Browsing by Subject "Wellness"

Now showing 1 - 10 of 12
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    10 Tips for Maintaining a Healthy Lifestyle and Body Weight
    (Fairbanks School of Public Health, 2020-03-18) Song, Yiqing; Epidemiology, School of Public Health
    At this extreme moment, we began working from home, away from campus, and keeping social distance for as many people as possible. As we stay home and are stuck with the foods that have been in our fridge or pantry for a while, we are temporarily living a sedentary lifestyle with increased odds of physical inactivity, excessive eating and sitting, stress, anxiety, and depression. In particular, many of us will gain some weight during the pandemic and may keep the extra weight permanently, which may carry considerable health risks for type 2 diabetes, hypertension, heart attack, stroke, and other health problems. Here, I’d like to share some basic tips and resources for how to maintain your healthy lifestyle, body weight, and overall well-being while staying home and engaging in social distancing.
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    247 Identifying Factors that Contribute to Joy and Gratitude for Emergency Medicine Healthcare Workers Amidst the COVID-19 Pandemic
    (Elsevier, 2021-10) Kelker, H.; Cushman, E.; Munson, C.; Yoder, K.; Musey, P.; Reed, K.; Henderson, B.; Vynas, P.; Johnson, O.; Welch, J.; Emergency Medicine, School of Medicine
    Study Objective: During COVID-19, emergency medicine (EM) providers have labored to protect the health of their patients, often at the expense of their own well-being. Increased demands imposed on providers without intentional efforts to evaluate and improve wellness can lead to burnout, attrition, and compromise patient care. Practices that promote mindfulness, reflection and gratitude have been shown to reduce burnout. The Institute for Healthcare Improvement (IHI) Framework for Improving Joy In Work provides an approach to restore joy and engagement by first identifying elements that "matter most” to healthcare workers. The objective of this study was to identify common themes and associations that contribute to EM provider and staff (1) joy in work, (2) gratitude, and (3) personal wellness. Methods: This descriptive study used an electronic survey tool with open-ended questions adapted from the IHI framework to assess what matters most. Q1: What brings you joy in your work? Q2: Thinking back to what matters most, what are you grateful for? Q3: What do you do to maintain your personal wellness? In Nov. 2020, email listservs were used to recruit a voluntary sample of emergency physicians, advanced practice providers (APPs), residents, fellows, nurses and staff from 10 academic and community hospitals. Data were managed in Qualtrics and Excel. Qualitative analysis used inductive thematic coding by two authors independently, with verification by a third. Information redundancy signaled saturation for common themes. Pivot tables examined themes across demographics, and associations were analyzed with 2x2 contingency tables using chi-square, Fisher’s exact tests, and odds ratios (95% CI). Results: Of 254 respondents, 63% were female and 89% identified as White. Roles were 32% physicians, 8% APPs, 16% residents/fellows, and 44% nurses/staff. Response rates were 39-54% for providers. Common themes for joy in work were patient care (47%) and teamwork/camaraderie (43%), followed by feeling valued/appreciated (13%), making a difference (13%), and teaching/mentoring (9%). EM providers at academic sites were more likely to find joy in teaching/mentoring than those in the community (p=0.01; OR 10.5, 95% CI 1.3-82.6). For gratitude, themes were teamwork/ camaraderie (13%), family (12%), health (7%), and supportive work environment (7%). Themes for maintaining personal wellness were physical exercise (46%), time with family and friends (32%), hobbies (15%), and self-care (13%). Conclusions: Results of this study reveal common themes for EM providers and staff surrounding joy, gratitude, and wellness. By identifying elements that matter most, systems can take the next steps in the IHI framework to support and rejuvenate their healthcare team. Implications from our findings suggest that practices and future research to remove barriers and encourage meaningful provider-patient interactions, team camaraderie, teaching/mentoring, physical activity, and time with family/friends could increase joy and fulfillment for frontline healthcare workers.
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    Approaches to Improve the Structure and Function of the Skeleton in Chronic Kidney Disease
    (2022-03) Swallow, Elizabeth Anne; Allen, Matthew R.; McNulty, Margaret A.; Moe, Sharon M.; Wallace, Joseph M.
    Chronic kidney disease (CKD) currently affects ~37 million Americans and causes substantially increased risk of skeletal fracture and fracture-related mortality. Current methods to treat CKD-related bone loss remain alarmingly ineffective. Skeletal fragility in CKD is predominately driven by deteriorations in cortical bone, highlighted by significant cortical porosity development. It is hypothesized that cortical porosity is largely driven by chronically high levels of parathyroid hormone (PTH), which alters the balance of bone remodeling in favor of rampant osteoclast activity and bone resorption. Restricting cortical bone deterioration and the development of cortical pores is likely essential to improve CKD patients’ bone health and reduce their fracture risk. The goal of this series of studies was to answer the following key questions: (1) to what degree do bisphosphonates, an approved pharmacological agent used in metabolic bone disease, accumulate in the skeleton of animals with CKD; (2) can smaller and more frequent doses of bisphosphonates alter skeletal accumulation and improve cortical architecture and the mechanical integrity of bone; (3) can non-bisphosphonate pharmacological interventions more specifically affect cortical bone deterioration. Utilizing epi-fluorescence and two-photon microscopy, our results show that bisphosphonates accumulate more in rats with renal impairment and fractionating bisphosphonates lowered skeletal accumulation irrespective of disease state. Further, studies in both rat and mouse models of CKD demonstrated different bisphosphonate treatments alone do not recover declines in cortical microarchitecture or mechanical properties in CKD. These findings demonstrate that a single intervention is not sufficient in managing CKD-induced bone alterations. Utilizing individual pore tracking analysis, we demonstrated cortical pores can be modulated with therapeutic interventions and can infill, despite the presence of CKD. Potent suppression of PTH led to significant pore infilling while more subtle reductions in PTH, via a calcimimetic, had less striking effects on bone. Calcimimetics mitigated cortical microarchitecture deterioration and reduced the rate of cortical pore expansion. Overall, these findings highlight the importance of PTH management for treating cortical deterioration in CKD. Although bisphosphonates can be utilized in ways that reduce skeletal accumulation, they appear to need co-therapies to reduce skeletal fragility associated with CKD.
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    Centering F.a.M.I.L.Y in Black Girls' STEM Learning. Equity by Design
    (Midwest and Plains Equity Assistance Center, 2022) Morton, Crystal; Palmer-Azikiwe, Chanae; Barlow, Marva Renee
    In this "Equity by Design" brief, the authors describe the F.a.M.I.L.Y (Fostering and Maximizing Interdisciplinary Learning Year-round) Project and discuss the Project's importance and impact on Black girls and their caregivers. The brief ends with a discussion of strategies implemented during the F.a.M.I.L.Y Project to create a holistic and inclusive environment for STEM learning and positive STEM identity development.
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    Factors influencing emergency medicine worker shift satisfaction: A rapid assessment of wellness in the emergency department
    (Wiley, 2024-10-29) Senken, Brooke; Welch, Julie; Sarmiento, Elisa; Weinstein, Elizabeth; Cushman, Emma; Kelker, Heather; Emergency Medicine, School of Medicine
    Objectives: In emergency medicine (EM), the interplay of wellbeing and burnout impacts not only patient care, but the health, productivity, and job satisfaction of EM healthcare workers. The study objective was to use a rapid assessment tool to identify factors that impact EM worker satisfaction, or "wellness," while on shift in the emergency department (ED) and the association with role and level of satisfaction. Methods: This prospective descriptive study utilized a QR-code-based electronic survey instrument that included a 7-point Likert shift satisfaction score. A voluntary response sampling was obtained from EM workers at five EDs. Respondents self-reported role and work site. Association and logistic regression analysis were performed. Results: Of 755 responses, 467 were dissatisfied (score ≤ 5) and 288 were satisfied (score ≥ 6) with their shifts. Physicians reported higher satisfaction on shift than nurses (OR 2.77, 95% CL 2.01-3.81, p < 0.01). Factors associated with dissatisfied responses included: admission or transfer process (OR 0.40, CL 0.21-0.77, p < 0.01), boarding patients (OR 0.13, CL 0.06-0.27, p < 0.01), tools to do my job (OR 0.65, CL 0.46-0.90, p = 0.01), and patient flow (OR 0.72, CL 0.53-0.98, p = 0.04). Factors linked to a satisfied response included: teaching/learning (OR 2.85, CL 1.86-4.37, p < 0.01) and team/coworker interaction (OR 8.92, CL 6.14-12.96, p < 0.01). Conclusions: Satisfaction on shift for EM physicians, nurses, and staff differ and are associated with multiple identifiable factors. Focused attention to work environment and operations could help mitigate on-shift dissatisfaction. Endeavors aimed at cultivating and enhancing a supportive teaching and learning environment with an emphasis on team member and coworker interaction could positively impact and improve wellness.
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    Health-related Quality of Life in a Prospective Study of Ultrasound to Detect Cystic Fibrosis-related Liver Disease in Children
    (Wiley, 2022) Schwarzenberg, Sarah Jane; Palermo, Joseph J.; Ye, Wen; Huang, Suiyuan; Magee, John C.; Alazraki, Adina; Freeman, A. Jay; Harned, Roger; Karmazyn, Boaz; Karnsakul, Wikrom; Leung, Daniel H.; Ling, Simon C.; Masand, Prakash; Molleston, Jean P.; Murray, Karen F.; Navarro, Oscar M.; Nicholas, Jennifer L.; Otto, Randolph K.; Paranjape, Shruti M.; Siegel, Marilyn J.; Stoll, Janis; Towbin, Alexander J.; Narkewicz, Michael R.; Alonso, Estella M.; CFLD NET; Pediatrics, School of Medicine
    Objectives: Cystic fibrosis liver disease (CFLD) begins early in life. Symptoms may be vague, mild, or nonexistent. Progressive liver injury may be associated with decrements in patient health before liver disease is clinically apparent. We examined Health-Related Quality of Life (HRQOL) in children enrolled in a multi-center study of CFLD to determine the impact of early CFLD on general and disease-specific QOL. Methods: Ultrasound (US) patterns of normal (NL), heterogeneous (HTG), homogeneous (HMG), or nodular (NOD) were assigned in a prospective manner to predict those at risk for advanced CFLD. Parents were informed of results. We assessed parent/child-reported (age ≥5 years) HRQOL by PedsQL 4.0 Generic Core and CF Questionnaire-revised (CFQ-R) prior to US and annually. HRQOL scores were compared by US pattern at baseline (prior to US), between baseline and 1 year and at 5 years. Multivariate analysis of variance (MANOVA) with Hotelling-Lawley trace tested for differences among US groups. Results: Prior to US, among 515 participants and their parents there was no evidence that HTG or NOD US was associated with reduced PedsQL/CFQ-R at baseline. Parents of NOD reported no change in PedsQL/CFQ-R over the next year. Child-report PedsQL/CFQ-R (95 NL, 20 NOD) showed improvement between baseline and year 5 for many scales, including Physical Function. Parents of HMG children reported improved CFQ-R scores related to weight. Conclusions: Early undiagnosed or pre-symptomatic liver disease had no impact on generic or disease-specific HRQoL, and HRQoL was remarkably stable in children with CF regardless of liver involvement.
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    How resilient is your team? Exploring healthcare providers’ well-being during the COVID-19 pandemic
    (Elsevier, 2020-09-11) Huffman, Elizabeth M.; Athanasiadis, Dimitrios I.; Anton, Nicholas E.; Haskett, Lindsay A.; Doster, Dominique L.; Stefanidis, Dimitrios; Lee, Nicole K.; Surgery, School of Medicine
    Background: The global COVID-19 pandemic has placed tremendous physical and mental strain on the US healthcare system. Studies examining the effects of outbreaks have demonstrated both an increased prevalence and long-term development of Post-Traumatic Stress Disorder (PTSD) symptoms in healthcare providers. We sought to assess the impact of the COVID-19 pandemic on the psychological well-being of medical providers, medical trainees, and administrators at a large academic center to identify stressors and moderators to guide future mental health and hospital-system interventions. Methods: A 42-item survey examining specific stressors, grit, and resilience was widely distributed to physicians, residents, fellows, and administrators a large academic institution for departmental distribution. Survey results were analyzed using descriptive statistics, ANOVA, and multivariate linear regressions. A p-value <0.05 was considered statistically significant. Results: A total of 785 participants completed the survey. The majority of respondents rated their stress to be significantly increased during the pandemic. Respondents’ fear of transmitting the virus to their family members was a significant stressor. Higher resilience was associated with lower stress, anxiety, fatigue, and sleep disturbances. Overall, respondents felt supported by their departments and institution and felt contingency plans and personal protective equipment were adequate. Conclusions: Healthcare workers have increased resilience in the face of heightened stress during a pandemic. Higher resilience and grit were protective factors in managing personal and system-level stressors at the peak of the COVID-19 pandemic in our institution. Implementing an intervention designed to enhance healthcare workers’ resilience in response to the COVID-19 pandemic is warranted.
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    Longitudinal Prospective Study of Emergency Medicine Provider Wellness Across Ten Academic and Community Hospitals During the Initial Surge of the COVID-19 Pandemic
    (2020-10-15) Kelker, Heather; Yoder, Kyle; Musey, Paul; Harris, Madison; Johnson, Olivia; Sarmiento, Elisa; Vyas, Punit; Henderson, Brooke; Adams, Zachary; Welch, Julie L.; Emergency Medicine, School of Medicine
    Background: While the coronavirus (COVID-19) has had far-reaching consequences on society and health care providers, there is a paucity of research exploring emergency medicine (EM) provider wellness over the course of a pandemic. The objective of this study was to assess the well-being, resilience, burnout, and wellness factors and needs of EM physicians and advanced practice providers (APPs) during the initial phase of the COVID-19 pandemic. Methods: A longitudinal, descriptive, prospective cohort survey study of 213 EM physicians and APPs was performed across ten emergency departments in a single state, including academic and community settings. Participants were recruited via email to complete four weekly, voluntary, anonymous questionnaires comprised of customized and validated tools for assessing wellness (Well Being Index), burnout (Physician Work Life Study item), and resilience (Brief Resilience Scale) during the initial acceleration phase of COVID-19. Univariate and multivariate analysis with Chi-squared, Fisher’s Exact, and logistic regression was performed. Results: Of 213 eligible participants, response rates ranged from 31 to 53% over four weeks. Women comprised 54 to 60% of responses. Nonrespondent characteristics were similar to respondents. Concern for personal safety decreased from 85% to 61% (p<0.001). Impact on basic self-care declined from 66% to 32% (p<0.001). Symptoms of stress, anxiety or fear was initially 83% and reduced to 66% (p=0.009). Reported strain on relationships and feelings of isolation affected >50% of respondents initially without significant change (p=0.05 and p=0.30 respectively). Women were nearly twice as likely to report feelings of isolation as men (OR 1.95; 95%CI 1.82-5.88). Working part-time carried twice the risk of burnout (OR, 2.45; 95% CI, 1.10-5.47). Baseline resilience was normal to high. Provider well-being improved over the four-weeks (30% to 14%; p=0.01), but burnout did not significantly change (30% to 22%; p=0.39). Conclusion: This survey of frontline EM providers during the initial surge of COVID-19 found that despite being a resilient group, the majority experienced stress, anxiety, fear, and concerns about personal safety due to COVID-19, with many at risk for burnout. The sustained impact of the pandemic on EM provider wellness deserves further investigation to guide targeted interventions.
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    Pathophysiology of Demineralization, Part II: Enamel White Spots, Cavitated Caries, and Bone Infection
    (Springer, 2022) Roberts, W. Eugene; Mangum, Jonathan E.; Schneider, Paul M.; Orthodontics and Oral Facial Genetics, School of Dentistry
    Purpose of review: Compare noninfectious (part I) to infectious (part II) demineralization of bones and teeth. Evaluate similarities and differences in the expression of hard tissue degradation for the two most common chronic demineralization diseases: osteoporosis and dental caries. Recent findings: The physiology of demineralization is similar for the sterile skeleton compared to the septic dentition. Superimposing the pathologic variable of infection reveals a unique pathophysiology for dental caries. Mineralized tissues are compromised by microdamage, demineralization, and infection. Osseous tissues remodel (turnover) to maintain structural integrity, but the heavily loaded dentition does not turnover so it is ultimately at risk of collapse. A carious tooth is a potential vector for periapical infection that may be life-threatening. Insipient caries is initiated as a subsurface decalcification in enamel that is not detectable until a depth of ~400μm when it becomes visible as a white spot. Reliable detection and remineralization of invisible caries would advance cost-effective wellness worldwide.
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    The Phenomenon of Burnout Among Occupational Therapists: A phenomenological mixed methods study
    (2023-04) Brooks, Emma; Wilburn, Victoria; Department of Occupational Therapy, School of Health and Human Sciences; Walters, Cherise; Palicki, Angela
    Burnout is a phenomenon that has existed well before the occurrence of the COVID-19 pandemic. Yet, since the global pandemic, there has been a greater awareness of the effects of burnout and how it uniquely impacts occupational therapists. Burnout is an experience that is often specific to each individual creating the multifactorial phenomenon. Therefore, the purpose of the doctoral capstone project was to understand the experience of occupational therapists burnout and identify their specific needs through mixed methods phenomenological research at Eskenazi Hospital, a Level I Trauma center in the heart of Indianapolis. Moreover the study sought to utilize research outcomes to assist in programmatic development regarding therapist health and wellness to decrease burnout and increase therapists management of burnout experience and symptoms.