Self-reported Well-being Research Articles

Growth Differentiation Factor 15 during pregnancy and postpartum as captured in blood, cerebrospinal fluid and placenta: A cohort study on associations with maternal mental health

IntroductionGrowth Differentiation Factor 15 (GDF15) increases substantially during pregnancy and is primarily produced by the placenta. Elevated levels of GDF15 have been associated with mental health problems in non-perinatal populations, higher corticosterone levels, and decreased estrogen receptor activity. However, the role of GDF15 in mental health during the perinatal transition remains unknown. This longitudinal study is the first to evaluate pregnancy levels of GDF15 in cerebrospinal fluid (cGDF15), plasma (pGDF15) and placenta GDF15 mRNA, along with mapping plasma GDF15 (pGDF15) level changes from late pregnancy to early postpartum. Moreover, we aimed to evaluate the association between pregnancy cGDF15 levels and cortisol early postpartum, evaluate the association between pregnancy cGDF15 levels and mental health in pregnancy and postpartum, and evaluate the association between pGDF15 and estrogens and high-sensitivity C-reactive protein (CRP). MethodsWe included data from 95 women scheduled for a planned cesarean section and obtained cerebrospinal fluid (CSF) and plasma levels of GDF15. We quantified GDF15 mRNA levels in placenta biopsies. Estrogens, high-sensitivity CRP, and mental health measures were further collected on the day or one day before the cesarean section. At five weeks postpartum, mental health measures and saliva samples for cortisol analyses were collected. Correlation analyses for GDF15 in CSF, plasma, and placenta mRNA were performed, along with association analyses for pregnancy cGDF15, Cortisol Awakening Response, and mental health outcomes. ResultsWe demonstrated a strong correlation between cGDF15 and pGDF15 (r=0.52; p<0.001) and found that both cGDF15 and pGDF15 correlated with placenta GDF15 mRNA*placental weight (r=0.62, p<0.001 and r=0.44, p=0.008, respectively). During late pregnancy, both estradiol (E2) and estriol (E3) were significantly associated with pGDF15 levels (E2: p=0.002; E3: p(corrected)<0.001). Finally, we found that cGDF15 levels were not associated with self-reported mental well-being or the Cortisol Awakening Response or absolute cortisol at awakening postpartum. ConclusionThis novel study points to the unique hormonal landscape during the perinatal transition and the specific role of GDF15 in pregnancy, which appears uncoupled with perinatal mental health and cortisol outcomes. Our data also strongly imply that the overall amount of circulating GDF15 in late pregnancy is closely related to placenta size.

Look after gardens and they look after you: Cultivating wellbeing in a pandemic through a popular TV gardening programme

Over the past few years there has been intense policy interest in the idea that nature-related activities such as gardening are good for wellbeing. Several studies have indeed found links between such activities and self-reported wellbeing. However, there are also sympathetic critiques of the limited conceptions of what kinds of activities are considered beneficial. Therefore, more attention should be paid to the social and cultural roots of the assumption that nature is good for us rather than treating connection to nature as an innate need. This article contributes to this task by showing how commonly held ideas about gardening and wellbeing were reproduced in the long-running and popular UK TV gardening programme Gardeners’ World ( GW) during 2020. As an exemplar of lifestyle programming, GW provides both information and entertainment and appeals to viewers to try out the techniques they observe on screen in their own gardens. Within the programme there is an emphasis on gardens as secluded havens from the outside world and on the attractive characteristics of individual plants. However, in many cases it is the work involved and the challenge that interests gardeners, as much as the qualities of the plants. Gardeners design a space and use it to express their identity. But the results of their actions are not guaranteed. Gardening can therefore be understood through a political ecology lens as a process whereby the social and nature constitute each other.

Contextual-compassion training for borderline personality disorder with long lasting symptoms: a randomized clinical trial

Long-term follow-up studies have shown that the symptoms of borderline personality disorder (BPD) tend to remit over time. However, many patients present long lasting symptoms (LLS), including low mood, emptiness, and persistent impairment in psychosocial adjustment. Given the high rate of LLS in BPD patients, new treatment strategies are needed. We conducted a randomized clinical trial (RCT) to evaluate the efficacy of a novel intervention that combines self-compassion and contextual-based skills for patients with persistent symptoms. Sixty BPD individuals with LLS who had received dialectical behavior therapy skills training (DBT-ST) in the previous six months were recruited and randomized to receive the experimental intervention or treatment as usual (TAU) for 12 weeks. All participants were evaluated pre- and post-intervention and at 3-months follow-up. The primary outcome measure was self-reported well-being. Other clinical variables were also evaluated, including depressive symptoms, BPD symptoms, functionality, self-compassion, and self-criticism. Participants in the experimental arm showed a significant increase in indicators of well-being (e.g., happiness and quality of life) and a significant decrease in depressive symptoms. These results were sustained—and even continued to improve—at the three-month follow-up. No significant changes were observed in BPD severity, self-criticism, or self-compassion. More RCTs are needed to test the efficacy of new interventions targeting this population with persistent symptoms, not only to reduce symptoms but also to promote well-being and personal recovery.

Coping With Side Effects: A Daily Diary Study in Women With Breast Cancer Living With Adjuvant Endocrine Therapy.

Adjuvant endocrine therapy (AET) is increasingly being prescribed for up to 10years to people diagnosed with hormone receptor-positive breast cancer. AET intake is often accompanied by side effects that significantly impact the well-being of people. The way individuals cope with medication-related side effects might play a pivotal role in their emotional adaption. This intensive-longitudinal study investigated the association between self-reported coping strategies (Brief COPE) and psychological well-being (Patient Health Questionnaire-4) among women undergoing AET. A multilevel factor analysis resulted in the identification of four coping factors, namely, problem-focused, support-focused, meaning-focused, and avoidance-focused coping. Daily coping efforts and experienced side effects were analyzed as predictors of psychological well-being using multilevel modeling. A total of 215 women (Mage=56.5±10.9years) participated, resulting in a total of n=2080 daily surveys (M=9.67±1.08). On average, women reported 3.7±2.2 different side effects per day. Days characterized by an elevated frequency of side effects and increased burden were associated with diminished well-being. Using more problem- and meaning-focused strategies than usual to cope with side effects correlated positively with well-being. Conversely, employing more support- and avoidance-focused coping strategies than usual was linked to reduced psychological well-being. Exploratory analyses focusing on individual coping strategies provided nuanced insights into coping behaviors. The present findings underscore the relationship between women's coping efforts concerning medication-related side effects during AET and their daily well-being. Psychosocial education (e.g., cognitive behavioral therapy) may offer valuable benefits for patients by helping them develop adaptive coping strategies to manage side effects.

Abstract C034: Impact of survivorship care plans on self-reported health and functional well-being

Abstract Introduction: Cancer survivors have varying physical, psychosocial, and informational needs. Organizations such as American Society of Clinical Oncology have developed survivorship care plans (SCP) for cancer screening, treatment side effect management, and care coordination. There is a need to better understand SCP utilization among underserved and diverse patient communities. Methods: Adults ages 18+ years with breast or colorectal cancer diagnosed between 2019 and 2021 were recruited from the Greater Bay Area Cancer Registry. Participants completed a 30-minute survey about their survivorship plans, quality of life, health behaviors, and social support. Analysis: Overall comparisons between groups were evaluated with chi-square tests. Associations between demographic characteristics and receipt of any type of survivorship plan were evaluated with univariate binomial logistic regression models, and associations between receipt of any type of survivorship plan and health/well-being outcomes were assessed using univariate ordinal regression models. Multivariable models will be built using relevant variables. Results: Participants (n=872) were on average 59 years (range=24-95) and mostly female (70.2%). Participants had either breast (41.3%) or colorectal cancer (58.7%). Participants were American Indian/Alaska Native (AIAN) (1.0%), Asian American (18.2%), NH Black (12.8%), NH White (38.0%), LatinX (29.0%), and Native Hawaiian or Pacific Islander (0.8%). Receipt of a SCP was reported by 258 (29.6%) participants, 328 (37.6%) had another type of post-treatment guide provided to them, and 224 (25.7%) were not offered any kind of survivorship plan. There were no differences in race/ethnicity, nativity status, non-English language spoken at home, marital status, or educational attainment between those who received any kind of survivorship plan vs. no plan. Being female was associated with 40% lower odds of receiving any kind of survivorship plan (OR=0.60, 95%CI=0.42-0.87). Being on public insurance was also associated with lower odds of receiving a survivorship plan than being on private insurance (OR=0.59, 95%CI=0.43-0.81). Receipt of a survivorship plan was associated with 52% higher odds of reporting a higher level of overall current health (OR=1.52, 95%CI=1.14-2.02) compared to those who did not receive any plan. Receiving a survivorship plan was also associated with higher odds of reporting a higher level of ability to work (OR=1.58, 95%CI=1.18-2.11), more fulfilling work (OR=1.69, 95%CI=1.27-2.23), ability to enjoy life (OR=1.55, 95%CI=1.17-2.06), ability to sleep well (OR=1.35, 95%CI=1.03-1.79), and contentment with their current quality of life (OR=1.51, 95%CI=1.14-1.99). Conclusion: Receipt of any survivorship plan was associated with higher levels of self-reported current overall health and measures of functional well-being. Women, as well as people on public insurance, are less likely to receive a survivorship plan, highlighting disparities in survivorship care planning for these populations. Citation Format: Aly M. Cortella, Katarina Wang, Debby Oh, Niharika Dixit, Zinnia Loya, Kathie Lau, Michelle Wadhwa, Chris Duffy, Salma Shariff-Marco, Kristan Olazo, Vlad Honcharov, Marika Dy, Urmimala Sarkar, Scarlett Lin Gomez. Impact of survivorship care plans on self-reported health and functional well-being [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C034.

Cognitive ability, gender, and well-being in school contexts: longitudinal evidence from Sweden.

While well-being does generally constitute a moderate predictor of school achievement, research on the predictive validity of cognitive ability for well-being in school contexts remains scant. The current study analyzed longitudinal relations between cognitive ability measured at age 13 (Grade 6) and well-being measured at age 18 (Grade 12, valid N = 2,705) in a Swedish sample, using several multivariate model techniques. The results indicate that cognitive ability was not a statistically significant predictor when several predictors were entered in a multiple regression model. However, gender was a significant covariate as girls and young women have a substantially lower degree of self-reported well-being. This casts light on the limitations of cognitive ability as a construct for some non-cognitive outcomes, at least in shorter and narrower spatial-temporal contexts.

Promoting long-lasting changes in student well-being through a pharmacy general education course: A pilot study

Objective Colleges and universities need effective strategies to help students develop medication-use behaviors that positively support their well-being. This pilot study evaluated the utility of Fink’s Taxonomy of Significant Learning (FTSL), an evidence-based instructional strategy, to create long-lasting changes in students’ well-being during a pharmacy general education course. Participants and methods Using a mixed methods survey design, we assessed 84 undergraduate students’ changes in self-reported well-being at three different time points (pre-intervention, post-intervention, and 6-month follow-up) through five variables (safe medication practices, general healthcare behaviors, healthcare self-efficacy, safe medication storage, and safe medication disposal). Results The results of multiple repeated-measures ANCOVAs, four McNemar chi-square tests, and qualitative thematic analysis showed significant positive changes in several variables over time. Conclusions This pilot study demonstrated that intentional integration of FTSL during the course design process helped students develop long-lasting general healthcare and safe medication-use behavior intentions. We discuss holistic approaches for promoting student well-being.

Unveiling the Longitudinal Journey: 3-Year Follow-up of Women with MINOCA and INOCA in a Specialized Heart Centre

BackgroundMyocardial infarction with no obstructive coronary arteries (MINOCA), and ischemia with no obstructive coronary arteries (INOCA), are female-predominant conditions; clinical trials are lacking to guide medical management for the common underlying vasomotor etiologies. Data on long-term outcomes of (M)INOCA patients following attendance at a women’s heart centre (WHC) are lacking. MethodsWomen diagnosed with MINOCA (n = 51) or INOCA (n = 112) were prospectively followed for 3 years at the Leslie Diamond WHC (LDWHC) in Vancouver. Baseline characteristics, diagnoses, chest-pain type, major adverse cardiac events, hospital encounters, medications, and Seattle Angina Questionnaire (SAQ) responses were compared between the baseline and 3-year timepoints. The χ2 test was used to compare categorical variables; the Student t test was used for continuous variables. ResultsMINOCA patients had significantly more nonexertional chest pain and more diagnoses of vasospasm than did INOCA patients, who had more exertional chest pain and more diagnoses of coronary microvascular dysfunction. Following the baseline timepoint, both groups had significant reductions in cardiovascular emergency room visits, with INOCA patients also experiencing fewer cardiovascular hospitalizations. At 3 years, the most commonly prescribed medications were calcium-channel blockers, long-acting nitrates, and beta-blockers, with MINOCA patients having more acetylsalicylic acid use, and INOCA patients having more short-acting nitrate and ranolazine prescriptions. Both groups observed significant improvements in SAQ scores, with greater improvements observed in INOCA patients. Patients with depression or who were prescribed ranolazine at 3 years had worse SAQ scores at baseline. ConclusionsThe 3-year outcomes of (M)INOCA patients indicate that the LDWHC's comprehensive care model effectively improves diagnostic clarity, reduces the number of hospital encounters, optimizes medication management, and improves self-reported patient well-being.

Daylight potential of Swedish residential environments: Visual and beyond-vision effects and the relationship with well-being assessment

Good lighting is one of the most important comfort factors in residential buildings. In creating a comfortable and restorative living space, the effects of light, both visual and effects beyond vision, play a crucial role. Daylight is considered an essential factor for indoor environments, which can benefit occupants’ health as well as lower energy use. This study investigated the potential daylight exposure for 10 apartments in Sweden, using metrics to quantify both visual effects and effects beyond vision and to understand the relationship between the light situation in the apartments and well-being metrics collected from occupants during a field study. Computational modelling of daylight conditions for visual effects and effects beyond vision was performed. Statistical analysis was utilised to investigate the possible relationship between the apartments’ daylight potential and the self-reported well-being of the occupants. The results show variations of light exposure for apartments in different seasons. Furthermore, possible relationships between well-being metrics and daylight exposure changes were observed despite being possibly influenced by seasonal light level contrasts.

From Happiness Data to Economic Conclusions

Happiness data—survey respondents’ self-reported well-being (SWB)—have become increasingly common in economics research, with recent calls to use them in policymaking. Researchers have used SWB data in novel ways—for example, to learn about welfare or preferences when choice data are unavailable or difficult to interpret. Focusing on leading examples of this pioneering research, the first part of this review uses a simple theoretical framework to reverse-engineer some of the crucial assumptions that underlie existing applications. The second part discusses evidence bearing on these assumptions and provides practical advice to the agencies and institutions that generate SWB data, the researchers who use them, and the policymakers who may use the resulting research. While we advocate creative uses of SWB data in economics, we caution that their use in policy will likely require both additional data collection and further research to better understand the data.

Perception of indoor and outdoor school soundscapes: A large-scale Cross-Sectional survey with UK teachers

This study explores variations in teachers’ perception of indoor and outdoor soundscapes across different spaces within schools. A quantitative research design involved 452 teachers in the United Kingdom who participated in an online questionnaire. The questionnaire was distributed to UK teachers via random sampling on the Prolific platform, utilizing its customizable demographics for participant recruitment. A multi-method approach, combining closed- and open-ended questions, captured the multifaceted nature of soundscape perception. Participants reported on perceptions and experiences of school soundscapes in general areas, classrooms, hallways, dinner halls, playgrounds, and gyms. Findings reveal that schools are perceived as dynamic environments, characterized by a blend of chaos, engagement, and excitement, contradicting expectations of a calm atmosphere. Correlation analysis demonstrated weak associations between age and perceptions of the acoustic environment (rs([452])=[0.116]), as well as gender (rs([450])=[0.060]), teaching experience (rs([450])=[0.117]), school type (rs([450])=[− 0.109]), school location (rs([450])=[0.098]), time spent in outdoor places (rs([450])=[0.09]). A significant positive correlations were observed between wellbeing and the overall school soundscape (rs([450])=[0.286]), indicating that as self-reported wellbeing increases, the perceived quality of the school soundscape tends to increase. Differences were seen in the soundscapes of playgrounds, dinner halls, gyms, hallways, and classrooms compared to the overall school soundscape. These distinctions highlight varying levels of engagement, comfort, intrusiveness, and privacy across different areas, emphasizing the multifaceted nature of sound perception within schools. The study shows teachers use sound in education for different reasons and methods, with perceived impacts on student learning and wellbeing. It suggests the possibility of enhancing the educational experience through tailored interventions targeting specific areas in schools based on their unique soundscapes.

Acceptability, engagement, and preliminary efficacy of a college human physiology course with integrated mindfulness practice to support student wellbeing.

To evaluate the acceptability of and engagement with an undergraduate human physiology course embedded with mindfulness practice. To assess its preliminary efficacy on student mindfulness and wellbeing. Students (N = 36, 17% freshman, 33% sophomore, 22% junior, and 28% senior) answered online surveys at course completion. Primary outcomes were course ratings, assignment and assessment completion rates, minutes, types of mindfulness practice, changes in trait mindfulness (Mindful Attention Awareness Scale, MAAS), and self-reported wellbeing outcomes. We ran Chi-square goodness of fit tests and paired Wilcoxon signed-rank tests to decide if the outcomes differed significantly post-class. We tested the dose-response relation between mindfulness practice time and trait mindfulness and whether the out-of-class practice time was consistent across the weeks with generalized linear mixed-effect models. All participants reported finding the course enjoyable and that they would recommend it to their friends. They practiced for an average of 66 (SD = 27) min per week in the class and 112 (SD = 59) min on their own. The most common out-of-class practices were mindful movements, sitting meditation, and breathing. Per self-reports, the course increased student understanding of specific mindfulness practices and appreciation for their body. It improved wellbeing and trait mindfulness (MAAS mean within-person change = 1.2, SD = 0.8, p < 0.00001). We found no does-response relation between practice time and trait mindfulness. This pilot study supports that incorporating mindfulness practice into college-level courses may promote student wellbeing and such approaches warrant further investigation.

Balint groups: an effective tool for improving health professionals’ perceived well-being

BackgroundPhysician burnout is a common problem that negatively impacts their well-being and patient care. Balint groups (BGs) deal with doctor-patient relationships. Previous studies that have demonstrated the positive effects of BGs are descriptive and based on small sample sizes. This study aims to evaluate the perceptions of health professionals who participated in BGs, determine the impact of BGs on their personal and professional well-being, and identify the factors related to these positive outcomes.MethodsOn January and February 2023 the authors have distributed a questionnaire to 142 healthcare providers in a conference and internet networks. Most respondents were family physicians.ResultsParticipation in BGs is seen to have a positive impact on healthcare professionals’ perceived well-being and professional development. Respondents who had participated in the BG reported a reduction in burnout, increased empathy, and enhanced professional identity and relationships with patients and colleagues. The study also highlighted the importance of duration of participation in BG, with attendance longer than 5 years linked to significantly more positive outcomes compared to less than 1 year. In a logistic regression analysis two factors were significantly associated with self-reported well-being: attending BGs for more than five years and perceiving BGs as a means of relieving burnout.ConclusionsThe findings suggest that medical organizations should encourage the regular availability of BGs to support physicians’ well-being.

COVID-19 Related Knowledge, Attitudes, and Behaviors Among Black Men with Chronic Health Conditions: A Latent Profile Analysis

ABSTRACT Research indicates that Black communities experienced disproportionately higher numbers of confirmed cases and fatalities throughout the COVID-19 pandemic with Black men experiencing marked reductions in life expectancy. Inequities were further magnified by known COVID-19 such as hypertension, diabetes, obesity, and higher prevalence of cardiovascular disease. The current project aimed to assess the knowledge, attitudes, and behaviors related to COVID-19 among Black men with chronic conditions. Specifically, we sought to determine whether COVID-19-related perspectives and behaviors impacted cross-sectional health outcomes. A national sample of Black men (N = 312) who self-reported at least one chronic disease responded to survey questions about their knowledge, attitude, and preventative behaviors (KAP) related to COVID-19. Analyses suggest that unique latent profiles based on COVID-19-related KAP differentially impacted participants’ self-reported health and well-being for those low on KAP items. The discussion includes considerations on viral hygiene interventions, misinformation, stigma, and perceptions of discrimination.

The importance of sampling frequency for estimates of well-being dynamics

Using a high-frequency panel survey, we examine the sensitivity of estimated self-reported well-being (SWB) dynamics to using monthly, quarterly, and yearly data. This is an important issue if SWB is to be used to evaluate policy. Results from autoregressive models that account for individual-level heterogeneity indicate that the estimated persistence using yearly data is near zero. However, estimated persistence from monthly and quarterly data is substantial. We estimate that persistence to shocks typically lasts around six months and has a net present value of 75–80 per cent of the contemporaneous effect. Estimates are similar for different domains of SWB.

Suicidal Ideation in Medicinal Cannabis Patients: A 12-Month Prospective Study

Objective To document the prevalence and correlates of suicidal ideation (SI) among individuals seeking cannabis-based medicinal products (CBMPs); to test whether SI declines or intensifies after three months of CBMP treatment and to document 12-month trajectories of depression in those reporting SI and other patients. Method Observational data were available for 3781 patients at entry to treatment, 2112 at three months and 777 for 12 months. Self-reported depressed mood and SI were assessed using items from the PHQ-9. Additional data included sociodemographic characteristics and self-reported well-being. Results 25% of the sample reported SI at treatment entry and those with SI had higher levels of depressed mood (mean = 17.4 vs. 11.3; F (1,3533) = 716.5, p < .001) and disturbed sleep (mean = 13.8 vs. 12.2, F (1,3533) = 125.9, p < .001), poorer general health (mean = 43.6 vs. 52.2, F (1,3533) = 118.3, p < .001) and lower quality of life (mean = 0.44 vs. 0.56 (F (1,3533) = 118.3, p < .001). The prevalence of SI reduced from 23.6% to 17.6% (z = 6.5, p < .001) at 3 months. Twelve-month follow-up indicated a substantial reduction in depressed mood with this reduction being more pronounced in those reporting SI (mean (baseline) = 17.7 vs. mean (12 months) = 10.3) than in other patients (mean (baseline) = 11.1 vs. mean (12 months) = 7.0). Conclusions SI is common among individuals seeking CBMPs to treat a range of chronic conditions and is associated with higher levels of depressed mood and poorer quality of life. Treatment with CBMPs reduced the prevalence and intensity of suicidal ideation.

Filial Piety Discrepancy and Wellbeing among Older Chinese Immigrants Living in Canada: The Role of Acculturation and Living Arrangement

This survey-based, cross-sectional study explored the independent and synergistic effect of filial piety discrepancy (FPD), acculturation, and living arrangement on the psychological, social, and physical wellbeing of older Chinese immigrants living in Canada. A total of 299 older Chinese immigrants were recruited from community organizations in the Greater Toronto Area. Participants completed questionnaires that assessed demographic information, filial piety, living arrangement, acculturation, and three domains of wellbeing. Greater FPD was associated with lower self-reported psychological, social, and physical wellbeing. Co-residence with adult children was also associated with greater psychological wellbeing. Although living arrangement did not moderate the association between FPD and wellbeing, a significant interaction between FPD and acculturation indicated that the association between greater FPD and poorer psychological wellbeing was strongest for those with lower acculturation levels. This study confirms previous associations found between FPD and psychological wellbeing, and further extends this association to social and physical indices of wellbeing. Study findings further highlight the importance of acculturation in the relationship between FPD and wellbeing among older Chinese immigrants.

Public greenspace and mental wellbeing among mid-older aged adults: Findings from the HABITAT longitudinal study

We explored temporal associations between public greenspace and adults’ mental wellbeing. Participants (n = 5,906) aged 40–65 years at baseline had data at >2 post-baseline waves of HABITAT, a multilevel longitudinal study (2007–16) in Brisbane, Australia. Participants self-reported mental wellbeing (short Warwick-Edinburgh Mental Wellbeing Scale) and neighbourhood self-selection reasons at Waves 2–5 (2009-11-13-16). We examined associations between Δgreenspace (within 1 km of home) and Δmental wellbeing using a linear fixed effects model, adjusting for time-varying confounders. Mental wellbeing increased (β = 1.75; 95% Confidence Interval:0.25–3.26) with greenspace exposure, adjusting for self-selection. Urban planning and policy initiatives to increase public greenspace may benefit mental wellbeing.

Hospital Chaplain Burnout, Depression, and Well-Being during the COVID-19 Pandemic.

Healthcare personnel experienced unprecedented stressors and risk factors for burnout, anxiety, and depression during the COVID-19 pandemic. This may have been particularly true for spiritual health clinicians (SHCs), also referred to as healthcare chaplains. We administered a daily pulse survey that allowed SHCs to self-report burnout, depression, and well-being, administered every weekday for the first year of the pandemic. We used a series of linear regression models to evaluate whether burnout, depression, and well-being were associated with local COVID-19 rates in the chaplains' hospital system (COVID-19 admissions, hospital deaths from COVID-19, and COVID-19 ICU census). We also compared SHC weekly rates with national averages acquired by the U.S. Census Bureau's Household Pulse Survey (HPS) data during the same timeframe. Of the 840 daily entries from 32 SHCs, 90.0% indicated no symptoms of burnout and 97.1% were below the cutoff for depression. There was no statistically significant relationship between any of the COVID-19 predictors and burnout, depression, or well-being. Mean national PHQ-2 scores were consistently higher than our sample's biweekly means. Understanding why SHCs were largely protected against burnout and depression may help in addressing the epidemic of burnout among healthcare providers and for preparedness for future healthcare crises.

Resonant breathing improves self-reported symptoms and wellbeing in people with Long COVID.

Long COVID involves debilitating symptoms, many of which mirror those observed with dysautonomia, and care must be taken with rehabilitation for autonomic dysfunction to avoid post-exertional malaise/post-exertional symptom exacerbation. Resonant breathing (breathing slowly at a defined rate of breaths per minute) requires less exertion and can potentially improve autonomic function. The objective of this work was to report on the impact of a resonant breathing program on self-reported symptoms and wellbeing in people with Long COVID. A retrospective analysis of de-identified data was completed in a convenience sample of people with Long COVID, who participated in the Meo Health (formerly known as Stasis HP) resonant breathing program. Participants completed baseline and follow up surveys. Data were available for 99 participants. Most measures of symptoms and wellbeing improved at follow up, with the largest differences per participant seen in sense of wellness (47.3%, p < 0.0001), ability to focus (57.5%, p < 0.0001), ability to breathe (47.5%, p < 0.0001), ability to control stress (61.8%, p < 0.0001) and sleep quality (34.9%, p = 0.0002). Most (92%) participants reported improvement at follow up on the Patient Global Impression of Change Scale. Self-reported symptoms and wellbeing improved in people with Long COVID completing resonant breathing. Resonant breathing can be considered as an option within the broader treatment plan of people with Long COVID.