Tuesday, April 30, 2019

April Leadership and Workplace Mondays Summary

keywords:  leadership, workplace, workplace culture, being an employee

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Inspiration for Employees and their Leaders 

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

Dare to Lead  by Brene Brown

  • Recommended books to read/listen to this month:  
  • Articles
    • Good sleep (quality and quantity) fills your resilience bucket. Don’t underrate it. 
      • Results from a Cigna workplace survey notes that women surveyed reported more lack of sleep than men. Not clear from this article if this is (a) better self-awareness of health than their male colleagues (b) self-awareness of lack and significantly less hours (quantity and quality) due to managing work responsibilities
    • “Instead, invite them to think about what kind of person they want to be — and about all the different things they might want to do.”

Want to see more resources related to the workplace for hospital-based integrative health practitioners?

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For more recommended reading (books and audiobooks) on leadership, see our Reflecting on Leadership post.

More posts on Leadership

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You can request a pdf copy of this blogpost via the website for the cost of a cup of coffee. All proceeds go toward basic operating costs to keep this HH Project work going. Thank you.

Research Thursdays Summary for April 2019

keywords:  research literacy, funding and grants, sharing related research in the field, research in integrative health; JACM special focus issue on whole system approach to integrative health in mainstream systems, the new Flourish Index from Harvard T. Chan School of Public Health in Boston, update on Medicare and Medicaid (CMS) policy papers on acupuncture for chronic low back pain (cLBP), humanism in healthcare spotlights from the Gold Foundation's research roundup, review of some research literacy basics, and funding announcements

You can request a pdf copy of this blogpost via the website for the cost of a cup of coffee. All proceeds go toward basic operating costs to keep this HH Project work going. Thank you.
The JACM Special Focus issue March 2019
 "Multimodal Approaches in Integrative Health: Whole Persons, Whole Practices, Whole Systems"
 the entire issue is free to access

The April Research Roundup

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

At the Hospital-practice Handbook Project, we encourage practitioners to cultivate mentor-relationships and practice research literacy.

Recommended Research Reads this Month
  • Models of integrative health in hospitals and medical centers.  An entire special issue focused
    on this topic in the March 2019 JACM.  volume 25, issue S1.  Special Focus Issue on Multimodal Approaches in Integrative Health: Whole Persons, Whole Practices, Whole Systems.  Article titles include:
    • "Values Align for Researching Whole Systems: A Reflective Overview of the Special Issue" by John Weeks, Heather Boon, and Cheryl Ritenbaugh
    • "What Should Health Care Systems Consider When Implementing Complementary and Integrative Health:  Lessons from Veterans Health Administration" by Taylor et al
    • "Whole Health in the Whole System of the Veterans Administration:  How Will We Know We Have Reached This Future State?" by Tracy Gaudet, MD and Benjamin Kligler, MD, MPH
    • "Evaluation of an Integrative Post-Traumatic Stress Disorder Treatment Program" by Hilton et al.

  • From this April’s IHPC newsletter—measuring health and wellness
    • A different set of metrics than the conventional paradigm of measuring the presence of disease: The Flourish Index
“Harvard T. Chan School of Public Health, Boston, released a much anticipated manifesto in JAMA on April 2, 2019 that dramatically shifts the philosophy of patient care from an "absence of disease or infirmity" to a concept that embraces whole-person care and patient well-being. This important paradigm change that "reimagines health" is a concept that is not new to integrative health. It respects patients' desires to grow and feel satisfied with their health and subsequent quality-of-life. 
 Author Howard, K. Koh, MD, MPH defines this as a flourish index, which includes six domains of patient wellness: 1: happiness and life satisfaction, 2. physical and mental health, 3. meaning and purpose, 4. character and virtue, 5. close social relationships, and 6. financial and material security. 
 Dr. Koh writes: "Measurement of flourishing makes possible weighing the effects of different treatment decisions not only on physical and mental health, but in the full context of what matters in a person’s life. While this makes treatment decisions more complex, it lies at the heart of patient-centered care."  link to JAMA article

  • New paper from Memorial Sloan-Kettering on insomnia in cancer patients
    • Both cognitive behavioral therapy and acupuncture had clinical effectiveness in treating the severity of insomnia and had sustained benefits for 20 weeks It was the first comparative effectiveness study for this clinical research query
    • Sheila N Garland, Sharon X Xie, Kate DuHamel, Ting Bao, Qing Li, Frances K Barg, Sarah Song, Philip Kantoff, Philip Gehrman, Jun J Mao, Acupuncture Versus Cognitive Behavioral Therapy for Insomnia in Cancer Survivors: A Randomized Clinical Trial, JNCI: Journal of the National Cancer Institute.  https://academic.oup.com/jnci/advance-article-abstract/doi/10.1093/jnci/djz050/5426666

When Clinical Research Impacts Health Policy

“States have considerable flexibility in determining what non-pharmacologic services are available in the state plan under optional benefits. For example, a state may elect to provide coverage for acupuncture, massage therapy, chiropractic care, cognitive behavioral therapy, physical therapy or other Medicaid-coverable services through an array of Medicaid coverage authorities. States wishing to add coverage in optional benefit categories described below would need to submit a state plan amendment for CMS approval.” 
Reviewing the Basics

Bodywork/Massage Therapy
  • Massage therapy can relieve low back pain, fibromyalgia pain, arthritis pain, tension headaches, and improve post-operative recovery.  AMTA article has a concise list with links.
    • “Research continues to support the health benefits of massage therapy for pain management. Find out how massage therapy can help these five painful conditions.”

Humanism in Healthcare: Patient-Centered-ness and Clinician Resilience
  • The April edition of the Jeffrey Silver Humanism in Healthcare Research Roundup includes:
    • "The timing of family meetings in the medical intensive care unit." Piscitello GM, Parham WM 3rd, Huber MT, Siegler M, Parker WF. Am J Hosp Palliat Care. 2019 Apr 14.  quote:
"This troubling pattern suggests that family meetings are often used to negotiate withdrawal of life support rather than to learn about values. The authors conclude that there are ample opportunities to improve communication skills training for clinicians in the ICU to help maximize the role of family meetings."
    • "The crossroads of posttraumatic stress disorder and physician burnout: a national review of United States trauma and nontrauma surgeons." Jackson TN, Morgan JP, Jackson DL, Cook TR, McLean K, Agrawal V, Taubman KE, Truitt MS. Am Surg. 2019 Feb 1;85(2): 127-135
    • "Healthcare provider compassion is associated with lower PTSD symptoms among patients with life-threatening medical emergencies: a prospective cohort study." Moss J, Roberts MB, Shea L, Jones CW, Kilgannon H, Edmondson DE, Trzeciak S, Roberts BW. Intensive Care Med. 2019 Mar 25.

Research Conferences
  • The Society of Acupuncture Research (SAR) conference will be June 27-29, program here.
  • The 2019 International Massage Therapy Research Conference will be May 9-10, 2019 in Alexandria, VA.  "IMTRC 2019 will feature keynote speaker Helene Langevin, MD, Director of the National Center for Complementary and Integrative Health (NCCIH), and panel sessions on pain management and addressing the opioid epidemic with massage therapy.  Education sessions will explore the use of therapeutic massage for arthritis, breast cancer, low back pain, and anxiety."  

Funding Announcements

For more on the topic of research
  • follow the tag/label in this blog for "research literacy"

Other monthly research summary blogposts

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Monday, April 22, 2019

Happy Earth Day and National Parks Week!

keywords:  spending time outdoors (nature) and health, environmental health, self-care, supporting kids and their adults to connect with nature, integrative healthcare paradigm, recommended books and resources
updated December 2020

Unless someone like you cares a whole awful lot, Nothing is going to get better.  It's not.  -Dr. Seuss

In the U.S. we honor today as Earth Day and the following week or so as National Parks week.  My school-age kid loves Earth Day and the variations of school-sponsored activities she's participated during the last several years.  If you've been following the blog and the HH Project newsletters, you know I love an excuse to get outdoors with the kids.  Growing up in the northern Midwest, I was taught that we can be outdoors in most weather, as long as we prepare for it (proper clothing, changes of clothes, etc).  Exceptions, of course, for dangerous-to-health weather conditions like skin-freeze warnings (cold weather) or the black flag days (hot and humid), etc.

I feel that building confidence in kids (and adults!) to enjoy the outdoors (and feel safe doing so) helps foster a sense of wonder.  And, there's nothing quite like wonder and finding wonder in the natural world, from backyards to local parks, to national parks. I am sure there are personal health benefits to feeling wonder and awe.  In fact, this is one of the many areas of nature research Florence Williams writes about in The Nature Fix.

If you are looking for ideas of how to get outdoors with kids of all ages (or need some fresh ideas for your list), check out Richard Louv's Vitamin N:  The Essential Guide to a Nature-Rich Life or the website for the Children and Nature Network.  I recently started reading How to Raise a Wild Child: The Art and Science of Falling in Love with Nature by Scott Sampson (who my kids know as the paleontologist from the PBS show, Dinosaur Train).

There has been a trend in "natural navigation" lately.  An old way of understanding our environment and direction that has been lost to some in the past generation or so requires practicing your skill of observation and pairing it with some farmer's almanac-style facts mixed with modern science.  Tristan Gooley has a full set of resources to learn more about this on his natural navigation website.

Nature time and Your Health
Connecting with nature, whether it is a walk in the town park, gardening, or a trip to your state or national park, is healthy for us.  Health benefits are myriad from movement to the air we breathe to the scenery (see Nature Fix for the details and research citations).  Also, hopefully, it keeps us mindful of our impact on our environment, on both local and regional/national scale.  From gardening classes in schools or your local Master Gardener county extension community courses, you can learn how to grow plants in your area from veggies to local flora.

Our connection and stewardship of our environment is integral to our health and the health of our community.  In traditional Chinese medicine, we talk about the body as a garden, affected by both internal and external factors.  Our environment is an essential piece to the integrative health paradigm. 
Rachel Carson, known for her groundbreaking book, Silent Spring, also wrote a book of poetry-prose of her time with her nephew and mentoring his sense of wonder.  If you are interested in this poetry-prose book of hers, The Sense of Wonder, I recommend the audiobook version narrated by Kaiulani Lee for the lyrical style.

How are you and your healthcare practice connecting to the environment/nature/Earth?
So, how are you connecting nature in your healthcare practice?  Does your healthcare system already have environmental stewardship, nature-mentoring, or other sustainable-environment health practices in place?  Maybe you have a nature area nearby for easy walking or a hidden sitting garden?  Are you connected to a Teaching Kitchen? Or maybe you have a gardening program with your county's Extension Service and Master Gardener resource? How are you working with your patient population in developing a healthy connection to nature?

More resources and ideas below.  And, please add a resource in the comments if it is not listed here and you think it may help others!  Thank you.
Note: if you follow a link directly from this article to Amazon and buy something, a few pennies of your purchase goes toward the Hospital Handbook Project (HHP), a nonprofit community resource.

Reflective reading and poetry

Resources for Parents, Grandparents, Educators (for kids)

Get Outside and Learn More 


Gear and Games

Related Blogposts

If you follow one of the Amazon links above and buy something from Amazon within 12 hours of clicking the link, a few pennies go toward the project.  
The most direct way to support the project?  
 If you love supporting your local library system, most of these books are available through Overdrive or through the Libby app via your library card.  :)

Happy Earth Day from the Hospital-practice Handbook Project!