January Self-Care Saturdays: inspiration for your home self-care practices

key words:  self-care, practitioner resilience, wellness, mindfulness practices, movement (walking, tai chi, qi gong), spending time outdoors, nutrition for health

The January Self-Care Roundup

Some inspiration from the Self-Care Saturdays theme over at our public Facebook Page

Breathwork, the basics of breathing for self-care

• As an east Asian medicine practitioner (acupuncturist) I have been teaching my patients diaphragmatic breathing on day one and reinforced practice throughout treatment course with related self-care homework. This breathing practice often also called "belly breathing" has been known for a long time to help us consciously switch our breathing state into the parasympathetic state (rest and digest). Because, in our modern world, most people go about their day in sympathetic state of breathing (fight or flight). Breathwork, the conscious control of your breath, is the foundation of qi gong and mindfulness practices.  More recently, research has been conducted to test these age-old practices, such as this article available on PubMed.      --Megan
• research article:   Russo, MA, Santarelli, DM, O’Rourke, D:  “The physiological effects of slow breathing in the healthy human”. Breathe, 2017 13(4): 298-309.  doi: 10.1183/20734735.009817
• Now, practice (self-care):
• Take a few moments to breathe. Check in on your breathing. One hand over heart, one over your belly. Practice belly breathing. Breathe in for a count of 5 and out for a count of 7. Repeat several times.
• If you want, you can watch this 1 minute video of a sunrise over a bay of the Salish sea while you practice.   
• Have a wonderful day! Remember you can come back to this breath-centering any time.

Food as Fuel, everything in moderation

• Everything in moderation.  Coffee is more than just caffeine.  There is wisdom to consuming foods in the traditional way.
• For example, a cup of warm black coffee (traditional) vs. iced, extra sugar, etc (modern).
• Water is the best liquid to drink. If you drink caffeinated beverages, you need to be drinking more water than coffee. Drink less coffee than water. Stay hydrated. See your licensed and board-certified acupuncturist for more specific advice. www.nccaom.org
• Note on coffee research from NIH:
• “Two substances from coffee, acting together, may protect against nerve cell damage and improve behavior in animal models of Parkinson’s disease and a related disease called dementia with Lewy bodies (DLB). This is according to a new study funded by NCCIH and conducted at the Rutgers Robert Wood Johnson Medical School.
• "The two coffee components, eicosanoyl-5-hydroxytryptamide (EHT) and caffeine, were evaluated separately and together in mouse models of the two diseases. Both diseases are associated with abnormal deposits of a protein called alpha-synuclein in the brain. The two substances administered together for 6 months, decreased the buildup of alpha-synuclein and led to better nerve cell function, less nerve inflammation, and closer-to-normal behavior.
• "These findings may help to explain the link between coffee consumption and reduced risk of Parkinson’s disease; however, other components of coffee—a complex mixture of more than a thousand different substances—may also be involved."
• You can read more about nutrition for health at our Nutrition Learning with Your Family post.

Mindset/inspiration and reflective reading

• Setting your new year resolutions--know your "why"

"Why? It’s a small word, but a mighty question, especially when it comes to setting a New Year’s resolution.... When you get right down to it, your why is about authenticity. And authenticity falls in lockstep with trusting yourself. What do you need this year and why?" Go to the Chopra.com article.

• Poetry

"Snow was falling,
so much like stars
filling the dark trees
that one could easily imagine
its reason for being was nothing more
than prettiness."
-Mary Oliver

• more on our Reflective Reads post.

Movement:  Tai Chi

• The health benefits of regular movement practice, particularly practicing Tai Chi, includes improved balance and strength.  More at the NY Times article, "Using Tai Chi to Build Strength".

Outdoors/Time in Nature

• You can read more about the health benefits of spending time outdoors in the book, Nature Fix. You can follow the link to the Amazon store for this book in paperback or audiobook at our gift ideas page under "outdoor fun and health benefits of nature".  I have been listening to the Nature Fix as a audiobook throughout January.  It is packed with scientific study references!

Mindfulness

• For resources on mindfulness, go to our "Are You in the Present Moment?" post.
• For more on practicing mindfulness with kids, the "Health and Wellness Learning with Family" post.

Related blog posts

• December Self-care Saturdays: inspiration for your home self-care practice
• November Self-care Saturdays Roundup

If you enjoyed this post, check out our public Facebook Page and subscribe to our email list. 

www.thehospitalhandbook.com

January Leadership and Workplace Mondays roundup

keywords:  leadership, workplace, workplace culture, being an employee, mentorship and mentor relationships, mindfulness and leadership

Inspiration for Employees and their Leaders 

Review of the "Leadership and Workplace Mondays" theme from the public HHP Facebook Page, January 2019

• A reading and listening list for reflecting on leadership for the new year 
• The Leadership Secret: Recognize You are Standing on Diamonds, an article from Entrepreneur
• Advice from the January wisdom-share interview session with Sondra Abanto, MBA:
• Connect (or re-connect) to your mentors
• Learn about your organization's mentoring program 
• Many medium to large organizations have organization-sanctioned mentoring programs.  Learn about yours.  
• Examples of such programs:  
• U.S. Health and Human Services 
• the National Institute of Health
• Kaiser Permanente
• Department of Defense.
• Mayo Clinic 

If you enjoyed this, check out our public Facebook Page and subscribe to our email list. 

Related blogposts on Leadership

• Lunchtime Listens
• December Leadership and Workplace Mondays roundup
• November Leadership and Workplace Mondays Roundup
• A leader that practices mindfulness and self-awareness is a positive force in his/her organization
• Making Space for Innovation
• National Academy of Medicine's Clinician Well-being Series
• The Mind of a Leader
• Reflecting on Leadership

If this was useful, please support this community work.  

You can buy me a coffee, sponsor a newsletter, or sponsor a project via the website.

www.thehospitalhandbook.com

CMS public comment call out for coverage of acupuncture for low back pain

Medicare, Medicaid, insurance coverage, major hospital insurance entities, federal health care coverage policy, health care policy

CMS and acupuncture coverage for LBP

The U.S. Center for Medicare and Medicaid Services (CMS), whose coverage policies are intertwined in hospital and medical center systems, has announced a call for public comment on the topic:  “acupuncture coverage for low back pain”.

To my knowledge, this is the first time in history the CMS has ever announced a public comment call for anything related to coverage of acupuncture services.  Tell your hospital sponsors and advocates.  If CMS reimbursed for acupuncture and other integrative health therapies, that would be a major milestone.

CMS is under the U.S. Department of Health and Human Services (HHS).  HHS is an enormous department that also contains the National Institutes of Health (NIH) and the Agency for Healthcare Research and Quality (AHRQ)

In the announcement, they state, 

“In response to the U.S. opioid crisis, HHS is focused on preventing opioid use disorder and providing more evidence-based non-pharmacologic treatment options for chronic pain. The [AHRQ, CMS, and NIH] are collaborating in this effort.”  In June 2018, AHRQ “published a systematic review of noninvasive, nonpharmacological treatment for chronic pain.”  “This review included assessment of several nonpharmacological interventions, including exercise, acupuncture, spinal manipulation, and multidisciplinary rehabilitation for [chronic low back pain] CLBP. “

Link to the June 2018 AHRQ paper:  https://effectivehealthcare.ahrq.gov/sites/default/files/cer-209-evidence-summary-non-pharma-chronic-pain.pdf

Then, the CMS announcement says:

“The NIH recently issued a Funding Opportunity Announcement for interested parties to apply to conduct an efficient, large-scale pragmatic trial to evaluate the impact of, and strategies to best implement, acupuncture treatment of older adults (65 years and older) with chronic low back pain.”

The NIH grant announcement is here:  https://grants.nih.gov/grants/guide/rfa-files/RFA-AT-19-005.html.

“CMS is opening this national coverage analysis (NCA) to complete a thorough review of the evidence to determine if acupuncture for CLBP is reasonable and necessary under the Medicare program.  CMS is soliciting public comment on this topic.  We are particularly interested in comments that include scientific evidence and discuss appropriate clinicians and training requirements to provide acupuncture that improves health outcomes.  In addition, for commenters recommending Coverage with Evidence Development, we are interested in comments related to appropriate outcomes and study designs.  While CMS has conducted previous national coverage analyses on acupuncture, the scope of this current review is limited to acupuncture for chronic low back pain.”

Go to the announcement to submit your comments.  

Public comment period ends 2.14.2019

www.thehospitalhandbook.com

January 2019 Research Thursdays Summary

key words:  research literacy, funding and grants, sharing related research in the field, research in integrative health

The January Research Roundup

(and funding announcements!)

Review of the "Research and Metrics Thursdays" theme from the public Facebook Page and newsletter

NCCIH and NIH Research Funding Opportunity--the HEAL Initiative 

• NCCIH and NIH funding if you work in pain management or addiction, especially the field of opioid addiction.   If you have heard me talk about the National Pain Strategy document the past couple years, HEAL builds upon parts of the work laid out in that very large federal public document.
• General announcement from December 2018.   
• Learn more about the HEAL initiative at this webpage. 
• Workshop on treating pain with natural products (Jan. 2019)
• New funding for basic and mechanistic research on pain and complementary healthcare (Jan 2019)

Patient-Centered Outcomes Research Institute (PCORI) Funding Announcement

• PCORI funding announcements

National Academy of Medicine (NAM) 2018 “Non-Pharm Pain” Conference.  

• December 2018 recording.  recommended lunchtime listen
• The recordings from this conference are now available to view.  I added the NAM playlist for this conference to the HH Project channel’s library.  Thank you to ACIH for announcing this information.  
• The NAM conference was 2 days, so the recordings playlist is long.  So far, I recommend the first video with Dr. Cherkin. 
• Here is the link to the playlist.
• Here is the link to this NAM conference agenda, to help you choose recordings most interesting to you.

Upcoming NCCIH Conference:  Workshop on Acupuncture Research

• Translating Fundamental Science of Acupuncture into Clinical Practice:  For Cancer Symptom Management, Pain, & Substance Abuse
• Free and open to the public
• February 11^th and 12^th, 2019
• Bethesda, MD
• More information available on the NCCIH “acupunctureworkshop” page

Massage Therapy

• Massage Therapy Foundation Poster Abstract Submission deadline 1.31.2019
• For those of you working with or leading massage therapists and collecting metrics, the 2019 call for poster abstracts for the International Massage Therapy Research Conference (IMTRC) is out:
• Call for Posters for IMTRC 2019 ends 1.31.2019
• Go here for the poster application
• The IMTRC is held once every 3 years.  It is “an opportunity to learn the latest research, connect with colleagues, and gain insight into best practices in massage therapy.” And it “brings together thought leaders in the profession and educators to discuss massage therapy innovations”
• The next IMTRC conference is May 9-10, 2019 in Alexandria, Virginia.
• Massage Therapy Foundation Research Grants for 2019—applications are now open. Submission deadline is March 1^st, 2019.
• “Massage Therapy Foundation Research Grants are awarded to those conducting studies that seek to advance our understanding of specific therapeutic applications of massage, public perceptions of and attitudes toward massage therapy, and the role of massage therapy in health care delivery.”
• Read more and apply at:  http://massagetherapyfoundation.org/grants-and-contests/research-grants/
• Massage Therapy Foundation Community Service Grants for 2019—applications are now open. 
• Submission deadline is April 1^st, 2019
• If you work with a 501c3 organization providing massage, you may qualify.  They say they take applications from the U.S., internationally, and have a specific grant opportunity for those providing massage therapy in northern Illinois.  Learn more about this community service grant here:  http://massagetherapyfoundation.org/grants-and-contests/community-service-grants/
• Massage therapy case report submissions
• The Massage Therapy Foundation also accepts case reports from practitioners for their journal publication, International Journal of Therapeutic Massage & Bodywork (IJTMB) and runs a student case report contest.  Learn more here:  http://massagetherapyfoundation.org/grants-and-contests/case-report-contest/

FDA Roadmap Series with the National Health Council

• The January 17th, 2019, webinar was on "Untangling the Terms: Endpoints, Items, Outcomes, PROs, PROMS, PRO-PMs" with Ashley Slagle, MS, PhD.  For more about this series and to watch the latest webinar, go to the FDA Roadmap Lunchtime Listen recommendation post.

Breathwork, a foundation in Traditional Chinese Medicine practice, and a research article

• Research Thursday...Breathwork
• As an east Asian medicine practitioner (acupuncturist) I have been teaching my patients diaphragmatic breathing on day one and reinforced practice throughout treatment course with related self-care homework. This breathing practice often also called "belly breathing" has been known for a long time to help us consciously switch our breathing state into the parasympathetic state (rest and digest). Because, in our modern world, most people go about their day in sympathetic state of breathing (fight or flight). Breathwork, the conscious control of your breath, is the foundation of qi gong and mindfulness practices.
• More recently, research has been conducted to test these age-old practices, such as this article available on PubMed.  --Megan
• research article:   Russo, MA, Santarelli, DM, O’Rourke, D:  “The physiological effects of slow breathingin the healthy human”. Breathe, 2017 13(4): 298-309.  doi: 10.1183/20734735.009817

adding more additions from earlier this month on the Facebook page soon (1.30.2019)...

Recommended Studies to Read this Month (started this in the summer and fall newsletters)


Recommended Studies to Read in Older Newsletters

• see the December 2018 Research Thursdays post  

For more on the topic of research

• follow the tag/label in this blog for "research literacy"

More Research Thursdays Summary posts
December 2018

If you enjoyed this post, subscribe to our email list for the latest updates and follow us for "research and metrics Thursdays" on the public Facebook Page.

You can support this community-wisdom-sharing work by
 buying me a coffee or sponsoring a newsletter via our website.  Thank you.

www.thehospitalhandbook.com

Resource: The Teaching Kitchen Collaborative (TKC) and Healthy Kitchens, Healthy Lives

www.tkcollaborative.org

key concepts:  improving public health through whole systems nutrition, patient-centered care, Traditional East Asian Medicine paradigm of wellness, incorporating integrative health paradigms into modern health care system practices, teaching cooking skills to improve health, teaching patients self-care, modifying determinants of health through changing individual behavior around eating & cooking..nutrition

key words: mind-body medicine, integrative health, community health and wellness,  learning nutrition for health, Teaching Kitchen Collaborative (TKC), Healthy Kitchens Healthy Lives® conference
TCM = Traditional Chinese Medicine
NCCAOM® = National Certification Commission on Acupuncture and Oriental Medicine
HKHL = Healthy Kitchens, Healthy Lives®

“If a patient has a chronic condition, first modify diet and lifestyle, then add medicine”.  –paraphrase, inspired by Sun Si Miao

In East Asian Medicine, we know that, for best long-term self-care and health maintenance, we prescribe patients foods to incorporate in their diet.  Why? To manage their conditions and support their constitution.  For example, individualized TCM nutrition consults was a self-care session I would do with my chronic pain patients when they were interested in learning more about food as basic support system for health.  As a board-certified TCM herbalist (NCCAOM®-board certification), it took me time to research and put their personalized plan together.  And, for a patient, modifying diet takes courage and commitment and follow up.

There is a new resource for helping patients learn and practice cooking healthy meals coming to a neighborhood medical facility or academic center near you, the "Teaching Kitchens".  Well, maybe not so new.  Several of these teaching kitchens have been around for a decade, but the hope is, that with the collaborative now helping stand-alone centers connect to more resources, that the movement will grow and expand.

What is this new resource for providers and patients?
The Teaching Kitchen Collaborative

Twenty years ago, Dr. David Eisenberg noticed that few health professionals understood the science of nutrition and most of them knew even less on how to cook healthy meals for themselves, let alone teach such skills to their patients.  So, he worked with a team (Harvard School of Public Health and the Culinary Institute of America) to create an annual conference for health care professionals to bring together physicians, dietitians, nurses, allied health professionals, hospital administrators and culinary specialists together, the Healthy Kitchens, Healthy Lives® conference, the first of which was in 2006 [Eisenburg, JACM, July 2018],

Dr. Eisenberg was an early advocate of the integrative health paradigm and, from the enthusiasm and success of the Healthy Kitchens Healthy Lives® conference, launched The Teaching Kitchen Collaborative (TKC). 

The resource-sharing collective that the TKC can be, has the potential to encourage academic health institutions to recognize that nutrition and lifestyle change are viable part of the treatment plan.

TKC is a "data-driven, taste-driven, whole system, experiential ... transformation campaign to put food, nutrition, and lifestyle front and center, in transitioning our medical industry toward ... a health care system."  [Eisenburg, JACM, July 2018]

TKC launched in 2016 by the Harvard T.H. Chan School of Public Health-Department of Nutrition and The Culinary Institute of America (CIA).  The TKC "is an invitational network of over 30 organizations using teaching kitchen facilities as catalysts of enhanced personal and public health.  The TKC's mission is to enable early adopters to learn about one another's facilities and educational programs, to develop best practices for reproducing and scaling emerging models, and to document the clinical, behavioral, and financial impact of teaching kitchens for a broad range of populations."

Individual Teaching Kitchens include:

• The Cleveland Clinic Center for Lifestyle Medicine
• Maine General Health
• Kaiser Permanente San Francisco Medical Center 
• Turner Farm with University of Cincinnati Center for Integrative Health and Wellness
• University of Michigan's MHealthy 
• University of Minnesota's Center for Spirituality and Healing 
• Vanderbilt University Medical Center's Osher Center for Integrative Medicine and Center for Biomedical Ethics 
• The Sampson Family Branch of YMCA Greater Pittsburgh
• Google

The Teaching Kitchen Collaborative is a movement to connect teaching kitchens to each other.  Because a teaching can, potentially, be a "catalyst of enhanced personal and public health across medical, corporate, school, and community settings.”

The TKC regularly hosts research days or other opportunities to share your program’s story, progress, and research.  If you are already doing this work, the TKC seems like a great way to share what you are doing and be connected to others doing similar work.  It seems like it would be a good place to support each other while changing the U.S. culture of health, wellness, and “food as grounding for health”.

Why join the TKC?
For all the reasons, watch the video below.  Here are some useful quotes from the video:

from long-term research studies:

“We've learned that healthy dietary choices have a huge impact on the number of years that we live and how we feel during those years that we're alive and the teaching kitchen collaborative is a way to translate what we've learned into the… meals that people can have available and enjoy.” minute 0:11 Walter C. Willett, MD, DrPH

On benefits of being a member: 

"tap into the expertise of all the other members on things like outcomes based research” minute 3:27   

“It's just been fabulous hearing from all the other members, the discussions, the collaborations, and opportunities that we have going forward to work as teams and across institutions all over the country” minute 03:32

“The benefit from being part of the collaborative is [it] helps… resource good information.  So, I see it as it’s not just a network of people collaborating together,  but… it will … be a rich database…to access…the research...  It is a network, too, so the ability to develop relationships with people around the country--for that matter around the world--is an opportunity that I think we couldn’t have gotten anywhere else.” Lori Knutson, RN minute 4.56

TKC kitchens are places/groups 

“who are using kitchens as catalysts of personal and societal health enhancement.  [Teaching kitchens are] the vehicle to teach people about food, nutrition, and new habits.” minute 00:31 

A teaching kitchen is “a platform to really acknowledge the crucial role of nutrition and dietary information in the entire whole look at a person's lifestyle choices and wellness” minute 01:40

“[Teaching] kitchens, when used appropriately for different populations in different settings, will change behaviors for the better…will change health outcomes for the better…will be sustained changes."  

"And ultimately we hope to prove that they will change [lower overall population healthcare] costs either by preventing chronic disease [or by] bringing people with chronic disease portfolios back to a healthier state.” David Eisenberg, MD  minute 4.19

“So I think the capacity for multi-site research trials around food and mindful living and exercise and movement is enormous to be able to scale up as opposed to a one kitchen .”  [TKC has] “the capacity to reach so many more kids and families.  The capacity to prevent cardiovascular disease…prevent diabetes and hypertension…prevent the major chronic conditions that we know are very heavily influenced by lifestyle… the capacity as a collective group is enormous.” Sian Cotton, PhD minute 5.16

“But the goal is to show that we can build reproducible teaching kitchens that will change our society for the better on the individual basis and across populations.  And that we will also save money while doing that.” David Eisenberg, MD minute 5.48

The conference for the TKC, the Healthy Kitchens, Healthy Lives conference, is next week, February 6-8^th, 2019

Is your program or hospital system connected to this resource? 

Sources

• the opening presentation for the research day and abstracts:
• David M. Eisenburg.  The Journal of Alternative and Complementary Medicine.  Jul 2018.  http://doi.org/10.1089/acm_2018.29052.dme.  volume: 24 Issue 7:  July 1, 2018.
• The Teaching Kitchen Collaborate
• video is https://youtu.be/rMAy5SBsCBE
• website: http://www.tkcollaborative.org/ 
• Overview of the TKC  
• The Healthy Kitchens, Healthy Lives conference, annual 
• “A leadership conference bridging nutrition science, healthcare, and the culinary arts”
• http://www.healthykitchens.org/
• PBS NewsHour 8 minute video 
• The 2018 TKC Research Day Abstracts
• The Journal of Alternative and Complementary Medicine.  Volume 24, no. 7. Teaching Kitchen Collaborative Research Day Abstracts.  The Estate Yountville, Napa Valley, CA, USA. February 7^th, 2018
• “A day of original research an innovative strategies involving teaching kitchens and their potential to positively impact behaviors, improve health outcomes, and reduce costs.”
• Published online 1 Jul 2018
• Citation:  The Journal of Alternative and Complementary Medicine.  Jul 2018. Ahead of print. Published in volume: 24 issue 7:  July 1, 2018. https://doi.org/10.1089/acm.2018.29049.abstracts

Related blogposts  

• Nutrition for health with your family, reading recommendations
• Blue Zones, nutrition and community philanthropy

If you enjoyed this post, subscribe to our email list for the latest updates and follow us for "research and metrics Thursdays" on the public Facebook Page.

You can support this community-wisdom-sharing work by
 buying me a coffee or sponsoring a newsletter via our website.  Thank you.

www.thehospitalhandbook.com

December 2018 Research Thursdays Summary

key words:  research literacy, funding and grants, sharing related research in the field, research in integrative health

The December Research Roundup

Review of the "Research and Metrics Thursdays" theme from the public Facebook Page and newsletter

1. Mindfulness program for the management of chronic pain, a Mindful.org article, What Mindfulness for Opioid Addiction Looks Like
2. Evidence-based Acupuncture.  Research summaries and EBA Connect program.
3. Research Funding Opportunity--NCCIH and NIH funding if you work in pain management or addiction, especially the field of opioid addiction.  Check out the new (12.10.2018) funding announcements related to the NIH HEAL initiative. Learn more about the HEAL initiative at this webpage.  If you have heard me talk about the National Pain Strategy document the past couple years, HEAL builds upon parts of the work laid out in that very large federal public document.

Recommended Studies to Read (started this in the summer and fall newsletters)

• December
• "Case Reports of Acupuncturists and Massage Therapists at Mayo Clinic:  New Allies in Expediting Patient Diagnoses".  Explore March/April 2018.  https://doi.org/10.1016/j.explore.2017.02.008
• November
• Acupuncture in the Emergency Department (ED), Allina system of Minnesota.  #EDacupuncture
• Adam S. Reinstein, Lauren O. Erickson, Kristen H. Griffin, Rachael L. Rivard, Christopher E. Kapsner, Michael D. Finch, Jeffery A. Dusek; Acceptability, Adaptation, and Clinical Outcomes of Acupuncture Provided in the Emergency Department:  A Retrospective Pilot Study, Pain Medicine, Volume 18, Issue 1, 1 January 2017, p.169-178. https://doi.org/10.1093/pm/pnv114
• October
• From the Mayo Clinic, St. Mary's and Methodist hospitals, a prospective study of integrative medicine services in an inpatient setting.  
• 87% of the integrative medicine services were massage therapy performed by an NCBTMB certified massage therapist and 9% were acupuncture services by an LAc.  
• Both services were found to statistically significantly decrease pain level post-treatment.  
• Over 1/3 of the hospitalized patients fell asleep during treatment, which researchers found fascinating as future research potential since good quality sleep/rest helps decrease need for medications (whether it is meds to induce sleep or meds to decrease pain because lack of sleep increases pain and other symptoms), and significantly improves outcomes in an environment (inpatient hospital space) that is not naturally conducive to rest.  
• source/citation:  Stephanie D. Clark, Brent A. Bauer, Sairey Vitek, Susanne M. Cutshall.  Effect of Integrative Medicine Services on Pain for Hospitalized Patients at an Academic Health Center.  Explore: The Journal of Science and Healing. 2018.  https://doi.org/10.1016/j.explore.2018.07.006 
• September--see the newsletter, under "Metrics and Research Thursday" for full list.
• Tai Chi for Fibromyalgia.  study highlight in September (BMJ visual abstract image):  Tai Chi for fibromyalgia significantly improves symptoms compared to exercise, particularly at longer-term (6 months) practice and interventions.  
• My take-away from the article:  keep practicing Tai Chi as part of your health and wellness routine!  
• Wang Chenchen, Scmid Christopher H, Fielding Roger A, Harvey William F, Reid Kieran F, Price Lori Lyn et al.  Effect of tai chi versus aerobic exercise for fibromyalgia: comparative effectiveness randomized controlled trial.  BMJ 2018; 360: k851.  

Recommended Studies to Read in Older Newsletters

• August 2018 newsletter
• Metrics:  Don't underestimate the simplicity and usefulness of patient satisfaction surveys as one of your clinic's metrics
• "We found that hospitals' patient satisfaction scores are useful signals of quality, which surprised me to some extent," said Joseph Doyle, an economist at M.I.T. and one of the studies authors.  
• "Hospitals with more satisfied patients have lower mortality rates, as well as lower readmission rates."  New York Times article. 2017.07.24  
• Original study is a working paper, Evaluating Measures of Hospital Quality by Joseph Doyle, John Graves, and Jonathan Gruber.  National Bureau of Economic Research (NBER), working paper no.23166, issued in February 2017.  
• Research and delivery method practicality for teaching self-care basic breathing and meditation techniques:  email and mobile app.  
• This study targeted oncology clinicians, who have a high burn-out rate.  What delivery method (tool) allows ease-of-access and may increase participant compliance for studying a self-care therapy?  possibly email and/or mobile apps.  More research needed.  
• Carie Heeter and Rebecca Lehto.  Meditation App Benefits Hospice and Palliative Care Clinicians.  Oncology Nursing News.  July 31, 2018.  
• July 2018 Newsletter
• Evidence-based Acupuncture. Research summary updating the old WHO statement on recommending acupuncture for specific conditions, Evidence for Acupuncture is Growing Exponentially.
• May 2018 Newsletter
• Spotlight on a research paper out of the Allina Health Systems of Minnesota, one of the Bravewell Legacy system programs, "Cost Savings from Reducing Pain through Delivery of Integrative Medicine Program", published in the peer-reviewed journal JACM.
• citation:  JA Dusek, Griffin KH, Finch MD, Rivard RL, Watson D. Cost Savings from Reducing Pain through Delivery of Integrative Medicine Program.  The Journal of Alternative and Complementary Medicine. Jun 2018.  https://doi.org/10.1089/acm.2017.0203

For more on the topic of research

• follow the tag/label in this blog for "research literacy"

If you enjoyed this post, subscribe to our email list for the latest updates and follow us for "research and metrics Thursdays" on the public Facebook Page.

You can support this community-wisdom-sharing work by
 buying me a coffee or sponsoring a newsletter via our website.  Thank you.

www.thehospitalhandbook.com

The December Self-Care Saturdays: inspiration for your home self-care practices

key words:  self-care, practitioner resilience, wellness, mindfulness practices; mindful cup of tea, mindfulness learning with kids, "forest bathing"--nature the outdoors and your health, dealing with holiday stress

The December Self-Care Roundup

Some inspiration from the Self-Care Saturdays theme over at our public Facebook Page

The Mindful Cup of Tea

• Practice mindfulness or "being-in-the-present-moment" with a warm cuppa.  My kids do this well with their hot chocolate lately--down to watching the marshmallows melt.  
• For resources (and gift ideas!) on mindfulness, go to our "Are You in the Present Moment?" post.
• For more on practicing mindfulness with kids, the "Health and Wellness Learning with Family" post.

Breathe Like a Bear by Kira Willey

• This is my family's 2018 favorite and the book is based on her songs.  I recommend getting the matching songs; most of them are part of her Mindful Moments for Kids music compilation.  More at this blogpost.  If you follow an Amazon affiliate link from our blogpost and buy within a few hours, a few pennies of your purchase go to the Project.  However, if you want to support the Project the best and most direct way is through our website. Thank you.

Have you heard about "forest bathing" or want to read more about the health benefits of spending time outdoors?
Check out these recommendations...🙂🏞🧗‍♀️🛶🚲🏔🎣☕️
Nature, the Outdoors, and Your Health on our Gift Ideas page, just below the "outdoor fun" section:

• Forest Bathing:  how trees can help you find health and happiness
• Shinrin Yoku:  The Japanese Art of Forest Bathing
• The Nature Fix: why nature makes us happier, healthier, and more creative by Florence Williams
• Blue Mind:  the surprising science that shows how being near, in, on, or under water can make you happier, healthier, more connected and better at what you do by Wallace J. Nichols
• The Lost Art of Reading Nature's Signs:  use outdoor clues to find your way, predict the weather, locate water, track animals--and other forgotten skills of natural navigation by Tristan Gooley

Self-care check in...how are you doing today with the holiday stress?  Challenged to stay grounded? (12.21.2018)

• Take a moment while you are reading this and breathe several belly breaths (diaphragmatic breathing) and stretch.
• It's the longest night of the year tonight.  Great time to be quiet in the evenings and enjoy the starlight or the bright winter moon (if you have minimal cloud cover).  Please share a photo of your night sky when you take time to go outdoors this weekend.  For all of you in stormy weather conditions, stay safe and maybe share a pic of your warm mug of cocoa cheer.
• Related articles:  mindful cuppa, short daily practices to manage overwhelm, and tips for dealing with holiday stress from Mindful.org.

Move Your Body!

"Remember how amazing you felt the last time you hit the gym or took a hike in the woods?  How clear and calm you felt after your last yoga class?  Exercise can settle your mind.  It can make you feel refreshed from head to toe.  It helps to dissolve tension in places you may not have realized were tense.  You want to remember this feeling.  The next time you exercise, pause for a few minutes afterward.  Sit down or lie down to fully savor the post-exercise glow....The state of your body reflects the state of your mind.  A good walk clears away the mental cobwebs."  Read more at Winter Got You Down? article on Mindful.org.

Get Outside and Move! 
This 6-month study found that exercise (walking or bicycling) for 30 minutes 3x/week improved your brain's function.  For the study group, about age 65 - 90+, 6 months of exercise at this rate lowered the "brain age" by 9 years.
My takeaways:

• Not moving/sedentary lifestyle is not good for your brain
• You can reverse the effects of a sedentary lifestyle by moving, at least 30 minutes at a time.  Every day if possible.
• With all the data now on health benefits of being outdoors and in nature, for that extra health boost:  do your movement time...
• Outdoors--better if it is a green area (assuming no smog or other air pollution warnings for your area that day), or woods or near a large body of water (lake, sea)
• Do some gardening every week--working with healthy soil is good for our brains, too
• Read more about this study at ReachMD or CNN.

You can read more about the health benefits of time spend outdoors in the book, Nature Fix. You can follow the link to the Amazon store for this book in paperback or audiobook at our gift ideas page under "outdoor fun and health benefits of nature".

Be proactive this holiday season to combat loneliness and help others do the same

"Be proactive this holiday season to combat loneliness or to help others do the same.  Map out a plan before you find yourself feeling fully disconnected and isolated.  By anticipating feelings of loneliness--either your own or of someone else (even a stranger)--you'll be better equipped to face them." If your mind is stuck in dark rut, call for free help at the national hotline:  1-800-273-8255.

Related blogposts
November Self-care Saturdays Roundup

If you enjoyed this post, check out our public Facebook Page and subscribe to our email list. 

www.thehospitalhandbook.com