Effect of a mindfulness-based intervention on burnout syndrome and associated biochemical and cognitive biomarkers: a case study in a university population sample

Effect of a mindfulness-based intervention on burnout syndrome and associated biochemical and cognitive biomarkers: a case study in a university population sample | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Effect of a mindfulness-based intervention on burnout syndrome and associated biochemical and cognitive biomarkers: a case study in a university population sample Mireya Velázquez-Paniagua, Laura Gómez-Virgilio, Blanca Margarita Gómez-Chavarín, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6598726/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objectives In Mexico, 25-45% of medical students experience burnout syndrome, which can be reduced through mindfulness-based interventions (MBI). No study has evaluated this intervention's impact on our country's population. Therefore, this study aimed to determine the effects of an eight-week MBI on medical students and university workers. Method A quasi-experimental design incorporating pre- and post-tests was implemented with 38 participants. The Mindfulness-Based Stress Reduction (MBSR) program was conducted over 8 weeks to evaluate its efficacy on psychological, biological, and neurophysiological parameters. Data were analyzed using either the paired Student’s t-test or the Wilcoxon test. Results Thirty-eight participants, with a mean age of 28 years, were recruited for this study. Of these, 84% were women. Twenty-four percent of this population were first-year students, and more than half attended all sessions. The intervention had significant effects on cortisol levels (p = 0.000), burnout syndrome in three dimensions (EE, p = 0.000; DP, p = 0.008; and PA, p = 0.000), and the P300 amplitude (p = 0.032). Conclusions The findings indicated that mindfulness-based intervention significantly alleviated burnout syndrome, lowered cortisol levels, and influenced neurophysiological metrics such as the P-300 amplitude. Future studies should explore its long-term effects. Mindfulness-based interventions (MBI) Burnout Syndrome Medical Students Cortisol P300 amplitude Figures Figure 1 Introduction Anxiety and depression are mental health conditions prevalent among university students, with implications for academic performance and well-being (Pinho et al., 2025 ). This is disturbing, particularly in lower-middle-income countries, where students of health science careers, such as medicine, experience academic and social pressures that lead them to stressful situations affecting their mental health (Alwhaibi et al., 2023 ). Burnout is a syndrome related to chronic stress that has not yet been effectively managed (World Health Organization, 2019). Burnout is a construct developed by Maslach for healthcare professionals. This construct is presented with a combination of three symptoms: Emotional Exhaustion (EE) (fatigue by exposure to stressors), depersonalization (DP) (negative attitude), and Personal Accomplishment (PA) (low self-esteem). The Maslach Burnout, and the most widely used scale to assess burnout Inventory (MBI). MBI allows the classification of burnout into low, intermediate, and elevated levels. This scale has been used and validated for 30 years by students in many languages (Frajerman et al., 2019 ). Some studies have investigated this syndrome among professionals as it was originally linked to occupational stress (Salvagioni et al., 2017 ; Shoman et al., 2021 ). However, several researchers have recently focused on the student population, particularly medical students (Cotobal Rodeles et al., 2025 ; Frajerman et al., 2019 ). This population receives intensive, arduous, and longer educational preparation than other college students, experiencing physical and emotional exhaustion due to the pressure and academic demands of this profession. The prevalence of burnout syndrome among medical students ranges from 5.6 to 88% (Di Vincenzo et al., 2024 ). In Mexico, a critical narrative analysis reported that the prevalence of academic burnout syndrome (ABS) among medical students ranges from 25–45%. However, some studies indicated less than 10% of cases, while others exceeded 70%. The differences observed in the reports are attributed to the time when the students were analyzed, sample size, and methodology employed (Puig-Lagunes et al., 2025 ). Mindfulness is a form of meditation based on Buddhist traditions involving the evaluation, surveillance, and control of mental processes (explicit metacognition) (Heyes et al., 2020 ). The neuroscience-based model explains that this construct incorporates self-regulatory features, such as self-related awareness, attentional control, and emotional regulation (Tang et al., 2015 ). Owing to these characteristics, mindfulness has been accepted as an alternative intervention or training for skill acquisition in the improvement of mental health among medical students. Previous studies have indicated that mindfulness-based interventions (MBI) decrease stress, burnout, anxiety, pain, and depression in this population (Kaisti et al., 2024 ; Zeidan et al., 2010 ). Concerning burnout syndrome, a systematic review and meta-analysis suggested that this syndrome can be reduced in medical students, particularly in two subdomains (academic efficacy and emotional exhaustion) (Wang et al., 2024 ). Chronic stress releases hormones that disrupt biological pathways in various systems (immune, metabolic, and cardiac) including the brain. Evidence shows that MBI improves the brain regions involved in the body's stress response and ameliorates endocrine, immune, and inflammatory responses. For instance, MBI increases prefrontal cortex activity and connectivity and decreases fasting glucose, blood pressure, cortisol, C-reactive protein, Th1 cytokines, and NKCA cell activity (Reive, 2019 ). A report concluded that MBI reduces serum cortisol levels (Turakitwanakan et al., 2013 ). In our country, a few studies have reported the use of MBIs to reduce stress, depression, and anxiety in university students, resulting in a decrease in the symptoms of these mental health conditions (Cortés-Hernández et al., 2023 ; Plata-Plata, 2024 ). However, no study has yet evaluated the impact of this type of intervention on medical students. Therefore, this study was designed to determine the effects of an eight-week mindfulness-based intervention in a sample that included students and staff members of the Faculty of Medicine at the Universidad Nacional Autónoma de México (UNAM). The hypothesis was that this intervention would improve participants' resilience to stress by reducing the dimensions of health and psychological well-being. Method Participants This study used a quasi-experimental design with a pre- and post-test evaluation, without a control group. This study was cross-sectional, quantitative, and descriptive. The study involved 38 individuals, including students and staff members from the UNAM School of Medicine, aged 19–72 years. The sample included 32 women and 6 men chosen through non-probability convenience sampling. Procedure Mindfulness-Based Stress Reduction (MBSR) was conducted over 8 weeks, in weekly 2-hour sessions, based on the program developed by Kabat-Zinn (Kabat-Zinn & Hanh, 2009 ). A certified MBSR instructor designed the contents. The study protocol was approved by the UNAM School of Medicine Research Ethics Committee (FM/DIV/49/2023). The study began with the recruitment of participants. Once the interested participants were identified, they received a brochure and informed consent form. After the consent form was signed, the initial burnout assessment was conducted using the Maslach Burnout Inventory-Human Service Survey (MBI-HSS). Information was collected anonymously to ensure complete confidentiality for each subject, in addition to the biological and neurophysiological measurements described later. Participants subsequently received the intervention for eight weeks, every Wednesday, for two hours. At the end of the workshop, the instruments used in the pre-test were administered again. The MBSR program consisted of physical and mental exercises that increased the participants' mindfulness of present-moment experiences. It also fostered a group dynamic that promoted reflection on mindfulness practices, both within and outside the classroom. The instructor focused on nurturing an open and receptive attitude toward all participants' experiences. Measures In addition to the demographic data collected (age, sex, and occupation), measures were obtained that reflected the effects of the intervention on psychological, biological, and neurophysiological aspects. Student compliance was measured on the basis of class attendance. Measurement of Blood Glucose and Triglyceride Levels Glucose and triglyceride levels were determined using test strips (MultiCare IN Glucose and Triglyceride Meter Test Kits). Before taking the test, the participants were instructed to wash their hands with soap and water and dry them thoroughly to avoid contamination or dilution of the sample. The first drop of blood was discarded, and the second drop was collected once. Triglyceride strips required 8 µL and glucose strips 0.5 µL. Each test required a different chip to be inserted into the meter before inserting the test strip. Once inserted, the participants' gender was indicated, and they were required to fast, ensuring accurate results. Triglyceride test results were obtained in 30 s, whereas glucose test results were obtained in 5 s. Measurement of Salivary Cortisol Participants were asked not to smoke, drink, or brush their teeth for at least one hour before sample collection. Samples were collected using a Salivette® system (Sarstedt, Germany) in the morning (before 11 a.m.) to minimize the effect of circadian rhythm on salivary production. The samples were centrifuged to remove the insoluble material, cell debris, and mucins. The supernatant was distributed into microtubes and stored at -80°C. A volume of 100 µL was used to determine the analyte concentration by ELISA using the commercial Abcam High-Sensitivity Human ELISA kit for cortisol (ab154996), according to the manufacturer's instructions. Body Composition Assessment Weight, body mass index (BMI), visceral fat area, and muscle mass were estimated using a bioelectrical impedance analysis (BIA) device (FitTrack DARA, Vienna, Austria). FitTrack uses a foot-to-foot BIA with four pressure-contact electrodes on a platform scale. Participants removed their shoes and stood still for approximately 5 minutes before measurement. The subjects were instructed to remain as still as possible during the measurements. Electrical signals were recorded from heel to heel, and the manufacturer's algorithms were used to estimate the values ​​of the assessed parameters. Burnout measure The validated Spanish MBI-HSS scale (Forne & Yuguero, 2022 ; Maslach et al., 1997 ) measures participants' burnout before and after the intervention. This scale is a 22-item instrument with a 7-point Likert rating system, ranging from 0 (never) to 6 (every day). It encompasses measurements of three dimensions of burnout: Emotional Exhaustion (EE), depersonalization (DP), and Personal Accomplishment (PA). Higher scores on EE and DP and lower scores on PA indicated higher levels of burnout. P300 - electrophysiological assessment For the long-latency auditory evoked potential (P300) assessment, each participant was seated on a chair in a quiet room. Measurements were performed using four-channel Biologic Systems Corp. equipment, with the Evoked Potential System version 5.7, and a computer. Before the procedure began, participants confirmed that they had not used any medications, tobacco, or stimulants 24 h before the procedure. The electrode placement was as follows: polar electrode on the forehead, recording electrode on the vertex, and reference electrode on the mastoid. Each stimulus window had a duration of 700 ms. The frequencies of both standard and target stimuli were 1000 and 2000 Hz, respectively, displayed in an oddball paradigm, where the probability of nontarget stimuli was 80% and that of targets was 20%. Each participant was assessed twice at 3- to 5-minute intervals, with a 10% error margin between the two measurements. The peak-to-peak difference between the mean baseline voltage and maximum peak of the event-related potential (ERP) before the preceding negative trough (250 and 500 ms) was defined as the P300 amplitude. The P300 component (latency) was identified as the largest preceding peak evoked by the deviant stimuli. Data Analyses Analysis to evaluate the intervention effect was performed using SPSS version 25 (Chicago, Illinois, USA). Descriptive statistics were used for sociodemographic variables (mean and standard deviation for quantitative variables, and percentages for qualitative variables). The Shapiro-Wilk test was used to determine whether the data conformed to a normal distribution. Paired Student’s t-test was used to compare study variables that followed a normal distribution. Wilcoxon test was used to evaluate data that did not follow a normal distribution. Statistical significance was set at p < 0.05 for all variables. Results Demographic features of the population receiving intervention Our study population consisted of 38 participants, whose demographic characteristics are shown in Table 1 . Our study population included 38 participants, mostly women (84%), with an average age of 28 years. In terms of occupation, the largest group consisted of first-year students (24%), followed by university employees (18%) and students who did not specify their current year (18%). Concerning workshop completion, more than half of the participants attended all sessions, while 20% attended the most (90%). Table 1 Sociodemographic variables of the population involved in the intervention. Gender Age Female 32 (84%) N 38 Male 6 (16%) Mean 28.21 Median 23 Standard Error of the Mean (S.E.M.) 2.243 Standard deviation 13.827 Variance 191.198 Min. 19 Max. 72 Occupation Percentage of Mindfulness Workshop Completed First-year student 9 (24%) 100% 21 (55%) University employee 7 (18%) 95% 1 (3%) Student 7 (18%) 90% 8 (20%) Medical intern in social service 6 (16%) 85% 1 (3%) Second-year student 3 (8%) 80% 3 (7%) Third-year student 2 (5%) 70% 1 (3%) Fifth-year student 2 (5%) 65% 1 (3%) Fourth-year student 1 (3%) 62% 1 (3%) Professional 1 (3%) 50% 1 (3%) Effect of the mindfulness intervention on altered biochemical parameters during stress. Table 2 and Fig. 1 illustrate the changes in the values of some biochemical parameters where alterations have been reported under situations of chronic stress, such as burnout syndrome (Fernandez-Sanchez et al., 2018 ; Melamed et al., 1992 ) where glucose and triglyceride levels did not show significant differences when comparing the pre-test concerning the post-test (p = 0.183 and p = 0.100, respectively), that is, the intervention did not modify the values quantified at the beginning of the study. In contrast, a significant difference was observed in the cortisol levels (p = 0.000). This difference was graphically observed in the third variable in Fig. 1 , which translates to a decrease of more than 10 points in this biochemical parameter due to the intervention (Table 2 ). Table 2 Summary of the results obtained for each variable assessed before and after the intervention conducted on the study participants. Variables N Mean Median Standard Error of the Mean Standard deviation Variance p-value Glucose_Pre 36 94.56 93.50 1.62 9.69 93.85 0.183 Glucose_Post 38 93.05 93.50 1.28 7.86 61.84 Triglycerides_Pre 38 238.03 221.00 17.58 108.38 11747.05 0.100 Triglycerides_Post 38 203.13 181.50 14.68 90.49 8189.20 Cortisol_Pre 38 30.62 24.52 3.74 23.05 531.31 0.000* Cortisol_Post 38 17.00 14.45 1.72 10.62 112.76 Weight_Pre 38 68.28 64.40 2.40 14.79 218.76 0.537 Weight_Post 38 68.14 63.50 2.37 14.62 213.80 BMI_Pre 38 26.21 25.10 0.83 5.14 26.42 0.162 BMI_Post 38 26.07 25.25 0.82 5.07 25.67 Visceral Fat_Pre 38 24.02 21.50 2.39 14.71 216.37 0.758 Visceral Fat_Post 38 24.18 21.50 2.46 15.14 229.27 Muscle_Pre 38 25.28 24.30 0.71 4.39 19.30 0.585 Muscle_Post 38 25.60 24.25 0.93 5.72 32.75 Emotional exhaustion_Pre 38 28.11 28.50 1.57 9.68 93.72 0.000* Emotional exhaustion_Post 38 20.05 20.00 1.70 10.49 110.05 Depersonalization_Pre 38 5.76 5.00 0.714 4.402 19.375 0.008* Depersonalization_Post 38 3.82 2.50 0.707 4.361 19.019 Personal accomplishment_Pre 38 27.87 27.50 1.332 8.214 67.469 0.000* Personal accomplishment_Post 38 33.58 37.00 1.629 10.039 100.791 P300_Pre 38 3.16 3.04 0.072 0.447 0.200 0.032* P300_Post 38 3.31 3.32 0.073 0.453 0.205 Effect of the mindfulness intervention on body composition parameters altered during stress. Figure 1 , variables 4 to 7, shows the changes in values for weight, BMI, visceral fat, and muscle. Although these parameters are known to be altered under chronic stress (Maruszczak et al., 2025 ), there were no significant differences between the pre-test and post-test results (Table 2 ). This indicates that the intervention did not affect these variables. The levels of each parameter remained unchanged before and after the intervention. Effect of the mindfulness intervention on burnout syndrome. Figure 1 , variables 8 to 10, shows the changes in the different domains of the MBI-HSS: Emotional Exhaustion (EE), Depersonalization (DP), and Personal Accomplishment (PA), in which significant differences were observed according to the statistical test used (Student's t or Wilcoxon, depending on whether the data fit a normal distribution) (Table 2 ). That is, the intervention affected reducing burnout syndrome, specifically, in the EE dimension, the level went from high to medium; in the DP, the level went practically from medium to low; and in the PA, the level went from high to medium (Table 2 ). Effect of the mindfulness intervention on P300 amplitude. In the present study, we chose to report the amplitude of the P300 component because its variation reflects the degree to which information is processed (Polich & Herbst, 2000 ). It has been reported as an effective marker for assessing mindfulness-based interventions (Klee et al., 2020 ). Table 2 shows that the changes in the P300 amplitude, expressed in µV, were statistically different (p = 0.032). The intervention significantly increased this value, indicating an effect on cognitive event-related brain potential (ERP). Discussion Numerous studies have evaluated the effects of interventions based on mindfulness in university contexts (Gonzalez-Martin et al., 2023 ). The results show effects at various levels, for example, improved mental health through the reduction of depression and anxiety, stress management, improved academic performance, and improved well-being (Gonzalez-Martin et al., 2023 ). However, few studies have assessed the impact of this type of intervention on chronic stress presented as a burnout syndrome, as well as the physiological implications that it entails, that is, determining the effect of mindfulness on physiological parameters modified due to stress in a university population sample that includes not only medical students but also professors and personnel related to the area (Singh et al., 2024 ; Turakitwanakan et al., 2013 ). Although it has been reported that the regular practice of static meditation is related to the decrease of triglycerides and glucose in the middle-aged adult population, which is attributed to the modifications caused by carrying out this type of activity in the autonomic nervous system (increase in ventral vagal tone and reduction of adrenergic activity) (Antonelli et al., 2024 ; Gupta et al., 2016 ), our results indicate that interventions based on mindfulness do not modify the values ​​of these biomarkers, which is consistent with a study carried out on medical students but with another type of meditation (Singh et al., 2024 ). Our results regarding cortisol levels are consistent with those reported in the literature. A systematic review and meta-analysis concluded that mindfulness-based interventions were the most effective in modifying the levels of this biomarker, and that studies that used cortisol measurements upon awakening showed greater effects (Rogerson et al., 2024 ). Furthermore, a clinical trial demonstrated that an eight-week mindfulness program reduced cortisol levels, stress, and anxiety in university staff (Gherardi-Donato et al., 2023 ). The explanation for the effect of mindfulness on reducing levels of biomarkers, such as cortisol, is that this type of activity promotes the regulation of the hypothalamic-pituitary-adrenal (HPA) axis (Creswell et al., 2019 ). Our study observed that mindfulness-based interventions affected all dimensions of burnout syndrome. This is consistent with the findings of other studies (Shoker et al., 2024 ). A systematic review indicated that emotional exhaustion was the most modified dimension when implementing this type of intervention. The observed effect of mindfulness is that healthcare professionals, including medical students, develop attentional skills and emotional flexibility, which help them regulate stress. The other dimensions showed a slight modification associated with the mindfulness-based intervention (Shoker et al., 2024 ). Few studies have linked the effect of mindfulness-based intervention or other meditation techniques, such as yoga, with P300 amplitude (Gholam et al., 2021 ; Lakey et al., 2011 ). One study determined the effect of mindfulness on brain-computer interface (BCI) performance by measuring the P300 amplitude. The findings showed that subjects who received the intervention produced significantly larger P300 amplitudes than those who did not (Lakey et al., 2011 ). Another study evaluated the effect of a yoga technique over an extended period of time (more than 36 months) on P300 amplitude, showing significantly higher values ​​in participants who practiced this technique than in non-participants. This suggests improved attention and working memory in subjects who practiced yoga given that the P300 amplitude is related to these cognitive abilities (Gholam et al., 2021 ). The results of our study indicate that mindfulness-based intervention had a positive effect on the P300 amplitude parameter, suggesting an improvement in the cognitive capacity of our participants. In conclusion, the results of this study indicate that mindfulness-based intervention was effective in improving burnout syndrome, specifically in its three domains, as well as in biochemical parameters such as cortisol and neurophysiological parameters such as the P-300 amplitude. However, no effect was observed on biochemical variables such as glucose or parameters associated with body composition. This study suggests that this type of intervention could be integrated into the academic curriculum for students or as a support program for university workers and that further research could explore its long-term effects. Limitations and Future Directions The findings of this study must be interpreted with consideration of several limitations. First, the sample size was small and inhomogeneous, resulting in insufficient statistical robustness. Second, the recruited population belonged to a single university campus, and the research used a quasi-experimental design without including a control group, which introduces a possible bias, limiting the possibility of assigning the effects obtained only to the intervention conducted. Finally, another potential limitation of the study was the dropout rate of 30% (data not shown). However, this rate is comparable to similar studies that reported dropout rates of close to 29% (Nam & Toneatto, 2016 ). On the other hand, one of the strengths of the study lies in the fact that, to our knowledge, this is the first study carried out in our country that evaluates the effect of an intervention based on mindfulness to alleviate burnout syndrome, not only from a psychological perspective, but also from a biochemical and neurophysiological perspective, in contexts such as the university, both in medical students and in educational and administrative personnel. The fact that the reported effects were observed regardless of the technical limitations suggests that they were due to the intervention. This also supports integrating these skills into university settings to achieve well-being among the participants. Finally, future studies should consider conducting large-scale randomized controlled and homogeneous trials to validate the results of this case study, minimize the risk of bias, and allow for the generalization of the observed effects. It would also be relevant to incorporate interviews to determine the social validity of mindfulness from participants' perspectives through qualitative analysis. Another aspect to consider in future studies is the need to identify the necessary conditions for implementing a mindfulness training program in university settings. Declarations Author Contribution RSC contributed to conceptualization, methodology, writing–original draft, and visualization of the study. RSC, MVP, and BMGC contributed to the obtaining of resources. RSC and LGV made the formal analysis. MVP and BMGC contributed to the project administration. LGV, MVP, and BMGC contributed to the data curation, writing, review, and editing of the manuscript. All authors approved the version to be published and agree to be accountable for all aspects of the work. Acknowledgement LGV is supported by the "Postdoctoral Fellowships in National Institutions" program from CITNOVA. 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(2019). The Biological Measurements of Mindfulness-based Stress Reduction: A Systematic Review. Explore (NY) , 15 (4), 295-307. https://doi.org/10.1016/j.explore.2019.01.001 Rogerson, O., Wilding, S., Prudenzi, A., & O'Connor, D. B. (2024). Effectiveness of stress management interventions to change cortisol levels: a systematic review and meta-analysis. Psychoneuroendocrinology , 159 , 106415. https://doi.org/10.1016/j.psyneuen.2023.106415 Salvagioni, D. A. J., Melanda, F. N., Mesas, A. E., Gonzalez, A. D., Gabani, F. L., & Andrade, S. M. (2017). Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies. PLoS One , 12 (10), e0185781. https://doi.org/10.1371/journal.pone.0185781 Shoker, D., Desmet, L., Ledoux, N., & Heron, A. (2024). Effects of standardized mindfulness programs on burnout: a systematic review and original analysis from randomized controlled trials. Front Public Health , 12 , 1381373. https://doi.org/10.3389/fpubh.2024.1381373 Shoman, Y., El May, E., Marca, S. C., Wild, P., Bianchi, R., Bugge, M. D., Caglayan, C., Cheptea, D., Gnesi, M., Godderis, L., Kiran, S., McElvenny, D. M., Mediouni, Z., Mehlum, I. S., Mijakoski, D., Minov, J., van der Molen, H. F., Nena, E., Otelea, M., & Guseva Canu, I. (2021). Predictors of Occupational Burnout: A Systematic Review. Int J Environ Res Public Health , 18 (17). https://doi.org/10.3390/ijerph18179188 Singh, S., Saxena, J., Rastogi, D., Kumar, A., Gupta, A., Singh, J., Kanawjia, P., & Saha, S. (2024). Effect of short-term breathing meditation on serum lipid profile and fasting blood glucose level among young healthy adults. National Journal of Physiology, Pharmacy and Pharmacology , 14 (1), 144-144. https://doi.org/10.5455/njppp.2023.13.05259202308062023 Tang, Y. Y., Holzel, B. K., & Posner, M. I. (2015). The neuroscience of mindfulness meditation. Nat Rev Neurosci , 16 (4), 213-225. https://doi.org/10.1038/nrn3916 Turakitwanakan, W., Mekseepralard, C., & Busarakumtragul, P. (2013). Effects of mindfulness meditation on serum cortisol of medical students. J Med Assoc Thai , 96 Suppl 1 , S90-95. https://www.ncbi.nlm.nih.gov/pubmed/23724462 Wang, Z., Wu, P., Hou, Y., Guo, J., & Lin, C. (2024). The effects of mindfulness-based interventions on alleviating academic burnout in medical students: a systematic review and meta-analysis. BMC Public Health , 24 (1), 1414. https://doi.org/10.1186/s12889-024-18938-4 World Health Organization, W. (2019). Burn-out an "occupational phenomenon": International Classification of Diseases . Retrieved 04/23/2025 from https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases Zeidan, F., Gordon, N. S., Merchant, J., & Goolkasian, P. (2010). The effects of brief mindfulness meditation training on experimentally induced pain. J Pain , 11 (3), 199-209. https://doi.org/10.1016/j.jpain.2009.07.015 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6598726","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":452472949,"identity":"fe64d1f2-c3ab-4e91-b6b2-038b6f5ba07b","order_by":0,"name":"Mireya Velázquez-Paniagua","email":"","orcid":"","institution":"National Autonomous University of Mexico","correspondingAuthor":false,"prefix":"","firstName":"Mireya","middleName":"","lastName":"Velázquez-Paniagua","suffix":""},{"id":452472950,"identity":"419e2048-b17e-41c4-80fe-2db1a4945c3c","order_by":1,"name":"Laura Gómez-Virgilio","email":"","orcid":"","institution":"National Autonomous University of Mexico","correspondingAuthor":false,"prefix":"","firstName":"Laura","middleName":"","lastName":"Gómez-Virgilio","suffix":""},{"id":452472951,"identity":"5bfbabdb-19c2-46cb-b7f5-1b56a9f270c9","order_by":2,"name":"Blanca Margarita Gómez-Chavarín","email":"","orcid":"","institution":"National Autonomous University of Mexico","correspondingAuthor":false,"prefix":"","firstName":"Blanca","middleName":"Margarita","lastName":"Gómez-Chavarín","suffix":""},{"id":452472952,"identity":"bac0a102-abb0-4986-afa7-e0a58cd4f990","order_by":3,"name":"Raúl Sampieri-Cabrera","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABBklEQVRIiWNgGAWjYLCCBAYGHn4IU4KxAcQlSotkA0laQMDgAIQmrEW+/XTagwcV92SMjx8+upl3h4Vsf3sCm3RBzTYG3RnY9Rqcyd1ukHCmmMfsTFrabd4zEsYzzjxgk55x7DaD2ZkD2LUw5G6TSGxL4DG7wWN2m7dNIrHhBtAWHjagluMN2B3W/xao5V8Cj/EMqJb5YC3/gFoO4/DMDZAtDQk8BhJQLRtAWnjbcNticOMt0C/HEngkgH65ObdNwnjjmYfN1rx9t3lw+UW+P3fbwx81Cfb87YeP3XjbVic773jywds8327Lmd3AHmJAwIYuwAh2EA8u9di0jIJRMApGwShABQAqimISoHuDyQAAAABJRU5ErkJggg==","orcid":"","institution":"National Autonomous University of Mexico","correspondingAuthor":true,"prefix":"","firstName":"Raúl","middleName":"","lastName":"Sampieri-Cabrera","suffix":""}],"badges":[],"createdAt":"2025-05-06 04:08:10","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6598726/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6598726/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":82358941,"identity":"ec119b97-9425-45cb-8e7d-d72cdff39b28","added_by":"auto","created_at":"2025-05-09 11:26:24","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":63318,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eGraphical representation of the variables assessed pre- and post-intervention in the study population. \u003c/strong\u003eTo compare the means or medians before and after the intervention, and to determine if there were any significant differences, either the Student's t-test for paired samples or the Wilcoxon signed-rank test was employed, depending on the normality of the data distribution. A significance level of * p \u0026lt; 0.05 was considered.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-6598726/v1/2c39844037df7bce992688c2.png"},{"id":82361388,"identity":"2711424a-0ddf-43aa-a61d-ce1c132c3cd2","added_by":"auto","created_at":"2025-05-09 11:50:24","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1222712,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6598726/v1/71384ca8-ba1a-45ca-8668-ceab12653bda.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Effect of a mindfulness-based intervention on burnout syndrome and associated biochemical and cognitive biomarkers: a case study in a university population sample","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAnxiety and depression are mental health conditions prevalent among university students, with implications for academic performance and well-being (Pinho et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). This is disturbing, particularly in lower-middle-income countries, where students of health science careers, such as medicine, experience academic and social pressures that lead them to stressful situations affecting their mental health (Alwhaibi et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eBurnout is a syndrome related to chronic stress that has not yet been effectively managed (World Health Organization, 2019). Burnout is a construct developed by Maslach for healthcare professionals. This construct is presented with a combination of three symptoms: Emotional Exhaustion (EE) (fatigue by exposure to stressors), depersonalization (DP) (negative attitude), and Personal Accomplishment (PA) (low self-esteem). The Maslach Burnout, and the most widely used scale to assess burnout Inventory (MBI). MBI allows the classification of burnout into low, intermediate, and elevated levels. This scale has been used and validated for 30 years by students in many languages (Frajerman et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). Some studies have investigated this syndrome among professionals as it was originally linked to occupational stress (Salvagioni et al., \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; Shoman et al., \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). However, several researchers have recently focused on the student population, particularly medical students (Cotobal Rodeles et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2025\u003c/span\u003e; Frajerman et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). This population receives intensive, arduous, and longer educational preparation than other college students, experiencing physical and emotional exhaustion due to the pressure and academic demands of this profession. The prevalence of burnout syndrome among medical students ranges from 5.6 to 88% (Di Vincenzo et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). In Mexico, a critical narrative analysis reported that the prevalence of academic burnout syndrome (ABS) among medical students ranges from 25\u0026ndash;45%. However, some studies indicated less than 10% of cases, while others exceeded 70%. The differences observed in the reports are attributed to the time when the students were analyzed, sample size, and methodology employed (Puig-Lagunes et al., \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2025\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMindfulness is a form of meditation based on Buddhist traditions involving the evaluation, surveillance, and control of mental processes (explicit metacognition) (Heyes et al., \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). The neuroscience-based model explains that this construct incorporates self-regulatory features, such as self-related awareness, attentional control, and emotional regulation (Tang et al., \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Owing to these characteristics, mindfulness has been accepted as an alternative intervention or training for skill acquisition in the improvement of mental health among medical students. Previous studies have indicated that mindfulness-based interventions (MBI) decrease stress, burnout, anxiety, pain, and depression in this population (Kaisti et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Zeidan et al., \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). Concerning burnout syndrome, a systematic review and meta-analysis suggested that this syndrome can be reduced in medical students, particularly in two subdomains (academic efficacy and emotional exhaustion) (Wang et al., \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eChronic stress releases hormones that disrupt biological pathways in various systems (immune, metabolic, and cardiac) including the brain. Evidence shows that MBI improves the brain regions involved in the body's stress response and ameliorates endocrine, immune, and inflammatory responses. For instance, MBI increases prefrontal cortex activity and connectivity and decreases fasting glucose, blood pressure, cortisol, C-reactive protein, Th1 cytokines, and NKCA cell activity (Reive, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). A report concluded that MBI reduces serum cortisol levels (Turakitwanakan et al., \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2013\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn our country, a few studies have reported the use of MBIs to reduce stress, depression, and anxiety in university students, resulting in a decrease in the symptoms of these mental health conditions (Cort\u0026eacute;s-Hern\u0026aacute;ndez et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Plata-Plata, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). However, no study has yet evaluated the impact of this type of intervention on medical students. Therefore, this study was designed to determine the effects of an eight-week mindfulness-based intervention in a sample that included students and staff members of the Faculty of Medicine at the Universidad Nacional Aut\u0026oacute;noma de M\u0026eacute;xico (UNAM). The hypothesis was that this intervention would improve participants' resilience to stress by reducing the dimensions of health and psychological well-being.\u003c/p\u003e"},{"header":"Method","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eParticipants\u003c/h2\u003e \u003cp\u003eThis study used a quasi-experimental design with a pre- and post-test evaluation, without a control group. This study was cross-sectional, quantitative, and descriptive.\u003c/p\u003e \u003cp\u003eThe study involved 38 individuals, including students and staff members from the UNAM School of Medicine, aged 19\u0026ndash;72 years. The sample included 32 women and 6 men chosen through non-probability convenience sampling.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eProcedure\u003c/h3\u003e\n\u003cp\u003eMindfulness-Based Stress Reduction (MBSR) was conducted over 8 weeks, in weekly 2-hour sessions, based on the program developed by Kabat-Zinn (Kabat-Zinn \u0026amp; Hanh, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2009\u003c/span\u003e). A certified MBSR instructor designed the contents. The study protocol was approved by the UNAM School of Medicine Research Ethics Committee (FM/DIV/49/2023).\u003c/p\u003e \u003cp\u003eThe study began with the recruitment of participants. Once the interested participants were identified, they received a brochure and informed consent form. After the consent form was signed, the initial burnout assessment was conducted using the Maslach Burnout Inventory-Human Service Survey (MBI-HSS). Information was collected anonymously to ensure complete confidentiality for each subject, in addition to the biological and neurophysiological measurements described later. Participants subsequently received the intervention for eight weeks, every Wednesday, for two hours. At the end of the workshop, the instruments used in the pre-test were administered again. The MBSR program consisted of physical and mental exercises that increased the participants' mindfulness of present-moment experiences. It also fostered a group dynamic that promoted reflection on mindfulness practices, both within and outside the classroom. The instructor focused on nurturing an open and receptive attitude toward all participants' experiences.\u003c/p\u003e\n\u003ch3\u003eMeasures\u003c/h3\u003e\n\u003cp\u003eIn addition to the demographic data collected (age, sex, and occupation), measures were obtained that reflected the effects of the intervention on psychological, biological, and neurophysiological aspects. Student compliance was measured on the basis of class attendance.\u003c/p\u003e\n\u003ch3\u003eMeasurement of Blood Glucose and Triglyceride Levels\u003c/h3\u003e\n\u003cp\u003eGlucose and triglyceride levels were determined using test strips (MultiCare IN Glucose and Triglyceride Meter Test Kits). Before taking the test, the participants were instructed to wash their hands with soap and water and dry them thoroughly to avoid contamination or dilution of the sample. The first drop of blood was discarded, and the second drop was collected once. Triglyceride strips required 8 \u0026micro;L and glucose strips 0.5 \u0026micro;L. Each test required a different chip to be inserted into the meter before inserting the test strip. Once inserted, the participants' gender was indicated, and they were required to fast, ensuring accurate results. Triglyceride test results were obtained in 30 s, whereas glucose test results were obtained in 5 s.\u003c/p\u003e\n\u003ch3\u003eMeasurement of Salivary Cortisol\u003c/h3\u003e\n\u003cp\u003e Participants were asked not to smoke, drink, or brush their teeth for at least one hour before sample collection. Samples were collected using a Salivette\u0026reg; system (Sarstedt, Germany) in the morning (before 11 a.m.) to minimize the effect of circadian rhythm on salivary production. The samples were centrifuged to remove the insoluble material, cell debris, and mucins. The supernatant was distributed into microtubes and stored at -80\u0026deg;C. A volume of 100 \u0026micro;L was used to determine the analyte concentration by ELISA using the commercial Abcam High-Sensitivity Human ELISA kit for cortisol (ab154996), according to the manufacturer's instructions.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eBody Composition Assessment\u003c/h2\u003e \u003cp\u003eWeight, body mass index (BMI), visceral fat area, and muscle mass were estimated using a bioelectrical impedance analysis (BIA) device (FitTrack DARA, Vienna, Austria). FitTrack uses a foot-to-foot BIA with four pressure-contact electrodes on a platform scale. Participants removed their shoes and stood still for approximately 5 minutes before measurement. The subjects were instructed to remain as still as possible during the measurements. Electrical signals were recorded from heel to heel, and the manufacturer's algorithms were used to estimate the values ​​of the assessed parameters.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eBurnout measure\u003c/h3\u003e\n\u003cp\u003eThe validated Spanish MBI-HSS scale (Forne \u0026amp; Yuguero, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Maslach et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e1997\u003c/span\u003e) measures participants' burnout before and after the intervention. This scale is a 22-item instrument with a 7-point Likert rating system, ranging from 0 (never) to 6 (every day). It encompasses measurements of three dimensions of burnout: Emotional Exhaustion (EE), depersonalization (DP), and Personal Accomplishment (PA). Higher scores on EE and DP and lower scores on PA indicated higher levels of burnout.\u003c/p\u003e\n\u003ch3\u003eP300 - electrophysiological assessment\u003c/h3\u003e\n\u003cp\u003e For the long-latency auditory evoked potential (P300) assessment, each participant was seated on a chair in a quiet room. Measurements were performed using four-channel Biologic Systems Corp. equipment, with the Evoked Potential System version 5.7, and a computer. Before the procedure began, participants confirmed that they had not used any medications, tobacco, or stimulants 24 h before the procedure.\u003c/p\u003e \u003cp\u003eThe electrode placement was as follows: polar electrode on the forehead, recording electrode on the vertex, and reference electrode on the mastoid. Each stimulus window had a duration of 700 ms. The frequencies of both standard and target stimuli were 1000 and 2000 Hz, respectively, displayed in an oddball paradigm, where the probability of nontarget stimuli was 80% and that of targets was 20%. Each participant was assessed twice at 3- to 5-minute intervals, with a 10% error margin between the two measurements. The peak-to-peak difference between the mean baseline voltage and maximum peak of the event-related potential (ERP) before the preceding negative trough (250 and 500 ms) was defined as the P300 amplitude. The P300 component (latency) was identified as the largest preceding peak evoked by the deviant stimuli.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eData Analyses\u003c/h2\u003e \u003cp\u003eAnalysis to evaluate the intervention effect was performed using SPSS version 25 (Chicago, Illinois, USA). Descriptive statistics were used for sociodemographic variables (mean and standard deviation for quantitative variables, and percentages for qualitative variables). The Shapiro-Wilk test was used to determine whether the data conformed to a normal distribution. Paired Student\u0026rsquo;s t-test was used to compare study variables that followed a normal distribution. Wilcoxon test was used to evaluate data that did not follow a normal distribution. Statistical significance was set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 for all variables.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eDemographic features of the population receiving intervention\u003c/h2\u003e \u003cp\u003eOur study population consisted of 38 participants, whose demographic characteristics are shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Our study population included 38 participants, mostly women (84%), with an average age of 28 years. In terms of occupation, the largest group consisted of first-year students (24%), followed by university employees (18%) and students who did not specify their current year (18%). Concerning workshop completion, more than half of the participants attended all sessions, while 20% attended the most (90%).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSociodemographic variables of the population involved in the intervention.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFemale\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32 (84%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eN\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMale\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (16%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eMean\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28.21\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eMedian\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eStandard Error of the Mean (S.E.M.)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.243\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eStandard deviation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.827\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eVariance\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e191.198\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eMin.\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eMax.\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOccupation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u003cb\u003ePercentage of Mindfulness Workshop Completed\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFirst-year student\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (24%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e100%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21 (55%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eUniversity employee\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 (18%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e95%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eStudent\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 (18%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e90%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8 (20%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMedical intern in social service\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (16%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e85%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSecond-year student\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e80%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3 (7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eThird-year student\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e70%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFifth-year student\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e65%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFourth-year student\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e62%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eProfessional\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e50%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eEffect of the mindfulness intervention on altered biochemical parameters during stress.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e and Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e illustrate the changes in the values of some biochemical parameters where alterations have been reported under situations of chronic stress, such as burnout syndrome (Fernandez-Sanchez et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Melamed et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e1992\u003c/span\u003e) where glucose and triglyceride levels did not show significant differences when comparing the pre-test concerning the post-test (p\u0026thinsp;=\u0026thinsp;0.183 and p\u0026thinsp;=\u0026thinsp;0.100, respectively), that is, the intervention did not modify the values quantified at the beginning of the study. In contrast, a significant difference was observed in the cortisol levels (p\u0026thinsp;=\u0026thinsp;0.000). This difference was graphically observed in the third variable in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, which translates to a decrease of more than 10 points in this biochemical parameter due to the intervention (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSummary of the results obtained for each variable assessed before and after the intervention conducted on the study participants.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMedian\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eStandard Error of the Mean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eStandard deviation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eVariance\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGlucose_Pre\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e94.56\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e93.50\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e9.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e93.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.183\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGlucose_Post\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e93.05\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e93.50\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e7.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e61.84\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTriglycerides_Pre\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e238.03\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e221.00\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e17.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e108.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e11747.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTriglycerides_Post\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e203.13\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e181.50\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e14.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e90.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e8189.20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCortisol_Pre\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e30.62\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e24.52\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e23.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e531.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e0.000*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCortisol_Post\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e17.00\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e14.45\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e10.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e112.76\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeight_Pre\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e68.28\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e64.40\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e14.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e218.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.537\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeight_Post\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e68.14\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e63.50\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e14.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e213.80\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI_Pre\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e26.21\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e25.10\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e5.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e26.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.162\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI_Post\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e26.07\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e25.25\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e5.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e25.67\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVisceral Fat_Pre\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e24.02\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e21.50\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e14.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e216.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.758\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVisceral Fat_Post\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e24.18\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e21.50\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e15.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e229.27\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMuscle_Pre\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e25.28\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e24.30\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e19.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.585\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMuscle_Post\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e25.60\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e24.25\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e5.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e32.75\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmotional exhaustion_Pre\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e28.11\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e28.50\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e9.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e93.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e0.000*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmotional exhaustion_Post\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e20.05\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e20.00\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e10.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e110.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDepersonalization_Pre\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e5.76\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e5.00\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.714\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4.402\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e19.375\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e0.008*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDepersonalization_Post\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e3.82\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e2.50\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.707\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4.361\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e19.019\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePersonal accomplishment_Pre\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e27.87\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e27.50\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.332\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e8.214\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e67.469\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e0.000*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePersonal accomplishment_Post\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e33.58\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e37.00\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.629\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e10.039\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e100.791\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP300_Pre\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e3.16\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e3.04\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.072\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.447\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e0.032*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP300_Post\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e3.31\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e3.32\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.073\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.453\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.205\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eEffect of the mindfulness intervention on body composition parameters altered during stress.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, variables 4 to 7, shows the changes in values for weight, BMI, visceral fat, and muscle. Although these parameters are known to be altered under chronic stress (Maruszczak et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2025\u003c/span\u003e), there were no significant differences between the pre-test and post-test results (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). This indicates that the intervention did not affect these variables. The levels of each parameter remained unchanged before and after the intervention.\u003c/p\u003e \u003cp\u003e \u003cb\u003eEffect of the mindfulness intervention on burnout syndrome.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, variables 8 to 10, shows the changes in the different domains of the MBI-HSS: Emotional Exhaustion (EE), Depersonalization (DP), and Personal Accomplishment (PA), in which significant differences were observed according to the statistical test used (Student's t or Wilcoxon, depending on whether the data fit a normal distribution) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). That is, the intervention affected reducing burnout syndrome, specifically, in the EE dimension, the level went from high to medium; in the DP, the level went practically from medium to low; and in the PA, the level went from high to medium (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cb\u003eEffect of the mindfulness intervention on P300 amplitude.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eIn the present study, we chose to report the amplitude of the P300 component because its variation reflects the degree to which information is processed (Polich \u0026amp; Herbst, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2000\u003c/span\u003e). It has been reported as an effective marker for assessing mindfulness-based interventions (Klee et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows that the changes in the P300 amplitude, expressed in \u0026micro;V, were statistically different (p\u0026thinsp;=\u0026thinsp;0.032). The intervention significantly increased this value, indicating an effect on cognitive event-related brain potential (ERP).\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eNumerous studies have evaluated the effects of interventions based on mindfulness in university contexts (Gonzalez-Martin et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). The results show effects at various levels, for example, improved mental health through the reduction of depression and anxiety, stress management, improved academic performance, and improved well-being (Gonzalez-Martin et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). However, few studies have assessed the impact of this type of intervention on chronic stress presented as a burnout syndrome, as well as the physiological implications that it entails, that is, determining the effect of mindfulness on physiological parameters modified due to stress in a university population sample that includes not only medical students but also professors and personnel related to the area (Singh et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Turakitwanakan et al., \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2013\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAlthough it has been reported that the regular practice of static meditation is related to the decrease of triglycerides and glucose in the middle-aged adult population, which is attributed to the modifications caused by carrying out this type of activity in the autonomic nervous system (increase in ventral vagal tone and reduction of adrenergic activity) (Antonelli et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Gupta et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2016\u003c/span\u003e), our results indicate that interventions based on mindfulness do not modify the values ​​of these biomarkers, which is consistent with a study carried out on medical students but with another type of meditation (Singh et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOur results regarding cortisol levels are consistent with those reported in the literature. A systematic review and meta-analysis concluded that mindfulness-based interventions were the most effective in modifying the levels of this biomarker, and that studies that used cortisol measurements upon awakening showed greater effects (Rogerson et al., \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Furthermore, a clinical trial demonstrated that an eight-week mindfulness program reduced cortisol levels, stress, and anxiety in university staff (Gherardi-Donato et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). The explanation for the effect of mindfulness on reducing levels of biomarkers, such as cortisol, is that this type of activity promotes the regulation of the hypothalamic-pituitary-adrenal (HPA) axis (Creswell et al., \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOur study observed that mindfulness-based interventions affected all dimensions of burnout syndrome. This is consistent with the findings of other studies (Shoker et al., \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). A systematic review indicated that emotional exhaustion was the most modified dimension when implementing this type of intervention. The observed effect of mindfulness is that healthcare professionals, including medical students, develop attentional skills and emotional flexibility, which help them regulate stress. The other dimensions showed a slight modification associated with the mindfulness-based intervention (Shoker et al., \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eFew studies have linked the effect of mindfulness-based intervention or other meditation techniques, such as yoga, with P300 amplitude (Gholam et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Lakey et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2011\u003c/span\u003e). One study determined the effect of mindfulness on brain-computer interface (BCI) performance by measuring the P300 amplitude. The findings showed that subjects who received the intervention produced significantly larger P300 amplitudes than those who did not (Lakey et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2011\u003c/span\u003e). Another study evaluated the effect of a yoga technique over an extended period of time (more than 36 months) on P300 amplitude, showing significantly higher values ​​in participants who practiced this technique than in non-participants. This suggests improved attention and working memory in subjects who practiced yoga given that the P300 amplitude is related to these cognitive abilities (Gholam et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). The results of our study indicate that mindfulness-based intervention had a positive effect on the P300 amplitude parameter, suggesting an improvement in the cognitive capacity of our participants.\u003c/p\u003e \u003cp\u003eIn conclusion, the results of this study indicate that mindfulness-based intervention was effective in improving burnout syndrome, specifically in its three domains, as well as in biochemical parameters such as cortisol and neurophysiological parameters such as the P-300 amplitude. However, no effect was observed on biochemical variables such as glucose or parameters associated with body composition. This study suggests that this type of intervention could be integrated into the academic curriculum for students or as a support program for university workers and that further research could explore its long-term effects.\u003c/p\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eLimitations and Future Directions\u003c/h2\u003e \u003cp\u003eThe findings of this study must be interpreted with consideration of several limitations. First, the sample size was small and inhomogeneous, resulting in insufficient statistical robustness. Second, the recruited population belonged to a single university campus, and the research used a quasi-experimental design without including a control group, which introduces a possible bias, limiting the possibility of assigning the effects obtained only to the intervention conducted. Finally, another potential limitation of the study was the dropout rate of 30% (data not shown). However, this rate is comparable to similar studies that reported dropout rates of close to 29% (Nam \u0026amp; Toneatto, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2016\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOn the other hand, one of the strengths of the study lies in the fact that, to our knowledge, this is the first study carried out in our country that evaluates the effect of an intervention based on mindfulness to alleviate burnout syndrome, not only from a psychological perspective, but also from a biochemical and neurophysiological perspective, in contexts such as the university, both in medical students and in educational and administrative personnel. The fact that the reported effects were observed regardless of the technical limitations suggests that they were due to the intervention. This also supports integrating these skills into university settings to achieve well-being among the participants.\u003c/p\u003e \u003cp\u003eFinally, future studies should consider conducting large-scale randomized controlled and homogeneous trials to validate the results of this case study, minimize the risk of bias, and allow for the generalization of the observed effects. It would also be relevant to incorporate interviews to determine the social validity of mindfulness from participants' perspectives through qualitative analysis. Another aspect to consider in future studies is the need to identify the necessary conditions for implementing a mindfulness training program in university settings.\u003c/p\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eRSC contributed to conceptualization, methodology, writing\u0026ndash;original draft, and visualization of the study. RSC, MVP, and BMGC contributed to the obtaining of resources. RSC and LGV made the formal analysis. MVP and BMGC contributed to the project administration. LGV, MVP, and BMGC contributed to the data curation, writing, review, and editing of the manuscript. All authors approved the version to be published and agree to be accountable for all aspects of the work.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eLGV is supported by the \"Postdoctoral Fellowships in National Institutions\" program from CITNOVA. MVP is supported by Special Chair \"Doctor Bernardo Sep\u0026uacute;lveda Guti\u0026eacute;rrez,\" awarded by the Technical Council of the Faculty of Medicine from August 2024 to 2025.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe study data are available from the corresponding author upon request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eAlwhaibi, M., Alotaibi, A., \u0026amp; Alsaadi, B. 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Burnout and risk factors for cardiovascular diseases. \u003cem\u003eBehav Med\u003c/em\u003e,\u003cem\u003e\u0026nbsp;18\u003c/em\u003e(2), 53-60. https://doi.org/10.1080/08964289.1992.9935172\u003c/li\u003e\n \u003cli\u003eNam, S., \u0026amp; Toneatto, T. (2016). The influence of attrition in evaluating the efficacy and effectiveness of mindfulness-based interventions. \u003cem\u003eInternational Journal of Mental Health and Addiction\u003c/em\u003e,\u003cem\u003e\u0026nbsp;14\u003c/em\u003e, 969-981. https://doi.org/10.1007/s11469-016-9667-1\u003c/li\u003e\n \u003cli\u003ePinho, L. G., Engstrom, M., Schneider, B. C., Fonseca, C., Lindberg, M., Schroder, J., Afonso, A., Jelinek, L., Borsting, J., Jacinto, G., \u0026amp; Nilsson, A. (2025). Symptoms of anxiety and depression among health and social science students: A multicenter study. \u003cem\u003eHeliyon\u003c/em\u003e,\u003cem\u003e\u0026nbsp;11\u003c/em\u003e(2), e41957. https://doi.org/10.1016/j.heliyon.2025.e41957\u003c/li\u003e\n \u003cli\u003ePlata-Plata, Z. (2024). \u003cem\u003eEntrenamiento en biofeedback y mindfulness para disminuir la ansiedad, estr\u0026eacute;s y depresi\u0026oacute;n en estudiantes universitarios\u003c/em\u003e Universidad Aut\u0026oacute;noma del Estado de M\u0026eacute;xico]. http://hdl.handle.net/20.500.11799/141395\u003c/li\u003e\n \u003cli\u003ePolich, J., \u0026amp; Herbst, K. L. (2000). P300 as a clinical assay: rationale, evaluation, and findings. \u003cem\u003eInt J Psychophysiol\u003c/em\u003e,\u003cem\u003e\u0026nbsp;38\u003c/em\u003e(1), 3-19. https://doi.org/10.1016/s0167-8760(00)00127-6\u003c/li\u003e\n \u003cli\u003ePuig-Lagunes, A. A., Mendez-Lara, L. A., \u0026amp; Ortiz-Cruz, F. (2025). Academic Burnout in Mexican Medical Students: A Critical Review of Prevalence, Risk Factors, and Gaps in Intervention. \u003cem\u003eInternational Journal of Medical Students\u003c/em\u003e,\u003cem\u003e\u0026nbsp;13\u003c/em\u003e(1), 73-86. https://doi.org/10.5195/ijms.2025.2461\u003c/li\u003e\n \u003cli\u003eReive, C. (2019). The Biological Measurements of Mindfulness-based Stress Reduction: A Systematic Review. \u003cem\u003eExplore (NY)\u003c/em\u003e,\u003cem\u003e\u0026nbsp;15\u003c/em\u003e(4), 295-307. https://doi.org/10.1016/j.explore.2019.01.001\u003c/li\u003e\n \u003cli\u003eRogerson, O., Wilding, S., Prudenzi, A., \u0026amp; O\u0026apos;Connor, D. B. (2024). Effectiveness of stress management interventions to change cortisol levels: a systematic review and meta-analysis. \u003cem\u003ePsychoneuroendocrinology\u003c/em\u003e,\u003cem\u003e\u0026nbsp;159\u003c/em\u003e, 106415. https://doi.org/10.1016/j.psyneuen.2023.106415\u003c/li\u003e\n \u003cli\u003eSalvagioni, D. A. J., Melanda, F. N., Mesas, A. E., Gonzalez, A. D., Gabani, F. L., \u0026amp; Andrade, S. M. (2017). Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies. \u003cem\u003ePLoS One\u003c/em\u003e,\u003cem\u003e\u0026nbsp;12\u003c/em\u003e(10), e0185781. https://doi.org/10.1371/journal.pone.0185781\u003c/li\u003e\n \u003cli\u003eShoker, D., Desmet, L., Ledoux, N., \u0026amp; Heron, A. (2024). Effects of standardized mindfulness programs on burnout: a systematic review and original analysis from randomized controlled trials. \u003cem\u003eFront Public Health\u003c/em\u003e,\u003cem\u003e\u0026nbsp;12\u003c/em\u003e, 1381373. https://doi.org/10.3389/fpubh.2024.1381373\u003c/li\u003e\n \u003cli\u003eShoman, Y., El May, E., Marca, S. C., Wild, P., Bianchi, R., Bugge, M. D., Caglayan, C., Cheptea, D., Gnesi, M., Godderis, L., Kiran, S., McElvenny, D. M., Mediouni, Z., Mehlum, I. S., Mijakoski, D., Minov, J., van der Molen, H. F., Nena, E., Otelea, M., \u0026amp; Guseva Canu, I. (2021). Predictors of Occupational Burnout: A Systematic Review. \u003cem\u003eInt J Environ Res Public Health\u003c/em\u003e,\u003cem\u003e\u0026nbsp;18\u003c/em\u003e(17). https://doi.org/10.3390/ijerph18179188\u003c/li\u003e\n \u003cli\u003eSingh, S., Saxena, J., Rastogi, D., Kumar, A., Gupta, A., Singh, J., Kanawjia, P., \u0026amp; Saha, S. (2024). Effect of short-term breathing meditation on serum lipid profile and fasting blood glucose level among young healthy adults. \u003cem\u003eNational Journal of Physiology, Pharmacy and Pharmacology\u003c/em\u003e,\u003cem\u003e\u0026nbsp;14\u003c/em\u003e(1), 144-144. https://doi.org/10.5455/njppp.2023.13.05259202308062023\u003c/li\u003e\n \u003cli\u003eTang, Y. Y., Holzel, B. K., \u0026amp; Posner, M. I. (2015). The neuroscience of mindfulness meditation. \u003cem\u003eNat Rev Neurosci\u003c/em\u003e,\u003cem\u003e\u0026nbsp;16\u003c/em\u003e(4), 213-225. https://doi.org/10.1038/nrn3916\u003c/li\u003e\n \u003cli\u003eTurakitwanakan, W., Mekseepralard, C., \u0026amp; Busarakumtragul, P. (2013). Effects of mindfulness meditation on serum cortisol of medical students. \u003cem\u003eJ Med Assoc Thai\u003c/em\u003e,\u003cem\u003e\u0026nbsp;96 Suppl 1\u003c/em\u003e, S90-95. https://www.ncbi.nlm.nih.gov/pubmed/23724462\u003c/li\u003e\n \u003cli\u003eWang, Z., Wu, P., Hou, Y., Guo, J., \u0026amp; Lin, C. (2024). The effects of mindfulness-based interventions on alleviating academic burnout in medical students: a systematic review and meta-analysis. \u003cem\u003eBMC Public Health\u003c/em\u003e,\u003cem\u003e\u0026nbsp;24\u003c/em\u003e(1), 1414. https://doi.org/10.1186/s12889-024-18938-4\u003c/li\u003e\n \u003cli\u003eWorld Health Organization, W. (2019). \u003cem\u003eBurn-out an \u0026quot;occupational phenomenon\u0026quot;: International Classification of Diseases\u003c/em\u003e. Retrieved 04/23/2025 from https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases\u003c/li\u003e\n \u003cli\u003eZeidan, F., Gordon, N. S., Merchant, J., \u0026amp; Goolkasian, P. (2010). The effects of brief mindfulness meditation training on experimentally induced pain. \u003cem\u003eJ Pain\u003c/em\u003e,\u003cem\u003e\u0026nbsp;11\u003c/em\u003e(3), 199-209. https://doi.org/10.1016/j.jpain.2009.07.015\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Mindfulness-based interventions (MBI), Burnout Syndrome, Medical Students, Cortisol, P300 amplitude","lastPublishedDoi":"10.21203/rs.3.rs-6598726/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6598726/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cem\u003e\u003cstrong\u003eObjectives\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eIn Mexico, 25-45% of medical students experience burnout syndrome, which can be reduced through mindfulness-based interventions (MBI). No study has evaluated this intervention's impact on our country's population. Therefore, this study aimed to determine the effects of an eight-week MBI on medical students and university workers.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eMethod\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eA quasi-experimental design incorporating pre- and post-tests was implemented with 38 participants. The Mindfulness-Based Stress Reduction (MBSR) program was conducted over 8 weeks to evaluate its efficacy on psychological, biological, and neurophysiological parameters. Data were analyzed using either the paired Student’s t-test or the Wilcoxon test.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThirty-eight participants, with a mean age of 28 years, were recruited for this study. Of these, 84% were women. Twenty-four percent of this population were first-year students, and more than half attended all sessions. The intervention had significant effects on cortisol levels (p = 0.000), burnout syndrome in three dimensions (EE, p = 0.000; DP, p = 0.008; and PA, p = 0.000), and the P300 amplitude (p = 0.032).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe findings indicated that mindfulness-based intervention significantly alleviated burnout syndrome, lowered cortisol levels, and influenced neurophysiological metrics such as the P-300 amplitude. Future studies should explore its long-term effects.\u003c/p\u003e","manuscriptTitle":"Effect of a mindfulness-based intervention on burnout syndrome and associated biochemical and cognitive biomarkers: a case study in a university population sample","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-09 11:26:17","doi":"10.21203/rs.3.rs-6598726/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"963b45e9-577b-4a4e-b698-a84803be0f6d","owner":[],"postedDate":"May 9th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-05-09T11:26:19+00:00","versionOfRecord":[],"versionCreatedAt":"2025-05-09 11:26:17","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6598726","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6598726","identity":"rs-6598726","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}