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Articles 2821 - 2850 of 8974
Full-Text Articles in Health and Medical Administration
Temporary Epicardial Pacing Wires In Isolated Coronary Artery Bypass Graft: Necessity Or Force Of Habit?, Mian Mustafa Kamal, Abdul Ahad Sohail, Majid Osman, Shiraz Hashmi, Muhammad Mehdi, Asma Altaf Hussain Merchant, Hasanat Sharif
Temporary Epicardial Pacing Wires In Isolated Coronary Artery Bypass Graft: Necessity Or Force Of Habit?, Mian Mustafa Kamal, Abdul Ahad Sohail, Majid Osman, Shiraz Hashmi, Muhammad Mehdi, Asma Altaf Hussain Merchant, Hasanat Sharif
Section of Cardiothoracic Surgery
Objective: To determine the frequency of Temporary epicardial pacing wires usage and its predictors in the immediate postoperative period in isolated coronary artery bypass graft surgery.
Methods: The longitudinal study was conducted at the Aga Khan University Hospital, Karachi, from September 2019 to August 2020, and comprised adult patients of either gender who underwent isolated coronary artery bypass graft in the Department of Cardiothoracic Surgery. Demographic, peri-operative and post-operative Temporary Epicardial Pacing Wires use data was extracted from patient's files and the institutional electronic database. Logistic regression models were built to explore predictors of Temporary epicardial pacing wires usage. Data …
Age-Associated Gut Dysbiosis, Marked By Loss Of Butyrogenic Potential, Correlates With Altered Plasma Tryptophan Metabolites In Older People Living With Hiv., Smita Ghare, Richa Singhal, Vaughn Bryant, Sabina Gautam, Chanakya Charan Tirumala, Praneet Kumar Srisailam, Andrea Reyes-Vega, Dushan Ghooray, Craig J. Mcclain, Kristi Hoffman, Joseph Petrosino, Kendall Bryant, Varand Govind, Ronald Cohen, Robert L. Cook, Shirish Barve
Age-Associated Gut Dysbiosis, Marked By Loss Of Butyrogenic Potential, Correlates With Altered Plasma Tryptophan Metabolites In Older People Living With Hiv., Smita Ghare, Richa Singhal, Vaughn Bryant, Sabina Gautam, Chanakya Charan Tirumala, Praneet Kumar Srisailam, Andrea Reyes-Vega, Dushan Ghooray, Craig J. Mcclain, Kristi Hoffman, Joseph Petrosino, Kendall Bryant, Varand Govind, Ronald Cohen, Robert L. Cook, Shirish Barve
Faculty and Staff Scholarship
Background:
Imbalance in tryptophan (TRP) metabolism and its neuroactive metabolites, serotonin and kynurenine (KYN), is a known pathogenic mechanism underlying neurocognitive impairment. Gut microbiota plays an important role in TRP metabolism, and the production of these neuroactive molecules affects neurocognitive function. Although both HIV infection and normal aging independently induce gut dysbiosis and influence TRP metabolism, their interactive effects on compositional/functional changes in gut microbiota and consequent alterations in TRP metabolites remain largely undetermined.
Methods:
Older people living with HIV infection (PLWH, aged 50–70 years, n = 22) were enrolled in this cross-sectional pilot study. Metagenomic analysis of fecal microbiome …
Advocacy Spotlight: Ada Lobbyist Conference Highlights Critical Advocacy Issues, Neema Katibai Jd
Advocacy Spotlight: Ada Lobbyist Conference Highlights Critical Advocacy Issues, Neema Katibai Jd
The Journal of the Michigan Dental Association
The ADA Lobbyist Conference highlighted crucial issues in dentistry, including Medicare reform, teledentistry, workforce concerns, and insurance challenges. State dental associations collaborated on building advocacy partnerships and shared successful grassroots engagement strategies. Medicare reform discussions focused on the ADA's opposition to Plan B inclusion and the impact of constituent outreach. State associations addressed Medicaid reform, emphasizing personal stories to convey the need for change. Teledentistry legislation and insurance company relationships were also key topics. The insights gained will shape the MDA's advocacy strategy for 2022.
Dentistry And The Law: Can I Be Reported To The Data Bank In Connection With A Billing Dispute?, Dan Schulte Jd
Dentistry And The Law: Can I Be Reported To The Data Bank In Connection With A Billing Dispute?, Dan Schulte Jd
The Journal of the Michigan Dental Association
This Dentistry and the Law column addresses a dentist's concern about being reported to the National Practitioner Data Bank (NPDB) during a billing dispute. The dentist questions the validity of such a report, considering no issues with treatment quality are raised. The response emphasizes that adverse actions based solely on billing practices may not be reportable to the NPDB. Additionally, it clarifies that a dental plan administrator may not be eligible to make a Data Bank report, offering guidance on informing the plan about rights and potential contestation.
Please Don’T Shoot The Messenger, Christopher J. Smiley Dds
Please Don’T Shoot The Messenger, Christopher J. Smiley Dds
The Journal of the Michigan Dental Association
This editorial emphasizes the importance of discerning reliable information amid the influx of COVID-19-related studies and guidelines. Drawing parallels with the ancient Greek sentiment from Sophocles' play Antigone, JMDA Editor Dr. Chris Smiley advocates for an open-minded approach to trustworthy sources, citing the World Health Organization's seven steps for evaluation. The Michigan Dental Association is highlighted as a reliable resource for synthesizing evolving information for clinicians. Despite pandemic-induced frustrations, the editorial urges practitioners to navigate changes resiliently, recognizing the dynamic nature of public health guidance.
Infection Prevention In Dentistry: Reaching Our “New Normal”, Karen K. Daw Mba, Cecm, Marie T. Fluent Dds
Infection Prevention In Dentistry: Reaching Our “New Normal”, Karen K. Daw Mba, Cecm, Marie T. Fluent Dds
The Journal of the Michigan Dental Association
This article addresses the evolving landscape of infection prevention in dentistry amid the COVID-19 pandemic, emphasizing the dynamic nature of guidance and standards. It explores historical perspectives, including the transition from "wet finger dentistry" to universal precautions and standard precautions. The focus then shifts to the regulatory considerations and the relevance of transmission-based precautions in the context of COVID-19. The Hierarchy of Controls is discussed, encompassing elimination, substitution, engineering controls, administrative control, and personal protective equipment. Respiratory hygiene, personal protective equipment, and infection prevention practices are compared between the pre-COVID era and the current landscape, emphasizing the importance of adapting …
Perioperative Registries In Resource-Limited Settings: The Way Forward For Pakistan, Usama Waqar, Shaheer Ahmed, Ayesha Nasir Hameed, Namrah Aziz, Hina Inam
Perioperative Registries In Resource-Limited Settings: The Way Forward For Pakistan, Usama Waqar, Shaheer Ahmed, Ayesha Nasir Hameed, Namrah Aziz, Hina Inam
Medical College Documents
Capable of improving surgical quality, perioperative registries can allow performance benchmarking, reliable reporting and the development of risk-prediction models. Well established in high-income countries, perioperative registries remain limited in lower- and middle-income countries due to several challenges. First, ensuring comprehensive data entry forums to power the registries is difficult because of limited electronic medical records requiring sustained efforts to develop and integrate these into practice. Second, lack of adequate expertise and resources to develop and maintain registry software necessitates the involvement of software developers and information technology personnel. Third, case ascertainment and item completion are challenging secondary to poor-quality medical …
Barriers In Surgical Research: A Perspective From The Developing World, Nadeem Ahmed Siddiqui, Muhammad Aanish Raees, Rehan Nasir Khan, Farhan Zafar
Barriers In Surgical Research: A Perspective From The Developing World, Nadeem Ahmed Siddiqui, Muhammad Aanish Raees, Rehan Nasir Khan, Farhan Zafar
Department of Surgery Docs
Research in surgery has led to significant advances over the last century in terms of how medicine is practised in and outside the operating rooms today. Surgical research in the developed countries is responsible for most of this advancement, but it is often inapplicable in resource-limited settings in the developing world. Lower- and middle-income countries are in a unique position to take this work further, but they are limited by certain barriers. These barriers could broadly be classified under social and cultural, infrastructure, financial, ethical, and personal categories. These barriers are often not fully realised, but can potentially be addressed …
Evaluating Patient Experience At A Novel Health Service For Aboriginal And Torres Strait Islander Prisoners: A Pilot Study, Lachlan Arthur, Ana Herceg, Heidi Shukralla, Jason Payne, Julie Tongs Oam
Evaluating Patient Experience At A Novel Health Service For Aboriginal And Torres Strait Islander Prisoners: A Pilot Study, Lachlan Arthur, Ana Herceg, Heidi Shukralla, Jason Payne, Julie Tongs Oam
Journal of the Australian Indigenous HealthInfoNet
Background
The Winnunga Alexander Maconochie Centre Health and Wellbeing Service (AMCHWS) is the first prison health service operated by an Aboriginal Community Controlled Health Organisation in Australia. This pilot study developed and implemented a patient experience survey to evaluate the novel model of healthcare delivered by the Winnunga AMCHWS to Aboriginal and Torres Strait Islander prisoners.
Methods
Patients accessing the Winnunga AMCHWS between February and May 2020 were invited to participate in the study. Descriptive data were analysed and compiled for demographics, patient satisfaction, patient perception of care quality, cultural safety, and patient thoughts on the Winnunga AMCHWS.
Findings
Sixteen …
Protocols For An Aboriginal-Led, Multi-Methods Study Of The Role Of Aboriginal And Torres Strait Islander Health Workers, Practitioners And Liaison Officers In Quality Acute Health Care, Annabelle Wilson, Tamara Mackean, Liz Withall, Eileen M. Willis, Odette Pearson, Colleen Hayes, Kim O'Donnell, Janet Kelly, Kerry Taylor, Judith Dwyer, Elizabeth Bourke, Kate Hunter, Lorna Murakami-Gold, Rebecca Ivers, Fran Baum
Protocols For An Aboriginal-Led, Multi-Methods Study Of The Role Of Aboriginal And Torres Strait Islander Health Workers, Practitioners And Liaison Officers In Quality Acute Health Care, Annabelle Wilson, Tamara Mackean, Liz Withall, Eileen M. Willis, Odette Pearson, Colleen Hayes, Kim O'Donnell, Janet Kelly, Kerry Taylor, Judith Dwyer, Elizabeth Bourke, Kate Hunter, Lorna Murakami-Gold, Rebecca Ivers, Fran Baum
Journal of the Australian Indigenous HealthInfoNet
Objectives
Aboriginal and Torres Strait Islander Health Workers/Practitioners and Liaison Officers play an important, often critical role providing advocacy and cultural and emotional support for Aboriginal and Torres Strait Islander patients. The main goals of this research are to explore i) how Aboriginal and Torres Strait Islander Health Workers/Practitioners and Liaison Officers are integrated in the routine delivery of care for Aboriginal and Torres Strait Islander peoples in hospital, and ii) how the role of Aboriginal and Torres Strait Islander Health Workers/Practitioners and Liaison Officers facilitates quality health outcomes.
Methods
This study is being conducted in three different hospitals using …
Colonoscopy Standardization: Insurance Verification And Direct Access, Connor Crutchfield, Jacqueline Chen, Kiernan Mcnelis, Luke Kelly
Colonoscopy Standardization: Insurance Verification And Direct Access, Connor Crutchfield, Jacqueline Chen, Kiernan Mcnelis, Luke Kelly
Physician Executive Leadership-Plus (PEL-Plus)
Outline
- Background
- Problem Scope
- Approach
- Progress
- Recommendations
Medication Reconciliation: Defining The Standard Of Care, Jenna Mandel, Matthew Matthew Piechnik, Rahul Muchintala
Medication Reconciliation: Defining The Standard Of Care, Jenna Mandel, Matthew Matthew Piechnik, Rahul Muchintala
Physician Executive Leadership-Plus (PEL-Plus)
No abstract provided.
02-08-22 Hsc Committee Meeting Notice, Hsc Committee
02-08-22 Hsc Committee Meeting Notice, Hsc Committee
HSC Committee (A subcommittee of the UNM Board of Regents)
No abstract provided.
A Fond Farewell, Dennis J. Baumgardner
A Fond Farewell, Dennis J. Baumgardner
Journal of Patient-Centered Research and Reviews
In this From the Editor introduction to Volume 9, Issue 1, the retiring editor-in-chief of Journal of Patient-Centered Research and Reviews recalls the history and initial aims of JPCRR, discusses the contents of articles in the current issue, and says good-bye.
Bridging The Patient Engagement Gap In Research And Quality Improvement Utilizing The Henry Ford Flexible Engagement Model, Heather A. Olden, Sara Santarossa, Dana Murphy, Christine C. Johnson, Karen E. Kippen
Bridging The Patient Engagement Gap In Research And Quality Improvement Utilizing The Henry Ford Flexible Engagement Model, Heather A. Olden, Sara Santarossa, Dana Murphy, Christine C. Johnson, Karen E. Kippen
Journal of Patient-Centered Research and Reviews
Purpose: This paper was intended to share a flexible engagement model (FEM) for organizing a structure to obtain patient input regarding health care operations and research, provide greater detail on recruitment, retention, and dissemination strategies, and demonstrate successes and potential applications in other health care settings.
Methods: Utilizing a pragmatic approach, the Patient-Engaged Research Center (PERC) at Henry Ford Health System developed the FEM, a 7-step process to introduce interested patients/caregivers to the patient advisor program and to follow up with placements. PERC developed a meeting evaluation to measure participant satisfaction. Retention and dissemination methods to keep participants …
Inpatient Discharge-By-Noon: Are Fewer Better Than All?, Nicholas Ballester, Pratik J. Parikh, Kara Combs, Jordan S. Peck
Inpatient Discharge-By-Noon: Are Fewer Better Than All?, Nicholas Ballester, Pratik J. Parikh, Kara Combs, Jordan S. Peck
Journal of Maine Medical Center
Introduction: To address boarding in hospital emergency departments, discharge-by-noon could free up inpatient beds earlier in the day. However, discharging all patients by noon can heavily burden inpatient units and may not be feasible. In this study, we determine the number of discharges after which the benefits of an additional discharge-by-noon diminish.
Methods: We conducted a simulation analysis to quantify how occupancy rate, mean daily number of discharges, and peak discharge time impact upstream boarding time in an inpatient neurology unit at Maine Medical Center. Using a day-of-discharge simulation model with one year of retrospective data, we assessed configurations approximating …
Clinical Interactions In Electronic Medical Records Towards The Development Of A Token-Economy Model, Nicole Allison S. Co, Jason Limcaco, Hans Calvin L. Tan, Ma. Regina Justina E. Estuar, Christian E. Pulmano, Dennis Andrew Villamor, Quirino Sugon Jr, Maria Cristina G. Bautista, Paulyn Jean Acacio-Claro
Clinical Interactions In Electronic Medical Records Towards The Development Of A Token-Economy Model, Nicole Allison S. Co, Jason Limcaco, Hans Calvin L. Tan, Ma. Regina Justina E. Estuar, Christian E. Pulmano, Dennis Andrew Villamor, Quirino Sugon Jr, Maria Cristina G. Bautista, Paulyn Jean Acacio-Claro
Graduate School of Business Publications
The use of electronic medical records (EMRs) plays a crucial role in the successful implementation of the Universal Healthcare Law which promises quality and affordable healthcare to all Filipinos. Consequently, the current adoption of EMRs should be studied from the perspective of the healthcare provider. As most studies look into use of EMRs by doctors or patients, there are very few that extend studies to look at possible interaction of doctor and patient in the same EMR environment. Understanding this interaction paves the way for possible incentives that will increase the use and adoption of the EMR. This study uses …
Adaptive Staffing Models And Their Translation To Future Disaster Response: What Can Be Learned From Covid Unit Staffing?, Lakeisha Day Pa-C
Adaptive Staffing Models And Their Translation To Future Disaster Response: What Can Be Learned From Covid Unit Staffing?, Lakeisha Day Pa-C
Internet Journal of Allied Health Sciences and Practice
Background: As much as hospital organizations like to be prepared for worst-case scenarios, situations inevitably arise that are unanticipated for which no amount of preparation would ever suffice. One such scenario was the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19). Hospitals had to use their existing staff in order to meet the onslaught of patients presenting with COVID-19. Purpose: The aim of this paper is to review the various COVID unit hospital staffing models that were implemented during the influx of patients with COVID-19 and then to examine …
Chargemasters In The Age Of Hospital Price Transparency, Anthony Drumm
Chargemasters In The Age Of Hospital Price Transparency, Anthony Drumm
Theses, Dissertations and Capstones
Introduction: The cost of health care services in the United States (U.S.) varies from state to state and facility to facility. The compilation of such costs and their associated codes is referred to as a chargemaster, or charge description master (CDM), and each is unique to an individual facility. . The implementation of the 2019 Centers for Medicare and Medicaid (CMS) Hospital Price Transparency Rule was an initial step toward consumer empowerment by making services more shoppable but published CDM data failed to present the information most pertinent to patients: total out-of-pocket costs and the availability of lower-cost alternatives. Initiatives …
The Effect Of Magnet Hospitals On Nursing Burnout, Jonathan Settle, Michael Davis
The Effect Of Magnet Hospitals On Nursing Burnout, Jonathan Settle, Michael Davis
Theses, Dissertations and Capstones
Introduction: Burnout has been a problem in health care for many years and it has particularly affected nurses. Nurse burnout was associated with worsened outcomes for nurses such as increased turnover or quitting and lower job satisfaction. There was a question as to how work environment and governance style influenced burnout.
Purpose of the study: The purpose of this research was to examine Magnet-designation status in U.S. hospitals, specifically shared governance and structural empowerment, and its effects on the rates of nurse burnout, nurse turnover, and job satisfaction of nurses.
Methodology: This study utilized a literature review. Four databases as …
Costs And Length Of Stay Associated With Treating Neonatal Abstinence Syndrome, Kimberly Stanfield, Kylie Day
Costs And Length Of Stay Associated With Treating Neonatal Abstinence Syndrome, Kimberly Stanfield, Kylie Day
Theses, Dissertations and Capstones
Introduction: Neonatal Abstinence Syndrome has been costly for the healthcare system, for every 19 minutes a baby was diagnosed in 2021. Costs and Length of Stay both had been increased for newborns diagnosed. Medically Assisted Treatment for expecting mothers has shown to decrease costs and length of stay for newborns with neonatal abstinence syndrome.
Methodology: This study utilized a literature review and a semi-structured interview. Three databases were used to collect 126 total sources. These sources were reviewed and reduced to 30 total sources that were used in the written research. Of these, 14 sources were used in the results …
Impact Of Cognitive Behavioral Therapy On Military Suicide Rates, Madison Lett, Jamia Bird
Impact Of Cognitive Behavioral Therapy On Military Suicide Rates, Madison Lett, Jamia Bird
Theses, Dissertations and Capstones
Introduction: Suicide has been labeled a serious public health dilemma in the United States. Military personnel have suicide rates greater than non-military individuals. Cognitive Behavioral Therapy has been used as a means to help military personnel to overcome suicidal thoughts and feelings.
Purpose of the Study: The purpose of this study was to analyze the effect of Cognitive Behavioral Therapy on military patients’ mental health and how it affects the rate of suicidal ideation, suicide attempts, and deaths by suicide in military patients.
Methodology: This study utilized a literature review and a semi-structured interview with a Veteran Affairs social worker. …
Childhood Obesity And Adverse Childhood Experiences: The Role Of Medicaid Expansion, Sonya Dunlap
Childhood Obesity And Adverse Childhood Experiences: The Role Of Medicaid Expansion, Sonya Dunlap
Theses, Dissertations and Capstones
Introduction: Obesity was defined as a Body Mass Index (BMI) over the 95th percentile as determined by the Centers for Disease Control and Prevention (CDC). Childhood obesity has been a worldwide concern, but has disproportionately affected the socioeconomically disadvantaged, racial/ethical minorities, and rural children. The presence of Adverse Childhood Experiences (ACEs) contributed to social and health problems. ACEs included the areas of domestic violence, mental illness, neighborhood violence, parent or guardian death, divorce or separation, parent or guardian incarceration, and substance misuse.
Purpose of Study: The purpose of this research was to compare the ACEs scores with childhood …
Covid-19 Financial Consequences In United States Hospitals, Hannah T. Osburn, Murat Mert Solakoglu, Gretel Toloza Alvarez
Covid-19 Financial Consequences In United States Hospitals, Hannah T. Osburn, Murat Mert Solakoglu, Gretel Toloza Alvarez
Theses, Dissertations and Capstones
Introduction: Since the wake of the coronavirus pandemic, United States (U.S.) hospitals have struggled to stay financially afloat amid the constant battle with unprecedented circumstances and financial consequences from the pandemic. The purpose of this research was to analyze the financial consequences of COVID-19 for U.S. hospitals to determine the impact on the number of inpatient cases, length of stay (LOS), surgeries performed, and operating expenses. The hypothesis was that U.S. hospitals were financially affected by the consequences of COVID-19, having more inpatient cases, increased LOS, fewer surgeries performed, and higher operating expenses.
Methodology: The methodology for this …
Sars-Cov-2 And Its Impact On Emergency Medicine, Abby Fowler
Sars-Cov-2 And Its Impact On Emergency Medicine, Abby Fowler
Theses, Dissertations and Capstones
The SARS-CoV-2 (COVID-19) pandemic impacted hospitals and healthcare workers throughout the world. This research sought to determine how the pandemic affected the mental health of healthcare workers in critical care, primarily because of hospitals’ focus on finances instead of healthcare workers’ mental well-being. This research included extensive literature review as well as a semi-structured interview with an emergency medicine physician in Ashland, KY, who worked before the COVID-19 pandemic and during the COVID-19 pandemic. It was hypothesized that as hospitals attempted to focus primarily on recovering financial losses incurred from the pandemic, the mental health of clinicians fell through the …
Complete Health Improvement Program To Implement Lifestyle Medicine, Robert Hobbs Jr
Complete Health Improvement Program To Implement Lifestyle Medicine, Robert Hobbs Jr
Doctor of Nursing Practice Projects
The health of many Americans continues to worsen. Over the past 20 years there has been a fifty percent increase in the incidence of Type 2 Diabetes Mellitus in the US. America has an increase in obesity rates, and lower mortality rates compared to other countries that spend less per capita. Currently the US healthcare system only contributes about 20% of the overall care of patients. Provider burned out is increasing and many remain uneducated regarding lifestyle medicine. Since up to 90% of chronic diseases are lifestyle related, a different approach to chronic disease care is needed. The Complete Health …
Eng 300: The Efficacy Of Bacteriophage & Lysin Antimicrobials In Industrial & Commercial Settings, Bella Norman
Eng 300: The Efficacy Of Bacteriophage & Lysin Antimicrobials In Industrial & Commercial Settings, Bella Norman
English 100-200-300 Conference
No abstract provided.
Go Home With Naloxone: A Resident-Led Quality Initiative To Increase Naloxone Prescribing For Hospitalized Patients At Risk For Opioid Overdose, Megan Block, Md, Theresa Morikawa, Md, Benjamin Pedroja, Md
Go Home With Naloxone: A Resident-Led Quality Initiative To Increase Naloxone Prescribing For Hospitalized Patients At Risk For Opioid Overdose, Megan Block, Md, Theresa Morikawa, Md, Benjamin Pedroja, Md
Poster Presentations
No abstract provided.
Response And Rebuttal To "Comment On: Risk Factors For Workplace Encounters With Weapons By Hospital Employees" In Public Health In Practice; 3 (2022) 100256 By Chidinma Okani And Carmen Black, James D. Blando, Chalsie Paul, Mariana Szklo-Coxe
Response And Rebuttal To "Comment On: Risk Factors For Workplace Encounters With Weapons By Hospital Employees" In Public Health In Practice; 3 (2022) 100256 By Chidinma Okani And Carmen Black, James D. Blando, Chalsie Paul, Mariana Szklo-Coxe
Community & Environmental Health Faculty Publications
No abstract provided.
The Impact Of Summer Program Intervention Strategies On Girls' Knowledge And Health Behaviors, Olivia Cerny, Dzifa Agbossey-Dimado, Awayinooluwa Seriki, Adejoke Ayoola
The Impact Of Summer Program Intervention Strategies On Girls' Knowledge And Health Behaviors, Olivia Cerny, Dzifa Agbossey-Dimado, Awayinooluwa Seriki, Adejoke Ayoola
Summer Research
The well-being of youth in the United States is being threatened by physical inactivity, poor nutrition, and a range of health risk behaviors (Pierce et al., 2017). According to the U.S. Center for Disease Control and Prevention, there are worsening trends in youth health behaviors (Pierce et al., 2017). Sepúlveda and Hutton (2019) suggest with evidence that summer programs effectively reduce drug use, decrease violent crime arrests, increase safe sex practices and dispositions, maintain physical fitness, prevent excessive weight gain, and reduce anxiety