Subjects -> HEALTH AND SAFETY (Total: 1464 journals)
    - CIVIL DEFENSE (22 journals)
    - DRUG ABUSE AND ALCOHOLISM (87 journals)
    - HEALTH AND SAFETY (686 journals)
    - HEALTH FACILITIES AND ADMINISTRATION (358 journals)
    - OCCUPATIONAL HEALTH AND SAFETY (112 journals)
    - PHYSICAL FITNESS AND HYGIENE (117 journals)
    - WOMEN'S HEALTH (82 journals)

HEALTH AND SAFETY (686 journals)                  1 2 3 4 | Last

Showing 1 - 200 of 203 Journals sorted alphabetically
16 de Abril     Open Access   (Followers: 1)
ACM Transactions on Computing for Healthcare     Hybrid Journal  
Acta Scientiarum. Health Sciences     Open Access   (Followers: 2)
Adultspan Journal     Hybrid Journal   (Followers: 1)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 11)
Advances in Public Health     Open Access   (Followers: 30)
Adversity and Resilience Science : Journal of Research and Practice     Hybrid Journal   (Followers: 3)
African Health Sciences     Open Access   (Followers: 7)
African Journal of Health Professions Education     Open Access   (Followers: 6)
Afrimedic Journal     Open Access   (Followers: 3)
Ageing & Society     Hybrid Journal   (Followers: 40)
Aging and Health Research     Open Access   (Followers: 3)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 10)
AJOB Empirical Bioethics     Hybrid Journal   (Followers: 3)
Akademika     Open Access  
American Journal of Family Therapy     Hybrid Journal   (Followers: 6)
American Journal of Health Economics     Full-text available via subscription   (Followers: 25)
American Journal of Health Education     Hybrid Journal   (Followers: 36)
American Journal of Health Promotion     Hybrid Journal   (Followers: 24)
American Journal of Health Sciences     Open Access   (Followers: 11)
American Journal of Health Studies     Full-text available via subscription   (Followers: 14)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 34)
American Journal of Public Health     Full-text available via subscription   (Followers: 208)
American Journal of Public Health Research     Open Access   (Followers: 31)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 9)
Annali dell'Istituto Superiore di Sanità     Open Access  
Annals of Global Health     Open Access   (Followers: 10)
Annals of Health Law     Open Access   (Followers: 7)
Applied Biosafety     Hybrid Journal   (Followers: 2)
Applied Ergonomics     Hybrid Journal   (Followers: 18)
Apuntes Universitarios     Open Access   (Followers: 1)
Archives of Community Medicine and Public Health     Open Access   (Followers: 2)
Archives of Medicine and Health Sciences     Open Access   (Followers: 5)
Archives of Suicide Research     Hybrid Journal   (Followers: 11)
Archivos de Prevención de Riesgos Laborales     Open Access  
ASA Monitor     Full-text available via subscription   (Followers: 18)
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 7)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 4)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 11)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 5)
Asian Journal of Medicine and Health     Open Access   (Followers: 1)
Asian Journal of Population Sciences     Open Access   (Followers: 9)
Asian Journal of Social Health and Behavior     Open Access   (Followers: 3)
Atención Primaria     Open Access   (Followers: 2)
Atención Primaria Práctica     Open Access  
Australasian Journal of Paramedicine     Open Access   (Followers: 8)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Indigenous HealthBulletin     Free   (Followers: 4)
Autism & Developmental Language Impairments     Open Access   (Followers: 15)
Bijzijn XL     Hybrid Journal  
Biograph-I : Journal of Biostatistics and Demographic Dynamic     Open Access   (Followers: 1)
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 7)
Biosafety and Health     Open Access  
Biosalud     Open Access  
Birat Journal of Health Sciences     Open Access  
BLDE University Journal of Health Sciences     Open Access   (Followers: 1)
BMC Oral Health     Open Access   (Followers: 5)
BMC Pregnancy and Childbirth     Open Access   (Followers: 19)
Brazilian Journal of Medicine and Human Health     Open Access  
British Journal of Health Psychology     Hybrid Journal   (Followers: 52)
Buletin Penelitian Kesehatan     Open Access  
Buletin Penelitian Sistem Kesehatan     Open Access  
Cadernos de Educação, Saúde e Fisioterapia     Open Access  
Cadernos de Saúde     Open Access  
Cambridge Quarterly of Healthcare Ethics     Hybrid Journal   (Followers: 13)
Canadian Family Physician     Partially Free   (Followers: 14)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 16)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 1)
Canadian Journal of Public Health     Hybrid Journal   (Followers: 26)
Cannabis and Cannabinoid Research     Hybrid Journal   (Followers: 1)
Carta Comunitaria     Open Access  
Case Reports in Women's Health     Open Access   (Followers: 4)
CASUS : Revista de Investigación y Casos en Salud     Open Access  
Central Asian Journal of Global Health     Open Access   (Followers: 2)
CES Medicina     Open Access  
CES Salud Pública     Open Access  
Child and Adolescent Obesity     Open Access   (Followers: 3)
Child's Nervous System     Hybrid Journal  
Childhood Obesity and Nutrition     Open Access   (Followers: 11)
Children     Open Access  
Chinese Journal of Physiology     Open Access   (Followers: 3)
CHRISMED Journal of Health and Research     Open Access   (Followers: 1)
Christian Journal for Global Health     Open Access   (Followers: 1)
Ciencia & Salud     Open Access  
Ciencia & Trabajo     Open Access  
Ciencia e Innovación en Salud     Open Access  
Ciencia y Cuidado     Open Access   (Followers: 1)
Ciencia y Salud     Open Access   (Followers: 1)
Ciencia, Tecnología y Salud     Open Access  
Cities & Health     Hybrid Journal   (Followers: 5)
Cleaner and Responsible Consumption     Open Access  
Clinical and Experimental Health Sciences     Open Access   (Followers: 1)
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 1)
Clocks & Sleep     Open Access   (Followers: 1)
CME     Hybrid Journal   (Followers: 1)
Community Health     Open Access   (Followers: 6)
Conflict and Health     Open Access   (Followers: 8)
Contact (CTC)     Open Access  
Contraception and Reproductive Medicine     Open Access   (Followers: 2)
Cuaderno de investigaciones: semilleros andina     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 10)
Current Opinion in Environmental Science & Health     Hybrid Journal  
D Y Patil Journal of Health Sciences     Open Access   (Followers: 4)
Das österreichische Gesundheitswesen ÖKZ     Hybrid Journal  
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Design for Health     Hybrid Journal   (Followers: 1)
Digital Health     Open Access   (Followers: 11)
Disaster Medicine and Public Health Preparedness     Hybrid Journal   (Followers: 12)
Discover Social Science and Health     Open Access   (Followers: 5)
Diversity and Equality in Health and Care     Open Access   (Followers: 10)
Diversity of Research in Health Journal     Open Access   (Followers: 1)
Dramatherapy     Hybrid Journal   (Followers: 2)
Drogues, santé et société     Open Access   (Followers: 2)
Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi / Journal of Duzce University Health Sciences Institute     Open Access  
Early Childhood Research Quarterly     Hybrid Journal   (Followers: 23)
East African Journal of Public Health     Full-text available via subscription   (Followers: 3)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 25)
EcoHealth     Hybrid Journal   (Followers: 5)
Education for Health     Open Access   (Followers: 9)
electronic Journal of Health Informatics     Open Access   (Followers: 7)
ElectronicHealthcare     Full-text available via subscription   (Followers: 2)
Emerging Trends in Drugs, Addictions, and Health     Open Access   (Followers: 1)
Ensaios e Ciência : Ciências Biológicas, Agrárias e da Saúde     Open Access  
Environmental Disease     Open Access   (Followers: 3)
Environmental Sciences Europe     Open Access   (Followers: 2)
Epidemics     Open Access   (Followers: 7)
EsSEX : Revista Científica     Open Access  
Estudios sociales : Revista de alimentación contemporánea y desarrollo regional     Open Access  
Ethics & Human Research     Hybrid Journal   (Followers: 4)
Ethics, Medicine and Public Health     Full-text available via subscription   (Followers: 7)
Ethiopian Journal of Health Development     Open Access   (Followers: 7)
Ethiopian Journal of Health Sciences     Open Access   (Followers: 6)
Ethnicity & Health     Hybrid Journal   (Followers: 16)
Eurasian Journal of Health Technology Assessment     Open Access   (Followers: 1)
EUREKA : Health Sciences     Open Access  
European Journal of Health Communication     Open Access  
European Journal of Investigation in Health, Psychology and Education     Open Access   (Followers: 5)
Evaluation & the Health Professions     Hybrid Journal   (Followers: 11)
Evidência - Ciência e Biotecnologia - Interdisciplinar     Open Access  
Exploratory Research in Clinical and Social Pharmacy     Open Access  
Expressa Extensão     Open Access  
F&S Reports     Open Access  
Face à face     Open Access  
Families, Systems, & Health     Full-text available via subscription   (Followers: 8)
Family & Community Health     Hybrid Journal   (Followers: 13)
Family Medicine and Community Health     Open Access   (Followers: 8)
Family Relations     Partially Free   (Followers: 11)
FASEB BioAdvances     Open Access  
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 3)
Finnish Journal of eHealth and eWelfare : Finjehew     Open Access  
Food and Public Health     Open Access   (Followers: 10)
Food Hydrocolloids for Health     Open Access  
Food Quality and Safety     Open Access   (Followers: 2)
Frontiers in Digital Health     Open Access   (Followers: 4)
Frontiers in Neuroergonomics     Open Access  
Frontiers in Public Health     Open Access   (Followers: 8)
Frontiers of Health Services Management     Partially Free   (Followers: 6)
Gaceta Sanitaria     Open Access   (Followers: 2)
Galen Medical Journal     Open Access  
Ganesha Journal     Open Access  
Gazi Sağlık Bilimleri Dergisi     Open Access  
Geospatial Health     Open Access   (Followers: 1)
Gestão e Desenvolvimento     Open Access  
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 7)
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Global Advances in Health and Medicine     Open Access  
Global Challenges     Open Access   (Followers: 2)
Global Health : Science and Practice     Open Access   (Followers: 7)
Global Health Annual Review     Open Access   (Followers: 2)
Global Health Innovation     Open Access   (Followers: 4)
Global Health Journal     Open Access   (Followers: 2)
Global Health Promotion     Hybrid Journal   (Followers: 15)
Global Journal of Health Science     Open Access   (Followers: 5)
Global Journal of Public Health     Open Access   (Followers: 16)
Global Medical & Health Communication     Open Access   (Followers: 1)
Global Mental Health     Open Access   (Followers: 13)
Global Reproductive Health     Open Access  
Global Security : Health, Science and Policy     Open Access   (Followers: 1)
Global Transitions     Open Access   (Followers: 1)
Global Transitions Proceedings     Open Access   (Followers: 1)
Globalization and Health     Open Access   (Followers: 7)
Hacia la Promoción de la Salud     Open Access  
Hastane Öncesi Dergisi     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 7)
HCU Journal     Open Access  
HEADline     Hybrid Journal  
Health & Place     Hybrid Journal   (Followers: 22)
Health & Justice     Open Access   (Followers: 5)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 19)
Health and Human Rights     Open Access   (Followers: 10)
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 9)
Health and Social Work     Hybrid Journal   (Followers: 63)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 5)
Health Behavior Research     Open Access   (Followers: 2)
Health Care Analysis     Hybrid Journal   (Followers: 12)
Health Equity     Open Access   (Followers: 4)
Health Information : Jurnal Penelitian     Open Access  
Health Information Management Journal     Hybrid Journal   (Followers: 26)
Health Notions     Open Access  

        1 2 3 4 | Last

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Global Advances in Health and Medicine
Number of Followers: 0  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2164-9561 - ISSN (Online) 2164-9561
Published by Sage Publications Homepage  [1175 journals]
  • Further Examination of the Psychometric Properties of the Current
           Experiences Scale and Model of Resiliency

    • Authors: James Groves, Christina Luberto, Gregory Fricchione, Elyse Park
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      BackgroundStress-related disease is increasing, with high resilience proposed as protective. Whilst the Current Experiences Scale (CES) shows promise as a measure of resilience, its psychological correlates and relationship to psychological stress remain unclear.Objectives(1) Further explore the psychometric properties of the CES, (2) identify modifiable psychological factors associated with the CES and (3) test a previously published model for the influence of adaptive strategies and stress management factors on resiliency and stress.MethodsN = 455 individuals (mean age = 47.8, 65.1% female) completed measures of adaptive strategies: mindfulness (Cognitive and Affective Mindfulness Scale-Revised), positive affect (Positive and Negative Affect Schedule) and gratitude (The Gratitude Questionnaire), stress management skills: coping (Measure of Current Status-A), depression (Patient Health Questionnaire-8) and anxiety (General Anxiety Disorder Assessment) and outcomes: resilience (CES) and stress (Perceived Stress Scale). Cronbach’s alpha and confirmatory factor analysis (CFA) examined the psychometric properties of the CES. Multivariable regression identified psychological variables associated with resilience. Structural equation modelling (SEM) tested the previously published model for resilience.ResultsThe CES and its subscales showed good internal consistency (ɑ = .75-.93). The 23-item CES produced excellent results for model fit (Root Mean Square Error of Approximation (RMSEA) = .07, Standardized Root Mean Square Residual (SRMR) = .06, Comparative Fit Index (CFI) = .99; Tucker-Lewis Index (TLI) = .99). Higher gratitude (P < .0001), mindfulness (P < .0001), positive affect (P < .0001) and coping (P < .0001) were associated with higher resilience. Depression (P = .23) and anxiety (P = .34) were not. A model of resilience which included gratitude, mindfulness, positive affect and coping as determinants of resilience and perceived stress performed well (RMSEA = .03, SRMR = .02, CFI = .99; TLI = .99).ConclusionsThe CES was validated in a large sample. The association of gratitude, mindfulness, positive affect and coping with resilience may guide practitioners seeking to design resilience-enhancing programs.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-10-04T08:44:16Z
      DOI: 10.1177/2164957X221128521
      Issue No: Vol. 11 (2022)
       
  • There is More to ‘Making Connections to Improve Health
           Outcomes’

    • Authors: Joachim Sturmberg
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      Langevin rightly points to the reductionist mindset being the stumbling block for providing person-centered care. While considering the interconnections between the various domains underpinning health is a necessary first step towards more person-centered care, it ultimately is not sufficient. Person-centered care arises from the appreciation of the interdependencies and interactions between the various domains across its large-scale supersystems as much as its small-scale subsystems. Viewed with a complex-adaptive systems mindset health and disease are the phenotypical outcome categorisations of a person’s whole-of-systems dynamics across all scales of organisation.,
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-09-21T08:57:03Z
      DOI: 10.1177/2164957X221126675
      Issue No: Vol. 11 (2022)
       
  • Covid-19 Outcomes Among US Veterans

    • Authors: Jun-Chieh J. Tsay, Robert L. Smith
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      Comparing Covid-19 mortality among the U.S. population overall with mortality among Veterans Affairs patients and U.S. military patients.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-09-19T04:04:14Z
      DOI: 10.1177/2164957X221119474
      Issue No: Vol. 11 (2022)
       
  • Characterizing Interprofessional Collaboration and Referral to
           Mindfulness-Based Stress Reduction Programs

    • Authors: Dhanesh D. Binda, Janice M. Weinberg, Tra Nguyen, Natalia E. Morone
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      BackgroundIn 2017, the American College of Physicians (ACP) designated Mindfulness-Based Stress Reduction (MBSR), an eight-week group program, as first-line non-pharmacological treatment for chronic low back pain. However, interprofessional collaboration between mindfulness instructors and Primary Care Providers (PCP) remains largely unknown.ObjectiveWe developed a survey to assess communication between mindfulness instructors and PCPs, identify predictors of referral to MBSR, and determine areas where interventions could increase patient access to MBSR.MethodsThe 25-question survey was sent via email to PCPs at the Division of General Internal Medicine, University of Pittsburgh, PA, the Piedmont Health Services Family Medicine Section, Chapel Hill, NC, the Boston Medical Center General Internal Medicine and Family Medicine Sections, Boston, MA, and the UMass Memorial Medical Center Family Medicine Section, Worcester, MA. We used descriptive statistics and logistic regression to analyze the data.ResultsAmong 118 eligible respondents, 85 (72.0%) were female PCPs, mean age was approximately 41.5±10.1, and the majority (65.2%) had been in medical practice ≤10 years. Of these PCPs, 83 (70.1%) reported familiarity with MBSR (95% CI: 62.1, 78.5), and 49 (59.0%) of them referred patients at least yearly. Of those who referred, 8 (16.3%) reported collaboration with mindfulness instructors. PCPs who were quite a bit or very much familiar with MBSR had 5.10 (1.10, 22.50) times the odds (P=.03), and those who were 50 years or younger had 3.30 times the odds (P=.04) of referring patients to MBSR. Frequency of PCPs’ personal practice of mindfulness was not significantly associated with referrals (P=.30).ConclusionThis is the first study to assess interprofessional collaboration between mindfulness instructors and PCPs. Suggestions for a potential integrative health care model are included; further studies on methods to augment communication and education are warranted to improve the referral process and ultimately increase accessibility and utilization of mindfulness-based programs.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-09-14T01:05:29Z
      DOI: 10.1177/2164957X221126484
      Issue No: Vol. 11 (2022)
       
  • The Effect of Heartfulness Meditation Program on Burnout and Satisfaction
           With Life Among Accounting Professionals

    • Authors: Pradeep K. Gupta, Jayaram Thimmapuram, Prasanna Krishna, Yamini Karmarkar, Divya K. Madhusudhan
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      BackgroundAccounting professionals experience a stressful working environment with previous studies demonstrating a high prevalence of burnout. Meditation-based interventions have a potential role in decreasing burnout and improving satisfaction with life. However, the benefits of Heartfulness meditation intervention have not been demonstrated among accounting professionals.ObjectiveTo evaluate the effects of an 8-week Heartfulness Meditation program on burnout and satisfaction with life in chartered accountants.MethodsThe study was a prospective cohort analysis comparing burnout and satisfaction with life outcomes among accounting professionals who either self-selected to participate in the Heartfulness Meditation Program (intervention group) or with no particular intervention (control group). Maslach Burnout Inventory (MBI) and Satisfaction with Life Scale (SWLS) scores were collected at baseline and at the end of the study period.ResultsTwo hundred and six participants completed the study. Participants in the intervention group (n = 107) experienced statistically significant improvement in MBI emotional exhaustion from 2.17 to 1.75 (P = .00) and overall MBI score decreased from 2.99 to 2.83 (P = .020). Participants in the control group (n = 99) experienced statistically significant improvement for emotional exhaustion only, from 1.82 to 1.52 (P = .009). Further, participants in the intervention group demonstrated statistically significant improvement with SWLS from 4.90 to 5.17 (P = .005). While participants in the intervention group experienced higher levels of decline (19.55%) compared to the control group (16.41%) for emotional exhaustion, it was not statistically significant.ConclusionThe current study is one of the first attempts of a Heartfulness meditation intervention to reduce burnout and improve satisfaction with life among accounting professionals. Both the intervention group and the control group showed an improvement of emotional exhaustion. The statistically significant improvements observed in the overall MBI and SWLS outcomes in the intervention group suggest an online Heartfulness meditation program could serve as a potential tool for reducing burnout and improving satisfaction among accounting professionals.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-09-01T06:46:55Z
      DOI: 10.1177/2164957X221123559
      Issue No: Vol. 11 (2022)
       
  • Household Income and Older Adult Population Predict Number of Integrative
           Medicine Providers Around US Hospitals: An Environmental Scan Study

    • Authors: Jacob D. Hill, Abigail M. Schmucker, Nina Siman, Keith S. Goldfeld, Allison M. Cuthel, Oluwaseun J. Adeyemi, Eliot Edwards, Jean-Baptiste Bouillon-Minois, Corita R. Grudzen
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      BackgroundIntegrative medicine (IM) is a growing subspecialty among the American healthcare system, but little is known about geographical and sociodemographic variability in access to services.ObjectiveTo better understand access to IM healthcare services, we aim to: 1.) document the number of IM providers within the hospital service area (HSA) of various hospitals across the United States (US) and, 2.) explore the relationship between age, income, and race as predictors of the number of IM providers.MethodsWe conducted an environmental scan to document the number of IM providers including naturopathic, acupuncture, chiropractic, and massage therapy providers within the HSA of 16 US hospitals using state and national search databases. We examined predictors of the number of providers per HSA using population and demographic data from the U.S. Census Bureau. Search database quality was evaluated using the Center for Disease Control and Prevention Clear Communication Index.ResultsThe number of IM providers varied from 11.6 – 67.4 providers/100,000 persons. Massage therapists were the most prevalent (n = 13.8/100,000), followed by chiropractors (n = 5.2/100,000), acupuncturists (n = 4.6/100,000), and naturopathic physicians (n = .5/100,000). Higher average household income and population>65 years old were associated with more IM providers within an HSA (Rate Ratio (RR) 4.22, 95% CI 1.49-12.01; and 1.14, 1.05 - 1.24, respectively). In addition, the quality of publicly available search databases varied widely among US states (4.84 - 8.00/10), but less so among IM provider types (6.21 - 7.57/10).ConclusionsThe high variability in number of IM providers and search database quality among various HSAs across the US warrants further investigation into factors influencing access to services. Our findings regarding income and older adult population raise concern for inequitable access to care, but are also promising when considering the increasing demand for healthcare services among the older adult population.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-08-20T03:05:54Z
      DOI: 10.1177/2164957X221121077
      Issue No: Vol. 11 (2022)
       
  • Integrating Health and Social Care Services

    • Authors: David Blockley, Gordon Stirrat, Kirsty Alexander, Sabrina Phillips
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      BackgroundA recent UK Government draft Heath White Paper follows the NHS England long term plan when it states that NHS England requires “a new framework that builds on changes already being made as well as building in the flexibility to support the system to tackle challenges of the future”. At present the structure of Health and Social Care Services UK reporting to Government seems unhelpfully complex and opaque.ObjectiveThe purpose of this paper is to contribute to the building of a new framework using a generic approach to identify and use ‘systemic processes’ to facilitate the integration of Health and Social Care services in NHS England and elsewhere.MethodsWe highlight some of the critical issues that are currently hindering integration and set out a new way of understanding the structure of NHS England through an ‘inside-out’ analysis of systemic processes.ResultsWe describe and give three examples of existing systemic processes as ‘Consulting a patient’, ‘Enhancing a Single point of access’ - to mental health services and ‘Delivering health and social care services England’.ConclusionsRethinking the interactions between existing organisations could arguably bring considerable benefits including cost savings, better co-ordination, less ‘admin’ stress on staff where the work is done and provide more organisational adaptability in an uncertain future. Ultimately our suggestions are aimed at helping people to deliver better patient care - the impelling purpose of all health and social care services.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-08-05T06:43:39Z
      DOI: 10.1177/2164957X221117112
      Issue No: Vol. 11 (2022)
       
  • MYTime: A Mindfulness and Yoga Program to Promote Health Outcomes in
           Parents of Children With Autism Spectrum Disorder

    • Authors: Leah R Ketcheson, Carissa M Wengrovius, Kerri L Staples, Nancy Miodrag
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      BackgroundParenting a child with Autism Spectrum Disorder can be stressful and result in health consequences for the caregivers, a population that is often overlooked and underserved. While mind-body interventions such as mindfulness yoga can help promote positive health outcomes, limited research has explored the impact of such a program on caregivers of children on the autism spectrum.ObjectiveThe primary objective of this pilot study was to evaluate the effects of a 12-week mindfulness yoga program (MYtime) on perceived stress, anxiety, and depression among urban caregivers of children on the autism spectrum.MethodsTwenty-seven parents were randomized into either MYTime (n = 13) or the control group (n = 14). Perceived Stress Scale (PSS) and Depression, Anxiety, and Stress Scale (DASS) were administered.ResultsThe MYTime group reported lower stress, depression and anxiety while the control group maintained similar scores across pre- and post-assessment. Following 12 weeks of participation the PSS and DASS scores improved by 25% and 49% respectively for parents in the MYTime group. In comparison, PSS scores worsened by 5% and DASS scores improved by 17% for the Control group. Differences in pre-and post-assessment scores were not significant for either group (P> .05).ConclusionThe results from this pilot study indicate that a mindfulness yoga program could be considered among feasible interventions aimed at improving the health of parents of children on the autism spectrum.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-08-04T04:35:32Z
      DOI: 10.1177/2164957X221110154
      Issue No: Vol. 11 (2022)
       
  • Valued living among veterans in breath-based meditation treatment or
           cognitive processing therapy for posttraumatic stress disorder:
           Exploratory outcome of a randomized controlled trial

    • Authors: R Jay Schulz-Heik, Laura C Lazzeroni, Beatriz Hernandez, Timothy J Avery, Danielle C Mathersul, Julia S Tang, Emily Hugo, Peter J Bayley
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      BackgroundValued living is the extent to which an individual’s behavior is consistent with what they believe is important or good. It is unknown whether many complementary and integrative treatments and psychotherapies for posttraumatic stress disorder enhance valued living, and for whom.ObjectivesMeasure within- and between-group changes in valued living in Veterans who completed cognitive processing therapy (CPT) and sudarshan kriya yoga (SKY) for posttraumatic stress disorder (PTSD); evaluate moderators of improvement.MethodsParticipants with clinically significant symptoms of PTSD were assigned to CPT, a first line, evidence-based psychotherapy for PTSD or SKY, an emerging breath-based meditation with strong preliminary empirical support in a parallel-groups randomized controlled trial at a single Veterans Affairs healthcare center. The Valuing Questionnaire subscales for progress in valued living (VQ-P) and obstruction in valued living (VQ-O) were exploratory outcome measures. Assessors were blind to treatment assignment.Results59 participants completed treatment (29 CPT, 30 SKY). Participants in the CPT group improved from baseline to end of treatment in both VQ-Progress (d=0.55, p=0.02) and VQ–Obstruction (d=-0.51, p=0.03), while the SKY group did not improve on either subscale (d=0.08, p=0.69; d=0.00, p=1.00). However, differences between treatments were not statistically significant (p=0.16, 0.11, respectively). Participants reporting less valued living and more depression symptoms at baseline reported greater improvements in valued living following treatment.ConclusionCPT may have a positive effect on valued living. Individuals lower in valued living and with more depression may derive relatively more benefit.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-06-24T06:14:07Z
      DOI: 10.1177/2164957X221108376
      Issue No: Vol. 11 (2022)
       
  • The Effects of a Forest Therapy on Work-Related Stress for Employees in
           the Manufacturing Industry: Randomized Control Study

    • Authors: Han Choi, Yo-Han Jeon, Jin-Woo Han, Joo Moon, Soo-Yeon Kim, Jong-Min Woo
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      BackgroundThe effect of a forest therapy in a natural environment noted that the forest therapy induced a state of relaxation among workers, thereby decreasing cortisol levels and work-related stress.ObjectiveThe primary objective of this study is to determine the effects of the forest therapy for employees in the manufacturing industry on psychological stress responds, stress hormone and heart rate variability (HRV). The secondary objective is to determine the effects of the forest therapy for employees in the manufacturing industry on cytotoxic activity of natural killer (NK) cells, health-related quality of life and mood states compare to urban untreated and remained in urban environment.MethodsForty-two employees were recruited from a single workplace located in Incheon city, Republic of Korea. Participants were allocated to either an experimental group (n= 21), wherein they participated in the forest therapy and or a control group (n= 21), wherein they were given no treatment. Participants were assigned to these groups on a randomized, open-label basis. Pre and post-test measures of natural killer (NK) cell activity, salivary cortisol, heart rate variability (HRV), health-related quality of life, stress response, and mood states were taken for both groups.ResultsThe results showed that participants who took part in the forest therapy showed greater physiological improvement when compared to those in the control group, as indicated by a significant increase in some HRV measures. The forest therapy also contributed to a significantly greater decrease in work-related stress symptoms and a significantly greater improvement in health-related quality of life and mood states compared to participants in the control group.ConclusionsThese results may suggest that the forest therapy could be an effective means of relaxation technique, reducing stress and leads to an increase in positive mood for employees in the manufacturing industry.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-06-20T11:42:22Z
      DOI: 10.1177/2164957X221100468
      Issue No: Vol. 11 (2022)
       
  • Comparing Types of Yoga for Chronic Low Back and Neck Pain in Military
           Personnel: A Feasibility Randomized Controlled Trial

    • Authors: Erik J Groessl, Danielle Casteel, Symone McKinnon, Adhana McCarthy, Laura Schmalzl, Douglas E Chang, Ian M Fowler, Crystal L Park
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      BackgroundChronic low back pain (cLBP) and chronic neck pain (cNP) are highly prevalent conditions and common reasons for disability among military personnel. Yoga and other mind-body interventions have been shown to safely decrease pain and disability in persons with cLBP and/or cNP but have not been adequately studied in active duty military personnel. The objective of this study was to examine the feasibility and acceptability of delivering 2 types of yoga (hatha and restorative) to a sample of active-duty military personnel with cLBP/cNP.MethodsMilitary personnel with cLBP and/or cNP (n = 49; 59% men) were randomized to either hatha or restorative yoga interventions. Interventions consisted of in-person yoga 1-2x weekly for 12 weeks. Feasibility and acceptability were measured by rates of recruitment, intervention attendance, attrition, adverse events, and satisfaction ratings. Health outcomes including pain and disability were measured at baseline, 12 weeks, and 6 months. Means and effect sizes are presented.ResultsRecruitment was completed ahead of projections. Over 90% of participants agreed or strongly agreed that they enjoyed participation, liked the instructor, and would like to continue yoga. Retention rates were 86% and 80% at 12 week and 6 month assessments, respectively. Intervention attendance was adequate but lower than expected. There were small to moderate reductions in back-pain related disability, pain severity and pain interference, and improvements in quality of life, grip strength, and balance. In general, effects were larger for those who attended at least 50% of intervention classes. Participants with cNP tended to have smaller outcome improvements, but conclusions remain tentative given small sample sizes.ConclusionsResults demonstrate feasibility for conducting a randomized controlled comparative effectiveness trial of yoga for cLBP and cNP among active duty military personnel. Acceptability was also established. Ongoing work will enhance the intervention for cNP and establish feasibility at another military facility in preparation for a fully-powered comparative effectiveness trial.ClinicalTrials #NCT03504085; registered April 20, 2018.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-06-16T09:29:31Z
      DOI: 10.1177/2164957X221094596
      Issue No: Vol. 11 (2022)
       
  • Corrigendum to “Impact of a Yogic Breathing Technique on the Well-Being
           of Healthcare Professionals During the COVID-19 Pandemic”

    • Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.

      Citation: Global Advances in Health and Medicine
      PubDate: 2022-05-25T05:14:09Z
      DOI: 10.1177/2164957X221098214
      Issue No: Vol. 11 (2022)
       
  • Assessment of Healthcare Professionals’ Wellbeing During a Peak of the
           COVID-19 Pandemic in a Healthcare System in Ohio

    • Authors: Natalie L Dyer, Francoise Adan, Tyler Barnett, Jeffery A Dusek
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      ObjectiveThe purpose of this cross-sectional study was to evaluate multiple indices of wellbeing in healthcare professionals during the COVID-19 pandemic.MethodsHealthcare professionals were invited to participate across the University Hospitals healthcare system in Ohio, USA. Participants (N = 6397) completed online questionnaires on their wellbeing, including healthy behaviors, safety and security, mental and physical health concerns, and social support. Differences in wellbeing across demographics were also assessed.ResultsOverall, healthcare professionals’ mean subjective wellbeing was 7.98 (1.50) and their future health score was 3.98 (1.13). Room for improvement was noted for diet, sleep, and positive thinking. Males reported significantly higher levels of overall wellbeing and future health scores, including fruit and vegetable intake and physical activity, and alcohol use, whereas females reported higher levels of positive thinking and tobacco use. Of the three largest racial groups, White and Asian employees scored significantly higher on future health, M = 4.00 (1.17) and M = 4.10 (1.13), than Black or African American employees, M = 3.74 (1.10).ConclusionsThis cross-sectional study assessed the wellbeing of healthcare workers during the initial peak of the COVID-19 pandemic prior to vaccine delivery. Future work will implement strategies to improve healthcare workers’ wellbeing in an individualized way based on our findings, as well as evaluate changes in wellbeing and future health scores across time.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-05-25T04:49:54Z
      DOI: 10.1177/2164957X221089258
      Issue No: Vol. 11 (2022)
       
  • Understanding Who Uses Whole Health Services: A Program Evaluation

    • Authors: Luke D. Mitzel, Kyle Possemato, Allyson R. Smith, Cheryl A. Seifert, Abigail E. Ramon, Harminder Grewal
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      BackgroundThe Veterans Health Administration is rolling out a Whole Health system of care as part of an enhanced focus on proactive, person-centered healthcare.ObjectiveOur program evaluation seeks to characterize what Veterans use Whole Health services, for what diagnoses they are seeking Whole Health services, and to examine “high utilizers” of Whole Health services.MethodsData were collected on 174 Veterans using Whole Health services from December 2018 through March 2020 and consisted of chart review and self-report data.ResultsWomen were more likely than men Veterans to use individual only Whole Health services. High utilizers (the top 30% of the sample in Whole Health services used) were more likely to attend groups than the remainder of the sample.ConclusionFuture work should examine the community-building aspects of Whole Health and ways to create group programming tailored to women Veterans.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-05-18T12:36:46Z
      DOI: 10.1177/2164957X221103550
      Issue No: Vol. 11 (2022)
       
  • Comment from the Academic Consortium for Integrative Medicine & Health on
           the CDC Clinical Practice Guideline for Prescribing Opioids–United
           States, 2022

    • Authors: Heather Tick, Arya Nielsen, Paula M. Gardiner, Samantha Simmons, Kathryn A. Hansen, Jeffery A. Dusek
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.

      Citation: Global Advances in Health and Medicine
      PubDate: 2022-05-18T12:25:32Z
      DOI: 10.1177/2164957X221104093
      Issue No: Vol. 11 (2022)
       
  • A Randomized Preference Trial Comparing Cognitive-Behavioral Therapy and
           Yoga for the Treatment of Late-Life Worry: Examination of Impact on
           Depression, Generalized Anxiety, Fatigue, Pain, Social Participation, and
           Physical Function

    • Authors: Suzanne C. Danhauer, Michael E. Miller, Jasmin Divers, Andrea Anderson, Gena Hargis, Gretchen A. Brenes
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      BackgroundDepression, generalized anxiety, fatigue, diminished physical function, reduced social participation, and pain are common for many older adults and negatively impact quality of life. The purpose of the overall trial was to compare the effects of cognitive-behavioral therapy (CBT) and yoga on late-life worry, anxiety, and sleep; and examine preference and selection effects on these outcomes.ObjectiveThe present analyses compared effects of the 2 interventions on additional outcomes (depressive symptoms, generalized anxiety symptoms, fatigue, pain interference/intensity, physical function, social participation); and examined whether there are preference and selection effects for these treatments.MethodsA randomized preference trial of CBT and yoga was conducted in adults ≥60 years who scored ≥26 on the Penn State Worry Questionnaire-Abbreviated (PSWQ-A), recruited from outpatient medical clinics, mailings, and advertisements. Cognitive-behavioral therapy consisted of 10 weekly telephone sessions. Yoga consisted of 20 bi-weekly group yoga classes. Participants were randomized to(1): a randomized controlled trial (RCT) of CBT or yoga (n = 250); or (2) a preference trial in which they selected their treatment (CBT or yoga; n = 250). Outcomes were measured at baseline and post-intervention.ResultsWithin the RCT, there were significant between-group differences for both pain interference and intensity. The pain interference score improved more for the CBT group compared with the yoga group [intervention effect of (mean (95% CI) = 2.5 (.5, 4.6), P = .02]. For the pain intensity score, the intervention effect also favored CBT over yoga [.7 (.2, 1.3), P < .01]. Depressive symptoms, generalized anxiety, and fatigue showed clinically meaningful within-group changes in both groups. There were no changes in or difference between physical function or social participation for either group. No preference or selection effects were found.ConclusionBoth CBT and yoga may be useful for older adults for improving psychological symptoms and fatigue. Cognitive-behavioral therapy may offer even greater benefit than yoga for decreasing pain.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-05-16T10:33:59Z
      DOI: 10.1177/2164957X221100405
      Issue No: Vol. 11 (2022)
       
  • ICIMH 2022 Abstracts

    • Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.

      Citation: Global Advances in Health and Medicine
      PubDate: 2022-05-02T06:12:40Z
      DOI: 10.1177/2164957X221096590
      Issue No: Vol. 11 (2022)
       
  • Managing the Built Environment for Health Promotion and Disease Prevention
           With Maharishi Vastu Architecture: A Review

    • Authors: Jon Lipman, Lee Fergusson, Anna Bonshek, Robert H. Schneider
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      Background and objectivesThe evolution of healthcare from 18th-century reductionism to 21st-century postgenomic holism has been described in terms of systems medicine, and the impact of the built environment on human health is the focus of investigation and development, leading to the new specialty of evidence-based, therapeutic architecture. The traditional system of Vāstu architecture—a design paradigm for buildings which is proposed to promote mental and physical health—has been applied and studied in the West in the last 20 years, and features elements absent from other approaches. This review critically evaluates the theory and research of a well-developed, standardized form of Vāstu—Maharishi Vastu® architecture (MVA). MVA’s principles include development of the architect’s consciousness, universal recommendations for building orientation, siting, and dimensions; placement of key functions; and occupants’ head direction when sleeping or performing tasks. The effects of isolated Vāstu elements included in MVA are presented. However, the full value of MVA, documented as a systematic, globally applicable practice, is in the effect of its complete package, and thus this review of MVA includes evaluating the experience of living and working in MVA buildings.MethodsThe published medical and health-related literature was systematically surveyed for research on factors related to isolated principles applied in MVA as well as on the complete system.ResultsPublished research suggests that incorporating MVA principles into buildings correlates with significant improvements in occupants’ physical and mental health and quality of life: better sleep, greater happiness of children, and the experience of heightened sense of security and reduced stress. The frequency of burglaries, a social determinant of health, also correlates. Potential neurophysiological mechanisms are described.ConclusionsFindings suggest that MVA offers an actionable approach for managing a key social determinant of health by using architectural design as preventive medicine and in public health.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-04-28T05:10:44Z
      DOI: 10.1177/2164957X221077084
      Issue No: Vol. 11 (2022)
       
  • Cultural Transformation to a Whole Health System: Lessons Learned

    • Authors: Tracy Gaudet
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      Perhaps, the biggest risk facing the efforts to improve health and well-being for all, is to fail to realize that this requires not simply improvement upon the existing systems, but TRUE transformation. And, transformation not of one massive, complex system but of a multitude of systems. The Whole Health Institute has identified thirteen large systems that impact health and well-being and are in need of true transformation.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-04-23T12:55:05Z
      DOI: 10.1177/2164957X221091452
      Issue No: Vol. 11 (2022)
       
  • What Are Adverse Events in Mindfulness Meditation'

    • Authors: Dhanesh D. Binda, Carol M. Greco, Natalia E. Morone
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      Mindfulness meditation has become a successful treatment of both physical and psychosocial ailments over the past decade. Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) are now implemented in various clinical and hospital settings for the treatment of stress, depression, substance abuse, and chronic pain. However, given mindfulness meditation’s exponential rise in popularity, scientific and media reports have called for the evaluation of mindfulness meditation’s safety for those who participate in its programs. Studies have described adverse events, such as anxiety and pain, and more severe events like psychosis, that have been associated with mindfulness meditation. However, there has not been a consistent, systematic way to define and report adverse events in meditation randomized control trials. The objective of our viewpoint was to dispel the notion that these emotive feelings and sensations are adverse events due to mindfulness meditation. Instead, they are actually expected reactions involved in the process of achieving the true benefits of mindfulness meditation. For the more severe outcomes of meditation, for example, psychosis and mania, these events are confounded by other factors, such as the intensity and length of the meditative practices as well as psychological stressors and the psychiatric histories of those affected. Comparatively, mindfulness-based programs like MBSR and MBCT are shorter in duration and less intense. They are designed to be adapted to their participants’ needs as to not induce pain or panic. Mindfulness meditation teaches its students to learn how to deal with their minds and bodies instead of using maladaptive coping techniques. Thus, we urge that further research in mindfulness meditation consistently use the definition of adverse events as those which lead to severe outcomes or hospitalization.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-04-20T06:48:13Z
      DOI: 10.1177/2164957X221096640
      Issue No: Vol. 11 (2022)
       
  • Training Interprofessional Staff in Whole Health Clinical Care at the
           Veterans Health Administration

    • Authors: Rebecca M. Ametrano, Morgan L. McGillicuddy, Shefali Sanyal, David R. Topor
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      IntroductionThe Veterans Health Administration (VHA) initiated a system-wide redesign in 2011 toward a patient-centered approach called the Whole Health System (WHS) of care. Education of VHA clinical staff in WHS-informed care, Whole Health Clinical Care (WHCC), is one critical element of this redesign effort. At a minimum, WHCC education should address core competencies for clinicians and be considered satisfactory for learners. This is the first study to evaluate learner satisfaction and perceived achievement of course objectives in WHCC that incorporated active learning strategies.MethodA large VA Healthcare System developed an in-person workshop focused on WHCC that used multiple active learning activities. These activities included case presentations, role playing, experiential learning, and group discussion.ResultsSixty-two interprofessional staff attended the workshop in November 2019. Forty (64.50%) participants completed post-workshop surveys within 30 days. Data suggest participants were highly satisfied with the workshop and that they successfully met stated learning objectives.ConclusionsWe call on VHA and private-sector hospitals to train clinical staff in WHCC that incorporates use of active learning strategies.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-04-12T05:22:29Z
      DOI: 10.1177/2164957X221092361
      Issue No: Vol. 11 (2022)
       
  • Returning Wholeness to Health

    • Authors: Paul J. Mills, William C. Bushell
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.

      Citation: Global Advances in Health and Medicine
      PubDate: 2022-04-09T01:30:14Z
      DOI: 10.1177/2164957X221092358
      Issue No: Vol. 11 (2022)
       
  • A Network Analysis of the Association Between Depressive Symptoms and
           Patient Activation Among Those With Elevated Cardiovascular Risk

    • Authors: Chiyoung Lee, Ruth Q. Wolever, Qing Yang, Allison Vorderstrasse, Se Hee Min, Xiao Hu
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      BackgroundNetwork analysis provides a new method for conceptualizing interconnections among psychological and behavioral constructs.ObjectiveWe used network analysis to investigate the complex associations between depressive symptoms and patient activation dimensions among patients at elevated risk of cardiovascular disease.MethodsThis secondary analysis included 200 patients seen in primary care clinics. Depressive symptoms were assessed using the 21-item Beck Depression Inventory. Patient activation was measured using the 13-item Patient Activation Measure. Glasso networks were constructed to identify symptoms/traits that bridge depressive symptoms and patient activation and those that are central within the network.Results“Self-dislike” and “confidence to maintain lifestyle changes during times of stress” were identified as important bridge pathways. In addition, depressive symptoms such as “punishment feelings,” “loss of satisfaction,” “self-dislike,” and “loss of interest in people” were central in the depressive symptom–patient activation network, meaning that they were most strongly connected to all other symptoms.ConclusionsBridge pathways identified in the network may be reasonable targets for clinical intervention aimed at disrupting the association between depressive symptoms and patient activation. Further research is warranted to assess whether targeting interventions to these central symptoms may help resolve other symptoms within the network.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-04-05T01:26:38Z
      DOI: 10.1177/2164957X221086257
      Issue No: Vol. 11 (2022)
       
  • Financing Whole-Person Health

    • Authors: Madison Hecht, James Marzolf, Ryan D. Castle
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      BackgroundCurrent payment models in the U.S. healthcare system are neither sustainable nor desirable. Expenses outpace revenue for most healthcare providers, while patients experience rising prices contrasted with inadequate health outcomes.ObjectiveThere is not a single, small adjustment that can remedy these issues; systemic problems require systemic solutions. One such solution involves whole-person care, an approach that emphasizes using diverse healthcare resources to align care with a patient’s values and goals as well as treat a patient’s physical, behavioral, emotional, and social risk factors.MethodsIn order to be most effective, whole-person care must be paired with a viable payment system that prioritizes positive outcomes and efficiency. The predominant fee-for-service payment system is not conducive to whole-person strategies.ResultsThis paper examines the role of capitated payments, risk adjustments, social and structural determinants of health, and expense trends in an interdependent approach to healthcare industry system reform.ConclusionThe Whole Health paradigm is optimized to improve both the financial performance of healthcare providers and the healthcare results of patients. Phased implementation is both feasible and sustainable.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-04-01T07:14:42Z
      DOI: 10.1177/21649561211062511
      Issue No: Vol. 11 (2022)
       
  • Examining Experiences of Poor Sleep During Pregnancy: A Qualitative Study
           to Inform the Development of a Prenatal Sleep Intervention

    • Authors: Jennifer N. Felder, Riya Mirchandaney, Jessica Harrison, Rachel Manber, Judith Cuneo, Andrew Krystal, Elissa Epel, Frederick Hecht
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      BackgroundPoor sleep is common during pregnancy and is associated with increased risk of negative health outcomes. Research indicates that physical discomfort and having an active mind are primary factors for prenatal sleep disturbances. Mindfulness-based interventions have the potential for addressing these factors, but have yet to be optimized for this purpose in this population.ObjectiveThe objective of this study was to gather input from pregnant and postpartum individuals about the value of a mindfulness-based program for improving prenatal sleep and their preferred content and delivery format.MethodsWe conducted 2 focus groups with 12 pregnant people experiencing poor sleep quality and 3 individual interviews with postpartum people. Interviews were thematically analyzed.ResultsThe majority of participants expressed strong interest in a mindfulness program for improving prenatal sleep. Participants reported that pregnancy-specific physical discomfort and worry (both general and pregnancy-specific) affected their sleep. Participants wanted sleep education, and strategies for calming the mind, reducing physical discomfort, reducing impact of bedtime partners on sleep, and tips for improving sleep schedule and quality. Participants recognized the convenience of an online intervention and the social benefits of an in-person intervention and favored a hybrid delivery model.ConclusionAddressing prenatal sleep problems is an unmet need. Given the challenges and discomfort women face during pregnancy, and the importance of adequate sleep for promoting mental and physical health during pregnancy, sleep difficulties are critical to address. A mindfulness-based intervention for improving prenatal sleep was deemed of high interest to this perinatal population.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-03-27T05:37:49Z
      DOI: 10.1177/2164957X221087655
      Issue No: Vol. 11 (2022)
       
  • Use of Complementary and Integrative Medicine Among Patients With
           Glioblastoma Multiforme Seen at a Tertiary Care Center

    • Authors: Amanda Munoz-Casabella, Dietlind L. Wahner-Roedler, Ivana T. Croghan, Tanya M. Petterson, Debbie L. Fuehrer, Brent A. Bauer
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      BackgroundGlioblastoma multiforme (GBM) is among the most aggressive and lethal tumors, with a median survival of 12–15 months. Many patients use complementary and integrative medicine (CIM) therapies to supplement their cancer treatment.ObjectiveTo determine the prevalence of CIM use and identify the most frequently used types of CIM in a cohort of patients with GBM seen at a tertiary care medical center in the United States.MethodsAn anonymous survey was mailed through the US Postal Service from August 1, 2019, through February 21, 2020, to patients with GBM.ResultsA total of 346 surveys were mailed, and 146 responses (42%) were received. The median age of respondents was 61 years (range, 52–68 years), and 85 (58%) were male. Most patients had undergone surgery (90%), chemotherapy (96%), and radiotherapy (95%). The median time from diagnosis of GBM to survey participation was 18 months (range, 12–31 months). Most respondents (81%) used some form of CIM, most frequently meditation (22%), relaxation and other stress management techniques (19%), chiropractic therapy (16%), and acupuncture (12%). Compared with men, women more commonly meditated (32% vs 16%; P = .046) and practiced yoga (20% vs 6%; P = .04). We observed age-based differences, with younger patients more commonly meditating, practicing relaxation and stress management techniques, and receiving chiropractic therapy (P < .05 for all).ConclusionsProviders should encourage patients with GBM to discuss their interest in CIM therapies and guide them to evidence-based treatments that may help improve their quality of life.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-03-25T11:31:08Z
      DOI: 10.1177/2164957X221078543
      Issue No: Vol. 11 (2022)
       
  • Cultural Transformation in Healthcare: How Well Does the Veterans Health
           Administration Vision for Whole Person Care Fit the Needs of Patients at
           an Academic Rehabilitation Center'

    • Authors: Jessica L Barnhill, Isabel J Roth, Keturah R Faurot, Gilson D Honvoh, Chanee E Lynch, Karla L Thompson, Susan A Gaylord
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      BackgroundThe Veterans Health Administration is undergoing a cultural transformation toward person-driven care referred to as the Whole Health System of Care.ObjectiveThis pilot study evaluated whether the Whole Health model resonates with patients of a large public university rehabilitation clinic.MethodsThirty participants completed the Veterans Health Administration’s Personal Health Inventory (PHI), and six attended the course “Taking Charge of My Life and Health.” Researchers analyzed PHI responses and post-course focus group transcripts. A short post-PHI survey and post-course evaluation were collected.ResultsParticipants agreed the PHI is a simple, useful tool. The course, while well attended, did not meet participants’ expectations. Participants wanted access to integrative therapies and opportunities to contribute to healthcare transformation.ConclusionRehabilitation patients resonated with the Whole Health vision. They expressed enthusiasm for the cultural transformation represented by the model along with frustration that standard healthcare experiences fall short of this vision.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-03-17T05:27:23Z
      DOI: 10.1177/2164957X221082994
      Issue No: Vol. 11 (2022)
       
  • Whole Person Health: The Role of Advocacy

    • Authors: Bill Reddy, Leonard A. Wisneski
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      The U.S. healthcare system is naturally evolving toward integrative, whole-person health. Optimal health is not just absence of disease—it is holistic in nature (physical, mental, emotional, and spiritual) including a person’s sense of purpose and meaning in their lives. Through the efforts of groups such as the Integrative Health Policy Consortium (www.ihpc.org ) and several others, Congress and many other stakeholder groups became aware that we need to focus on all aspects of health including environmental considerations. Currently, the U.S. healthcare system is in the process of embracing whole-person health with its focus on wellness and well-being in addition to the treatment of clinical disorders. The Veterans Administration Whole Health Program is one such example, where they are shifting the healthcare paradigm from “What’s the matter with you'” to “What matters to you'” On the Hill, we are seeing growth in the Congressional Caucus on Integrative Health and Wellness as well as the Social Determinants of Health Caucus.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-03-09T11:02:30Z
      DOI: 10.1177/2164957X221082650
      Issue No: Vol. 11 (2022)
       
  • Anthroposophic Medicinal Products: A Literature Review of Features,
           Similarities and Differences to Conventional Medicinal Products,
           Scientific and Regulatory Assessment

    • Authors: Erik W. Baars, Gunver S. Kienle, Peter Heusser, Peter A. Pedersen, Herman A. van Wietmarschen, Helmut Kiene, Tido von Schoen-Angerer, Harald J. Hamre
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      BackgroundRegulatory assessment of anthroposophic medicinal products (AMPs) can be challenging due to their specific features.ObjectiveThe aim of this paper is therefore to provide adequate scientific information on AMPs for regulatory purposes.MethodsA literature review was executed with database searches in PubMed, Cinahl, Merkurstab, Anthromedics, and https://iaap-pharma.org/. Search terms were: anthroposophic medicinal products, anthroposophic medicines, anthroposophic pharmacy. There was no language restriction; searches were executed from onset until June 11, 2020. In addition, experts were invited to suggest relevant literature.ResultsEighty-seven of 660 identified publications were included. The system of anthroposophic medicine (AM) with its conceptual background and various aspects of AMPs was described: definition, pharmaceutical properties, an example of AMP development, use in clinical practice, similarities with and differences to conventional medicinal products, societal aspects, scientific and regulatory assessment.ConclusionAMPs are part of the integrative whole medical system of AM. AMPs are manufactured according to Good Manufacturing Practice and national drug regulations and have an excellent safety status; the limited available evidence suggests clinical benefits. Current drug regulation of AMPs in the EU and most European countries does not take the special properties of AMPs into account. Future research should focus on appropriate methodologies for the evaluation of effects of AMPs as part of the AM whole medical system, the scientific quality of its non-atomistic holistic ontological position, and the integration of AM and conventional medicine in clinical practice. Future policies should focus on appropriate ways of addressing regulatory challenges to AMPs.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-03-09T02:32:49Z
      DOI: 10.1177/21649561211073079
      Issue No: Vol. 11 (2022)
       
  • A Multi-Site Evaluation of A National Employee Wellness Initiative at the
           Department of Veterans Affairs

    • Authors: Freny Shah, Joanna R. Sells, Jennifer Werthman, Corrine Abraham, Asma M. Ali, Carol Callaway-Lane
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      BackgroundThe Department of Veterans Affairs (VA) seeks to transform its health care delivery from disease-centered, episodic care to a holistic and patient-centered model known as the Whole Health System (WHS) of care. Employee engagement and buy-in are crucial to this cultural transformation. The VA aspires to provide employees with opportunities to experience whole health in their personal and professional lives through a national Employee Whole Health (EWH) program. Although there are national recommendations, different local facilities may have unique strategies and challenges as they implement this program.ObjectiveThis study aimed to conduct a program evaluation of EWH at three different VA facilities across the United States in order to identify facilitators and barriers to the implementation of EWH.MethodsThe team used the RE-AIM framework to develop an interview guide to assess various domains of implementation. Quantitative data on whole health offerings at each site were gauged using a national employee education platform. Standardized employee-related metrics at each site were assessed using the annual, national VA employee survey.ResultsEWH has had variable implementation at the three sites. Sites noted main facilitators as employee interest as well as available skills and expertise for delivering complementary and integrative care to employees. Limited staffing for EWH and a lack of dedicated employee time were cited as barriers. The infrastructure to perform local program evaluations to demonstrate effectiveness and impact were missing.ConclusionEmployee engagement in whole health activities has the potential to support the VA’s mission to transform its health care delivery model. Currently, the use of EWH and its potential impact are difficult to discern based on available information. Local sites need guidance to conduct program evaluations and find creative solutions to enhance employee participation. A robust measurement system to demonstrate effectiveness is paramount to ensure the success of this initiative.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-03-03T12:41:58Z
      DOI: 10.1177/21649561211053805
      Issue No: Vol. 11 (2022)
       
  • Whole Health in the Veterans Health Administration

    • Authors: Benjamin Kligler
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      The Whole Health System being developed and implemented at the Veterans Health Administration is an approach to care which aims to shift the discussion from "What's the Matter With You'" to "What Matters to You'" This article describes some of the progress and future challenges in the implementation of this approach across the VHA.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-03-03T07:30:48Z
      DOI: 10.1177/2164957X221077214
      Issue No: Vol. 11 (2022)
       
  • Making Connections to Improve Health Outcomes

    • Authors: Helene M. Langevin
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      This issue of Global Advances in Health and Medicine sends a vital message about the importance of whole person health. Whole person health rests on the idea that our health involves multiple interconnected factors across physiological systems, as well as biological, behavioral, social, and environmental domains. The urgency of better understanding whole person health is highlighted by the current global health crisis. Yet, biomedical research often favors a reductionist approach. The current emphasis on diseases or single organ systems can fall short when it comes to addressing the interconnected factors that contribute to worse health outcomes. This, coupled with a fragmented health care delivery system, contributes to the challenges that patients face every day in becoming healthier. As part of the U.S. National Institutes of Health, our role at the National Center for Complementary and Integrative Health (NCCIH) is to foster research in this field. NCCIH’s twenty years of research has built a body of knowledge that has established a clear path forward for exploring whole person health in the coming years. Within the framework of our strategic plan, NCCIH is working to build research methods for studying whole person health and explore how this understanding of health can transform the way complementary and integrative health is perceived and implemented within the wider health care delivery system.The collection of papers highlighted in this month’s issue of Global Advances in Health and Medicine sends an important and encouraging signal about the efforts being made to deliver health care in a way that recognizes the importance of whole person health. Each of these studies provides new insights on how stakeholders might approach transforming the delivery of health care, integrating approaches that can improve health outcomes for people.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-03-03T06:44:47Z
      DOI: 10.1177/2164957X221079792
      Issue No: Vol. 11 (2022)
       
  • Effects of Group-delivered Stress-reduction Guided Imagery on Salivary
           Cortisol, Salivary Amylase, and Stress Mood in Urban, Predominantly Latino
           Adolescents

    • Authors: Marc J. Weigensberg, Cheng K. Fred Wen, Donna Spruijt-Metz, Christianne Joy Lane
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      ObjectivesTo determine acute effects of stress-reduction guided imagery delivered in group format on stress biomarkers salivary cortisol and salivary amylase, and on self-reported stress mood, in healthy, predominantly Latino adolescents.Study Design111 adolescent participants (94% Latino), a subset from a large, randomized controlled lifestyle intervention to improve obesity-related health behaviors, received either 4 weekly lifestyle education sessions (Lifestyle group; LS) or the same weekly lifestyle education sessions plus an additional weekly stress-reduction guided imagery session delivered in group format (Guided imagery group; GI). Salivary cortisol, salivary amylase, and self-reported stress moods were assessed before and after sessions on intervention weeks 3 and 4. Statistics: Linear mixed effects models examined within- and between-session and group differences in pre- to post-session changes.ResultsBoth groups showed decreases in salivary cortisol, 5% decrease in LS group and 32% in GI group (within-group differences all P < .05), with between-group difference in salivary cortisol of moderate size (P = .05; Cohen’s d = .44). Within the GI group alone, salivary cortisol decrease was similar following either the lifestyle or GI sessions (P = .64). There were no statistically significant amylase changes within or between groups. All 5 individual stress moods declined by 27% to 46% in the GI group (all P < .05), while only 1 of the 5 declined in LS group.ConclusionsGroup stress-reduction guided imagery reduces the stress biomarker salivary cortisol, as well as reducing subjective stress mood states, making it a viable modality for large scale stress-reduction interventions.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-02-23T07:45:27Z
      DOI: 10.1177/21649561211067443
      Issue No: Vol. 11 (2022)
       
  • Psychedelic Psychotherapy: Building Wholeness Through Connection

    • Authors: Gita Vaid, Barry Walker
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      BackgroundWe are confronted with dire statistics that document our current mental health crisis. New treatment modalities are desperately needed to address escalating mental suffering and trauma. Psychedelic medicines are attracting increased attention in psychiatry as effective treatment for a range of conditions. The mechanisms of actions and context necessary to maximize their full healing potential represent a radical departure from current psychiatric frameworks and present an opportunity to reimagine psychiatry as a healing art.ObjectivePsychedelic psychotherapy leverages biological, psychological, and spiritual domains to harness innate healing potentials. A novel psychotherapeutic methodology utilizing psychedelic medicines as catalyzing agents is presented, one that provides a developmental model to promotes self-actualization. The paper outlines transformational psychotherapy, the therapeutic process and corresponding practice implications.ConclusionPsychedelic psychotherapy represents a paradigm shift in healing, one that promotes self-integration and whole health. These shifts in internal health are correspondingly reflected in enhanced empathy, improved relatedness, and increased capacity for social connection. Much of human suffering and disregard for the planet is a reflection of our own collective inner impoverishment, fundamental disconnects, and unaddressed trauma. Psychedelic psychotherapy offers a healing approach to restore beauty and health to both the inner and outer worlds we inhabit.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-02-23T05:23:11Z
      DOI: 10.1177/2164957X221081113
      Issue No: Vol. 11 (2022)
       
  • Naturopathic Doctors: An Underutilized Resource of Whole Health Delivery
           in Primary Care

    • Authors: Adam Sadowski, Luciano Garofalo, Alanna Welsh, Ryan Bradley
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      Naturopathy, recognized by the National Institutes of Health and the World Health Organization as a distinct system of complementary and integrative health care, is an existing model of whole health delivery. Its unifying principles, respect for the interconnectedness of biological systems, and representation globally uniquely positions naturopathy to serve an integral role in addressing the needs of primary health care. In this viewpoint, we aim to 1) highlight key areas and existing literature supporting the use of naturopathy for health promotion and disease prevention of noncommunicable diseases; 2) describe how naturopathy can addresses the mental health needs of today’s societies; and 3) discuss the importance of naturopathy in the access and navigation of complementary and integrative health therapies.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-02-23T04:45:35Z
      DOI: 10.1177/2164957X221079787
      Issue No: Vol. 11 (2022)
       
  • Posttraumatic Stress Disorder Does Not Compromise Behavioral Pain
           Treatment: Secondary Analysis of a Randomized Clinical Trial Among
           Veterans

    • Authors: R. Jay Schulz-Heik, Timothy J. Avery, Booil Jo, Louise Mahoney, Peter J. Bayley
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      BackgroundIndividuals with posttraumatic stress disorder (PTSD) and chronic pain evince different presentations, coping strategies, and treatment utilization patterns than individuals with chronic pain alone. Theorists have suggested that comorbid PTSD may complicate chronic pain treatment, and that integrated pain and PTSD treatment may be preferable to pain treatment alone.ObjectiveAssess whether comorbid PTSD moderates Veterans’ response to yoga and/or cognitive behavioral therapy (CBT) for pain.MethodsVeterans with Gulf War illness (n = 75) were assessed using the Brief Pain Inventory at baseline and posttreatment as part of a randomized clinical trial. PTSD status was abstracted from participants’ medical records.ResultsPTSD+ participants (n = 41) reported more pain at baseline than PTSD− participants (n = 34; d = .66, p < .01). PTSD+ participants experienced more improvement in pain from baseline to posttreatment than PTSD− participants by a small to moderate, marginally statistically significant amount (d = .39, p = .07). The relationship between PTSD and treatment outcome was not moderated by treatment type (yoga vs CBT; p = .99). Observation of treatment responses across PTSD status (+ vs −) and treatment (yoga vs CBT) revealed that PTSD+ participants responded well to yoga.ConclusionPTSD is not associated with reduced effectiveness of behavioral chronic pain treatment among Veterans with Gulf War illness. Therefore behavioral pain treatment should be made readily available to Veterans with pain and PTSD. Yoga deserves further consideration as a treatment for pain among individuals with PTSD.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-02-16T09:57:36Z
      DOI: 10.1177/21649561221075578
      Issue No: Vol. 11 (2022)
       
  • The Integration of a Hospitalist

    • Authors: Carla Pia Kuon
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.

      Citation: Global Advances in Health and Medicine
      PubDate: 2022-02-15T12:28:09Z
      DOI: 10.1177/21649561211073879
      Issue No: Vol. 11 (2022)
       
  • Ginseng for the Treatment of Chronic Fatigue Syndrome: A Systematic Review
           of Clinical Studies

    • Authors: Juan Yang, Kyung-Min Shin, Abd Moain Abu Dabrh, Dennis M Bierle, Xuan Zhou, Brent A. Bauer, Arya B Mohabbat
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      BackgroundChronic fatigue syndrome (CFS) is a complex and often disabling chronic condition emerging worldwide, with no curative or definitive therapy yet identified. Ginseng has been widely used to treat fatigue in other patient groups and conditions; however, a systematic review focusing solely on the impact of ginseng on fatigue in patients with CFS has not been performed.ObjectiveThis study aimed to assess the current state of evidence regarding ginseng for CFS.MethodsMultiple databases were searched from inception to October 2020. All data was extracted independently and in duplicates. Outcomes of interest included the effectiveness and safety of ginseng in patients with CFS.Results2 studies enrolling 68 patients were deemed eligible, including one randomized clinical trial and one prospective observational study. The certainty of evidence in the effectiveness outcome was low and moderate from both studies, while the safety evidence was very low as reported from one study.ConclusionStudy findings highlight a potential benefit of ginseng therapy in the treatment of CFS. However, we are not able to draw firm conclusions due to limited clinical studies. The paucity of data warrants limited confidence. There is a need for future rigorous studies to provide further evidence.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-02-14T03:50:30Z
      DOI: 10.1177/2164957X221079790
      Issue No: Vol. 11 (2022)
       
  • Whole Health Use and Interest Across Veterans With Co-Occurring Chronic
           Pain and PTSD: An Examination of the 18 VA Medical Center Flagship Sites

    • Authors: David E. Reed, Barbara G. Bokhour, Lauren Gaj, Anna M. Barker, Jamie H. Douglas, Rian DeFaccio, Rhonda M. Williams, Charles C. Engel, Steven B. Zeliadt
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      ObjectiveVeterans Healthcare Administration (VHA) conducted a large demonstration project of a holistic Whole Health approach to care in 18 medical centers, which included making complementary and integrative health (CIH) therapies more widely available. This evaluation examines patterns of service use among Veterans with chronic pain, comparing those with and without PTSD.MethodsWe assessed the use of Whole Health services in a cohort of Veterans with co-occurring chronic pain and PTSD (n = 1698; 28.9%), comparing them to Veterans with chronic musculoskeletal pain only (n = 4170; 71.1%). Data was gathered from VA electronic medical records and survey self-report. Whole Health services were divided into Core Whole Health services (e.g., Whole Health coaching) and CIH services (e.g., yoga). Logistic regression was used to determine whether Veterans with co-occurring chronic pain and PTSD utilized more Whole Health services compared to Veterans with chronic pain but without PTSD.ResultsA total of 40.1% of Veterans with chronic pain and PTSD utilized Core Whole Health services and 53.2% utilized CIH therapies, compared to 28.3% and 40.0%, respectively, for Veterans with only chronic pain. Adjusting for demographics and additional comorbidities, Veterans with comorbid chronic pain and PTSD were 1.24 (95% CI: 1.12, 1.35, P ≤ .001) times more likely than Veterans with chronic pain only to use Core Whole Health services, and 1.23 (95% CI: 1.14, 1.31, P ≤ .001) times more likely to use CIH therapies. Survey results also showed high interest levels in Core Whole Health services and CIH therapies among Veterans who were not already using these services.ConclusionEarly implementation efforts in VHA led to high rates of use of Core Whole Health and CIH therapy use among Veterans with co-occurring chronic pain and PTSD. Future assessments should examine how well these additional services are meeting the needs of Veterans in both groups.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-02-11T08:56:45Z
      DOI: 10.1177/21649561211065374
      Issue No: Vol. 11 (2022)
       
  • Patient Perspectives on the Development of a Novel Mobile Health (mHealth)
           Application for Dietary Supplement Tracking and Reconciliation—A
           Qualitative Focus Group Study

    • Authors: Elana Post, Keturah Faurot, Zachary O. Kadro, Jacob Hill, Catharine Nguyen, Gary N. Asher, Susan Gaylord, Amanda Corbett
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      BackgroundMore than 170 million adults use dietary supplements (DS) in the United States, which can have both benefit and harm to patient health. DS use is often poorly documented in the medical record and can pose health risks if not properly communicated with providers. Reasons for poor DS documentation include low disclosure rates, time constraints of clinical encounters, and providers’ failure to inquire about DS use. This study was conducted to assess patients’ views on the facilitators and barriers to using a mobile health (mHealth) application (app) to collect and share DS information with their healthcare providers.MethodsUtilizing a theory-based conceptual model, we conducted 7 patient focus groups (FGs) to assess opinions on DS safety, provider communication, comfort with technology use, and our proposed mHealth app. Participants were recruited from the general public and through patient advisory groups. Patient views will inform the creation of an mHealth app to improve DS patient-provider communication and tracking and reconciliation in the electronic medical record (EMR).ResultsOverall, participants believe their DS information is inaccurately represented in the EMR, leading to safety concerns and negatively impacting overall quality of care. Participants desired an app designed with (1) Health Insurance Portability and Accountability Act (HIPAA) compliance; (2) ease of use for a variety of technical efficacy levels; (3) access to reliable DS information, including a DS-drug interaction checker; and (4) integration with the EMR.ConclusionAn app to simplify and improve DS entry and reconciliation was of interest to patients, as long as it maintained health autonomy and privacy and possessed key valuable features.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-01-27T10:50:31Z
      DOI: 10.1177/21649561221075268
      Issue No: Vol. 11 (2022)
       
  • Mindfulness-Based Programs: Why, When, and How to Adapt'

    • Authors: Eric B. Loucks, Rebecca S. Crane, Menka A. Sanghvi, Jesús Montero-Marin, Jeffrey Proulx, Judson A. Brewer, Willem Kuyken
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      This paper provides a framework for understanding why, when and how to adapt mindfulness-based programs (MBPs) to specific populations and contexts, based on research that developed and adapted multiple MBPs. In doing so, we hope to support teachers, researchers and innovators who are considering adapting an MBP to ensure that changes made are necessary, acceptable, effective, cost-effective, and implementable. Specific questions for reflection are provided such as (1) Why is an adaptation needed' (2) Does the theoretical premise underpinning mainstream MBPs extend to the population you are considering' (3) Do the benefits of the proposed adaptation outweigh the time and costs involved to all in research and implementation' (4) Is there already an evidenced-based approach to address this issue in the population or context' Fundamental knowledge that is important for the adaptation team to have includes the following: (1) essential ingredients of MBPs, (2) etiology of the target health outcome, (3) existing interventions that work for the health outcome, population, and context, (4) delivery systems and settings, and (5) culture, values, and communication patterns of the target population. A series of steps to follow for adaptations is provided, as are case examples. Adapting MBPs happens not only by researchers, but also by MBP teachers and developers, who endeavor to best serve the populations and contexts they work within. We hope that these recommendations for best practice provide a practical framework for skilfully understanding why, when, and how to adapt MBPs; and that this careful approach to adaptation maximizes MBP safety and efficacy.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-01-27T10:49:51Z
      DOI: 10.1177/21649561211068805
      Issue No: Vol. 11 (2022)
       
  • A Multi-step Approach to Adapting a Mind-Body Resiliency Intervention for
           Fear of Cancer Recurrence and Uncertainty in Survivorship (IN FOCUS)

    • Authors: Daniel L. Hall, Gloria Y. Yeh, Conall O'Cleirigh, Jeffrey Peppercorn, Lynne I. Wagner, John Denninger, Andrea J. Bullock, Helen R. Mizrach, Brett Goshe, Tina Cheung, Raissa Li, Alexandros Markowitz, Elyse R. Park
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      BackgroundFor cancer survivors, there is a paucity of fear of recurrence (FOR) interventions that integrate empirically supported mind-body and psychological skills for managing FOR and are delivered in scalable formats.ObjectiveTo adapt an evidence-based resiliency intervention to address FOR among cancer survivors.MethodsA multidisciplinary team of researchers, clinicians, and patient stakeholders followed an iterative intervention adaptation process (ORBIT). In Step 1, we sought to define key FOR management skills through a literature review and feedback from stakeholders. In Step 2, we integrated findings into a treatment manual and refined procedures for in-person delivery to groups of cancer survivors, defined as adults who had completed primary cancer treatment for non-metastatic cancer. In Step 3, we conducted a single arm trial to assess initial acceptability and change in FOR severity with 23 cancer survivors (N=4 intervention groups). In Step 4, we conducted additional qualitative interviews with 28 cancer survivors (N=6 focus groups stratified by FOR severity, N=15 individual interviews) to define adaptive and maladaptive strategies for coping with FOR and to identify preferences for delivery. In Step 5, we refined the treatment manual and procedures for testing in a future pilot randomized feasibility trial.ResultsWe identified critical feedback using a combination of qualitative and quantitative methods. The single arm trial suggested preliminary feasibility and sustained reductions in FOR severity, yet need for refinement (i.e., eligibility, delivery modality), prompting additional qualitative interviews for further targeting. The resulting intervention (IN FOCUS) is comprised of virtual, synchronous, group-delivered sessions that offer an integrated approach to FOR management by teaching cognitive-behavioral techniques, meditation, relaxation training, adaptive health behaviors, and positive psychology skills. Sessions are targeted by applying skills to FOR and associated healthcare engagement.ConclusionsIN FOCUS is a targeted intervention for teaching mind-body resiliency skills to groups of cancer survivors with elevated FOR. Next steps are testing feasibility in a pilot randomized trial.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-01-27T10:48:10Z
      DOI: 10.1177/21649561221074690
      Issue No: Vol. 11 (2022)
       
  • SEAttle-based Research of Chinese Herbs for COVID-19 Study: A Whole Health
           Perspective on Chinese Herbal Medicine for Symptoms that may be Related to
           COVID-19

    • Authors: Lisa Taylor-Swanson, Daniel Altschuler, Katherine Taromina, Belinda Anderson, Daniel Bensky, Misha Cohen, Helen Huang, Shouchun Ma, Iman Majd, Craig Mitchell, Rosa N Schnyer, Lisa Conboy
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      IntroductionEast Asian Medicine (EAM) is a Whole System medicine that includes Chinese herbal medicine (CHM). Chinese herbal medicine has been utilized to reduce symptom burden in infectious disease, with notable theoretical reformulations during pandemics of the 3rd, 13th, and 17th centuries. Today, Licensed Acupuncturists trained in CHM have utilized it to treat symptoms and sequelae of COVID-19. However, little is known about its use or efficacy by the public and health practitioners. Understanding and evaluating whole medicine systems of healthcare is inherently complex; there is international consensus for a descriptive, pragmatic approach. We are conducting a feasibility pilot study using a prospective, pragmatic, observational design using Whole Health and Whole Person perspectives. The complexity of COVID-19 reflects the impact on multiple homeoregulatory systems and provides a unique opportunity to assess the impact of interventions such as EAM on whole health. Observation of these EAM encounters will provide valuable qualitative and quantitative data on the interface of an extant Whole System medicine with a novel complex illness as a precursor to a randomized clinical trial.MethodsThis ongoing study observes a CHM clinic offering telehealth consultations to a diverse patient population since April, 2020. Patients who report symptoms potentially related to COVID-19 disease are consented for standardized collection and analysis of demographic and clinical data from each clinical encounter.ResultsTo date, 61 patients engaged in 195 consultations (mean 3.3) with 49 reporting symptom resolution sufficient to complete treatment, and 4 withdrawals. Just over half (62%) were female, with an average age of 45.7 years. A wide variety of CHM formulas and EAM dietary and lifestyle modifications were provided.DiscussionAdequate recruitment and retention suggest feasibility of the intervention and data collection. The rich dataset may facilitate the construction of Whole Health models of CHM’s clinical impact, as well as integrative inquiry into CHM’s effects on symptoms.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-01-25T09:32:28Z
      DOI: 10.1177/21649561211070483
      Issue No: Vol. 11 (2022)
       
  • Lessons Learned From VHA’s Rapid Implementation of Virtual Whole Health
           Peer-Led Groups During the COVID-19 Pandemic: Staff Perspectives

    • Authors: Ekaterina Anderson, Kelly Dvorin, Bella Etingen, Anna M. Barker, Zenith Rai, Abigail Herbst, Reagan Mozer, Rodger P. Kingston, Barbara Bokhour
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      BackgroundCommitted to implementing a person-centered, holistic (Whole Health) system of care, the Veterans Health Administration (VHA) developed a peer-led, group-based, multi-session “Taking Charge of My Life and Health” (TCMLH) program wherein Veterans reflect on values, set health and well-being-related goals, and provide mutual support. Prior work has demonstrated the positive impact of these groups. After face-to-face TCMLH groups were disrupted by the COVID-19 pandemic, VHA facilities rapidly implemented virtual (video-based) TCMLH groups.ObjectiveWe sought to understand staff perspectives on the feasibility, challenges, and advantages of conducting TCMLH groups virtually.MethodsWe completed semi-structured telephone interviews with 35 staff members involved in the implementation of virtual TCMLH groups across 12 VHA facilities and conducted rapid qualitative analysis of the interview transcripts.ResultsHolding TCMLH groups virtually was viewed as feasible. Factors that promoted the implementation included use of standardized technology platforms amenable to delivery of group-based curriculum, availability of technical support, and adjustments in facilitator delivery style. The key drawbacks of the virtual format included difficulty maintaining engagement and barriers to relationship-building among participants. The perceived advantages of the virtual format included the positive influence of being in the home environment on Veterans’ reflection, motivation, and self-disclosure, the greater convenience and accessibility of the virtual format, and the virtual group’s role as an antidote to isolation during the COVID-19 pandemic.ConclusionFaced with the disruption caused by the COVID-19 pandemic, VHA pivoted by rapidly implementing virtual TCMLH groups. Staff members involved in implementation noted that delivering TCMLH virtually was feasible and highlighted both challenges and advantages of the virtual format. A virtual group-based program in which participants set and pursue personally meaningful goals related to health and well-being in a supportive environment of their peers is a promising innovation that can be replicated in other health systems.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-01-25T03:29:07Z
      DOI: 10.1177/21649561211064244
      Issue No: Vol. 11 (2022)
       
  • Cross Cultural Adaptation and Cognitive Testing of a
           Psycho-Social-Spiritual Healing Measure, the NIH Healing Experiences in
           All Life Stressors-NIH-HEALS

    • Authors: Eve Namisango, Emmanuel B. K. Luyirika, Ann Berger
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      BackgroundCancer is associated with trauma and stress which impacts the physical, psychological, and spiritual/existential well-being of patients. Psychological/behavioral healing may help alleviate this distress and the associated health-related suffering. Psycho-Social-Spiritual healing outcome measures are thus needed to stimulate service development. The NIH Healing Experiences in All Life Stressors (NIH-HEALS), is a novel 35-item measure of psycho-social-spiritual healing, developed in USA and is yet to be validated and adapted for use in African countries.ObjectivesThis study aimed to assess the face and content validity of the NIH-HEALS in the population of cancer patients in Uganda and to culturally adapt this measure.MethodsCross-sectional study using cognitive interviewing alongside standard piloting. We recruited adult (18 years and above) patients with advanced cancer from Hospice Africa Uganda. Interviews were conducted in two phases, using the think aloud technique and concurrent probing and were audio recorded. Phase 1 was used to identify initial concerns around clarity of the statements, and phase 2 further explored whether the issues of clarity had been addressed, alongside the standard cognitive interview parameters. The transcripts were imported into NVivo-12 analyzed using the content analysis technique and categorized using Tourengeau’s information processing model.ResultsWe recruited thirty-five (35) patients: phase one (n = 5) two (n = 30). The median completion time was 20 minutes. Problems identified included comprehension of some statements, words, and phrases, suggestions to include local examples, highlighting of potentially sensitive statements that lean towards difficult conversations, and some cultural differences in the construction of the “Trust and Acceptance” construct, our sample showed less emphasis on family/friend relations. This feedback was used to adapt the NIH-HEALS for the local context.ConclusionThe NIH-HEALS has sufficient face and content validity properties to be used among palliative cancer patients in Uganda. We propose some changes to inform the adaptation of this measure for the local context.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-01-25T01:49:36Z
      DOI: 10.1177/21649561211067189
      Issue No: Vol. 11 (2022)
       
  • Wellbeing, Whole Health and Societal Transformation: Theoretical Insights
           and Practical Applications

    • Authors: Andrew H Kemp, Zoe Fisher
      Abstract: Global Advances in Health and Medicine, Volume 11, Issue , January-December 2022.
      Society faces several major interrelated challenges which have an increasingly profound impact on global health including inequalities, inequities, chronic disease and the climate catastrophe. We argue here that a focus on the determinants of wellbeing across multiple domains offers under-realised potential for promoting the ‘whole health’ of individuals, communities and nature. Here, we review recent theoretical innovations that have laid the foundations for our own theoretical model of wellbeing – the GENIAL framework – which explicitly links health to wellbeing, broadly defined. We emphasise key determinants across multiple levels of scale spanning the individual, community and environmental levels, providing opportunities for positive change that is either constrained or facilitated by a host of sociostructural factors lying beyond the immediate control of the individual (e.g. social cohesion and health-related inequities can either promote or adversely impact on wellbeing, respectively). Following this, we show how the GENIAL theoretical framework has been applied to various populations including university students and people living with neurological disorders, with a focus on acquired brain injury. The wider implication of our work is discussed in terms of its contribution to the understanding of ‘whole health’ as well as laying the foundations for a ‘whole systems’ approach to improving health and wellbeing in a just and sustainable way.
      Citation: Global Advances in Health and Medicine
      PubDate: 2022-01-24T12:35:06Z
      DOI: 10.1177/21649561211073077
      Issue No: Vol. 11 (2022)
       
 
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