Effect of Heartfulness meditation based integrative therapy on infertility outcomes: A retrospective case series evaluation.

BACKGROUND: In Indian context, infertility is often a silent struggle. Despite the high prevalence of infertility in the country, the majority of couples do not share their struggles with family or friends due to social stigma, thus increasing their psychological vulnerability. Heartfulness meditation has shown to decrease stress, anxiety, loneliness and improve sleep along with quality of life. OBJECTIVES: The current retrospective series evaluated the effectiveness of Heartfulness-based integrative therapy on infertility outcomes. METHODS: The program consisted of a 5- day onsite lifestyle modification workshop and online follow up meditation sessions. RESULTS: 54 couples with infertility participated in the program with a mean age of 30.74 years (SD 5.04) for females and 34.03 years (SD 4.54) for males. 15 couples presented with male infertility, 16 couples presented with female infertility and in 5 couples both partners had infertility problems. Further, 18 couples had unexplained infertility. 24 couples conceived with 18 natural conceptions, five via assisted reproductive technology and one spontaneous abortion. CONCLUSION: The program was beneficial in the cohort who utilized it as prescribed resulting in conception of 24 out of 54 couples. Future research investigating the causal relationship of Heartfulness meditation on fertility outcomes in a randomized control study could solidify this treatment method to be used independently or as an adjuvant therapy with assisted reproductive technologies.

The Effect of Heartfulness Meditation Program on Burnout and Satisfaction With Life Among Accounting Professionals.

Background: Accounting professionals experience a stressful working environment with previous studies demonstrating a high prevalence of burnout. Meditation-based interventions have a potential role in decreasing burnout and improving satisfaction with life. However, the benefits of Heartfulness meditation intervention have not been demonstrated among accounting professionals. Objective: To evaluate the effects of an 8-week Heartfulness Meditation program on burnout and satisfaction with life in chartered accountants. Methods: The study was a prospective cohort analysis comparing burnout and satisfaction with life outcomes among accounting professionals who either self-selected to participate in the Heartfulness Meditation Program (intervention group) or with no particular intervention (control group). Maslach Burnout Inventory (MBI) and Satisfaction with Life Scale (SWLS) scores were collected at baseline and at the end of the study period. Results: Two hundred and six participants completed the study. Participants in the intervention group (n = 107) experienced statistically significant improvement in MBI emotional exhaustion from 2.17 to 1.75 (P = .00) and overall MBI score decreased from 2.99 to 2.83 (P = .020). Participants in the control group (n = 99) experienced statistically significant improvement for emotional exhaustion only, from 1.82 to 1.52 (P = .009). Further, participants in the intervention group demonstrated statistically significant improvement with SWLS from 4.90 to 5.17 (P = .005). While participants in the intervention group experienced higher levels of decline (19.55%) compared to the control group (16.41%) for emotional exhaustion, it was not statistically significant. Conclusion: The current study is one of the first attempts of a Heartfulness meditation intervention to reduce burnout and improve satisfaction with life among accounting professionals. Both the intervention group and the control group showed an improvement of emotional exhaustion. The statistically significant improvements observed in the overall MBI and SWLS outcomes in the intervention group suggest an online Heartfulness meditation program could serve as a potential tool for reducing burnout and improving satisfaction among accounting professionals.

Costs of Specialist Referrals From Employer-Sponsored Integrated Health Care Clinics Are Lower Than Those From Community Providers.

BACKGROUND: There have been very few published studies of referral management among commercially insured populations and none on referral management from employer-sponsored health centers. OBJECTIVE: Describe the referral management system of an integrated employer-sponsored health care system and compare specialist referral rates and costs of specialist visits between those initiated from employer-sponsored health clinics and those initiated from community providers. DESIGN: Retrospective, comparative cohort study using multivariate analysis of medical claims comparing care initiated in employer-sponsored health clinics with propensity-matched controls having specialist referrals initiated by community providers. PATIENTS: Adult patients (≥ 18 years) eligible for employer-sponsored clinical services incurring medical claims for specialist referrals between 12/1/2018 and 12/31/2020. The study cohort was comprised of 3129 receiving more than 75% of their care in the employer-sponsored clinic matched to a cohort of 3129 patients receiving care in the community. INTERVENTION: Specialist referral management program implemented by Crossover Health employer-sponsored clinics. MAIN MEASURES: Rates and costs of specialist referrals. KEY RESULTS: The relative rate of specialist referrals was 22% lower among patients receiving care in employers-sponsored health clinics (35.1%) than among patients receiving care in the community (45%, p <0.001). The total per-user per-month cost for patients in the study cohort was $372 (SD $894), compared to $401 (SD $947) for the community cohort, a difference of $29 (p<0.001) and a relative reduction of 7.2%. The lower costs can be attributed, in part, to lower specialist care costs ($63 (SD $140) vs $76 (SD $213) (p<0.001). CONCLUSIONS: Employer-sponsored health clinics can provide effective integrated care and may be able to reduce avoidable specialist utilization. Standardized referral management and care navigation may drive lower specialist spend, when referrals are needed.

Health-Related Quality of Life Outcomes With Regular Yoga and Heartfulness Meditation Practice: Results From a Multinational, Cross-sectional Study.

BACKGROUND: Although the benefits of yoga are well established across the world, there are limited studies exploring the long-term interrelation between yoga, meditation, and health. Specifically, there is limited research exploring the differences in health-related quality of life (HRQOL) among regular meditators and nonmeditators. OBJECTIVE: This study explored the differences in 7 domains of HRQOL (including quality of life, ability to adopt a healthy lifestyle, ability to relax, frequency of nervousness and stress, coping with day-to-day stress, workplace productivity, and staying healthy during the COVID-19 pandemic) among practitioners of yoga and meditation. METHODS: A cross-sectional, online survey was distributed to all members who participated in a 100-day yoga and meditation program, culminating in the International Day of Yoga event, organized by the Heartfulness Institute in partnership with the Central Council for Research in Yoga and Naturopathy, Ministry of Ayush, SVYASA Yoga University, and Patanjali Yoga Institute, India. The program consisted of daily virtual yoga, meditation, and speaker sessions. The data were analyzed by nonparametric Mann-Whitney U test and Kruskal-Wallis tests for continuous variables and chi-square test for categorical variables. RESULTS: A total of 3164 participants from 39 countries completed the survey. Mean age was 33.8 (SD 13.6) years. The majority of the participants were female (n=1643, 52%) and students (n=1312, 41.5%). Regular yoga and meditation practice was associated with a positive impact on all 7 domains of HRQOL (Mann-Whitney P<.05 and χ2P<.05). Notably, experienced Heartfulness (≥2 years) meditators reported better outcomes in all the domains of HRQOL as compared to those not currently practicing this form of meditation and participants with ≤1 year of Heartfulness meditation experience (P<.05). CONCLUSIONS: This is one of the first cross-sectional studies to explore HRQOL outcomes among participants of a 100-day virtual yoga and meditation program. Overall, a yoga and meditation practice was found to be an effective tool for promoting HRQOL. Regular yoga and meditation practice was associated with factors promoting health and well-being, with long-term meditation practice associated with increased benefits.

Sleep Patterns of Resident Physicians and the Effect of Heartfulness Meditation.

BACKGROUND: Medical residents are vulnerable to poor sleep quality due to intense work shifts and academic load. Studies objectively quantified with sleep quantity and quality among resident physicians are limited. Meditation techniques have been shown to improve sleep but are rarely studied in this population. The aim of the present study is to evaluate sleep patterns of internal medicine residents and the effect of a structured Heartfulness meditation program to improve sleep quality. METHODS: A total of 36 residents participated in a pre-post cohort study from January 2019 through April 2019. Sleep was monitored during a one-week outpatient rotation with two validated assessment tools, namely consensus sleep diary and actigraphy. After four intervening weeks, when the residents returned to the same rotation, Heartfulness meditation was practiced and the same parameters were measured. At the end of the study period, an anonymous qualitative feedback survey was collected to assess the feasibility of the intervention. RESULTS: All 36 residents participated in the study (mean age 31.09 years, SD 4.87); 34 residents (94.4%) had complete pre-post data. Consensus sleep diary data showed decreased sleep onset time from 21.03 to 14.84 min (P = .01); sleep quality and restfulness scores increased from 3.32 to 3.89 and 3.08 to 3.54, respectively (P < .001 for both). Actigraphy showed a change in sleep onset time from 20.9 min to 14.5 min (P = .003). Sleep efficiency improved from 83.5% to 85.6% (P = .019). Wakefulness after initial sleep onset changed from 38.8 to 39.9 min (P = .682). Sleep fragmentation index and the number of awakenings decreased from 6.16 to 5.46 (P = .004) and 41.71 to 36.37 (P = .013), respectively. CONCLUSIONS: Residents obtained nearly 7 h of sleep during outpatient rotation. Findings suggest a structured Heartfulness meditation practice to be a feasible program to improve subjective sleep onset time and several objective measures among resident physicians.

Inadequate Measles, Mumps, Rubella, and Varicella Immunity Among Employees.

OBJECTIVES: The purpose of this cohort study was to evaluate measles, mumps, rubella (MMR), and varicella immunity among a population of adult employees receiving primary care in an employer-sponsored health center. METHODS: Participants were eligible for MMR and varicella immunity screening if they were an employee receiving primary care in an employer-sponsored health center between January 1, 2019 and November 1, 2020 who could not provide proof of immunization and 1) had it recommended by their provider, 2) specifically requested immunity testing (often because they had heard of measles outbreaks in their country of origin), or 3) were seen for an immigration physical for their Green Card application. RESULTS: Overall, 3494 patients were screened for their MMR immunity. Of these, 3057 were also screened for varicella immunity. Among these patients, 13.9% lacked measles immunity, 0.83% lacked immunity to all 3 components of MMR, and 13.2% lacked varicella immunity. Among the 262 patients who presented specifically for immunity screening, the rates of lacking immunity were higher for all conditions: 22.7% lacked measles immunity and 9.2% lacked varicella immunity. CONCLUSION: Given declines in immunizations during the COVID-19 pandemic, there is reason to be concerned that measles and varicella-associated morbidity and mortality may rise. Employers, especially those with large foreign-born populations or who require international travel may want to educate their populations about common contagious illnesses and offer immunity validation or vaccinations at no or low cost.

Heartfulness meditation improves loneliness and sleep in physicians and advance practice providers during COVID-19 pandemic.

Objective: Unprecedented work pressures and social isolation during the COVID-19 pandemic may worsen loneliness and sleep problems in health-care professionals. Heartfulness meditation has been shown to improve burnout and sleep. In the current study, the effects of remote Heartfulness meditation in improving loneliness and sleep quality were measured. Methods: Physicians and advance practice providers were randomly assigned to receive either daily Heartfulness Meditation program or no intervention (control group) in a prospective four-week randomized control study design. UCLA loneliness and PSQI scores were collected at baseline and after the program duration of 4 weeks. The study was retrospectively registered with trial Number, ISRCTN85787008 (8 January 2021). Results: Of the 155 subjects enrolled in the study, 50% were lonely and 97% had sleep problems. Attrition rate was 36%. Among those who completed the study, the mean UCLA loneliness scores decreased from 42.1 to 39.4 in the Heartfulness group (N = 40, p = 0.009) and 42.2 to 41.15 in the control group (N = 57, p = 0.254). The mean PSQI scores decreased from 10.75 to 9.14 in the Heartfulness group (N = 41, p = 0.001) and 9.41 to 8.87 in the control group (N = 58, p = 0.122). Younger participants aged 30 and under had higher loneliness and sleep problems. Conclusions: The current study is one of the first attempts to assess loneliness and sleep problems among physicians and advance practice providers during COVID-19 pandemic in the US. A significant burden of loneliness and sleep problems was identified. An improvement of sleep and loneliness was noted with the practice of Heartfulness meditation. This remote intervention might be a useful tool to be explored in larger studies.

Employer-Sponsored Health Centers Provide Access to Integrated Care via a Hybrid of Virtual and In-Person Visits.

Background: Since the explosion of telemedicine resulting from the SARS-CoV2 pandemic, employers have been particularly interested in virtual primary care as a novel means of expanding primary care services. The purpose of this study is to describe a model of integrated care delivered both in-person and virtually at employer-sponsored health centers nationwide. The key outcomes of this analysis were the proportion of all care delivered in-person and virtually by clinical discipline, the types of care and member satisfaction for care delivered in-person and virtually, and a description of the use of multiple clinical disciplines by the employee population. Methods: Retrospective observational study comparing health services utilization of primary care, behavioral health, and physical medicine services both in-person and virtually in employer-sponsored clinics between January 1, 2020 and June 30, 2021. Results: Of the 331,967 visits with employer-sponsored health center staff, 63% were in-person and 37% were delivered virtually. Most visits were for primary care services (59.5%), with physical medicine visits and behavioral health visits accounting for 25.1% and 15.4%, respectively. Whereas the preponderance of behavioral health visits were virtual visits (72.5%), less than a quarter (18.2%) of physical medicine visits were delivered virtually. 19.6% of patients were seen by more than two clinical disciplines and 2.6% were seen by three different disciplines. Overall, patients were highly likely to recommend the health center across both modalities (Net Promoter Score 89.1 for in-person care and 88.4 for virtual care). Discussion: The future of employer-sponsored integrated team-based care may require a hybrid approach that can lean heavily on virtual visits but requires the infrastructure necessary for in-person care.

An Employer-Sponsored Musculoskeletal Care Coordination Service Can Improve Clinical Outcomes and Self-Reported Productivity.

OBJECTIVE: To evaluate the effects of participation with a novel musculoskeletal care coordination service on clinical outcomes, self-reported productivity, and satisfaction. METHODS: Prospective analysis of participants using the service from January 1, 2019 to December 31, 2019. RESULTS: One hundred eighty nine participants were enrolled; 54 participants completed their recommended clinical pathway. Low back pain was the most common musculoskeletal issue (N = 86, 46%). 88 participants (47%) were triaged to home exercise and 59 (31%) to physical therapy. Behavioral health issues were common: 47 participants (25%) were referred to their EAP. Only 30 participants (16%) required a medical referral. Engagement was associated with improvements in pain, physical function, mood, and self-reported productivity (P < 0.01). The net promotor score for this service was 95. CONCLUSIONS: Employers with populations for whom musculoskeletal complaints are common might benefit from integrating a musculoskeletal care coordination service in their benefits offering.

Prevalence, Predictors, and Treatment of Impostor Syndrome: a Systematic Review.

BACKGROUND: Impostor syndrome is increasingly presented in the media and lay literature as a key behavioral health condition impairing professional performance and contributing to burnout. However, there is no published review of the evidence to guide the diagnosis or treatment of patients presenting with impostor syndrome. PURPOSE: To evaluate the evidence on the prevalence, predictors, comorbidities, and treatment of impostor syndrome. DATA SOURCES: Medline, Embase, and PsycINFO (January 1966 to May 2018) and bibliographies of retrieved articles. STUDY SELECTION: English-language reports of evaluations of the prevalence, predictors, comorbidities, or treatment of impostor syndrome. DATA EXTRACTION: Two independent investigators extracted data on study variables (e.g., study methodology, treatments provided); participant variables (e.g., demographics, professional setting); diagnostic tools used, outcome variables (e.g., workplace performance, reductions in comorbid conditions); and pre-defined quality variables (e.g., human subjects approval, response rates reported). DATA SYNTHESIS: In total, 62 studies of 14,161 participants met the inclusion criteria (half were published in the past 6 years). Prevalence rates of impostor syndrome varied widely from 9 to 82% largely depending on the screening tool and cutoff used to assess symptoms and were particularly high among ethnic minority groups. Impostor syndrome was common among both men and women and across a range of age groups (adolescents to late-stage professionals). Impostor syndrome is often comorbid with depression and anxiety and is associated with impaired job performance, job satisfaction, and burnout among various employee populations including clinicians. No published studies evaluated treatments for this condition. LIMITATIONS: Studies were heterogeneous; publication bias may be present. CONCLUSIONS: Clinicians and employers should be mindful of the prevalence of impostor syndrome among professional populations and take steps to assess for impostor feelings and common comorbidities. Future research should include evaluations of treatments to mitigate impostor symptoms and its common comorbidities.