Breathing Curriculum for Stress Reduction in High School Students: A Feasibility Randomized Controlled Trial

Methods: This cluster-randomized pilot compared 5-minute slow DB with treatment-as-usual among four 12th-grade public high school classes. Students individually participated in the curriculum after school during COVID-19-related hybrid teaching, with DB 3 times/week and breath science education once/week. Feasibility was based on overall compliance and qualitative assessments. Preliminary effectiveness was measured with the State-Trait Anxiety Inventory (STAI) and a timed-exhale carbon dioxide tolerance test (CO2TT). Descriptive statistics and repeated analysis of variance were performed to quantify and compare cross-sectional and temporal outcomes between classes and time periods. Human subjects research approval was granted through WCG-IRB. Results: Forty-two students consented to participate. Intervention and effectiveness assessments' compliance varied from 29-91% across classes and weeks, and decreased on average 40% from baseline to follow-up. Compliance of ease/ tolerability assessments ranged from 41% to 86%, and averaged 55% for open-ended assessments. Usefulness, ease and tolerability ratings for the DB ranged from 1.63±0.74 to 2.88±0.35 on scales of 0-3 (“not at all” - “very much”);and from 2.24±0.84 to 2.60±0.55 for effectiveness assessments. Students reported enjoying the DB, CO2TT, and breath science;some found the extended exhales challenging and the curriculum and assessments time-consuming. Outcome measures demonstrated trends towards improvements (e.g., improved STAI and CO2TT before-to-after breathing exercises), but were not statistically significant. Background: Nearly 1 in 3 US adolescents meet the criteria for anxiety, an issue that has worsened with the COVID-19 pandemic. We developed a video-based, 5-week, slow diaphragmatic breathing (DB) stress-reduction curriculum for high school students and evaluated its feasibility and preliminary effectiveness. Conclusion: Implementation of this 5-week slow breathing curriculum was feasible and tolerable to this cohort. Compliance, tolerability, and effectiveness may be improved with in-class participation. Future research on simple and accessible slow-breathing exercises is warranted to address today's adolescent stress-management crisis.

The Impact of the COVID-19 Pandemic on Occupational Stress in Restaurant Work: A Qualitative Study.

The economic downturn due to the COVID-19 pandemic disproportionately impacted the food service industry-one of the largest workforce sectors in the United States. The purpose of this qualitative study was to explore the occupational stressors experienced by restaurant and food service workers during the COVID-19 pandemic through a detailed assessment of their lived experiences. Thematic analysis was used to identify patterns within data from sixteen semi-structured interviews with people employed or recently employed in the restaurant industry during July of 2020. Five themes were highlighted including fear of being exposed to the COVID-19 virus while working under inadequate safety policies, job insecurity, inconsistent pay and hours and a lack of health benefits and paid time off, all of which increased occupational stress and led to uncertainty if respondents would return to the restaurant industry. Hardships associated with the pandemic were mitigated by the support and connections fostered by the communities built within the restaurants. Results led to several recommendations to address the social and economic contributors to occupational stress at the structural and population levels which can be used in the current and post-pandemic workplace.

We Are Not Pontius Pilate: Acknowledging Ethics and Policy

A new AI system is being developed to optimize vaccination strategies based on the structure and shape of a community's social contact network. The technology is minimally constrained and not hound by preconceived notions or human biases. With this come novel outside the box strategies;however, the system is only capable of optimizing what it is instructed to optimize, and does not consider any ethical or political concerns. With the growing concern for systematic discrimination as a result of artificial intelligence, we acknowledge a number of relevant issues that may arise as a consequence of our new technology and categorize them into three classes. We also introduce four normative ethical approaches that are used as a framework for decision-making. Despite the focus on vaccination strategies, our goal is to improve the discussions surrounding public concern and trust over artificial intelligence and demonstrate that artificial intelligence practitioners are addressing these concerns.

Taking Perioperative Nursing Skills Back to the Bedside in Response to the Pandemic: The Official Voice of Perioperative Nursing

With several multiagency counterparts, including the Centers for Disease Control and Prevention, the US Public Health Service, the New York State Department of Health, and many others, we discussed areas of concern and eventually developed processes for clean and unclean traffic flow in the locker room, personal protective equipment (PPE) donning and doffing, hand hygiene, N95 fit testing, preventing the transmission of other infectious diseases, and transforming a massive convention center from positive to negative air pressure-just to name a few. Through coordinated efforts with an onsite Centers for Disease Control and Prevention infectious disease physician and individuals from the US Public Health Service and the New York State Department of Health, policies were created that amplified the positive multiagency collaboration among organizations. The view(s) expressed herein are those of the author and do not reflect the official policy or position of Brooke Army Medical Center, the US Army Medical Department, the US Army Office of the Surgeon General, the Department of the Army, the Department of the Air Force, or the Department of Defense or the US Government.