overviewWomen’s Health Overview

Social Media Consumption Mental Health and Working and Inoculation Against Remotely Misinformation Many have been working remotely since the COVID-19 pandemic Before COVID-19, social media was a of news, health information, risk began and workers are feeling source of provocative research in the perception and social connection. What the strain on their mental health. psychological field as we explored the attracted people to social media before Here are some tips to maintain questions: What is excessive use? Is the pandemic may not be the same your health and wellness as you social media addiction real? What are motivating use factors we see now. continue to work from home: the consequences for physical and Virtual connection has become our • Keep a regular schedule during mental health? This research area safest means of social connectivity, so the work day. Start and end work has been thrust into a political and the standards and theories of addiction at the same time every day. Take scientific spotlight with the emergence and excess may need redefinition. breaks as needed to rest your of COVID-19. Now, more than ever, However, we can say with certainty eyes and stretch your body we are asking how social media that our level of media consumption consumption and addiction play a role and sources of information can have • No working from the couch! Set in mental and physical health. significant impacts on our mental well- boundaries between work time being and health behavior. and your personal life by working Before the pandemic, emerging from a dedicated space like a research suggested that excessive What have researchers discovered home office, writing desk or and addictive social media use was about the impact of social and kitchen table tied to poor mental health outcomes mass media on our mental health • Stay connected with friends, such as anxiety and depression, and and safety behavior? First, we have family and colleagues via that individuals with lower self-esteem learned that social media is rife with FaceTime, Skype, Zoom, were more likely to become addicted to misinformation about COVID-19. Microsoft Teams, text message the “like and share” world. Misinformation includes unverifiable or or phone call false information, conspiracy theories During the uncertainty of the COVID-19 and rumors. In a study of 87 countries, • Keep your immune system pandemic, we have increasingly turned the U.S. had the second highest rate strong by getting enough sleep, to mass and social media as a source of social media misinformation by a eating well, staying hydrated and getting regular exercise see Social Media pg 1

Volume 26, Issue 1 | January 2021 From the chairman

The Omaha World-Herald recently printed an article about a new physician wellness program sponsored by the Medical Association. Designed to help manage stress and reduce the stigma of mental health struggles, the program is confidential and operates separately from employers, insurers and state licensing agencies. It is run by peer physicians who offer both an outlet and support.

Doctors, like all workers, face extreme pressures in the workplace, which negatively affect their wellness. We are not immune to depression, anxiety or substance use problems, but are less likely to seek care for these conditions. Astonishingly, the rate of doctor suicide is the highest of any profession – more than double the rate in the general population. The current COVID-19 pandemic has only worsened the strain on our health care workers and their well-being.

I bring this to your attention to illustrate that doctors and nurses are human. Our front-line colleagues have been disproportionately burdened by the pandemic, and the health care system has been stressed in ways we never imagined. People are overview leaving the health care professions due to burnout and to reduce their chances of exposure to this deadly virus. Women’s Health Overview newsletter is published quarterly for health care professionals and the We have seen colleagues and leaders step up to lead our enterprise with general public with special interest in compassion, transparency and intelligence. I am blessed to work in an organization women’s health issues by the Olson that is working hard to deliver the level of care that we need and expect. Center for Women’s Health. I have a few simple requests for all of us at this time: Address all comments to: Lana Molczyk 1. Wear your masks, practice social distancing and wash your hands. Olson Center for Women’s Health University of Nebraska Medical Center 2. Be kind to one other. 989450 Nebraska Medical Center Omaha, NE 68198-9450 3. Ask your friends and colleagues who work in health care how they are doing, 402.559.6345 | 800.775.2855 and offer your support. [email protected]

Women’s Health Overview newsletter is available to everyone. If you would like to receive the newsletter free of charge, please contact the Olson Center at 402.559.6345 or e-mail your request to [email protected]. If you do not wish to receive the newsletter, please contact us. Carl V. Smith, MD, FACOG An alternative electronic version of the Chairman newsletter is available. If you would like to receive this electronic version in addition Department of Obstetrics and Gynecology to the print version, or instead of, please College of Medicine email your request to [email protected]. University of Nebraska Medical Center

overview | 2 Social Media continued from pg 3 Mission Statement The Mission of the Olson Center for significant margin. This misinformation can lead to drastic individual and public Women’s Health is to provide a national health implications as it affects the likelihood to participate in preventive health comprehensive health science center at behaviors such as masking and social distancing. the University of Nebraska Medical Center. Based in the Department of Obstetrics and Interestingly, misinformation is just as likely to be shared, liked and disseminated as Gynecology, the center enables UNMC verifiable information. Thus, the frequency with which you see information on social to make distinctive strides in education, media is a poor indication of its accuracy. However, social media users with higher research, and service through innovative followers, verified accounts and business/government/news accounts spread approaches to women’s health issues. less misinformation than other social media accounts. Research shows that public health/health care accounts contain the least amount of misinformation. Want More Information? Visit our website: OlsonCenter.com Second, we know that the frequency and duration of time we spend consuming Learn more about our health care media, as well as the type of news source we use, have implications for mental providers, services, and programs health. Individuals who spend an excess of 2.5 hours a day or check into social available at the Olson Center for media 7+ times a day are far more likely to experience depression and general Women’s Health. Our website also anxiety symptoms. Individuals who turn to social media as their main source offers women’s health information. Here are a few topics: of information on COVID-19 are more likely to express negative mental health • Breastfeeding symptoms than people who mainly follow mass media. It is no coincidence that this • Breast Health and Disease is tied to the significantly larger occurrence of misinformation on social media sites. • Cardiovascular Health • Gastrointestinal Health With the warning of misinformation also comes what I hope is some helpful • Gynecologic Health advice. Think critically about where you get your information – your physical and • Reproductive Endocrinology/Infertility mental health may depend on it. Psychological research shows the simple act of • Pregnancy trying to think critically about our information increases the likelihood we will spot • Wellness misinformation. In fact, just like how the vaccine can prevent COVID-19, mental • Incontinence health researchers are suggesting people can use “psychological inoculation” to help prevent them from falling victim to misinformation. Psychological inoculation Newsletter Committee Noelle Lynn Blood, MA involves “prebunking” conspiracy and misinformation before you even come Richard G. Blum, MPA across it. While it is difficult to target specific falsified statements with inoculations, John S. Davis, PhD such as “spinach will cure COVID-19” (an unverified and intentionally misleading Sonja Kinney, MD statement), we can start to prepare ourselves to recognize common themes in Lana Molczyk, MA misinformation, how it tends to be presented and how to verify information. Karen C. Olson, MD Carl V. Smith, MD My last takeaway is to know where you are getting your information. Utilize the World Health Organization and CDC websites for information about the virus. Olson Center for Women’s Health Also, limit the time you spend consuming COVID-19 news. This pandemic is Advisory Committee difficult, unpredictable, scary and stressful. Even if you are reading the most Carl V. Smith, MD, Chairman accurate information possible, it can still contribute to anxiety and depression. Donald Gibbens, MD Jennifer Larsen, MD Try not to spend your time in the rabbit hole of what-ifs – come up for air in the David L. Olson, MD present moment and use social media for its greatest purpose: social connection. Karen C. Olson, MD Meaningful engagement and life satisfaction are correlated with a wealth of positive Nancy D. Olson, MS, MBA mental health outcomes including reduced social media addiction. So, video chat Kendra Swanson, MD with loved ones, play virtual games, look at pictures of cute babies, do something Gail Walling-Yanney, MD every day that brings you joy and meaning in this difficult time. Any part of this newsletter may be If you are struggling with anxiety and depression during this time or feel that you reproduced provided credit is given to could use assistance in limiting your social media use, please reach out for support. the Olson Center for Women’s Health. offers behavioral health care through most of its The information provided by the Olson clinics and we would be happy to help you. We are all in this together. Center for Women’s Health is for educational purposes only and should not take the place of advice and guidance Contributed by Kelly Spanier, MS, PLMHP from your own health care providers. Nebraska Medicine Psychology Department

overview | 3 research news COVID-19 Data Collectors

Crises do not affect all people equally. of Health Promotion in the UNMC designing evidence-based policy and Their worst impacts are often felt College of Public Health, has been programs that respond to women’s more by the vulnerable and less by the recognized nationally as a COVID-19 needs, reduce risks, and mitigate privileged. In the absence of consistent data collector. Her recent publications adverse effects during and after the government or corporate leadership to describe her experience and approach pandemic. These data can also provide accurately and reliably track COVID-19 in addressing COVID-19 outbreaks important insights into and inform the infections, concerned groups and in meat processing facilities. Dr. development of tailored strategies and individuals across the country began Ramos’s data about workplace interventions that may be particularly collecting, analyzing and sharing this protections were collected from over effective in preventing violence against data themselves. Their efforts helped 600 responses to surveys conducted women during emergencies and public establish a record of the pandemic in Nebraska. Together with a team of health crises in the future. that likely kept countless people safe UNMC infectious diseases experts and can inform future public health and UNMC’s Global Center for Health I encourage all of us to not be mere decisions. Security, technical assistance was objective observers, but to be active provided to 14 meat processing participants in the prevention and Starting with our own health and facilities, and educational materials control of COVID-19 and its many wellness, including what we eat, were developed to prevent COVID-19 untoward consequences. We need everyone is learning more about spread at work and outside of work. a national strategy to develop and important essential services that implement infection control, one that make daily survival possible during During the COVID-19 pandemic, expedites workplace and domestic this pandemic. This was made clear domestic violence cases have abuse case reporting and response and to Nebraskans when the President of increased in the and one that encourages all of us to be part the United States signed an executive across the world. Data is a crucial of the solution. order invoking the Defense Production tool for understanding how and why Act to keep meat processing facilities pandemics such as COVID-19 may Contributed by John S. Davis, PhD open. From the farms to the packing result in an increase in violence against UNMC Department of OB-GYN plants, essential workers in critical food women. It can help identify the risk production industries kept food on factors, how availability of services for our tables while risking their and their women survivors of violence is being families’ health and well-being to bring affected, how women’s access to home a paycheck. such services and help-seeking from formal and informal sources is affected, Athena Ramos, PhD, MBA, an what new short and medium-term assistant professor in the Department needs arise. These data are critical to

overview | 4 The Scientific Truth About Herd Immunity

As we enter a crucial stage in the the U.S. population has experienced follow what we know works to stop coronavirus pandemic, Nebraska’s COVID-19 coronavirus infection. Given the spread: mask wearing and hand and public health agencies the overall number of confirmed deaths, hygiene. want you to know the truth about we can estimate that approximately herd immunity. You may have read 0.6% of people with COVID-19 will In addition, we agree with state leaders about this concept as a way to get us perish as a result. who encourage you to avoid the three through this difficult time. It would be Cs: disastrous for our country, our health As of this writing, over 380,000 Crowded places: Avoid gathering in care systems, and for millions of fellow Americans have already died from groups where you cannot maintain a Americans. COVID-19. So, what would happen if minimum of 6 feet of distance from 60% of the population were infected others. The herd immunity concept assumes rather than 15%? Here are our that everyone who recovers from estimates for what a herd immunity Close contact: Wear a mask whenever COVID-19 is immune from re-infection. experience in the US would look like: you are within 6 feet of people from outside your household. Masks work. That is an assumption that has not been • 197 million cases proven. In fact, medical scientists have In areas with mask mandates, the now reported a number of persons • 3.6 million people hospitalized primary driver of COVID cases is with proven re-infection. With a virus • 1.2 million deaths people who spent significant time that has existed for only about a year, it without their masks on in places like is impossible to know whether people This is not a solution. The loss of life bars and restaurants. can be re-infected on a large scale. would be many times more devastating Confined spaces: Avoid enclosed than what we see now. The economic spaces with poor ventilation. When Let’s look at the numbers: impact would be ruinous for our state people are physically separated from For herd immunity to take hold, you and country. If you see statements that others by 6 feet or more in well- would need a minimum of 60% of claim otherwise, keep in mind there ventilated areas, they are much less the entire population to be infected. has not been a single scientifically likely to become infected. Antibody studies tell us that some verified study anywhere in the world small pockets of New York City and that shows unchecked herd immunity Learn more up-to-date information Mumbai, India, may have reached 50% as a solution. about COVID-19 at NebraskaMed. infection rates, but cities with major com/COVID outbreaks have had overall infection What is the solution? While vaccines rates of less than 25%. Based on CDC continue to be developed, approved Reprinted with permission from testing nationally, we estimate 15% of and eventually distributed, we must Nebraska Medicine

overview | 5 Incorporating Spiritual Practices for Holistic Wellness

Research shows that spirituality can health journey, often engage in a range that can help you learn to manage influence relief or recovery from of holistic health practices. The holistic habits you usually don’t even notice. addiction, depression, eating disorders, medical model recognizes that physical, fibromyalgia, chronic pain, heart mental, spiritual and social needs affect What we choose to practice or not disease, obesity, breast cancer and your overall health, and being unwell in practice reflects our attitudes, beliefs, other conditions. Engaging in spiritual one of these aspects can affect you in values and cultural norms. Ultimately, practices promotes healthy behaviors, others. the type of spiritual practice you reduces stress, creates meaning in life engage in is not important. What is and positively affects mood. Spiritual practices that fit into the important is how you practice and why. holistic model of health include: Regularly focusing your attention to Spirituality includes the ways we seek • Contemplative practices, requiring and express meaning and purpose in engage in meaningful spiritual practices disciplined concentration and with the expectation of a positive life, as well as the ways we experience sustained focused attention on connectedness to ourselves, to others, outcome helps you unlearn sometimes a specific mental or sensory toxic or unhealthy ways of sensing, to and to the significant or experience, such as yoga or prayer sacred. feeling and thinking. Spirituality can • Mindfulness practices, focusing stimulate a return to each present However, the field of medicine is often on awareness and acceptance moment with a fresh and clear reluctant to address spirituality. Blurry of the present moment reality in perspective that promotes healing and boundaries among religion, spirituality, a nonjudgmental way, such as coping with illness. cultural norms, health and wellness can meditation or just noticing your make it challenging for patients and breath Although each person’s intent caregivers to know how to approach determines the purpose of their • Directive practices, intentionally spiritual practice, whether religious or this issue, so it often remains a private embodying ethical principles matter. secular, the technique (prayer, yoga, or specific qualities, such as body scan, meditation, tai chi, etc.), Spirituality is a highly personal and compassion, acceptance or empathy, the dosage (intensity and duration of ever-evolving dimension of wellness. like doing charity work or breathing the practice) and the frequency of the People who recognize themselves as with patience practice are all important factors to being mind, body and spirit, as well as Each of these is an exercise in self- consider. those who personally participate in their awareness and personal understanding

see Spirituality pg 7

overview | 6 Telehealth Options for Care Anywhere

As the COVID-19 pandemic continues which is especially important for care from a new or regular provider to surge throughout our community pregnant patients, seniors and people when an in-person visit isn’t required and state, the Olson Center continues who are immunocompromised or have or possible. Virtual care connects you to follow best practices to keep you, preexisting conditions such as diabetes with local board-certified health care your family and our providers safe and or heart disease. providers whenever, and wherever, it’s healthy. most convenient for you. Individual in-person visits are less Our best tool at this time is telehealth frequent right now and correspond Insurance companies now cover most appointments, which allow for the to visits that require lab work or an telehealth visits, and enhanced safety same quality care as in-person visits examination that is not possible during measures are in place to protect your while maintaining social distancing, a telehealth visit – ultrasound as an privacy. and is a great option for all patients, example. Telehealth or virtual care is a including our pregnant patients. way for you to connect with a provider For more information, including which at a distance – using technology. These conditions are treatable with telehealth, Telehealth visits allow you to decrease appointments enable you to receive visit NebraskaMed.com/Telehealth the frequency you will be out in public,

Recap: 23rd Annual Omaha Women’s Health and Wellness Conference

The 23rd Annual Omaha Women’s MBA, RN and Charity Evans, MD, was Chad Boukal, husband and caretaker Health and Wellness Conference took titled “Understanding Trauma Informed of Nebraska Medicine breast cancer place on Oct. 9. Due to COVID-19 Care, Resiliency and Your Health.” patient Molly Boukal, gave the safety concerns, the event was held conference closing session, which entirely online via Zoom - a first for the Afternoon breakout topics covered focused on balancing the role of conference. genetic cancer risk factors, mental caretaker and self care. health challenges associated with More than 400 nurses and community perimenopause and complementary All lecture presentations were members attended the day’s main alternative medicines such as essence recorded and can be viewed at sessions. The keynote, titled “Losses oils and acupuncture. Additional OmahaWomensHealthAndWellness. Due to COVID-19: What Stages of Grief sessions explored the philosophy of com. Nursing credit is available until Are You In?” was presented by Sheritta “Health at Every Size,” how depression Nov. 8, 2021. See the website for Strong, MD. Meghan McLarney, MS, affects pregnancy and the ways health details. RDN, LMNT, presented “The Power of technology intended for women (apps, Plants: How Eating ‘Plant-based’ Can wearables, etc) is developed and Fight Disease.” The final main session, marketed. presented by Ashley Farrens, MSN,

Spirituality continued from pg 6 Here are some examples for seven • Movement practices: walking, areas of spiritual practice. Try one on dancing, yoga that could be meaningful to you and, • Stillness practices: meditation, like medicine, modify the technique, silence, visualization the dosage and the frequency of your practice to find what you find healing. • Creative practices: drawing, writing, beading • Relational practices: deep listening, storytelling, game playing • Ceremonial practices: praying, singing, drumming • Sensory practices: seeing/beholding, feeling/body scan, tasting • Activism practices: protecting, Contributed by Regina Idoate, PhD advocating, bearing witness Department of Health Promotion UNMC College of Public Health

overview | 7 University of Nebraska Medical Center 989450 Nebraska Medical Center Omaha, NE 68198-9450

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olsoncenter.com

welcoming new providers in this issue

Shannon Roth, PT, DPT, recently joined the Olson page 1 Social Media Center women’s physical therapy team. She graduated Consumption and Inoculation from the University of Nebraska Medical Center in Against Misinformation Omaha, Nebraska, in 2013 and completed a 15-month Women’s Health Physical Therapy Residency at The explains how social media impacts our Ohio State University Wexner Medical Center in mental health and knowledge during Columbus, Ohio, in 2019. Roth believes in taking a the pandemic holistic approach and empowering individuals to be advocates for their own health. page 4 Research News COVID-19 data collectors are helping influence public health decision- Brittany Bowman, LCGC, joined the Olson Center’s making genetic counseling group. She completed her Master of Genetic Counselor Studies degree at the University page 6 Incorporating Spiritual of Wisconsin School of Medicine and Public Health in Madison, Wisconsin. Bowman’s passions are patient Practices for Holistic Wellness advocacy and health equity, while staying on top of the details how spiritual practices can help newest and most appropriate ways to use genetics in in times of illness health care.

Volume 26, Issue 1 | January 2021