bluuebunny/crossref_metadata_2025 huggingface dataset:
A World with Many Ends: Eschatology and Perspectivism
Authors: Björk Mårten
Published: February 2022

In this article, the relation between crisis, dying, and apocalypse is examined from the vantage point of Franz Rosenzweig’s philosophy of revelation. Following Rosenzweig’s suggestion that truth—for finite and temporal beings like us—can only be found in time, the article suggests that there exists an intrinsic relation between truth and death. Truth is not only or even primarily logical or mathematical truth according to Rosenzweig. Truth is the reality of our finite lives and implies an eschatological understanding of death as that which gives life unity by eternalising it as that which it forever was in the past. Life, Rosenzweig argues, is polytheistic by entailing manifold perspectives and possibilities, while death is monotheistic by endowing living beings with the unity and completion they lack in life. All death, even the most horrid death, is, if not a completion, at least an end, which gives the living the possibility to judge and verify the meaning of the past once and for all. Yet, if we believe Rosenzweig, the dead are not gone in the past but rather the eternal ground that makes present and future time possible. The dead, by literally being the past, reveal that all time exists after itself, as something that already was, and that the world is nothing but a world with many ends by dying away into the “life outside life” that Rosenzweig called God.
Stranger Things, Plant Life, and Posthuman Endgames: Reading Beckett with Others
Authors: Olsson Jesper
Published: February 2022

This essay reads work by Samuel Beckett, especially his prose, with a focus on vegetal ontology and plant life, soil, mud, and dirt. By juxtaposing Beckett with recent fiction, e.g., the Netflix series Stranger Things, contemporary plant theory, and the general ecology of Erich Hörl, posthuman entanglements and relations are discussed as part of an ontological infrastructure in the texts, which can also be linked to Beckett’s interest in prosthetics and technical media. It is suggested that an approach of this kind might offer new perspectives on the dispersed subjectivity in Beckett’s texts.
An Association between Alexithymia and the Characteristics of Sport Practice: A Multicenter, Cross-Sectional Study
Authors: Proença Lopes Catarina , Allado Edem , Poussel Mathias , Hamroun Aghilès , Essadek Aziz , Albuisson Eliane , Chenuel Bruno
Published: February 2022

Background: This was a multicenter, cross-sectional study which aimed to investigate the relationship between the characteristics of sport practice (weekly training duration, level of practice) and alexithymia in adults who were officially licensed at a sports club. Methods: From a sample of sports club licensed adults, 188 participants were included. The participants completed computerized questionnaires on anthropometric data and characteristics of sport practice (level and weekly time spent on sport practice) as well as alexithymia (TAS 20), depression (BDI-13) and anxiety traits (STAI-Y form B). Results: In this sample, 91 (48.4%) and 97 (51.6%) athletes engaged in recreational and competitive sport practice, respectively. We observed a prevalence of 31.9% for alexithymia. Moreover, alexithymics were more involved in competitive than recreational practice (40.2% versus 23.1%, respectively; p = 0.019) and they were less anxious (63.9% versus 80.2%, respectively; p = 0.010). Finally, alexithymia was significantly more pronounced than non-alexithymia among sports competition practitioners (OR: 3.57 (95 CI [1.26–10.08]; p = 0.016) and we observed less alexithymia in team sports practice than confrontation sports (OR: 0.20 (95 CI [0.05–0.78]; p = 0.020). Conclusions: Alexithymic athletes were more involved in competition than recreational sports compared to non-alexithymic subjects, whilst there were more alexithymic athletes in confrontation sports than in team sports.
The Impact of Do-Not-Resuscitate Order in the Emergency Department on Respiratory Failure after ICU Admission
Authors: Hsu Ting-Yu , Wang Pei-Ming , Chuang Po-Chun , Lin Yan-Ren , Syue Yuan-Jhen , Tsai Tsung-Cheng , Li Chao-Jui
Published: February 2022

(1) Background: It has been hypothesized that a discrepancy exists in the understanding of a do-not-resuscitate (DNR) order among physicians. We hypothesized that a DNR order signed in the emergency department (ED) could influence the patients’ prognosis after intensive care unit (ICU) admission. (2) Methods: We included patients older than 17 years, who visited the emergency department for non-traumatic disease, who had respiratory failure, required ventilator support, and were admitted to the ICU between January 2010 and December 2016. The associations between DNR and mortality, hospital length of stay (LOS), and medical fees were analyzed. Prolonged hospital LOS was defined as hospital stay ≥75th percentile (≥26 days for the study). Patients were classified as those who did and did not sign a DNR order. A 1:4 propensity score matching was conducted for demographics, comorbidities, and etiology. (3) Results: The study enrolled a total of 1510 patients who signed a DNR and 6040 patients who did not sign a DNR. The 30-day mortality rates were 47.4% and 28.0% among patients who did and did not sign a DNR, respectively. A DNR order was associated with mortality after adjusting for confounding factors (hazard ratio, 1.9; confidence interval, 1.70–2.03). It was also a risk factor for prolonged hospital LOS in survivors (odds ratio, 1.2; confidence interval, 1.02–1.44). Survivors who signed a DNR order were charged higher medical fees than those who did not sign a DNR (217,159 vs. 245,795 New Taiwan Dollars, p < 0.001). (4) Conclusions: Signing a DNR order in the ED increased the ICU mortality rate among patients who had respiratory failure and needed ventilator support. It increased the risk of prolonged hospital LOS among survivors. Finally, signing a DNR order was associated with high medical fees among survivors.
Temper the Specialist Nurses Heterogeneity in the Interest of Quality Practice and Mobility—18 EU Countries Study
Authors: Decock Nico , Friganovic Adriano , Kurtovic Biljana , Oomen Ber , Crombez Patrick , Willems Christine
Published: February 2022

Background: The position of the specialist nurse profession varies across the European Union. Action is required to address the challenges to promote mobility and the contribution of specialist nurses to quality of care. The purpose of the study is to identify the interfaces of the specialist nurse profession across the European Union. Methods: A mixed method study was conducted in October 2019 and total of 40 answers from 18 different European Union countries were selected using a purposive sampling method. Results: The participants had completed various Bologna degree cycles and 57.2% had followed a specific educational programme to become a specialist nurse. More professional autonomy was acquired by 81.9% participants. Conclusion: A striving for homogeneity in the interpretation of the specialist nurses role and competencies is needed to achieve better quality of care provision and facilitate their mobility around the European Union. The lack of recognition identified in this study should encourage nurse managers to consider specialist nurse roles with the aim of capitalizing on the advanced care and expertise that specialist nurses provide. These results are an opportunity to improve the specialist nurses profession with an ultimate impact on management practices of streamlined, cost-effective clinical services.
Factors Influencing Self-Management among Non-Dialysis Chronic Kidney Disease Patients
Authors: Almutary Hayfa , Tayyib Nahla
Published: February 2022

Aim: The new trend in the management of chronic kidney disease (CKD) is based on the adoption of self-management approaches. However, there is a paucity of research assessing the level of self-management behavior among non-dialysis patients. The aim of the study is to assess the association between self-management behaviors and the level of disease-specific knowledge among non-dialysis CKD patients. In addition, this study aimed to assess the predictors of self-management among non-CKD patients. Methods: A convenience sample of 203 non-dialysis patients with stage 3–5 CKD was surveyed from the nephrology clinics in Saudi Arabia. Descriptive statistics and linear regression were used to analyze the data. Results: The mean level of knowledge and self-management was 17.9 ± 3.2 and 76.9 ± 13.3, respectively. The results of the multiple regression of self-management showed that knowledge was independently associated with self-management (r = 0.51, **, p < 0.001). Conclusions: This study demonstrated that knowledge and self-management were associated with each other in non-dialysis patients. More efforts are needed to track and enhance the knowledge levels in patients with CKD. Future research should focus on the effectiveness of educational programs of self-management behavior.
Satisfaction Factors with a Dental Unit Chair System in South Korea: A Dentist’s Perspective
Authors: Son Keunbada , Son Young-Tak , Jin Myoung-Uk , Lee Kyu-Bok
Published: February 2022

This study aimed to survey users’ satisfaction with a dental unit chair in order to highlight the elements affecting the dentist’s satisfaction. The questionnaire items were drawn up with seven components that constitute a dental unit chair, including the light, patient seat, foot controller, water fountain and cuspidor, monitor, bracket table and controller, and dentist chair. With these questionnaire elements, a pilot experiment was conducted to test the reliability, and reliability analysis was conducted. The scale reliability was checked using Cronbach’s alpha coefficient. Bartlett’s test of sphericity, the Kaiser-Meyer-Olkin (KMO) measure, and factor analysis were performed to test whether the items would constitute appropriate questionnaire items for the survey. The survey was conducted with 26 dentists with more than three years of clinical experience. A correlation analysis was conducted using Pearson’s correlation coefficient (PCC) (α = 0.05) to analyze the impact of the factors on the overall satisfaction with the dental unit chair. The items that were strongly correlated with the overall satisfaction score of the dental unit chair were the design and appearance quality of the dental unit chair (PCC = 0.781), its maintenance (PCC = 0.784), and the overall satisfaction with the water fountain and cuspidor (PCC = 0.703) (p < 0.05). Most of the questionnaire items could affect the overall satisfaction with the dental unit chair. Additionally, because the design and appearance quality, maintenance, and overall satisfaction with the water fountain and cuspidor may have the greatest impact on the overall satisfaction with the dental unit chair, the improvement of these elements may bring about the enhancement of the overall satisfaction.
Association between Frequency of Going Out and Psychological Condition among Community-Dwelling Older Adults after the COVID-19 Pandemic in Japan
Authors: Shimokihara Suguru , Maruta Michio , Akasaki Yasuaki , Ikeda Yuriko , Han Gwanghee , Kamasaki Taishiro , Tokuda Keiichiro , Hidaka Yuma , Akasaki Yoshihiko , Tabira Takayuki
Published: February 2022

Background: The psychological condition and frequency of going out (FGO) of community-dwelling older adults after the spread of COVID-19 will provide insights for supporting the daily lives of community-dwelling older adults. Going out is defined as moving from one’s own home to a place or region beyond one’s own home and is considered to reflect the daily and social life of community-dwelling older adults. This study investigates the relationship between the FGO and current psychological condition after the second wave of COVID-19 in community-dwelling older adults in Japan. Methods: This study adopted a self-administered questionnaire by mail. A total of 493 members of CO-OP Kagoshima were included in the analysis and divided into two groups according to the change in FGO. Multiple logistic regression analysis was conducted after a bivariate analysis to investigate the relationship between the FGO and psychological condition. Results: Significant differences were noted between the groups with decreased FGO and those with increased/unchanged FGO in general and pandemic-related psychological condition. Multiple logistic regression analysis showed a significant relationship between FGO and psychological condition, such as mental fatigue, not smiling as much as before, and anxiousness to go outside. Conclusion: Community-dwelling older adults may have experienced a decrease in the frequency of going out and a detrimental effect on their psychological condition after the COVID-19 pandemic. This finding may inform strategies to identify priorities for psychological approaches altered by COVID-19 to prevent confinement and stress in older adults.
Change of Direction Speed and Reactive Agility in Prediction of Injury in Football; Prospective Analysis over One Half-Season
Authors: Mijatovic Dragan , Krivokapic Dragan , Versic Sime , Dimitric Goran , Zenic Natasa
Published: February 2022

Agility is an important factor in football (soccer), but studies have rarely examined the influences of different agility components on the likelihood of being injured in football. This study aimed to prospectively evaluate the possible influences of sporting factors, i.e., flexibility, reactive agility (RAG), and change of direction speed (CODS), on injury occurrence over one competitive half-season, in professional football players. Participants were 129 football professional players (all males, 24.4 ± 4.7 years), who underwent anthropometrics, flexibility, and RAG and CODS (both evaluated on non-dominant and dominant side) at the beginning of second half-season 2019/20 (predictors). Over the following half-season, occurrence of injury was registered (outcome). To identify the differences between groups based on injury occurrence, t-test was used. Univariate and multivariate logistic regressions were calculated to identify the associations between predictors and outcome. Results showed incidence of 1.3 injuries per 1000 h of training/game per player, with higher likelihood for injury occurrence during game than during training (Odds Ratio (OR) = 3.1, 95%CI: 1.63–5.88) Univariate logistic regression showed significant associations between players’ age (OR = 1.65, 95%CI: 1.25–2.22), playing time (OR = 2.01, 95%CI: 1.560–2.58), and RAG (OR = 1.21, 95%CI: 1.09–1.35, and OR = 1.18, 95%CI: 1.04–1.33 for RAG on dominant- and non-dominant side, respectively), and injury occurrence. The multivariate logistic regression model identified higher risk for injury in those players with longer playing times (OR = 1.81, 95%CI: 1.55–2.11), and poorer results for RAG for the non-dominant side (OR = 1.15, 95%CI: 1.02–1.28). To target those players who are more at risk of injury, special attention should be paid to players who are more involved in games, and those who with poorer RAG. Development of RAG on the non-dominant side should be beneficial for reducing the risk of injury in this sport.
Short-Term Effects of the EU Nitrate Directive Reintroduction: Reduced N Loads to River from an Alluvial Aquifer in Northern Italy
Authors: Severini Edoardo , Bartoli Marco , Pinardi Monica , Celico Fulvio
Published: February 2022

The Po Plain (northern Italy) is one of the largest aquifers in Europe, and 67% of the utilized agricultural land in this area is classified as a nitrate vulnerable zone (NVZ). However, it hosts intensive agriculture and livestock farming. In a stretch of the Mincio River (a tributary of the Po River), hydraulic heads and physico-chemical parameters of river and groundwater were monitored for a hydrologic year (2020–2021), to evaluate the effects of manure fertilization and flooding irrigation on surface- and groundwater chemistry. From 2020 the Nitrate Directive’s fertilization limit was reintroduced and a comparison has been performed comparing surface- and groundwater data from the 2019 fertilization period (before limit reintroduction) and 2020 (after). Results suggest that in 2021 the phreatic aquifer displayed elevated nitrate (NO3−) concentrations, exceeding 50 mg L−1, although average values were lower than those of 2019. Nitrate loads in the Mincio River reached 6670 kg NO3− d−1 and resulted from the overfertilization in the surrounding area and the quick transfer of nitrogen from groundwater to the river. As compared to 2019, the river loads decreased by 59%, suggesting that the introduction of fertilization limits can produce measurable, short-term responses in alluvial aquifers.
Is Population Density Associated with Non-Communicable Disease in Western Developed Countries? A Systematic Review
Authors: Carnegie Elaine Ruth , Inglis Greig , Taylor Annie , Bak-Klimek Anna , Okoye Ogochukwu
Published: February 2022

Over the last three decades, researchers have investigated population density and health outcomes at differing scale. There has not been a systematic review conducted in order to synthesise this evidence. Following the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines, we systematically reviewed quantitative evidence published since 1990 on population density and non-communicable disease (NCD) within Westernised countries. Fifty-four studies met the inclusion criteria and were evaluated utilising a quality assessment tool for ecological studies. High population density appears to be associated with higher mortality rates of a range of cancers, cardiovascular disease and COPD, and a higher incidence of a range of cancers, asthma and club foot. In contrast, diabetes incidence was found to be associated with low population density. High and low population density are therefore risk markers for a range of NCDs, indicating that there are unidentified factors and mechanisms underlying aetiology. On closer examination, our synthesis revealed important and complex relationships between population density, the built environment, the nature of greenspace and man-made exposures. In light of increasing rates of morbidity and mortality, future research is required to investigate these associations in order to establish causative agents for each NCD.
Parental Autonomy Support and Pathological Internet Use among Chinese Undergraduate Students: Gratitude Moderated the Mediating Effect of Filial Piety
Authors: Ma Chunhua , Ma Yongfeng , Lan Xiaoyu
Published: February 2022

Applying an integrated theoretical model consisting of the socioecological theory, the self-determination theory, and the broaden-and-build theory, the present study tested a moderated mediation model of parental autonomy support, filial piety, and gratitude to study how these factors are jointly related to pathological Internet use (PIU) in Chinese undergraduate students. A total of 1054 Chinese undergraduate students (M age = 20.35, SD = 1.00, 34.7% females) aged between 16 and 24 years participated in this study. They were instructed to complete self-reported questionnaires on parental autonomy support, filial piety, gratitude, and PIU. The results showed that parental autonomy support was negatively associated with PIU, and filial piety partially mediated this relation. Specifically, parental autonomy support was positively related to filial piety, which, in turn, was negatively associated with PIU. In addition, gratitude moderated the first path of the indirect relation and the direct relation of this mediation effect. To be specific, undergraduate students with higher gratitude showed high filial piety and low PIU, in the context of low parental autonomy support, than those with lower gratitude. Taken together, the current study contributes to extant research by highlighting the vital role of parental autonomy support in mitigating undergraduate students’ PIU and illustrating how filial piety explains the underlying mechanism of this association. This study also provides novel insights into intervention or prevention programs by demonstrating that gratitude alleviates the adverse effect of low parental autonomy support on students’ PIU.
Restriction of Access to Healthcare and Discrimination of Individuals of Sexual and Gender Minority: An Analysis of Judgments of the European Court of Human Rights from an Ethical Perspective
Authors: Skuban Tobias , Orzechowski Marcin , Steger Florian
Published: February 2022

Individuals of sexual and gender minority (SGM) form a vulnerable group with specific healthcare needs that might be prone to experience discrimination and restrictions regarding their access to healthcare. As the judgments of the European Court of Human Rights (ECtHR) offer a normative perspective on these issues, we analyzed them systematically (1) to identify whether and in what manner ECtHR’s judgments concern restriction of access to healthcare for SGM individuals and (2) to identify and categorize the ways of discrimination to which SGM individuals are exposed. We conducted a systematic search of the database of the ECtHR’s judgments with the use of specified search terms. Descriptive statistics were performed on the identified judgments. Subsequently, we analyzed the judgments with the use of a qualitative method of thematic analysis. We identified n = 73 cases relevant for our study. In n = 7 (9.59%) of judgments, we found limitations of access to healthcare for SGM individuals, e.g., in cases of restrictions for transsexual individuals to receive hormone or surgical therapy. We regard this as a specific form of discrimination. Furthermore, we identified five other categories of discrimination: restriction of parental rights, failure to respect one’s gender identity/sexual orientation, discrimination by jurisdiction, prohibition of promotion, and verbal/physical attacks. The ECtHR proves to have a balanced view on the sensitive topic of sexual self-determination condemning any form of discrimination or restriction of access to healthcare. However, there is a need for further research on discriminatory acts by other individuals, e.g., healthcare providers, rather than by public authorities.
Interventions to Improve Physical Capability of Older Adults with Mild Disabilities: A Case Study
Authors: Wu Cheng-En , Li Kai Way , Chia Fan , Huang Wei-Yang
Published: February 2022

Ageing is related to changes in physical health, including loss of mobility and muscle function. It can lead to impaired physical capability and reduced quality of life. The purpose of this study was to investigate whether a physical activity rehabilitation program (PARP) could improve range of joint motion (ROM), grip strength, and gait speed of older adults with mild disabilities. Forty older adults in a long-term care center in Taiwan joined as human participants and were split into control and experimental groups. The participants in the experimental group joined a PARP for eight weeks. The ROM of bodily joints, grip strength, and gait speed of all participants were measured both before and after the eight-week period. The results showed that all the ROMs, grip strength, and gait speed of the participants in the experimental group increased significantly after attending the program. The improvement of the ROMs for male and female participants in the experimental group ranged from 3.8% to 71% and from 7.8% to 75%, respectively. Male participants had greater improvement on gait speed (50%) than their female counterparts (22.9%). Female participants, on the other hand, had greater improvement on grip strength (25.4%) than their male counterparts (20.3%). The ROM, grip strength, and gait speed of the control group, on the other hand, did not change significantly during the same period. The results showed that the PARP adopted in this study was effective in increasing the ROM, grip strength, and gait speed of those who had joined the PARP. This study shows that an eight-week PARP without the use of gym machines was beneficial in reducing sarcopenia in elderly people with mild disabilities.
Factors Associated with Attitudes toward Aging among Taiwanese Middle-Aged and Older Adults: Based on Population-Representative National Data
Authors: Lee Shu-Hsin , Yeh Chih-Jung , Yang Cheng-Yu , Wang Ching-Yi , Lee Meng-Chih
Published: February 2022

In middle-aged and older adults, attitude toward aging (ATA) exerts significant influences on their current and future health. For health promotion to be successful, participants’ ATA requires health care providers’ attention. Knowing the factors associated with ATA can facilitate future studies to investigate effective interventions. The aim of this study was to identify the factors associated with ATA in middle-aged and older adults. This cross-sectional study analyzed data of a nationally representative sample of adults aged 58 years and older collected in a population-based longitudinal study: the Taiwan Longitudinal Study on Aging (TLSA). To identify the factors associated with ATA, we investigated demographic factors (age, gender, education, marital and cohabitation status, and financial satisfaction status) and health-related factors (number of co-morbidities, depression, physical function dependency) with bivariate analysis and multiple regression analysis. To identify the activities beneficial to ATA over and above demographic and health-related factors, various activities (exercise, volunteer service, and leisure activities) were each examined individually by multiple regression analysis. The factors detrimental to ATA were advanced age, a higher number of co-morbidities, living alone, depression, and dependence on physical function. Those beneficial to ATA were higher education, financial satisfaction, physical exercise, volunteer service, and six leisure activities.
Over-the-Counter Medicine Attitudes and Knowledge among University and College Students in Brunei Darussalam: Findings from the First National Survey
Authors: Abdullah Ishpa Shapiah , Chaw Li Ling , Koh David , Hussain Zahid , Goh Khang Wen , Abdul Hamid Asma A’tiyah , Ming Long Chiau
Published: February 2022

Over-the-counter (OTC) medicine is defined as safe and effective for the general public to use, without seeking therapy from a health professional. As primary social media and internet users, university and college students are more likely to be exposed to unverified sources of health information. This study aims to assess the knowledge, attitudes, and behaviour of students at institutions of higher learning in Brunei with regard to the safe use of OTC medicines. A cross-sectional study was performed using a self-administered online questionnaire, adapted from the literature with additional information from the United States Food and Drug Administration (FDA) on the educational resources in understanding OTC medicine for consumers. The questionnaire consisted of 4 sections: demographic information, knowledge of OTC medicines, attitudes, and practice. Descriptive and inferential statistics were used for data analysis. A total of 335 students returned a completed questionnaire. The students had a mean knowledge score of 7.1 out of 9, with more than half (53.4%) having good knowledge (knowledge score > 7), and only a small percentage (5.7%) with poor knowledge. Almost all of the students (99.7%) had a positive attitude toward OTC medicine use. Few of the students practiced improper habits in terms of OTC medicine use, such as not reading the instructions or taking more than the recommended dose. Awareness of proper OTC medicine use among students in institutions of higher learning is necessary to prevent the rise of inappropriate user practices.
Environmental Penalties, Investor Attention and Stock Market Reaction: Moderating Roles of Air Pollution and Industry Saliency
Authors: Wu Hua , Feng Taiwen , Jiang Wenbo , Kong Ting
Published: February 2022

Despite the importance of environmental penalties in environmental enforcement, how and under what situations they impact stock market reaction is still unclear. Drawing on the theories of expectancy violation and attention driven, a conceptual model is built to explore how environmental penalty influences stock market reaction through investor attention. Furthermore, it is explored that the air pollution and industry saliency facilitate the indirect relationship between environmental penalty and investor attention. We empirically test this theoretical framework using a sample of 88 listed companies that received the environmental penalty. Up to 31 December 2020, a total of 88 A-share listed companies in Shanghai and Shenzhen stock exchanges were obtained as samples by collecting the announcement of environmental penalties of listed companies on Juchao Network. Furthermore Baidu index is taken as a proxy for investor attention in this study. Our findings reveal that investor attention plays mediating role in the relationship between environmental penalty and abnormal returns, while the direct effect of environmental penalty on stock market reaction has not been verified, thus, investor attention plays a complete mediating role between them. In addition, air pollution moderates the relationship between Environmental penalties and investor attention. The study found that enterprises in heavy pollution industries might suffer safety-in-numbers effect, which would weaken the directly negative impact of environmental penalties, and verified the moderating effect of industry saliency. These findings provide theoretical and practical implications for understanding how environmental penalties influence on stock market reaction.
Dilemmas and Repercussions of Workplace Violence against Emergency Nurses: A Qualitative Study
Authors: Hsu Mei-Chi , Chou Mei-Hsien , Ouyang Wen-Chen
Published: February 2022

Nurses received the highest rate of workplace violence due to their close interaction with clients and the nature of their work. There have been relatively few qualitative studies focus on nurses’ perceptions of and experiences with the antecedents, dilemma and repercussions of the patient and visitor violence (PVV), leaving a considerable evidence gap. The aim of this study was to explore nurses’ experience of PVV in emergency department, the impact of PVV on quality of care, and supports needed after exposure to such incidents. We conducted semi-structured interviews with a purposive and snowball sample of nurses, and analyzed the content of the interview transcripts. A total of 10 nurses were approached and agreed to participate. Those participants ranged in age from 24 to 41 years old, eight female and two male nurses, and the majority of them (80%) held a university Bachelor degree in nursing. The average time in nursing practice was 7.2 years. We conceptualized five analytical themes, which comprised: (1) multifaceted triggers and causes of PVV; (2) experiences following PVV; (3) tangled up in thoughts and struggle with the professional role; (4) self-reflexivity and adjustment; and, (5) needs of organizational efforts and support following PVV. This paper provides compelling reasons to look beyond solely evaluating the existence of workplace, and considering the perceived professional inefficacy, impacts of being threatened or assaulted in nurses. There are also urgent needs in provision of prevention and management of workplace training programs to ensure the high-quality nursing care.
Netball Shoots for Physical and Mental Wellbeing in Samoa: A Natural Experiment
Authors: Richards Justin , Sherry Emma , Tamala Fetuao , Schuster Suzie , Schulenkorf Nico , Keane Lewis
Published: February 2022

Sport-for-development programs claim to address key determinants of recreational physical activity participation and subsequent development outcomes in low-income settings. We conducted a natural experiment with pre–post measures taken from women in the 12 villages in Samoa, some of which voluntarily participated in the sport-for-development intervention. The intervention comprised a six-week netball league delivered by local volunteers who attended coaching workshops, received ongoing support from the national governing body and were provided with infrastructure and equipment to conduct local training sessions. Changes in netball participation, recreational physical activity, body composition, mental wellbeing and socio-ecological determinants of physical activity were compared between intervention and comparison villages using a univariate ANOVA. The intervention reached women who participated in little recreational physical activity and had poor physical and mental wellbeing. Program uptake was higher in villages with the strongest social support for netball participation. Local social support and capacity to independently organize netball activities increased. There were concurrent improvements in netball participation, physical activity levels, mental wellbeing and body weight in the intervention villages. Our findings support scaling-up of the intervention in similar settings but preceding this with formative evaluation to identify low active communities that are “primed” to participate in the proposed activity.
Methodology for the Determination of a Process Safety Culture Index and Safety Culture Maturity Level in Industries
Authors: Siuta Dorota , Kukfisz Bożena , Kuczyńska Aneta , Mitkowski Piotr Tomasz
Published: February 2022

A mature of safety culture is crucial to preventing and mitigating accidents, incidents, and unsafe behaviors in the process industry, so as to make it more sustainable and economically responsible. Measurement, investigation, and assessment of the safety culture using interviews, questionnaires, behavior observation, reviewing documentation, and its impact on the safety performances of an organization is complicated, challenging, and requires a commitment to all employees. The aim of this study was to propose a novel, unique semi-quantitative methodology for the determination of a total process safety culture index and parametric model of process safety culture maturity in an organization based on the Bradley model. The methodology includes a questionnaire concerning different process safety culture factors, calculation procedures, and a graphical tool. In addition, three quantitative survey indicators were proposed: indicators of direct communication, average communication time, and the applicability rate of the proposed changes by employees. A fully-developed total process safety culture index allows for identifying, hierarchizing, and benchmarking different factors of the safety culture among companies and sectors. Moreover, it will enable identifying the area of actions required to improve safety practices and elements applied to the organization analyzed. The proposed methodology was verified in a case study of one energy company with three locations in Poland and can be easily applied to different industrial fields, including logistics and warehousing, the food industry, the paper industry, security services, fire services, and environmental and other agencies.
Super Divya, an Interactive Digital Storytelling Instructional Comic Series to Sustain Facilitation Skills of Labor and Delivery Nurse Mentors in Bihar, India—A Pilot Study
Authors: Kalra Anika , Subramaniam Nidhi , Longkumer Ojungsangla , Siju Manju , Jose Liya Susan , Srivastava Rohit , Lin Sunny , Handu Seema , Murugesan Sudha , Lloyd Mikelle , Madriz Solange , Jenny Alisa , Thorn Kevin , Calkins Kimberly , Breeze-Harris Heidi , Cohen Susanna R. , Ghosh Rakesh , Walker Dilys
Published: February 2022

To improve the quality of intrapartum care in public health facilities of Bihar, India, a statewide quality improvement program was implemented. Nurses participated in simulation sessions to improve their clinical, teamwork, and communication skills. Nurse mentors, tasked with facilitating these sessions, received training in best practices. To support the mentors in the on-going facilitation of these trainings, we developed a digital, interactive, comic series starring “Super Divya”, a simulation facilitation superhero. The objective of these modules was to reinforce key concepts of simulation facilitation in a less formal and more engaging way than traditional didactic lessons. This virtual platform offers the flexibility to watch modules frequently and at preferred times. This pilot study involved 205 simulation educators who were sent one module at a time. Shortly before sending the first module, nurses completed a baseline knowledge survey, followed by brief surveys after each module to assess change in knowledge. Significant improvements in knowledge were observed across individual scores from baseline to post-survey. A majority found Super Divya modules to be acceptable and feasible to use as a learning tool. However, a few abstract concepts in the modules were not well-understood, suggesting that more needs to be done to communicate their core meaning of these concepts.
Relationship between Health Literacy and Knowledge, Compliance with Bowel Preparation, and Bowel Cleanliness in Older Patients Undergoing Colonoscopy
Authors: Gwag Minju , Yoo Jaeyong
Published: February 2022

Compared to young adults, it is difficult for the older people with relatively low health literacy to perform proper bowel preparation for a colonoscopy. This study aims to identify the relationship between knowledge, compliance with bowel preparation, and bowel cleanliness with health literacy in older patients undergoing colonoscopy. The participants were 110 older people undergoing colonoscopy, recruited from an endoscopy hospital in G metropolitan city, South Korea. Data obtained from a structured questionnaire that included items on health literacy and knowledge of and compliance with bowel preparation, and the Aronchick bowel cleanliness scale. The data were analyzed using descriptive statistics, χ-test, Pearson’s correlation, t-test, and ANCOVA. Participants who were younger and those with a higher education level and better economic status had a statistically significantly higher health literacy level. Older people with a health literacy level of 7 points and above had a higher knowledge level and bowel cleanliness index, a showed better compliance with bowel preparation. The results highlight the need for developing a customized education intervention program that can improve health literacy for successful bowel preparation and examination of the older population undergoing colonoscopy.
Development of a Survey of Sunscreen Use and Attitudes among Adults in Two Coastal States, 2019
Authors: Glanz Karen , Kwong Pui L. , Avelis Jade , Cassel Kevin
Published: February 2022

Skin cancer is the most common form of cancer in the United States, and regular use of broad-spectrum sunscreens can prevent skin cancer. However, a new law in Hawaii that limits sunscreen choices due to the belief that some UV (ultraviolet) filters may damage coral reefs may reduce sunscreen use and increase skin-cancer risk. Because of this, there is a need for measurement tools to help understand consumer behavior and determinants of sunscreen purchase and use. The objectives of this study were (1) to test new questionnaire measures relevant to the Hawaii Sunscreen Ban; and (2) to assess adults’ knowledge, attitudes, and habits related to sunscreen in two other coastal states. This survey of adult residents of California and Florida was conducted in the summer of 2019. Newly developed scales addressed beliefs about effects of sunscreens on aquatic/marine environments and awareness of the Hawaii sunscreen ban. Respondents completed the survey twice to evaluate the test–retest reliability. Respondents (n = 162) were mainly female, White, and college-educated. New scales had moderate-to-high internal consistency and high test–retest reliability. Sunscreen use was high, sunburn was common, and knowledge and attitudes about sunscreen were modest. Most respondents did not know the specifics of the Hawaii Sunscreen Ban. In multivariate models, significant predictors of sunscreen use were being older, female, and having higher sunscreen knowledge. Sunscreen beliefs were not significantly associated with sunscreen use or sunburn. The findings support the use of the newly developed survey and suggest that more education about sunscreen and sunscreen ingredients is needed.
Physical Fitness—Not Physical Activity Levels—Influence Quality of Life in Anorexia Nervosa
Authors: Agne Alexa , Olmedillas Hugo , Pérez Ruiz Margarita , del Valle Soto Miguel , Fernandez-del-Valle Maria
Published: February 2022

Background: Incorporating physical activity (PA) has been a challenge for health care professionals working with anorexia nervosa (AN) patients. This has contributed to partial physical fitness (PFit) recovery that persists after weight restoration. Objective: This cross-sectional study aimed to examine the relationships between PA, sedentary behaviors, PFit, and quality of life (QoL) in a group of adolescents after hospitalization. Methods: QoL, PA, and sedentary behaviors were measured using the Health-Questionnaire Short-Form 36 (SF-36) and accelerometers, while PFit was assessed through cardiorespiratory fitness, body composition (anthropometry), and strength (six repetition maximum) tests in a total of 63 patients. Results: Light-PA (LPA), moderate-PA (MPA), moderate-to-vigorous-PA (MVPA), and relative sedentary time (%ST) did not meet the recommendations (p < 0.001). Only 22% of the patients met MVPA criteria, and ~82% exceeded %ST. SF-36 scores were lower than normative values except the physical component scale. Absolute cardiorespiratory fitness was reduced (p < 0.001) in 84% of the patients, and was positively associated to body weight, body mass index (BMI), circumferences, and muscle areas. Additional positive significant relationships were found between QoL, muscular strength, and body composition, and negative associations between vigorous-to-very vigorous PA and BMI, skinfolds, and percent body fat. Regression analyses revealed lower body strength as an explanatory factor for improved QoL (OR 1.03, 95%CI 1.00–1.07). Conclusions: PFit and QoL scores are poor after hospitalization. LPA, MPA, and MVPA do not meet recommendations. PFit management—with emphasis on improving muscular fitness—may be a valuable strategy for QoL improvement in AN after hospitalization.
Tapping the Potential of Resilience to Support an Integrated and Person-Centred Approach to Health and Wellbeing—Developing a Simple Assessment Tool for Practice
Authors: Stein Katharina Viktoria , Rutz Wolfgang , Hladschik-Kermer Birgit , Dorner Thomas E.
Published: February 2022

(1) Background: The push towards population health management and the need for new approaches in health services delivery focusing on the prevention and management of chronic diseases has helped in advocating for more person-centred care, and thus for integration of physical and mental health. Resilience plays a key role in supporting sustainable lifestyle changes and promoting health and wellbeing, but most assessment tools available today are too long for widespread use. The purpose of this paper is to describe the development of a new diagnostic tool to capture a person’s resilience and resources. (2) Methods: This paper outlines the interrelatedness of different theories of salutogenesis, social determinants of health and health promotion with resilience and establishes resilience as a key enabler to promote health and wellbeing. (3) Results: A new, short questionnaire is proposed based on the triade of evidence-based medicine, which should be easy to use and give a good assessment of a person’s resilience. (4) Conclusions: There are many reasons why the call for a short and easy-to-use assessment tool for resilience is warranted. In view of the international transition towards integrated, person-centred health systems, such a tool would find many usages. It would also support the strategies to tackle multi-morbidity, complex conditions and the social determinants of health in its focus on strengthening an individual’s ability to cope with adverse events, and actively engage in health promotion and community involvement programmes. The next step is to test the tool in practice and validate it.
M-GRCT: A Dynamic Circular Economy Model for the Optimal Design of Waste Management Systems in Low-Income Municipalities
Authors: Vargas-Terranova Camilo-A. , Rodrigo-Ilarri Javier , Rodrigo-Clavero María-Elena , Rozo-Arango Miguel-A.
Published: February 2022

This article introduces M-GRCT, a circular economy decision support model for the design of recyclable waste management systems in low-income municipalities. The model allows for performing calculations on a set of two scenarios integrating a sociocultural dynamics assessment, this being a characteristic feature of this type of municipalities. The model also integrates the analysis of the remaining variables usually addressed in solid waste management schemes while considering topics such as reduction of the carbon footprint due to activities such as the transport of recyclable waste, the generation of leachates, the generation of greenhouse gases and the promotion of an increase in the number of associated recyclers and selective routes. The economic evaluation of the different implementation scenarios is supported by a dynamic tool called DATA4 (a macro-type array accompanied by two control panels programmed in Visual Basic and dashboards by Power BI). M-GRCT constitutes a tool for the promotion of good environmental practices and the identification of strategies for the promotion of local development mechanisms. Results provided by the model contrast with those obtained by traditional linear economy approaches. An illustrative example of the application of the M-GRCT model is shown. The model was used to simulate the municipal solid waste managing system of the municipality of Guateque (Colombia). The results show the importance of integrating both economic and environmental costs to optimally allocate governmental and private resources when the recycling rate is expected to increase in the next 10 years.
Accidentally Swallowing a Toothbrush in a Patient during a Vomiting Attempt: Literature Review and Case Report
Authors: Mesa-López Maria José , Martínez-Camacho Carina , Mesa Francisco
Published: February 2022

Swallowing a whole toothbrush is a rare event. As of today, no case described has documented that the foreign body has passed through the entire gastrointestinal tract and has been spontaneously eliminated. Places where it is most frequently retained have been described. Only in one single case described did the foreign body reach the colon. We describe the main injuries caused by this foreign body, and the most common correct therapeutic approach for solving the problem. The third case in the literature is presented, with diagnosis and treatment of a woman who, in an attempt to induce vomiting, swallowed a toothbrush which became lodged in her stomach. The patient, at the time of the examination, only showed abdominal pain and anxiety.