The COVID‐19 pandemic has presented many novel situations that have amplified the presence of moral distress in healthcare. With limited resources to protect themselves against the virus and strict safety regulations that alter the way they work, healthcare providers have felt forced to engage in work behaviours that conflicted with their professional and personal sense of right and wrong. Although many providers have experienced moral distress while being physically in the workplace, others suffered while at home. Some healthcare providers worked in facilities that were unable to open during the pandemic due to restrictions, which could contribute to a sense of powerlessness and guilt. The current study assessed whether the ability to see patients each week impacted the relationship between an employee's moral distress and their mental health strain, burnout, and maladaptive coping. A total of 378 healthcare providers responded to weekly surveys over the course of 7 months (April 2020–December 2020). Hierarchical linear modeling techniques were used to examine the study variables over time. Results showed that moral distress predicted an individual's mental health strain and burnout, even after controlling for the prior week. However, moral distress was not a significant predictor of maladaptive coping. Interestingly, there was not a significant difference between the average ratings of moral distress between those who were able, and those who were not able to see patients, meaning that both groups experienced symptoms of moral distress. However, cross‐level moderation results indicated that the ability to see patients magnified the relationships between moral distress and mental health strain and burnout over time. Implications of the results and recommendations for how moral distress should be addressed among healthcare providers are discussed.

There is a clear benefit in delaying serial casting after the injection of botulinum toxin in the recurrence of spasticity at the gastrosoleus that may also offer an advantage regarding the incidence of painful episodes associated with casting. Most importantly, reducing the recurrence of spasticity by delayed serial casting may offer the possibility of decreasing the frequency of botulinum toxin reinjections.

Three decades ago, the relative importance of the detrimental effects of obesity on health was called into question by a longitudinal study 1 that included 10 224 men and 3120 women who were followed up for more than 8 years. The findings showed that better cardiorespiratory fitness (CRF), as measured by a maximal treadmill exercise test, was associated with decreased all-cause mortality in both sexes. Based on the maximal treadmill tests, participants were stratified into quintiles of fitness categories, with 1 equaling the lowest level of fitness and 5 being the highest level of fitness. Analysis of lifestyle behaviors and clinical measures, such as blood pressure, hyperlipidemia, smoking, and body mass index (BMI, calculated as weight in kilograms divided by height in meters squared), found that for both men and women, all variables, except BMI and familial coronary heart disease (CHD) only for women, VIEWPOINT

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Mindfulness and mindful activity can have a profound effect on physical and mental health. When considering mindfulness and physical activity, it is important to differentiate between physical activities, which are geared toward mindfulness and have mindful components, for example, yoga, platies, and tai chi, from other mindfulness interventions that are then geared toward greater awareness and mindfulness, which may then lead to healthful behavior change such as increasing physical activity. Prescribing mindfulness interventions may be another resource to help physicians when interacting with their patients, considering motivating patients to exercise and become more physically active can be challenging. Engaging in mindfulness can elicit change over time. Integrating mindfulness to interventions with exercise is one way to initiate exercise adherence as well as improve self-efficacy. When practicing mindful-based exercise programs, the benefits can also be seen with improved breathing rate and depth, heart rate, and parasympathetic activity. Promoting mindfulness-based training for physical activity has positive effects both psychologically and physiologically.

The goal of providing these models is to give massage therapists tools to deliver the best possible care. The models need testing to see if they help advance the profession.

While scientific evidence demonstrates conclusive associations between unhealthy lifestyle behaviors and increased morbidity and mortality related to noncommunicable chronic diseases (NCDs), most physicians are not formally taught the root causes of NCDs nor how to counsel patients regarding their lifestyle behaviors for disease prevention and treatment. Since its inception in 2012, the University of South Carolina School of Medicine Greenville has designed, developed, and implemented an innovative, formalized lifestyle medicine curriculum to provide required undergraduate medical student training with a graduating program-level goal to “Deliver total health care using lifestyle medicine to prevent and treat morbidity and mortality related to chronic diseases.” The process was guided by the Association of American Medical Colleges’ Core Entrustable Professional Activities (required for graduates entering residency) and aimed to satisfy the Quadruple Aim components of better outcomes, lower cost, improved patient experience, and improved physician experience. Four essential instructional design phases, Analysis, Design, Development, and Evaluation, were used as systematic steps to create and deploy the curriculum. This article describes the evidence-based approach used and offers guidance to other undergraduate medical schools that may wish to implement lifestyle medicine training to improve physicians’ medical knowledge and clinical skills for optimum health care.