cannulation.

Effect of Recreational Intervention on the Approach of Pediatric Patients in Dental Treatment: Analysis of Salivary Cortisol

Objective: To verify whether recreational interaction with pediatric patient before dental care influences cortisol levels and anxiety. Material and Methods: Twelve children were selected and divided into two groups: 6 children who had not previously received recreational intervention (Group I) and 6 children who received recreational intervention before dental care (Group II). Saliva was collected with Salivettes™ kits before and soon after dental care for the measurement of cortisol. Wilcoxon test was applied to verify the difference in salivary cortisol levels before and after the dental visit in the whole sample, and the Mann-Whitney U test was used to analyze the difference between groups I and II. A significance level of 0.05 was considered . Results: Among patients from Group I, 3 had their cortisol levels increased after dental care, 2 had their cortisol levels decreased, and the other 1 patient remained constant. All participants from Group II had no significant difference in cortisol levels pre- and post-procedure. Mean salivary cortisol level was higher in Group I, pre- and post-procedure, compared to Group II . Conclusion: Pediatric patients who participated in an interactive activity prior to dental care have a lower level of anxiety according to the salivary cortisol levels obtained, compared to patients who did not participate in recreation. The techniques for the dentist to approach the child control the anxiety of the patient and make the procedure calmer and less stressful for both of them.

Psychoneuroendocrinoimmunology-based meditation (PNEIMED) training reduces salivary cortisol under basal and stressful conditions in healthy university students: Results of a randomized controlled study

BackgroundMeditation represents an effective and safe practice to lower distress and promote well-being. PsychoNeuroEndocrinoImmunology-based Meditation (PNEIMED) is a validated method that can reduce stress-related symptoms and salivary cortisol secretion. To date, few randomised controlled trials (RCTs) have assessed cortisol levels through salivary samples, collected both in the morning phase and during acute mental stress elicitation, in healthy young subjects following brief meditation training. AimThe present study aims to investigate, in healthy young undergraduate students, the effects of a brief PNEIMED training course on HPA axis by measuring salivary cortisol levels. MethodsForty students attending the Faculty of Psychology, without comorbidities and previous experience of meditation, were enrolled in the study. Twenty subjects were randomly assigned to 30 h of PNEIMED training (intervention group, IG), and twenty subjects were randomly assigned to 30 h of academic lessons (control group, CG). Salivary cortisol measures included basal morning (t0 = baseline time, collected 30 min after waking) and under stress-eliciting task values. Cortisol measurement under the stress-eliciting task was provided through the Subtraction Stress Task (SST) at scheduled time intervals (t1 = 5 min pre-SST, t2 = 10 min post-SST, t3 = 30 min = post-SST). Salivary cortisol was measured among all subjects (IG + CG) at the beginning (pre-test) and at the end (post-test, four days later) of the study. ResultsANOVA between-group analysis of basal diurnal salivary cortisol showed a significant hormone deflection in the IG at the end of the PNEIMED course (post-test) when compared to the CG (IG post-test 5.64 ± 4.2 vs CG post-test 9.44 ± 4.9; F1,38 = 6.838; p = 0.013). RM-ANOVA within-group analysis for the IG also showed that time and condition effects were statistically significant, with Ftime = 5.438; p = 0.002 and Fcondition = 10.478; p = 0.004, respectively. The IG group presented a significant reduction in basal morning cortisol at the end of the PNEIMED course (post-test) compared to the salivary concentration at baseline (pre-test) (IG pre-test 9.42 ± 6.0 vs IG post-test 5.64 ± 4.2; F1,38 8,354; p = 0.009). RM-ANOVA for the control group showed only the main effect of time (F1,38 = 40.348; p < 0.001). Regarding cortisol measures under the SST-stress eliciting task, ANOVA between-groups analysis showed higher cortisol levels in the IG than in the CG before the PNEIMED course, with significant differences between groups at time t2 and time t3. After the PNEIMED course, the cortisol levels in the IG had decreased, although the differences between groups were not significant. Interestingly, ANOVA within-groups analysis showed that in the IG, the cortisol levels post-test (after the PNEIMED course) were lower than at pre-test (before the PNEIMED course), showing a significant difference of cortisol salivary concentration between conditions at t3 (F = 5.326; p = 0.032). In the control group, the post-hoc analyses for pairwise comparisons between conditions (pre-test vs post-test) did not show significant differences. ConclusionAlthough the low number of subjects enrolled in the study does not allow for definitive conclusions to be drawn, the present findings confirmed the capability of the PNEIMED method to lower stress hormone secretion both at baseline and under acute mental stimulation in a group of young naïve practitioners and make a contribution to the existing literature by increasing the number of published RCTs about the topic.

Hair or salivary cortisol analysis to identify chronic stress in piglets?

Hair cortisol might better represent chronic stress than salivary cortisol in piglets. To test this hypothesis, 24 female, 7-day old piglets were allocated to two groups and artificially reared. The piglets in the stressed group were exposed to overcrowding (0.10m2/piglet) and frequent mixing with unfamiliar piglets until the age of 28 days. The control group remained in an unchanging group at a density of 0.29m2/piglet. After 3 weeks, stressed animals had gained significantly less weight (median, here and throughout, 7.58kg) than the control animals (6.43kg; P=0.021). Additionally, hair from the stressed group contained significantly higher cortisol concentrations (87.29 vs. 75.60pg/mg hair; P=0.005), whereas salivary cortisol concentrations did not significantly differ between groups (0.30 vs. 0.25 μg/dL saliva; P=0.447). Weight gain and hair cortisol concentrations were significantly correlated (P=0.036, r=−0.430), but neither of these parameters were correlated with salivary cortisol concentrations (P=0.929, r=0.019 and P=0.904, r=0.026, respectively).

The Use of the Buzzy, Jet Lidokaine, Bubble-blowing and Aromatherapy for Reducing Pediatric Pain, Stress and Fear Associated with Phlebotomy

PurposeThis study aimed to investigate the effects of the Buzzy, Jet lidokaine, bubble-blowing and inhalation aromatherapy with lavender essence on pain, stress and fear in children undergoing phlebotomy. Designs and methodsThis study was a prospective, randomized controlled trial. The sample was comprised of children aged 5 to 10 years requiring blood tests. Children were assigned to five subgroups through randomization performed using a computer program: the Buzzy group (n = 39), Jet lidokaine group (n = 39), bubble-blowing group (n = 39), inhalation aromatherapy with lavender essence group (n = 39) and control group (n = 39). The children's levels of pain were evaluated and reported by the parents, observers and the children, who self-reported using the Oucher Pain Scale. The children's fear levels were assessed using the Children's Fear Scale, and salivary cortisol analysis was conducted to evaluate stress levels. ResultsA significant difference was found between the intervention and control groups in terms of levels of pain during and after phlebotomy in favor of the Buzzy group (p < 0.05). There was a significant difference between the fear scores of the children in the intervention and control groups before phlebotomy (p < 0.05). This difference was found to be caused by the bubble-blowing method. There was a significant difference between intervention and control groups fear levels in favor of the Buzzy group during phlebotomy (p < 0.05). Practice implicationsIt is recommended that the Buzzy and bubble-blowing be used during phlebotomy in children to reduce the severity of their pain.

Development of competitive lateral flow immunoassay coupled with silver enhancement for simple and sensitive salivary cortisol detection.

Cortisol is known as a stress biomarker. The measurement of cortisol levels is an early warning indicator for health conditions and diagnosis of stress-related diseases. Herein, a lateral flow immunoassay using a gold nanoparticle label with a silver enhancement system was developed for the simple, sensitive and rapid detection of cortisol. The developed assay was based on a competitive platform of which cortisol-BSA conjugate was immobilized at the test zone to compete with an analyte. The quantitative analysis was performed using gold nanoparticles (AuNPs) as signal labeling. Sequentially, the silver enhancement solution was applied in order to enhance the sensitivity of the assay with the results easily seen by the naked eye. Using this system, the limit of detection (LOD) was found to be 0.5 ng/mL with a 3.6 fold more sensitive detection than without the enhancement system (LOD = 1.8 ng/mL). The salivary cortisol analysis was in the range of 0.5-150 ng/mL (R2 = 0.9984), which is in the clinical acceptable range. For the semi-quantitative analysis, the intensity color of the results was analyzed using an image processing program. The proposed method was successfully applied to detect cortisol in saliva. In addition, the results from our method also complied with the ones of those obtained by using the commercial enzyme-linked immunosorbent assay (ELISA). This developed assay offers great promise for a non-invasive screening test of salivary cortisol.

Chemiluminescence-based biosensor for monitoring astronauts’ health status during space missions: Results from the International Space Station

During space missions, real-time monitoring of astronauts’ health status is of crucial importance and therefore there is a strong demand for simple analytical devices that astronauts can use to perform clinical chemistry analyses directly onboard.As part of the “IN SITU Bioanalysis” project, we designed a biosensor for analysing salivary levels of cortisol in astronauts, a marker of chronic stress. The biosensor is based on the Lateral Flow Immunoassay (LFIA) approach coupled with chemiluminescence (CL) detection and comprises a 3D-printed plastic cartridge containing a sealed fluidic element with the LFIA strip, in which the flow of sample and reagents is activated by pressing buttons on the cartridge and sustained by exploiting capillary forces. For measurement, the photon emission is imaged employing a CL reader based on an ultrasensitive cooled charge-coupled device (CCD) camera.The payload was designed to operate in microgravity and to withstand mechanical stress, such as take-off vibrations, and onboard depressurization events, while the microfluidics was developed considering alterations of physical phenomena occurring in microgravity, such as bubble formation, surface wettability and liquid evaporation. The biosensor, which was successfully used by the Italian astronaut Paolo Nespoli during the VITA mission (July-December 2017), demonstrated the feasibility of performing sensitive LFIA analysis of salivary cortisol down to 0.4 ng/mL directly onboard the International Space Station. It could be easily adapted for the analysis of other clinical biomarkers, thus enabling the early diagnosis of diseases and the timely activation of appropriate countermeasures.

SALIVARY CORTISOL AND METABOLIC SYNDROME COMPONENT'S ASSOCIATION.

ABSTRACTBackground:Actually the lifestyle exposes the population to several risk factors related to alimentary habits and less physical activity that contributes to chronic diseases appearance worldwide. Aim:To analyze the association between salivary cortisol and the components of metabolic syndrome. Methods:This is a cross-sectional study. As part of it, 28 individuals aged 30-59 years presenting three or more of the following findings: CA: ≥88 cm for women and ≥102 cm for men; SBP>130 mmHg and DBP>85 mmHg; GL>100 mg/dl; TG>150 mg/dl; HDL<40 mg/dl for men and <50 mg/dl for women. Was performed analysis of salivary cortisol (by radioimmunoassay) from 25 salivary samples collected throughout the day, for evaluating changes in the circadian rhythm of this hormone (8AM, noon and 8PM). Results:28 evaluated individuals had a mean age of 51.9±7.5 years, mostly women (64.3%) and a mean of BMI 33.6±3.2 kg/m². The cortisol level from the 8AM averaged 18.7±4.8 ng/dlL. Individuals with FPG>110mg/dl, have significantly lower average levels of cortisol than ones with FPG <110 (12.8±5,2 vs. 17.3±4.2). Significant correlations were HOMA vs. WC (r=0,465; p˂0,005) and TG (r=0,473; p˂0,005), WC vs. FG (r=0,446; p˂0,005) and BMI (r=0,730; p˂0.0001); TG vs. HDL (r=0,441 p˂0,005) and FG (r=0,440; p˂0,005). Conclusion:Morning salivary cortisol in subjects with chronically elevated blood glucose can represent a downregulation of the hypothalamic-pituitary adrenal axis. This is an important finding not yet well investigated.

Analysis of Salivary Cortisol and Its Relationship with Burnout Dimensions in Prison Workers

Workers in the prison system experience stress at high levels in their daily lives, so they become prone to the development of the Burnout Syndrome. In order to evaluate the occupational stress, the most sensitive and of easy access biochemical method is salivary cortisol. Aim: to evaluate the concentration of salivary cortisol in prison workers and to relate it to the Burnout Syndrome. Methodology: a cross-sectional and analytical study with 240 prison workers from the 3rd Penitentiary Region of the State of Rio Grande do Sul in Brazil, covering 8 counties and 10 prison houses. The instruments of data collection used were a sociodemographic characterization form, the Maslach Burnout Inventory and some salivary samples. The data collection period was from April to June 2017. Results: It was observed an increase in the dimensions of burnout concomitant with the increase of salivary cortisol levels in the research participants. Conclusion: The population studied experienced occupational stress evidenced by the use of the burnout and salivary cortisol instrument analysis, which is an important physiological indicator.

Salivary cortisol and cortisone: UPLC-MS/MS method validation and temporal variability over one week

Aims: The present study aims to provide a comprehensive analytical and biological validation of an ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method for analysis of salivary cortisol and its inactive metabolite cortisone. Variation in cortisol awakening response (CAR) over one week were investigated. Methods: Saliva samples were collected from 19 healthy volunteers. To determine CAR, participants collected saliva samples at three time points: immediately after awakening, 15 and 30 minutes thereafter. The same procedure was repeated each morning over one week period. In addition, all participants filled in diaries containing information about duration of sleep, time of awakening, smoking, and coffee and alcohol intake. Upon collection, the saliva samples were stored at -20°C until analysis. Prior to analysis, the saliva samples were thawed and spiked with internal standard and extracted using solid phase extraction columns (Oasis Prime-HLB). The identification and quantification of cortisol and cortisone were performed using the developed UPLC-MS/MS method, on a Waters Aquity TQ-XS system. Results: The obtained limits of quantification (LoQ) were 1ng/ml for cortisol and 500pg/ml for cortisone. Intra-assay accuracy values of calibration points were between 83-111%. The mean levels of cortisol and cortisone in the total sample were 3.55 ± 1.99 ng/ml and 10.51 ± 3.46 ng/ml, respectively. In the first 30 minutes after awakening, there was a 70% increase in the average cortisol levels (CAR) and a 49% increase in the levels of cortisone. A high intra-individual variability of CAR was observed over the week (CV ranged between 17.9-68.9%), whereas the inter-individual variability of the average CAR equaled 28.2%. Furthermore, the changes in CAR were related to variables from participants’ diaries. Conclusion: The UPLC-MS/MS method has shown to be a sensitive and specific technique for determination of salivary cortisol and cortisone. However, in the clinical context, CAR data should be interpreted with precaution due to high inter- and intra-individual variability.

Microfluidic Line-Free Mass Sensor Based on an Antibody-Modified Mechanical Resonator.

This research proposes a mass sensor based on mechanical resonance that is free from power supply lines (line-free) and incorporates both microfluidic mechanisms and label-free techniques to improve its sensitivity and reusability. The microfluidic line-free mass sensor comprises a disk-shaped mechanical resonator, a separate piezoelectric element used to excite vibrations in the resonator, and a microfluidic mechanism. Electrical power is used to actuate the piezoelectric element, leaving the resonator free from power lines. The microfluidic mechanism allows for rapid, repeat washings to remove impurities from a sample. The microfluidic line-free mass sensor is designed as a label-free sensor to enable high-throughput by modifying and dissociating an antibody on the resonator. The resonator was fabricated by photolithography and the diameter and thickness were 4 mm and 0.5 mm, respectively. The line-free mass sensor enabled a high Q-factor and resonance frequency of 7748 MHz and 1.402 MHz, respectively, to be achieved even in liquids, facilitating the analysis of human salivary cortisol. The line-free mass sensor could be used for repeated measurements with the microfluidic mechanism, and the resonator could be fully washed out. It was concluded that the microfluidic line-free mass sensor was suitable to analyze the concentration of a salivary hormone, cortisol, in human saliva samples, and that it provided high-throughput suitable for point-of-care testing.

Salivary cortisol in the diagnosis of adrenal insufficiency: cost efficient and patient friendly.

Saliva as a diagnostic tool is patient friendly and offers analytical advantages. Hormonal analysis of saliva is not influenced by changes in concentrations of binding globulins as the free concentration of the hormones is measured. Analysis of salivary cortisol is common practice in the diagnostic work-up of hypercortisolism. We investigated the potential role of measuring salivary cortisol when adrenal insufficiency (AI) is suspected, to reduce the numbers of ACTH stimulation tests. Over a period of 6 years, patients undergoing an ACTH stimulation test (tetracosactide, 250 µg) in our hospital were included. Plasma cortisol (Elecsys, Cobas, Roche Diagnostics) and salivary cortisol and cortisone (LC–MS/MS) were determined at t = 0, 30 and 60 min after stimulation. Based on peak plasma cortisol levels, AI was ruled out in 113 patients and was established in 16 patients. Patients without AI displayed maximal salivary cortisol concentrations of 12.6–123.4 nmol/L (95th percentile) after stimulation, as opposed to 0.5–15.2 nmol/L in AI patients. At t = 0 min, a minimal salivary cortisol concentration of 1.0 nmol/L was observed in patients without AI, whereas AI patients had a maximum concentration of 5.9 nmol/L. Using these cut-off values, 34% of the initial patient group could be diagnosed without an ACTH stimulation test (28% >5.9 nmol/L, 6% <1.0 nmol/L). A novel diagnostic algorithm, including early morning salivary cortisol analysis can reduce the numbers of ACTH stimulation tests in patients suspected of AI. This patient-friendly method can thereby reduce total health care costs.

Healthy Parks Healthy People as an Upstream Stress Reduction Strategy.

One of the primary goals of the Healthy Parks Healthy People (HPHP) program, located in the San Francisco Bay Area, is to offer group-based physical activities in natural settings. These activities arefor racially and ethnically diverse groups of individuals as an "upstream" strategy for improving health. This study investigated the health impact of selected two-hour HPHP Bay Area events that targeted low-income racial and ethnic minority groups using physiological and self-reported measures of stress and related variables. Study participants (N=52) in the selected HPHP Bay Area events donated saliva and filled out psychological measures of perceived stress (PSS-4; Cohen et al.) and mood state (I-PANAS-SF; Thompson, 2007) at the beginning and the end ofa two-hour guided walk in green spaces. Moreover, a measure of perceived restoration (SRRS; Han, 2007) was completed at the end ofthe walk. Study participants wore a physical activity self-monitoring device (Garmin Vivofit 2) to capture their step count and heart rate during the event. Stress, both measured by the analysis of salivary cortisol and self-reported perceived stress, significantly decreased over the course of the event (p<.0$) and there was a significant increase in positive mood (p<.05). The monitoring device also indicated that individuals were engaged in moderate levels of physical activity during the guided walks (<di>x</di> =8,990 steps, HR 95 bpm). The results encourage further development of nature-based health interventions to mitigate stress. Such interventions may be especially appropriate for low-income, urban, racial and ethnic minority groups that likely experience increased levels of stress due to social inequities and poor living conditions.

In-Person Versus eHealth Mindfulness-Based Intervention for Adolescents With Chronic Illness: Protocol for a Randomized Controlled Trial.

BackgroundEight-week mindfulness-based interventions (MBIs) have a beneficial impact on mental health and well-being in adolescents with chronic health conditions. Usually delivered in person in a group setting, these programs are difficult to access for teens with disabilities or who do not have in-person MBIs available in their communities.ObjectiveThis paper outlines the rationale, development, and design of a randomized controlled trial comparing the effects of an MBI delivered in person or via eHealth in adolescents with a chronic illness. Quantitative outcomes will include mindfulness skills acquisition (primary outcome), effects of the MBI on self-reported mood, anxiety, self-esteem, illness perception, and physiological stress (via salivary cortisol), and qualitative outcomes will include individual practice, participant appreciation, and adaptation of the MBI for eHealth.MethodsThis is a randomized noninferiority mixed methods study comparing 2 MBI arms: in-person and eHealth. Participants are eligible to participate if they are aged 13 to 18 years, have a diagnosis of chronic medical condition, live close enough to the recruitment hospital to participate in the in-person arm of the study, and are currently followed by a health care provider. Each participant will receive an adapted 8-week MBI delivered either in person at a tertiary pediatric hospital or via a secure audio-visual platform allowing group interactions in real time. Groups will be facilitated by 2 experienced mindfulness providers. Quantitative and qualitative data will be collected through standardized research questionnaires administered via a secure, youth-friendly online platform and through semistructured interviews, participant log books, facilitator log books, and salivary cortisol analysis. Qualitative data will be analyzed using a grounded theory model.ResultsData collection is currently underway. Data analysis, manuscript writing, and additional publications are expected to be completed in the winter and spring of 2018.ConclusionsBased on previous results from in-person trials conducted in adolescents and eHealth trials conducted in adults, we anticipate that both modes of delivery will significantly improve mindfulness skills acquisition, mood, anxiety, self-esteem, illness perception, and stress and that the magnitude of the effects will be correlated to the level of home practice. We predict that participants in both arms will show similar levels of home practice and that both modes of delivery will have high levels of feasibility and acceptability. If successful, this study could provide evidence for the use of eHealth in the delivery of 8-week MBIs in clinical adolescent populations, potentially increasing availability to MBIs for a large group of youth with mobility issues or living away from large urban centers.Trial RegistrationClinicalTrials.org NCT03067207; https://clinicaltrials.gov/ct2/show/NCT03067207 (archived by WebCite at http://www.webcitation.org/6v4ZK8RBH)

Time–motion analysis and patterns of salivary cortisol during different judo championship phases

Purpose The aim of this study was to investigate the time–motion of the matches and patterns of salivary biomarkers during different championship judo phases. For this, eight male judo athletes from all weight divisions (16 ± 6 years of practice) were studied during an official championship.