Bruce Barrett

University of Wisconsin–Madison | UW · Department of Family Medicine

This study investigates practicing clinician and staff perspectives on potential protocol modifications for the “Nasal Irrigation, Oral Antibiotics, and Subgroup Targeting for Effective Management of Acute Sinusitis” (NOSES) study, a pragmatic randomized controlled trial aiming at improving acute rhinosinusitis management. Focus groups with clinici...

This paper reports the results of a hybrid effectiveness-implementation randomized trial that systematically varied levels of human oversight required to support the implementation of a digital medicine intervention for persons with mild-to-moderate alcohol use disorder (AUD). Participants were randomly assigned to three groups representing possibl...

The impending climate catastrophe and the worldwide epidemics of metabolic syndrome, obesity, diabetes, and cardiovascular disease are linked to many of the same behaviors, especially to what people eat and how they move around [...]

Objective: The purpose of this qualitative analysis was to better understand what pain management strategies adults with opioid-treated chronic low back pain (CLBP) found most helpful. Design: A subgroup of participants from a larger randomized control trial of two psychological interventions were asked: "What helps your back pain?" at baseline...

This article reports qualitative outcomes from a randomized controlled trial of an eight-week intervention of either cognitive-behavioral or mindfulness-based therapy (MBT) group therapy for chronic low back pain (CLBP) on individuals’ overall life and health. Approximately 10 months post-treatment, 108 participants completed structured qualitative...

Antibiotic use remains common for the treatment of lower respiratory tract infections. The objective of this study was to evaluate the impact of antibiotic use on the duration and severity of acute lower respiratory tract infection (LRTI). Adult patients presenting to US primary or urgent care sites with a chief complaint of cough and symptoms cons...

Background Testing for influenza in patients with acute lower respiratory tract infection (LRTI) is common and in some cases is performed for all patients with LRTI. A more selective approach to testing could be more efficient. Methods We used data from two prospective studies in the US primary and urgent care settings that enrolled patients with...

This paper reports results of a hybrid effectiveness-implementation randomized trial that systematically varied levels of human oversight required to support implementation of a digital medicine intervention for persons with mild to moderate alcohol use disorder (AUD). Participants were randomly assigned to three groups representing possible digita...

Rising greenhouse gas levels heat the earth’s surface and alter climate patterns, posing unprecedented threats to planetary ecology and human health. At the same time, obesity, diabetes, and cardiovascular disease have reached epidemic proportions across the globe, caused in part by decreases in physical activity and by over-consumption of carbon-i...

Background: The extent of human interaction needed to achieve effective and cost-effective use of mobile health (mHealth) apps for individuals with mild to moderate alcohol use disorder (AUD) remains largely unexamined. This study seeks to understand how varying levels of human interaction affect the ways in which an mHealth intervention for the pr...

Background Resistance to antibiotics is rising and threatens future antibiotic effectiveness. ‘Antibiotic targeting’ ensures patients who may benefit from antibiotics receive them, while being safely withheld from those who may not. Point-of-care tests may assist with antibiotic targeting by allowing primary care clinicians to establish if symptoma...

This study aimed to evaluate the impact of the COVID-19 pandemic on adults with opioid-treated chronic low back pain (CLBP), an understudied area. Participants in a “parent” clinical trial of non-pharmacologic treatments for CLBP were invited to complete a one-time survey on the perceived pandemic impact across several CLBP- and opioid therapy-rela...

Objectives Chronic pain is a significant health concern that adversely affects all aspects of life, including emotional well-being. Opioids are prescribed for the management of refractory, severe chronic pain although they have been associated with adverse effects, including addiction and overdose. The aim of this study was to examine factors that...

Introduction Mindfulness-based programmes (MBPs) are widely used to prevent mental ill-health that is becoming the leading global cause of morbidity. Evidence suggests beneficial average effects but wide variability. We aimed to confirm the effect of MBPs on psychological distress, and to understand whether and how baseline distress, gender, age, e...

Introduction: Climate change poses enormous threats to humanity and much of life on earth. Many of the behavioral patterns that drive climate change also contribute to the epidemics of obesity, diabetes, and cardiovascular disease. Objectives: The primary objective of this study was to compile and categorize the literature on interventions aimed...

Background: Individuals with chronic low back pain (CLBP) are commonly prescribed long-term opioid therapy (LTOT) for analgesia, placing this population at increased risk for opioid misuse and opioid use disorder. Acceptance of aversive experiences (e.g., chronic pain) and awareness of automatic thoughts and behaviors (i.e., automaticity) are two...

Background Global climate change is a rapidly evolving, existential public health emergency with incrementally worsening effects on both physical and mental health.¹ In accordance, family medicine and primary care clinicians have fundamental and essential roles at the forefront of climate adaptation, mitigation, and advocacy. This rather obvious si...

Our objective was to externally validate 2 simple risk scores for mortality among a mostly inpatient population with COVID-19 in Canada (588 patients for COVID-NoLab and 479 patients for COVID-SimpleLab). The mortality rates in the low-, moderate-, and high-risk groups for COVID-NoLab were 1.1%, 9.6%, and 21.2%, respectively. The mortality rates fo...

Meditation training may promote pro-environmental behavior and related variables, though limited research has tested this experimentally. We investigated whether short- or long-term meditation training were associated with pro-environmental behavior, environmental attitudes, and sustainable well-being (i.e., well-being per unit consumption). In a c...

Two of the greatest challenges of our times - climate change and the linked epidemics of obesity, diabetes, and cardiovascular disease - are fueled in part by the over-consumption of carbon-intensive high calorie foodstuffs. Converging evidence from hundreds of studies has confirmed that transitioning from diets high in meat and dairy to largely pl...

Objectives An accurate prognostic score to predict mortality for adults with COVID-19 infection is needed to understand who would benefit most from hospitalizations and more intensive support and care. We aimed to develop and validate a two-step score system for patient triage, and to identify patients at a relatively low level of mortality risk us...

Background The Wisconsin upper respiratory symptom survey (WURSS) is a validated English questionnaire to evaluate the quality of life and severity of upper respiratory tract infections (URTIs). We aimed to develop a Mandarin Chinese version of WURSS-24 (WURSS-24-C) and evaluate its reliability, validity and minimal important difference (MID). Met...

Objective Chronic low back pain (CLBP) is disabling and costly. Existing therapies have proven suboptimal, with many patients resorting to long-term opioid therapy, which can cause harms. Cognitive behavioral (CBT) and mindfulness-based (MBT) therapies can be effective and offer unique skills for safe pain coping. This article describes the protoco...

Background: The extent of human interaction needed to achieve effective and cost-effective use of mobile health (mHealth) apps for individuals with mild to moderate alcohol use disorder (AUD) remains largely unexamined. This study seeks to understand how varying levels of human interaction affect the ways in which an mHealth intervention for the p...

Purpose: Develop and validate simple risk scores based on initial clinical data and no or minimal laboratory testing to predict mortality in hospitalized adults with COVID-19. Methods: We gathered clinical and initial laboratory variables on consecutive inpatients with COVID-19 who had either died or been discharged alive at 6 US health centers....

Acute respiratory infections (ARIs) are the most common illness seen in the pediatric ambulatory setting. Research in this area is hampered by the lack of validated ARI measures. The aim of this study was to assess the reliability and validity of the Wisconsin Upper Respiratory Symptom Survey for Kids (WURSS-K), a 15-item instrument, which measures...

Objective Many young adults are affected by attention deficit hyperactivity disorder (ADHD) and often desire non-pharmacological treatment options. Mind-body techniques might serve as complementary therapies to first-line stimulant medications, but studies are limited. Tai Chi is an increasingly popular practice that integrates movement with cognit...

Objectives To assess the benefits of training in mindfulness-based stress reduction (MBSR) or moderate intensity exercise (EX) for improving sleep quality. Design Randomized controlled trial. Setting Outpatient, community-based. Participants Healthy adults (n = 413) aged 30–69 who did not regularly exercise or practice meditation, and who had no...

This study describes an intervention with low-income, Black primary care patients and their experience in changing a health risk behavior. Participant themes, including behavioral coping, personal values, accomplishments and strengths, barriers and strategies, and social support, are understood in relationship to health behavior theories. Two struc...

Background The Wisconsin Upper Respiratory Symptom Survey (WURSS) is a validated English questionnaire to evaluate the severity of upper respiratory tract infections (URTIs). We aimed to develop a Chinese version of WURSS-24 (WURSS-24-C) and evaluate its reliability, validity and minimal important difference (MID). Methods The WURSS-24 was translat...

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:...

Background: Low-income people are disproportionately affected by chronic back and neck pain. Yoga may be an effective therapy. Aims: This feasibility pilot study evaluated an individualized yoga plan for the treatment of chronic spinal pain. Methods: Results: Individuals showed a mean change of -2.4 from pre/post 10-cm pain scale recordings...

While great interest in health effects of natural product (NP) including dietary supplements and foods persists, promising preclinical NP research is not consistently translating into actionable clinical trial (CT) outcomes. Generally considered the gold standard for assessing safety and efficacy, CTs, especially phase III CTs, are costly and requi...

The production of food is associated with significant environmental impact. In this paper, we describe the first assessment of the environmental impact of food consumption in the United States using individually reported dietary intake data from a nationally representative sample. Using individual-level dietary intake data from the National Health...

Objectives Health-supporting behaviors can be challenging to initiate and maintain. Data from the MEPARI-2 randomized trial were used to assess predictors of sustained exercise and meditation practice. Methods Adults aged 30 to 69 years not exercising regularly and without prior meditation training were randomized to 8-week trainings in mindfulnes...

Objective Past studies have documented links between mindfulness practice and stress-related outcomes, but these links have typically been found over the course of treatment and at the between-person level of analysis. Building on past work, the present study aimed to evaluate practice-stress associations after treatment and at the within-person an...

While great interest in health effects of natural product (NP) foods and dietary supplements persists, promising preclinical NP research is not consistently translating into actionable clinical trial (CT) outcomes. Generally considered the gold standard for assessing safety and efficacy, CTs,especially Phase III CTs, are costly and require rigorous...

Objectives: To discuss good practices and criteria for optimal design and interpretation of pre-clinical and clinical natural product (NP) research in order to increase benefit from our investment in NP clinical trials (CT). Background: Large, randomized, controlled CT often fail to reject the null hypothesis or show rigorous evidence of benefit....

Exercise and meditation improve health and well-being, potentially through decreasing systemic inflammation. In this study, healthy adults (N = 413) were randomized to 8 weeks of training in aerobic exercise, matched mindfulness-based stress reduction, or wait-list control. Three inflammation-related biomarkers (C-reactive protein, interleukin-6, a...

Semi-continuous data, also known as zero-inflated continuous data, have a substantial portion of responses equal to a single value (typically 0) and a continuous, right-skewed distribution among the remaining positive values. For jointly modeling multivariate clustered semi-continuous responses, the covariate effects in the positive parts can be pr...

Context: There is need for a short validated self-report instrument for assessing the feeling of being loved. The Feeling Loved instrument asks: "Do you feel loved?" and "How loved do you feel?" as well as "Do you love yourself?" and "How much do you love yourself?" with 100 mm visual analogue scales assessing the continuous response options. Obj...

Background Practice of meditation or exercise may enhance health to protect against acute infectious illness. Objective To assess preventive effects of meditation and exercise on acute respiratory infection (ARI) illness. Design Randomized controlled prevention trial with three parallel groups. Setting Madison, Wisconsin, USA. Participants Comm...

CONSORT checklist of information for a randomized trial. (DOC)

TIDieR (Template for Intervention Description and Replication) checklist. (DOCX)

Pro-environmental behaviors and the cultural shifts that can accompany these may offer solutions to the consequences of a changing climate. Mindfulness has been proposed as a strategy to initiate these types of behaviors. In 2017, we pilot-tested Mindful Climate Action (MCA), an eight-week adult education program that delivers energy use, climate c...

This study investigated the effects of mindfulness and exercise training on indicators of mental health and stress by examining shared mediators of program effects. Community-recruited adults (N = 413) were randomized into one of three conditions: (a) mindfulness-based stress reduction, (b) moderate intensity exercise, or (c) wait-list control. Com...

Purpose: Compare 8-weeks of MBSR, AET and no-treatment control during the fall season on objectively-measured physical activity in healthy adults. Methods: Participants (n=66) wore an Actigraph GT3X+ accelerometer for seven days pre-randomization, and following 8-week MBSR or AET interventions, or neither (control). Mean daily minutes (min) of m...

Background: The inflammatory chemokine, interferon-gamma inducible protein of 10kDa (IP-10), is a biomarker associated with several conditions. Objectives: This study investigated serum concentrations of IP-10 in healthy individuals who developed acute respiratory infection (ARI). The hypothesis is that serum IP-10 concentrations correlate with...

Greenhouse gases from human activities are causing climate change, creating risks for people around the globe. Behaviors involving transportation, diet, energy use, and purchasing drive greenhouse gas emissions, but are also related to health and well-being, providing opportunity for co-benefits. Replacing shorter automobile trips with walking or c...

Background: To assess the concurrent and predictive validity of the Nasal Mucus Index (NMI), a novel measurement of acute respiratory infection (ARI) severity. Objective: ARI, including the common cold and influenza, imposes a great burden on individuals and society. Previous research has attempted to assess the severity of ARI with self-reporte...

This systematic review examines the efficacy of oral ginger for dysmenorrhea. Key biomedical databases and grey literature were searched. We included randomized controlled trials comparing oral ginger against placebo or active treatment in women with dysmenorrhea. Six trials were identified. Two authors independently reviewed the articles, extracte...

Background: The purpose of this study is to use Rasch analysis to explore the validity of considering self-report scores from Wisconsin Upper Respiratory Symptom Survey (WURSS-21) as a single global illness severity domain. The WURSS-21 is a widely used questionnaire instrument that assesses symptom severity and functional impact of common cold an...

Background The practice of clinical medicine rests on a foundation of ethical principles as well as scientific knowledge. Clinicians must artfully balance the principle of beneficence, doing what is best for patients, with autonomy, allowing patients to make their own well-informed health care decisions. The clinical communication process is compli...

Procalcitonin (PCT) is a biomarker of inflammation that is used to help make clinical decisions, like starting antibiotics or admitting a patient to the hospital. While PCT levels have been widely studied in pneumonia, levels in less severe acute respiratory infections (ARI) have not been well studied. To measure PCT levels in otherwise healthy adu...

Poor mental health conditions, including stress and depression, have been recognized as a risk factor for the development of acute respiratory infection (ARI). Very few studies have considered the role of general mental health in ARI occurrence. The aim of this analysis is to determine if overall mental health, as assessed by the mental component o...

Are Echinacea products associated with a reduced incidence and a shorter duration of common colds compared with placebo? Individual prophylaxis trials show no association with prevention of the common cold, but exploratory meta-analysis suggests that Echinacea products may be associated with a small reduction in cold incidence. In treatment trials,...

Using a large data set (n = 811), the relationship between acute respiratory infection illness severity and inflammatory biomarkers was investigated to determine whether certain symptoms are correlated more closely than others with the inflammatory biomarkers, interleukin-8 (IL-8) and nasal neutrophils. Participants with community acquired acute re...

Preparations of the plant Echinacea (familiy Compositae) are widely used in some European countries and in North America for common colds. Most consumers and physicians are not aware that products available under the term Echinacea differ appreciably in their composition, mainly due to the use of variable plant material, extraction methods and addi...

The health of populations depends on the availability of clean air, water, food, and sanitation, exposure to pathogens, toxins and environmental hazards, and numerous genetic, behavioral and social factors. For many thousands of years, human life expectancy was low, and population growth was slow. The development of technology-based civilizations f...

The purpose of this article is to update the primary care community on the evidence and guidelines for cardiovascular disease screening in a general-risk adult population, with the goal of assisting clinicians in developing an evidence-based approach toward screening. This article discusses global risk assessment and screening strategies, including...

Introduction. In the United States, dietary supplement (DS) use is common, often takes place outside of the purview of health care providers, and may involve DS in combination with pharmaceuticals. This situation has led to concerns about interactions between DS and pharmaceuticals, as well as the risks from polypharmacy and polysupplement use. Met...

Background Echinacea plant preparations (family Asteraceae) are widely used in Europe and North America for common colds. Most consumers and physicians are not aware that products available under the term Echinacea differ appreciably in their composition, mainly due to the use of variable plant material, extraction methods and the addition of other...

The role of bacteria in acute respiratory illnesses (ARI) of adults and interactions with viral infections is incompletely understood. This study tested the hypothesis that bacterial co-infection during ARI adds to airway inflammation and illness severity. Two groups of 97 specimens each were randomly selected from multiplex-PCR identified virus-po...

To develop a shorter version of the Wisconsin Upper Respiratory Symptom Survey (WURSS-21), a self-report questionnaire for evaluating daily symptoms and functional impairments during acute respiratory illness (ARI). WURSS-21 data were retrieved from 4 studies (n = 1167) spanning the years 2002-2010. Similar methodologies were employed among these s...

Background: Strategies to improve influenza vaccine protection among elderly individuals are an important research priority. Mindfulness-based stress reduction (MBSR) and exercise have been shown to affect aspects of immune function in some populations. We hypothesized that influenza vaccine responses may be enhanced with meditation or exercise tr...