Digital Commons Network^™

Covid-19 Hospital Mortality Among Patients With Invasive Mechanical Ventilation: A Comparison Between Public And Private Healthcare Services In San Luis Potosí 2020–2022, María E. Torres-Acosta, Rocío M. Cubos-Moncada, Alan Y. Martínez-Castellanos

The University of Louisville Journal of Respiratory Infections

Background: During 2019, México’s total public spending on health was 5.43% of the national gross domestic product, making it one of the countries of the Organisation for Economic Co-operation and Development that invested the least in developing public health systems. This study analyzes hospital mortality among intubated patients with laboratory-confirmed COVID-19 according to type of institution in San Luis Potosí, México, from March 18, 2020, to April 7, 2022.

Methods: This is a secondary data analysis of publicly available information about mortality among intubated patients with a laboratory-confirmed diagnosis of COVID-19 with respect to the type of hospitalization institution.

Results: …

Innovative Virtual Wellness Interventions At An Academic Medical Center: A Pilot Feasibility Study, Ritika Baweja, Michael Hayes, Aditya Joshi, Raman Baweja

Journal of Wellness

Introduction: There is generally a concerning likelihood of burnout in healthcare workers. Given the impact of COVID-19 on healthcare workers, our institution identified the need for wellness interventions to foster adaptive functioning and mitigate burnout. The purpose of this pilot project was to assess the feasibility of virtual holistic interventions like meditation, art, laughter therapy and dance and their impact on overall well-being of physicians and advanced practice providers (APPs).

Methods: A series of 12 virtual sessions (art therapy, dance therapy, mindfulness-based practices/meditation and laughter therapy) were offered to providers over a 6-month period. Participants completed an online survey reporting …

Virtual Delivery Of Stress Management And Resiliency Training (Smart) During The Covid-19 Pandemic To Hematology/Oncology Fellows: A Pilot Study, Colt Williams, Sherry Chesak, Deirdre R. Pachman, Ross Dierkhising, Laura Rhee, Konstantinos Leventakos

Journal of Wellness

Introduction: Medical trainees experience a high degree of stress that predisposes them to burnout. This pilot study tested a scalable approach to deliver a validated resilience program (Stress Management and Resiliency Training (SMART)) among Hematology/Oncology fellows at an academic medical center.

Methods: This was a mixed-methods, prospective, single-arm clinical trial involving Hematology/Oncology fellows at Mayo Clinic in Rochester, MN, USA. Four one-hour training sessions were conducted virtually with 26 fellows. Stress, burnout, and emotional resilience were measured at baseline, three months, and six months post-intervention using the Perceived Stress Scale (PSS-10), Maslach Burnout Inventory (MBI-HSS), and Connor-Davidson Resilience …

Exploration Of Burnout, Emotional Thriving, And Emotional Recovery In An Academic Medical Center: A Mixed Methods Quality Improvement Project, Roxana Naderi, Katherine T. Morrison, Zuzanna Czernik, James E. Carter Jr, Katherine N. Dickerman, Alexandra Gallant, Lara Kirkbride-Romeo, Lauren Mcbeth, Angela Keniston, Kristin M. Jensen

Journal of Wellness

Introduction: Healthcare provider burnout, an indicator of wellbeing, impacts patient safety, provider distress, and employee turnover. In this mixed methods, multi-site quality improvement study conductedpandemic, we assessed employee wellbeing in a large clinical department.

Methods: Wellbeing surveys were sent electronically to Department of Medicine clinicians, researchers, administrators, and staff from August-September 2019 assessing perceptions of Burnout, Emotional Thriving (ET), and Emotional Recovery (ER). Qualitative responses were reviewed for themes using mixed inductive-deductive analysis. The initial coding was done by small teams with consensus obtained through large group discussions. This study was IRB-approved as non-human subjects research.

Results: Of the 671 …

Sexual Well-Being Among Medical Residents At A Community-Based Academic Institution, Fiore Casale, Hinduja Nallamala, Todd Foster, Christine Alicea, Laurel Fick

Journal of Wellness

Introduction: Medical residency training is demanding, with challenging workloads, long hours, and excessive stress that impact residents’ physical, mental, and emotional health. Although the concept of health and wellness in residency has become more widespread across programs, few studies have explored the sexual health of medical residents during training.

Methods: To better understand the current state of sexual health and well-being of resident physicians, physicians in training across Internal Medicine, Pediatrics, Family Medicine, OB/GYN, Transitional Year, and General Surgery completed anonymous surveys that incorporated validated questionnaires, including the International Index of Erectile Function (IIEF) and the Index of Premature Ejaculation …

Utilization Of Wellness Practices For Burnout And Stress During Covid-19 Among An Interdisciplinary Cohort Of Emergency Healthcare Workers, Michael J. Zdradzinski, Sheri-Ann O. Kaltiso, Roslyn Seitz, Timothy P. Moran, Jennifer Clements, Sheryl L. Heron, Michelle D. Lall

Journal of Wellness

Introduction: The Coronavirus Disease (COVID-19) introduced additional stress to the baseline occupational stressors of emergency care workers. The objectives of this study were to evaluate perceived stress and burnout and the utilization and perceived benefit of wellness practices among emergency healthcare workers (EHCWs), including: emergency physicians, advanced practice providers (APPs), nurses, and departmental administrative staff during the COVID-19 pandemic.

Methods: A cross-sectional 28-item electronic survey of EHCWs at three hospitals in a major United States city was used to measure participants’ utilization and perceived benefit of wellness practices, burnout (2-item measure), overall stress (perceived stress scale), and stress …

Evaluating The Feasibility And Impact Of A Well-Being Retreat For Physicians And Advanced Practice Providers, Amanda K. Bailey, Amanda T. Sawyer, Hong Tao, Leila Durr, Alexandra Lajeunesse, Ravindran Sabapathy, Tyon L. Hall

Journal of Wellness

Introduction: Work stress experienced by physicians and advanced practice providers (APPs) can have a detrimental psychological and physical impact. Targeted interventions that focus on self-awareness, peer connection, and intentional self-care may reduce stress and improve well-being and professional fulfillment.

Methods: This is a summative program evaluation of a two-day well-being retreat for physicians and APPs employed at a healthcare system headquartered in Florida. Led by mental health professionals in May 2022, this retreat combined facilitator-led workshops and experiential practice activities with opportunities for peer connection and designated time with family members. The retreat objectives were to facilitate social …

The Association Of Hobbies And Leisure Activities With Physician Burnout And Disengagement, Yan Li, Cindy Y. Lai, Bill Friedrich, Chenxing Liu, Joel H. Popkin

Journal of Wellness

Introduction: Burnout among physicians is a worldwide burden. While many causes of physician stress have been reported, we have found few quantitative studies of associations between burnout and participation in hobbies and interests outside of medicine. Our objective was to determine if health care professional burnout/disengagement could be mitigated by incorporating leisure interests and to characterize which specific interests, if any, are most significantly related.

Methods: We conducted an online survey of 2,563 US-based physicians and 512 residents/fellows and queried their participation in a list of 117 individual hobbies, which we then further categorized into three perceived levels …

Barriers And Facilitators To Achieving Well-Being In Pediatric Providers, Whitney Marvin, Jillian Harvey, Natasha Ruth

Journal of Wellness

Introduction: Physician well-being has become increasingly important for health systems across the country due to the strong ties between quality, safety, and overall patient outcomes. Burnout has increased steadily and has been exacerbated by the COVID-19 pandemic. This study seeks to successfully identify factors that both enhance and detract from well-being in a cohort of pediatric faculty and advanced practice providers (APPs).

Methods: This study utilized a multimethod approach including surveys and a total of 8 semi-structured, virtual focus groups of pediatricians and advanced practice providers (orchestrated through Microsoft Teams) to understand perspectives on burnout and well-being. Each …

Women Physicians And Medical Conferences: A Pilot Survey Study Of Participation Challenges And Options To Optimize Wellness And Work-Life Integration, Marah N. Kays, Ekas Singh Abrol, Ariela L. Marshall

Journal of Wellness

Introduction: Women physicians experience challenges in career advancement, work-life integration (WLI), and wellness. Participation (attending and speaking) at academic conferences is one way for women physicians to advance their careers, but barriers to physical participation (travel, WLI) pose challenges. Virtual participation options may enhance career advancement. In this pilot study, we explored women physicians’ conference participation patterns and preferences regarding virtual participation options.

Methods: In this cross-sectional pilot study of 70 women physicians from the Physician Women in Leadership (PWL) and Physician Moms Group (PMG) Facebook groups, we collected demographic, burnout, and WLI data, information on barriers to …

Health Professional Well-Being And Preparedness During The Covid-19 Pandemic In Trinidad And Tobago: An Online Survey, Loren De Freitas, Darren Dookeeram, Shastri Motilal

Journal of Wellness

Introduction: Poor well-being impacts mental health and subsequently affects personal lives, leads to absenteeism, poor productivity, and compromised patient safety. Frontline healthcare workers are highly vulnerable to COVID-19 pandemic-related mental health strain. This study assessed the well-being and preparedness of frontline healthcare workers in Trinidad and Tobago during the pandemic.

Methods: An online cross-sectional survey was sent to doctors, nurses, and prehospital providers from public and private healthcare sectors. Data was collected from May to June 2020 utilizing a self- administered online platform. The WHO Five Well-being Index (WHO-5) was used to assess well-being. Raw scores less than 13 indicated …

Self-Perceived Well-Being Among Doctor Of Physical Therapy Students In The United States, David Kietrys, Ellen Anderson, Suchismita Ray

Journal of Wellness

Introduction: The purpose of this study was to describe self-perceived well-being among Doctor of Physical Therapy (DPT) students in the United States during the COVID-19 pandemic and explore factors associated with well-being.

Methods: This observational study was cross-sectional, using an anonymous, self-administered, nationwide survey. The survey included questions about an array of factors theoretically related to well-being, and incorporated the WHO-5 Well-being Index, the Perceived Stress Scale-10, and the Brief Resiliency Scale.

Results: A total of 1,542 responded to the survey. Data from 1,537 DPT students in the U.S. were included in the analysis. Well-being was positively correlated with resilience …

Covid-19 Coagulopathies: Highlights Of 2020–2021 Reported Data, Shreya Anil Kumar, Anushka Pradhan, Abdelrahman Elsebaie, Karina Fainchtein, Abdelrahman Noureldin, Yousra Tera, Sajida Kazi, Maha Othman

The University of Louisville Journal of Respiratory Infections

Background: The COVID-19 pandemic has evolved dramatically over the past two years, and literature on COVID-19 coagulopathy has been overwhelming, which complicates the process of understanding the literature or assessing the quality of the data available. The objective of this narrative review was to highlight and analyze data reported on COVID-19-induced coagulopathy and its outcomes in patients with severe or critical disease over two years of the pandemic.

Methods: Studies published in high-impact journals reporting on hospitalized adult COVID-19 patients, their coagulation parameters, and their thrombotic complications were included. We searched MEDLINE, Embase, and Ovid between Dec 1, 2019 and …

Survey Of Nutrition Education Among Medical Students, Michael P. Duggan, Anahita T. Kodali, Zach A. Panton, Shannon M. Smith, Grant J. Riew, Jack F. Donaghue, Gregory A. Leya, Logan G. Briggs

Journal of Wellness

Introduction: The current literature regarding both specific interventions and the current level of nutrition education in the United States is scarce. The purpose of this paper is to provide medical student perspectives on both the degree and necessity of nutrition education during medical school.

Methods: Medicine in Motion (MM) is a non-profit student-run organization founded in 2018 that aims to address burnout in medicine through physical activity, community service, and philanthropy. MM issued a survey to nine of its chapters in January 2021 to assess a range of topics including burnout, physical activity, and nutrition education.

Results: Of 5500 invited …

Emergency Medicine In-Training Examination Scores Are Not Associated With Burnout And Not Affected By The Introduction Of A Wellness Curriculum, Kelly Williamson Md, Patrick M. Lank, Nicholas Hartman, Nathan Olson, Elise O. Lovell

Journal of Wellness

Introduction: There is little research examining the relationship between burnout and medical knowledge. Study Objectives: The authors sought to determine if emergency medicine (EM) resident performance on the In-Training Examination (EM-ITE) is associated with burnout and if EM-ITE scores are affected by the implementation of a wellness curriculum.

Methods: As part of a multi-institution prospective education intervention trial, the Maslach Burnout Inventory, a valuable tool in the assessment of physician burnout, was administered at 10 EM residencies in February 2017. Then, five intervention sites introduced a year-long wellness curriculum. The MBI was re-administered at all sites in August 2017 and …

Does Positive Psychology Coaching Improve Trainee Well-Being? Evidence From A Longitudinal Professional Development Coaching Program In A Cohort Of Pediatric Trainees, Benjamin Nelson, Jacqueline T. Chu, Michael G. Healy, Yoon Soo Park, Kerri Palamara Md

Journal of Wellness

Introduction: Trainee burnout is common and evidence supporting the effectiveness of well-being interventions for this population is limited. We studied the effect of a longitudinal coaching program grounded in positive psychology on measures of pediatric trainee well-being.

Methods: Pediatric interns and fellows (n = 67) were enrolled in a positive psychology coaching program in 2017-2019. Pediatric faculty (n = 23) underwent training and were paired with trainees outside their field of interest. Trainees were surveyed at the beginning and end of the program to assess burnout and well-being, and key skills necessary to achieve well-being.

Results: Thirty-one …

A Focused Review Of Multidimensional Well-Being Assessments, Samantha Schonhardt, Stephanie Sullivan, Rebecca Shisler Marshall

Journal of Wellness

Introduction: Interest in the topic of well-being continues to grow and has resulted in the creation of a variety of well-being assessments. However, each assessment often brings its own terminology, theories, definitions, and dimensions. This creates a muddled research base that produces inconsistencies in the field of well-being. Therefore, the aim of this review was to identify assessments that measure multiple dimensions of well-being, catalogue and group the dimensions into categories, and develop definitions for the categories based on the conceptualizations in the literature. In doing so, the dimensionality of well-being portrayed in the literature can be better understood. …

Factors In Primary Care Use Among Young Adult Refugees From Burma And Bhutan In Early Resettlement: Findings From Colorado, Sarah Brewer, Jini Puma

Journal of Refugee & Global Health

Background: Young adult refugees have suboptimal primary care use in early resettlement—domains of integration influence primary care engagement during this time.

Methods: Adjusted logistic regression models were used to estimate odds of (1) having a primary care exam and (2) identification of a primary care provider (PCP) as predicted by domains of integration among young adult refugees (n=154) from Burma and Bhutan across four years following resettlement.

Results: Overall integration and predisposing factors, such as language and cultural knowledge, were lower odds of having a primary care provider. Enabling factors such as having insurance and knowing how to make an …

Assessing The Efficacy Of A Meditation Intervention On Dispositional Mindfulness Among Medical Students And Resident Physicians, Kelsey Stefan, Michael Villeneuve, Varun Konanki, Erica Rarity, Rahul Mhaskar, Liwei Chen, Amelia Phillips

Journal of Wellness

Introduction: Dispositional mindfulness is the act of paying attention to one’s thoughts and feelings with an open and non-judgemental attitude. Medical students and resident physicians are under immense pressure and stress daily, and they need effective tools to help increase their dispositional mindfulness. This project examined the impact of a meditation intervention on medical students’ dispositional mindfulness.

Methods: In 2020, medical students and resident physicians at the University of South Florida were given the option to practice daily meditation for thirty days; time spent on the practice varied depending on comfort with the practice. Dispositional mindfulness levels were assessed using …

Investigating Stigma During The Early Stages Of A Pandemic Through The Lens Of Covid-19, Zach Thornton, Bethany Hodge, Sheridan Langford

The University of Louisville Journal of Respiratory Infections

Background: Individuals face stigma associated with numerous health conditions. Stigma can arise rapidly during the early spread of a new disease, adding to the burden felt by those affected. COVID-19 can be used as an example to study stigma during the early phases of a pandemic. This narrative review is a descriptive analysis that tracks the ways in which COVID-19 stigma was discussed in the scholarly literature during the first year of the pandemic to understand how stigma was viewed in the context of a rapidly spreading pandemic.

Methods: PubMed was used as a non-exhaustive sample of the literature. Searches …

Development And Use Of A Survey Tool To Prioritize And Catalyze Change Surrounding Faculty Wellness In A Department Of Pediatrics, Sarah Rhoads, Alison Riese, Mohammed Faizan, Lloyd Feit, Shuba Kamath, Albert Ross, Katherine Mason

Journal of Wellness

Introduction: Physician wellness is an important factor in the delivery of safe, effective and humanistic patient care. There is compelling data describing the widespread prevalence of physician burnout and its subsequent adverse impact on patient care, healthcare costs, and relationships. Initiatives to improve wellness are necessary to maintain the healthcare work force as well as to ensure high-quality care. This project investigated faculty physicians’ attitudes and priorities regarding physician wellness within the department of Pediatrics at a single-center academic institution.

Methods: A survey was created and distributed via e-mail to all faculty physicians employed within the Department of Pediatrics in …

Insights From Nursing Students About Factors Affecting And Strategies Supporting Their Mental Health, Saima Hirani, Ambreen Tharani, Zohra Jetha, Shehla Khan

Journal of Wellness

Introduction: Nursing students experience high stress and mental health issues. It is essential to pay adequate attention to students’ mental health so they are trained to deliver quality patient care in complex settings. In order to provide a healthy environment to student nurses, it is essential that nursing students’ voices are heard. This study aims to explore nursing students’ perceptions about factors that influence their mental health and understand strategies that support mental health during nursing education.

Methods: The study used an exploratory descriptive qualitative design to achieve the objective. Purposive sampling was used to recruit nursing students from a …

Associations Between Faculty Vitality And Burnout In The Covid-19 Era: The Experience Of One Institution, Megan Ferriby Ferber, Tina H. Chen, Patrice L. Vallot, Jane Mchowat, Cindy C. Bitter

Journal of Wellness

Introduction: Faculty vitality is the ideal synergy between engaged faculty and mission-driven institutions that generates a fruitful environment for academic productivity, career satisfaction, and fulfillment of shared goals. The COVID-19 pandemic has introduced unprecedented disruptions to faculty vitality, with profound perturbations to individual and institutional support networks. However, the extent of this impact is unclear, as are strategies to mitigate loss of faculty vitality and prevent burnout.

Methods: We developed a survey instrument to evaluate the impact of COVID-19 on faculty vitality and burnout at a mid-sized, Midwestern academic institution affiliated with a university hospital. Survey items focused on individual …

Wellness Review 2022, Part 1, Martin Huecker, Brian A. Ferguson, Jacob Shreffler

Journal of Wellness

Introduction: This article represents the first of a two-part assessment of 2022 literature addressing wellness in healthcare professionals published from January 1, 2022 to June 30, 2022.

Methods: Three editors conducted a similar keyword search in Pubmed, also adding manually curated articles. Focusing chiefly on clinical trials and other prospective research, we settled on a final 25 significant papers focusing on wellness in medical professionals to include in this review.

Literature Review: Recent literature into HCW wellness continues to describe burnout factors and COVID-19 impact, but includes more resilience-targeting interventions and systematic reviews of trials seeking bolstering of well-being. Subsections …

An Evaluation Of Covid-19 Vaccination Rates Of The Patients At The Kentucky Racing Health Services Center, Aditya Mehta, Dedra Hayden

The Cardinal Edge

COVID-19 vaccines have been widely available to the U.S. public since early 2021. However, vaccination rates still vary considerably across geographical areas and different populations. The objective of this study was to research overall vaccination rates against COVID-19 for Latinx patients at the Kentucky Racing Health Services Center (KRHSC). Vaccination and booster data was collected from June to December 2021 for all unique patients visiting the center. It was initially hypothesized that these rates of vaccination and booster doses for the KRHSC patients would be lower than the data reported by Kentucky and Jefferson County. After a retrospective review, the …

More Work, Less Reward: The Minority Tax On Us Medical Students, Marija Kamceva, Baffour Kyerematen, Sabina Spigner, Samuel Bunting, Simiao Li-Sauerwine, Jane Yee, Michael Gisondi

Journal of Wellness

Introduction: Minority tax is defined as the burden of time and resources placed on minority persons to represent and advocate for their communities. We determined whether medical students underrepresented in medicine (URM) or from historically excluded (HE) populations experience a minority tax and characterized its effects.

Methods: This cross-sectional survey of US medical students occurred November 2020 - June 2021. We used Mann-Whitney U tests to compare metrics between URM and HE participants and their peers. The primary outcome was time invested in activism/diversity initiatives versus other work. Secondary outcomes included measures of microaggressions, discrimination, institutional culture, anxiety/depression, …

Comparing Outcomes For Community-Acquired Pneumonia Between Females And Males: Results From The University Of Louisville Pneumonia Study, Pavani Nathala, Simrat Sarai, Vidyulata Salunkhe, Mahder A. Tella, Stephen P. Furmanek, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

Introduction: Male sex is currently considered to be a risk factor for worsened community-acquired pneumonia (CAP) outcomes compared to female sex; hence, female sex equates to a lower score on the Pneumonia Severity Index. There is no recent update on sex-based outcomes of patients with CAP. The objective of this study was to compare the outcomes of CAP between females and males.

Methods: This was a secondary analysis of the University of Louisville Pneumonia Study database. It was a prospective population-based cohort study of all hospitalized adults with CAP who were residents of Jefferson County in the city of Louisville, …

Evaluating Burnout, Secondary Traumatic Stress, And Sleep Disturbances In Healthcare Professionals During A Global Pandemic, Laura K. Miller, Sarah Pehlke

Journal of Wellness

Introduction: For healthcare workers, the COVID-19 pandemic resulted in increased workload, work related stress and patient acuity potentially leading to burnout, secondary traumatic stress (STS), and sleep disruptions. This study aims to assess the prevalence of burnout and STS symptoms, as well as sleep disturbances among healthcare personnel working in the United States during the pandemic.

Methods: Healthcare workers from all disciplines and settings in the United States completed a cross-sectional survey about work and personal characteristics from January 20-March 1, 2021. Participants reported on symptoms of burnout, STS, and sleep disruptions.

Results: A total of 360 participants in the …

A Resident Retreat With Emergency Medicine Specific Mindfulness Training Significantly Reduces Burnout And Perceived Stress, James O'Shea, Mark Dannenfelser, Melissa White, Anwar Osborne, Timothy P. Moran, Michelle D. Lall

Journal of Wellness

Introduction: We hypothesize that a resident retreat with mindfulness training tailored for Emergency Medicine (EM) physicians can significantly reduce levels of burnout and perceived stress in EM residents.

Methods: We conducted an intervention study of 60 EM residents undergoing an annual resident retreat with a 2.5-hour mindfulness training. The retreat was a department-funded 2-day off-site experience with a wellness theme. The training was developed and delivered by an EM physician (JO'S) who is a Mindfulness-Based Stress Reduction (MBSR) teacher trainee, and a certified MBSR teacher (MD). The training focused on techniques that can be used on shift, such as mindful …

Knowledge And Awareness Of Vitamin D Among Pregnant Or Lactating Iraqi Refugee Women: A Call For Different Approaches In Health Education And Outreach, Someireh Amirfaiz, Ed.D.

Journal of Refugee & Global Health

Vitamin D deficiency during pregnancy and lactation has negative impacts on maternal, fetal, and infant health. Low health literacy and other social determinants of health may increase the risk of deficiency among refugee women. This qualitative study used a survey and in-depth individual interviews to examine knowledge of vitamin D among ten pregnant or breastfeeding Iraqi refugee women in the United States, and sought participants’ recommendations on culture-centered and participatory health promotion strategies. All participants reported having insufficient information and understanding of vitamin D, its health benefits, and the risks of deficiency. The four primary themes that emerged from the …