Members Of Association Research Articles

The use of digital occupational health services among employer customers: A cross-sectional study

Occupational health (OH) service providers, together with their client organizations co-operate in promoting health and work ability. Alongside with the so-called traditional services, more and more digital services are offered by OH service providers. However, little is known how the employer customers experience and use digital OH services. This study evaluates the types of digital OH services employer customers use and how they assess the usefulness and ease of use of these digital services. Furthermore, the aim is to find out factors associated the usefulness and ease of use. To determine these features of usefulness and ease of use of digital services the Technology Acceptance Model was utilized. A cross-sectional, electronic survey was carried out to the members of human resources (HR) and entrepreneur associations between December 2022 and January 2023. The survey was in Finnish. The research material consisted of the employer customers’ answers to the multiple-choice questions of the use, usefulness and ease of use of digital OH services. The data was analyzed by quantitative statistical analysis. A total of 455 respondents took part in the study, comprising 198 representatives of HR professionals and 257 entrepreneurs. Most of the respondents were women (65%) and over 50 years old (61%). HR professionals rated their information and communications technology skills significantly more often good or really good compared to the entrepreneurs, being 92 % and 62 %, respectively. The most frequently utilized digital OH services were the ability to update personnel’s information in the OH patient registry (48.0%) and remote action plan negotiations (37.1%). Less than one-third of the respondents (29.9%) took part in remote work ability negotiations, while approximately one-fifth (20.8%) participated in remote workplace surveys. In general, the HR professionals used digital OH services more frequently and estimate the usefulness and the use of digital OH services more positively compared to the entrepreneurs (p<0.05). The study produced new information of the use and experiences of using digital OH services among the employer customers. The findings can be used to optimize the delivery and effectiveness of digital OH services for all employer customers, especially for the entrepreneurs who seemed be less used to utilize digital services.

Burnout, Personal, and Occupational Factors as Predictors of Physician Assistant Faculty Intent to Leave After the COVID-19 Pandemic.

This study addressed whether burnout, personal, or occupational factors predicted physician assistant (PA) faculty intent to leave and established a new postpandemic national benchmark for PA faculty burnout and intent to leave. In spring 2023, a nonexperimental, cross-sectional survey was emailed to 2031 PA faculty drawn from program faculty listings and the PA Education Association member database. Descriptive statistics were used to describe the sample, and a multiple regression analysis was conducted to analyze the predictive ability of the independent variables on intent to leave. The response rate was 30% (609 of 2031), with 496 responses (24.4%) included in the analysis. The sample reflected the population of PA faculty. The regression model significantly predicted intent leave (P < .001). The adjusted R2 was 0.46, indicating the combination of independent variables predicted 46% of the variance in PA faculty intent to leave. Significant predictors included emotional exhaustion and identifying as multiracial (P < .001), control and values (P < .01), and depersonalization, fairness, rewards, and clinical year faculty role (P < .05). The sample had moderate levels of burnout and experienced burnout at higher rates than in prepandemic studies. Physician assistant faculty in administrative leadership roles had the highest levels of burnout and intent to leave. Despite this, PA faculty intent to leave measures were similar to prepandemic levels. Several of the predictive variables were related to well-being and social-emotional aspects of the workplace. These findings have implications for institutional policies and practices that support faculty well-being and workplace culture to enhance retention.

British Oncology Pharmacy Association Delphi consensus guidelines: Co-infusion of trometamol-containing calcium folinate (Leucovorin) with systemic anti-cancer treatments.

Drug stability and compatibility are critical factors influencing the cost and logistics of treatment delivery, therapeutic effectiveness, and patient safety. This is particularly significant in the realm of cancer chemotherapeutics, where stability and compatibility studies play a vital role in ensuring rational and safe medicine administration. Oxaliplatin, fluorouracil, and irinotecan, commonly used in various combinations for gastrointestinal cancers, are complemented by co-administration of folinic acid in certain protocols. Notably, some folinic acid preparations include trometamol as an excipient, potentially impacting the stability of the chemotherapeutic agents if infused concomitantly. This study seeks to establish guidelines for oncology multidisciplinary teams, addressing potential risks associated with the combination of trometamol-containing folinic acid and chemotherapeutics. To achieve this, a quantitative questionnaire was distributed to members of the British Oncology Pharmacy Association (BOPA) and non-BOPA members through an online survey. Nineteen healthcare professionals with oncology experience, comprising 18 pharmacists and one nurse, completed the questionnaires. Each participant rated the validity and clarity of statements on a 5-point scale. The Delphi process concluded after the fourth round, consolidating the findings and recommendations from the multidisciplinary team. Twelve recommendations for safe practice have been made.

BRICS expansion: new geographies and spheres of cooperation. Editorial for special Issue

Starting from January 1, 2024 the ranks of the BRICS grouping expanded to include new regional powers from the Global South. The paper aims to explore the implications of the new composition of the BRICS grouping for the vectors of its economic cooperation. The conclusion reached in the paper is that the widening of the ranks of the BRICS raises the importance of coordinating policies in the economic sphere, macroeconomic policy specifically, with particular attention to reforming the BRICS Contingent Reserve Arrangement (BRICS CRA). To estimate the prospects of the BRICS development after the expansion is to assist the group’s financial institutions, including the New Development Bank and the BRICS CRA, in the creation of a diversified array of policy instruments aimed at providing support for economic development of the expanded BRICS association members.

‘Understanding socialism from the outside and from the inside’ – Interview with Alberto Chilosi

Alberto Chilosi is a former Professor of Economic Policy in the Department of Economics at the University of Pisa, Italy. After obtaining a degree in Law at Pisa, he earned a scholarship to Warsaw, receiving a Diploma in Economic Planning in 1968 and a Doctorate in Economics in 1972. He has been mainly active in the area of Comparative Economics, the Economics of Socialism, and the Economics of Transition. As a chairman of the Italian Association of Comparative Economic Studies, he has cooperated to organise the founding of the European Association of Comparative Economic Studies, serving as a member of its first Executive Committee. As a Senior Associate Member of St Antony’s College, University of Oxford (UK), he has taken part in its research in the area of Economics of Eastern Europe. He has also contributed in the areas of Macroeconomics and Growth Theory. While there are numerous examples of Western scholars who have studied the socialist system from the outside, as well as Eastern scholars who have studied it from the inside, Chilosi represents a rare case of a scholar who has managed to study the system from both perspectives simultaneously.

Socioeconomic determinants of modern climate change adaptation of small-scale vegetable farmers in Bohlabela District, Mpumalanga Province

Climate change significantly impacts small-scale agriculture, with limited adaptation capabilities due to lack of access to advanced science and technology. Traditional methods are ideal, but modern adaptations require significant financial investment, affecting the smallholder under-resourced agricultural sector's economic activities. The study analyzed climate change adaptation drivers among small-scale vegetable farmers, using a representative sample of 244 farmers from four villages through face-to-face interviews and semi-structured questionnaires. Using the Logistic regression model, the results showed resources (extension services), institutional (association membership) and societal influence (farm produce theft, and animal trespassing in the farming plots) to be associated with the use of modern climate change adaptation measures in the study area. The study recommends expanding extension services, strengthening community policing, creating community grazing guidelines, and training farmers on climate change causes, social cohesion, and mitigation strategies to address farm produce theft and animal trespassing. The study contributes new knowledge to the discourse of climate change adaptation by providing empirical evidence pointing out the need to consider critical non-climate factors for farmers when making climate change adaptations interventions in the smallholder farming sector.

Academic Engagement of Women as Orthopaedic Surgeons at the Annual Meetings of the Japanese Orthopaedic Association From 2012 to 2022.

Higher gender diversity correlates with higher patient satisfaction, higher-quality medical education, increased research productivity, and higher revenues. Although the field of Japanese orthopaedic surgery includes the lowest proportion ofwomen and lags in gender diversity, reports on the current gender diversity status in academic activities are scarce. We investigated changes in women's participation in academic activities at the Japanese Orthopaedic Association (JOA) annual meetings over the past 11 years. Data on the percentage of women in the JOA membership during 2012-2022 were analyzed to ascertain the proportion of women as first authors of oral and poster presentations, abstract reviewers, invited lecturers, seminar lecturers, general abstract oral chairpersons, symposium chairpersons, and speakers. Regarding the ratio of women among the JOA members during 2012-2022, we relied on data provided by the JOA. Data related to other categories were collected from the abstract book presented at the JOA Annual Meetings between 2012 and 2022. We analyzed the time trend for women's proportions using the Cochran-Armitage trend test. A p-value < 0.05 was considered statistically significant. During 2012-2022, the percentage of female members (4.9-6.7%), poster first authors (2.7-4.3%), abstract reviewers (0-1.5%), general abstract oral chairpersons (0-2.3%), symposium chairpersons (0-3.6%), and symposium speakers (1.6-6.8%) had increased significantly (p < 0.05). Oral first authors (2.2-4.1%), invited lecturers (0-6.8%), or seminar lecturers (0%-6.7%) showed no trend. Women engaged in academic activities at all annual association meetings did not exceed the women's proportion among the association members. Although the proportion of women members of the JOA has gradually increased and more women are involved in its annual meetings, the proportion of female presenters, invited speakers, symposiasts, and chairpersons of oral and poster presentations is generally lower than that of women as JOA members. Members should be asked to raise awareness, including more active education of women as physicians in educational institutions and the creation of positive actions to select women as physicians for more important roles (chairpersons, educational speakers, and symposiasts) in the organization of annual meetings.

Between Kochel and Kalmunz. Early plein airs by Gabriele Munter at the school "Phalanx" by Vasily Kandinsky.

The subject of the study of the proposed article is the early plein-air works of the German expressionist artist Gabriele Munter, later a member of the Blue Horseman art association, a student and friend of Vasily Kandinsky. The authors of the article aim to review and introduce into scientific circulation a number of Munter's sketches created by her during summer trips to the plein air in 1902-1903 to the Alpine towns of Kochel and Kalmunz with the Munich art school "Phalanx", headed by Kandinsky. The article also examines the picturesque plein-air works by Kandinsky, created by him in the same years there, in Bavaria - mainly landscapes and sketches of figures in the landscape. The authors of the study see as their task to trace the influence of Kandinsky's artistic manner and his role as a teacher on the formation of a Munter painter. The research methodology includes formal stylistic, comparative methods of art criticism analysis, as well as a comprehensive historical and biographical approach. The relevance of the study is due to its scientific novelty: the authors of the article for the first time in Russian-language art history literature describe the pre-expressionist works of Munter during the period of joint plein-airs with Kandinsky, trace the formation of her artistic vision and picturesque manner, the influence of Kandinsky on her formation. The development of the impressionistic technique common to Munter and Kandinsky in the early 1900s, according to the authors of the article, is combined with individual searches for expressiveness of form and color. The first experiments of plein-air oil painting in a special "spatula technique" under the guidance of Kandinsky were accompanied by the successful search for Munter in the field of graphics, mastering the technique of printing color woodcuts. The authors of the article come to the conclusion that the formation of the original manner of Munter was equally influenced by both pictorial emancipation through sketching practice in oil, as well as their own experiences in drawing and engraving.

The pediatric surgeon-scientist: An evolving breed or endangered phenotype?

IntroductionNational Institute of Health (NIH) funding is a “gold-standard” of achievement; we examined trends in NIH-funded pediatric surgeons. MethodsNIH Research Portfolio Online Reporting Tools (RePORT) was queried for American Pediatric Surgical Association (APSA) members (2012 vs 2022). Demographics and time-to-award (TTA) from fellowship were compared. Number of grants, funding allotment, award classification, administering institutes/centers, research type were studied. ResultsThirty-eight (4.6%) APSA members were NIH-funded in 2012 compared to 37 (2.9%) in 2022. Of funded surgeons in 2022, 27% were repeat awardees from 2012. TTA was similar (12 vs 14years, p=0.109). At each point, awards were commonly R01 grants (40 vs 52%, p ​= ​0.087) and basic science-related (76 vs 63%, p = ​0.179). Awardees were predominantly men (82% in 2012 vs 78% in 2022, p=0.779) and White (82% in 2012 vs 76% in 2022, p=0.586). Median amount per grant increased: $254,980 (2012) to $364,025 (2022); by $96,711 for men and $390,911 for women. Median awards for White surgeons increased by $215,699 (p=0.035), and decreased by $30,074 for non-White surgeons, though not significantly (p=0.368). ConclusionThe landscape of NIH-funded pediatric surgeons has remained unchanged between time points. With a substantial number of repeat awardees, predominance of R01 grants, and a median TTA over a decade after fellowship graduation, the phenotypes of early career pediatric surgeon-scientists are facing academic endangerment.

The Influence of Traditional Games on Freestyle Swimming Speed in Riau Aquatic Pekanbaru Swimming Association Athletes

Increased swimming speed can be attributed to factors such as improved motor coordination, physical endurance, and possibly other benefits gained through traditional play. This study aims to evaluate the effect of participation in traditional games on increasing freestyle swimming speed in athletes who are members of the Riau Aquatic Swimming Association in Pekanbaru. This study used an experimental approach by dividing athletes into two groups: a group that underwent additional traditional game sessions and a control group that underwent regular training without additional intervention. Swimming speed measurements were carried out before and after the intervention period. The results of the T test in table 4 for the experimental group obtained a calculated T value = 29.665 &gt; T table = 2.052 and a sig value. (2.tailed) = 0.000 &lt; 0.05. The conclusion of the research shows that traditional games have a significant influence on freestyle swimming speed in athletes from the Riau Aquatic Swimming Association, Pekanbaru, Riau Province.

도시 및 주거환경정비법상 조합원 지위 및 분양받을 지위

The law responsible for the biggest axis of new housing supply is the ACT ON THE IMPROVEMENT OF URBAN AREAS AND RESIDENTIAL ENVIRONMENTS (hereinafter referred to as the “Urban Improvement Act”). The Redevelopment Project and the Reconstruction Project are very close to people's lives among the Improvement Projects stipulated in the Urban Improvement Act. In these cases, the fundamental issue is whether the status of the Association Member and the Status to Purchase a Unit of Structure are recognized since the Improvement Projects are implemented by supplying new housing to those who participated as an Association Member.&#x0D; The Urban Improvement Act also has provisions concerning the Status of Association Member and limits the Right to Purchase a Unit of Structure. This is to restrain the inflow of speculators and protect the property rights of existing association members by limiting changes in the number of members and splitting shares. However, there are still various cases in the Improvement Projects. And the court's ruling on individual cases appeared to be an inconsistent result. The working community on the Improvement Projects has been quite embarrassed by that.&#x0D; It is difficult to find academic research on it, even though the legal situation regarding the recognition of the Status of Association Member and the Status to Purchase a Unit of Structure is not stable. Therefore, this paper examines the validity of the cases—the Supreme Court Decision 2023. 6. 29, 2022Du56586, etc.—that are representative cases concerning the Status of Association Member and the Status to Purchase a Unit of Structure. In particular, the Supreme Court Decision 2023. 6. 29, 2022Du56586 dealt with not only the case where one person owns a number of housings but also the situation where one household owns a number of housings as the major issues. This paper analyzes the main arguments in the precedents above. For example: (1) determination of the Status of Association Member and the Status to Purchase a Unit of Structure; (2) overlapping application of the household standard regulation and individual standard regulation; and (3) statutory interpretation.

The Development of the Cooperative Banking Sector in Selected Central and Eastern European Countries

The study assesses the development of the cooperative banking sector in selected Central and Eastern European (CEE) countries against the average statistics of the segment in those countries. It also compares it to the largest European cooperative banking group in Germany. The article presents the results of an analysis of the cooperative banking sectors between 2016 and 2021 in Poland, Bulgaria, Romania, Hungary and Germany, all of which are members of the European Association of Cooperative Banks (EACB). The selection criterion was based on the availability of detailed data on cooperative banks published by the EACB on a temporal and spatial basis.&#x0D; The empirical basis for the issues addressed in the article is a review of the reference literature and the comparative analysis of the development of the cooperative banking sector using a synthetic development indicator for the period 2016–2021. According to the theoretical and empirical analysis, Romania demonstrates the lowest level of development of the cooperative banking segment. In turn, the Polish and Bulgarian cooperative banking sectors represents a higher level of development than the Romanian one. Hungary has reached the highest level of development in the group of Central and Eastern European countries. While comparing the CEE countries to the German cooperative banking sector, their development was almost one and a half times lower and, in the case of Romania, three times lower.

Gendered perception and factors influencing the choice of innovation in the fisheries sector: A case of southern Ghana

This study seeks to examine the perception of fish workers about fisheries innovation and factors influencing the choice of innovation in Ghana's Greater Accra and Central regions. The study uses weighted mean index and multinomial logit model to analyze the data on 230 fish workforces. The results reveal that fish workforces perceive the likelihood of men innovating to be more relative to women due to the difference in the nature of fish activity undertaken by men and women. Factors such as age, gender, education, marital status, saving, credit access, perceived usefulness, association membership and location significantly affect the choice of innovation techniques. Specifically, female fish workers were found to be less likely to use entrepreneurial innovation but more likely to choose demand/supply driven innovation techniques. The paper recommends that the Ministry of Fisheries and Aquaculture Development (MoFAD) and its Development partners organize training sessions on gender dimensions to reiterate the importance of adopting fisheries innovation for enhanced productivity. Also, fish workers especially women should be encouraged to join groups and develop a culture of savings to position them for innovation adoption. With growing interest in innovative initiatives within the fisheries sector that facilitate fishing activities, this study is one of the first to explore innovation adoption from a gendered perspective in Ghana.

Do all patients with history of pelvic ring injuries need a cesarean section? – A survey of orthopaedic and obstetric providers

Objective(s)The recommended mode of delivery following pelvic ring fractures with surgical fixation is unclear. The objective of this study was to assess expert opinions from orthopaedic surgeons and obstetrician gynecologists on their recommended delivery recommendations for pregnant individuals with a history of pelvic ring injury, and to see if there was any difference in recommendations between the two specialties, and what factors influenced recommendations. Study designAn electronic, web-based survey was administered to a convenience sample of orthopaedic surgeons and obstetrician gynecologists, via advertisement to members of the Orthopaedic Trauma Association (OTA), the Society for Maternal Fetal Medicine, and querying obstetrician gynecologists practicing within the Military Health System. The survey was administered from November 2021 to December 2022. A two-proportion z-test, Chi-square or Fisher's Exact Test, and descriptive statistics were used to analyze data. ResultsSurvey respondents included 44 orthopaedic surgeons and 37 obstetricians. A total of 74 % obstetricians would recommend a trial of labor with hardware in place, while orthopaedic surgeon's recommendations varied based on the type of fixation. Forty four, 100 % of orthopaedic surgeons, recommended trial of labor if non-operative pelvic injury or unilateral posterior fixation only, 88 % recommended trial of labor if bilateral posterior fixation only, and 47.7 % for anterior trans-symphyseal plating only, 50 % for unilateral posterior and trans-symphyseal plating, and 43.2 % for bilateral posterior fixation with trans-symphyseal plating. ConclusionsThe results of these surveys demonstrate the lack of consensus as to the most appropriate birth plan for patients with a history of pelvic ring injuries. Vaginal delivery following pelvic ring fracture and fixation is possible, yet these patients are significantly more likely to undergo cesarean section than the general population. As such, we recommend that women who become pregnant after operative treatment of a pelvic ring injury develop an in-depth birthing plan with their obstetrician to determine the best course.

A Comparative Case Study of Mentoring in the Library Profession in Botswana and Trinidad and Tobago

Mentoring is a dynamic and evolving experience despite cultural, social and environmental influences in the library profession and the organization. The needs of each society and institution determine the criteria for the programme. Minimal information exists in the Caribbean and some areas of Africa on informal and formal mentoring programmes in the library profession. This paper is a comparative study into mentoring in Trinidad and Tobago and Botswana for members of the library associations. The study confined its scope to library professionals. An electronic form which contained a total of nine (9) questions, with some questions having appendages to them, derived from the research objectives was disseminated for a comprehensive comparative analysis of the two societies. The findings revealed similar information in both countries on the need for mentoring in the information profession. Librarians in both countries are not conversant with the concept of mentoring and mentoring programmes that boost library professionals. This study will raise important issues that relate to mentoring programmes for information professionals in this career field.

Investigation of Dental and Oral Health in Children and Adolescents with Special Support Needs from a Child and Adolescent Psychiatric Perspective.

The current literature lacks scientific research on child and adolescent psychiatrists' (CAPPS) perspectives on dental and oral health. This study aims to investigate the opinions and approaches of child and adolescent psychiatrists and their patients regarding oral and dental health. A questionnaire-based cross-sectional study was conducted among members of the Professional Association for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy in Germany. Out of the association members, 10.9% (n = 109) participated, with 5.2% (n = 52; 38f/14m) completing the questionnaire. Dental and oral health topics were discussed with one-fifth of the patients (19.2%), while 11.5% reported that they were "never" a part of their therapy. Patient-related concerns about dental and oral health were primarily brought into the context of child and adolescent psychiatric work. Dental treatment anxieties were prominent. Only 3.8% of the participants regularly assigned diagnoses related to dental status. The CAPPS employ a bio-psycho-social model for the genesis of oral health-related conditions in Children and Adolescents with Special Needs. CAPPS have a foundation in relationship-based work for assessing oral and dental healthcare and providing recommendations for further dental care. Regional networking and science must be further developed.

Effectiveness of Online Learning to Improve Knowledge About Metabolic Syndrome in Pregnancy

Background: Metabolic syndrome is a persistent global health problem and a risk factor for diabetes and heart disease. A metabolic syndrome that occurs during pregnancy will pose a threat to maternal and fetal health. The incidence of metabolic syndrome during pregnancy, especially in developing countries, will become a serious public health problem in the future. This study aims to assess the effectiveness of online learning in improving the knowledge of online learning participants on metabolic syndrome cases in pregnancy. Subjects and Method: This was a cross-sectional study conducted in July through Zoom online learning on Metabolic Syndrome in Pregnancy attended by 125 participants. The dependent variable was knowledge about metabolic syndrome in pregnancy. The independent variable was online learning. The data obtained from this study were in the form of pretest and post-test scores. The data were analyzed by t-test. Results: The mean score of knowledge about metabolic syndrome in pregnancy after online learning was higher (Mean= 90.8; SD= 14.05) than before (Mean= 60.08; SD= 6.94), and this was statistically significant (p= &lt;0.001). Conclusion: Online learning is effective to improve knowledge about metabolic syndrome in pregnancy among Indonesian Obstetrics and Gynecology Association (POGI) members and young POGI members. Keywords: metabolic syndrome, pregnancy, online learning. Correspondence: Nutria Widya Purna Anggraini. Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Maret/Dr. Moewardi General Hospital, Surakarta, Central Java, Indonesia. Mobile: +62 812-2651-819. E-mail: nutria_dr@staff.uns.ac.id

Azerbaijan in regional integration processes: Role and prospects of interaction with the EAEU

The study deals with theoretical and practical aspects of Azerbaijan’s participation in regional integration processes. The historical excursus of formation of international cooperation of Azerbaijan with the countries of CIS region and key economic partners in the world is considered. Azerbaijan’s economic interaction with the EAEU countries and possible potential of its development are analyzed. Based on the data of the State Statistical Committee of the Republic of Azerbaijan, we have calculated the key indicators of Azerbaijan’s foreign trade with regional economic integration groupings and proposed their hierarchy. The study substantiates that there is a significant economic and socio-humanitarian potential of Azerbaijan’s attraction to the EAEU grouping. The possibilities of Azerbaijan’s integration interaction with the EAEU are objective in nature and are primarily related to its transport and geographical location, as well as to its production capabilities and the interaction of commodity markets. So far, the integration potential has not been fully realized, but there is a clear trend towards the rapprochement of Azerbaijan with the EAEU countries. Acceleration and deepening of the use of integration potential will depend on many factors, but first of all on geopolitical and socio-economic factors. The most realistic option for Azerbaijan’s integration into the EAEU grouping is the scenario of granting the country the status of an associate member followed by a deeper degree of economic integration.

Multidisciplinary First-Line Healthcare Leaders' Roles and Experiences During the COVID-19 Pandemic in Ontario Canada.

Throughout the COVID-19 pandemic, first-line healthcare leaders across the healthcare system played crucial roles leading, motivating, and supporting staff. This study aims to describe multidisciplinary first-line healthcare leaders' experiences during the COVID-19 pandemic in Ontario, Canada using transformational and crisis leadership theory. A descriptive two-phase (quantitative & qualitative) design was conducted in the spring of 2021. Phase 1 employed an online survey sent via email to first-line leaders from various sectors who were members of healthcare professional associations in Ontario. Participants included nurse managers, professional practice leaders (e.g., occupational and physiotherapists), advanced practice nurses, and clinical educators. In Phase 2, a subset (n = 19) of the Phase 1 participants were interviewed to gain a deeper understanding of these leaders' experiences including role impact and support available. Semistructured individual interviews were conducted and recorded via Zoom©. Inductive and deductive analysis approaches identified key themes. This paper reports the qualitative findings from Phase 2. Leaders' behaviors were representative of the key dimensions of transformational and complexity leadership theories. Recommendations for leading during a crisis included: engaging in self-care activities to manage the personal impact of the crisis; teamwork and collaborative leadership; and support from fellow first-line leaders and senior leaders. Findings can inform healthcare leadership education programs designed to manage future crises for both academic and practice settings. Descriptions of first-line healthcare leaders' roles and experiences during multiple waves of the COVID-19 pandemic validated their important contributions within various health sectors.

Rectus muscle diastasis in Italian women: determinants of disease severity, and associated disorders.

Diastasis of rectus abdominis (DRA) refers to a separation of the rectus abdominis from the linea alba, which is common in the female population during pregnancy and in the postpartum period. The present study aimed at investigating DRA severity, risk factors and associated disorders. In the present cross-sectional study, a web-based questionnaire was addressed to the 23,000 members of the Women's Diastasis Association. The questionnaire comprised three parts, dedicated respectively to diastasis characteristics, possible risk factors, and related disorders. Faecal and urinary incontinences were assessed using the Wexner and ICIQ-SF score, respectively. Risk factors for diastasis severity (<3, 3-5, >5 cm) were evaluated by a multinomial regression model. Four thousand six hundred twenty-nine women with a mean age (SD) of 39.8 (6.5) years and a median BMI of 23.7 kg/m2 (range 16.0-40.0) responded to the questionnaire. Proportion of DRA >5 cm increased from 22.8% in norm weight women to 44.0% in severely obese women, and from 10.0% in nulliparous women to 39.3% in women with >3 pregnancies. These associations were confirmed in multivariable analysis. DRA severity was associated with the risk of abdominal hernia and pelvic prolapse, whose prevalence more than doubled from women with DRA <3 cm (31.6% and 9.7%, respectively) to women with DRA >5 cm (68.2% and 20.2%). In addition, most patients reported postural pain and urinary incontinence, whose frequency increased with DRA severity. The present study confirmed that DRA severity increases with increasing BMI and number of pregnancies. Larger separation between rectal muscles was associated with increased risk of pain/discomfort, urinary incontinence, abdominal hernia and pelvic prolapse. Prospective studies are needed to better evaluate risk factors.