Signs Of Distress Research Articles

Empowering women in central banking

ABSTRACT When are women appointed to the board of central banks? While progressive societal gender norms may facilitate women's ascension to leadership positions, recent research indicates that women are more likely to assume leadership positions during crisis periods. Because of the widely documented 'male dominance' in the policy domain of central banking, analyzing changes in women's descriptive representation on central bank boards provides a unique laboratory to study the role of women in economic policymaking. Building on previous literature on women's political leadership, we argue that sovereign debt crises are powerful catalysts for lifting women into leadership positions. We hypothesize that appointing women to central bank leadership positions during sovereign financial distress signals a policy change to bolster monetary policy credibility. Using data covering 90 countries from 2000 to 2017, we show that women are more likely to be appointed to central bank leadership positions during a sovereign debt crisis. A sovereign debt crisis increases the likelihood of women’s appointments to a central bank board by 21.1 percent. To mitigate concerns that our results are spurious, we implement a battery of robustness checks. Our study suggests that women's empowerment can be beneficial in restoring monetary policy credibility during sovereign financial distress.

Supporting distress behaviours in people with dementia in the community

The outward signs of distress can take many forms, including agitation, aggression, apathy, anxiety and depression and is experienced by most people with dementia at some point during the disease trajectory. Supporting people with dementia who experience distress can pose a significant challenge to community nurses who may lack the time, knowledge and skills to manage distress effectively. This article discusses distress in dementia, including the interplay between stress and distress, examines the various forms of distress and its causes. The article also presents two fictionalised case studies, drawn from the authors’ clinical experience, demonstrating evidence-based approaches community nurses can use in their practice to support people with dementia who experience distress.

Nanoplastic Contamination in Freshwater Biofilms Using Gel Permeation Chromatography and Plasmonic Nanogold Sensor Approaches.

The worldwide contamination of aquatic ecosystems by plastics is raising concern, including their potential impacts on the base of the food chain, which has been poorly documented. This study sought to examine, for the first time, the presence of nanoplastics (NPs) in biofilms from freshwater streams/rivers. They were collected at selected polluted sites, such as the industrial sector for plastic recycling and production, miscellaneous industries, agriculture, municipal wastewaters/effluents and road runoffs. In parallel, the functional properties of sampled biofilms were determined by proteins, lipids, esterase (lipase), viscosity and oxidative stress. The results revealed that biofilms collected at the plastic industries and road runoffs contained the highest NP levels based on size exclusion chromatography, fluorescence detection and a new nanogold sensor visualization method. Examination of the chromatographic elution profiles showed increased abundance and size of NPs in the 10-150 nm size range at the polluted sites. Biofilms from the plastic industry site had elevated levels of aldehydes (oxidative stress) and lipids compared to the other sites. Biofilms collected at the municipal sites had elevated levels of proteins and esterases/lipases, with a decrease in total lipids. Biofilms collected at agriculture sites had the lowest levels of NPs in this campaign, but more samples would be needed to confirm these trends. In conclusion, biofilms represent an important sink for plastics in freshwater environments and display signs of distress upon oxidative stress.

Italian university students' future time perspective and well-being during the COVID-19 pandemic.

During the COVID-19 pandemic, young adults worldwide showed signs of distress as they were affected in their specific developmental tasks, including the construction of personal and professional futures. The present study aimed to assess the situational future time perspective of Italian university students during the second pandemic wave, as measured by an ad hoc constructed instrument, to explore its interaction with some dispositional traits relevant in future construction, such as optimism, sense of life, aggression, and dispositional future time perspective, and to test their effect on psychological well-being. The total sample consisted of 389 subjects (18-35 years, M = 23.5, SD = 4.4). The results indicated that the pandemic experience, assessed by surveying specific indicators, negatively affected the future time perspective of students, particularly those dispositionally optimistic and convinced that life has meaning. However, awareness of the negative impact that the pandemic brought to the vision of the future seems to have dampened the levels of depression and stress, while anxiety was found to be related only to dispositional traits. The results also suggested the need for educational and economic policies that help young adults develop confidence in the future and in their ability to build it.

Post Obstructive Acute Pulmonary Edema after Sedation

Post-obstructive acute pulmonary edema (POAPE) is a serious and rare respiratory complication, especially under sedation. We report the case of a patient without comorbidities undergoing sedated colonoscopy who developed respiratory distress, desaturation, and clinical and radiological signs suggestive of acute pulmonary edema. Etiological investigations, including cardiac assessment, returned normal, and the patient's condition improved within hours. The diagnosis of post-obstructive pulmonary edema was established. Through this case report, we emphasize the seriousness of this complication, necessitating early intervention.

Prospective, non-blinded, randomized controlled trial on early administration of pulmonary surfactant guided by lung ultrasound scores in very preterm infants: study protocol.

Bedside lung ultrasonography has been widely used in neonatal intensive care units (NICUs). Lung ultrasound scores (LUS) may predict the need for pulmonary surfactant (PS) application. PS replacement therapy is the key intervention for managing moderate to severe neonatal respiratory distress syndrome (NRDS), with early PS administration playing a positive role in improving patient outcomes. Lung ultrasonography aids in the prompt diagnosis of NRDS, while LUS offers a semi-quantitative assessment of lung health. However, the specific methodologies for utilizing LUS in clinical practice remain controversial. This study hypothesizes that, in very preterm infants [<32 weeks gestational age (GA)] exhibiting respiratory distress symptoms, determining PS application through early postnatal LUS combined with clinical indicators, as opposed to relying solely on clinical signs and chest x-rays, can lead to more timely PS administration, reduce mechanical ventilation duration, improve patient outcomes, and lower the occurrence of bronchopulmonary dysplasia (BPD). This is a protocol for a prospective, non-blinded, randomized controlled trial that will be conducted in the NICU of a hospital in China. Eligible participants will include very preterm infants (< 32 weeks GA) exhibiting signs of respiratory distress. Infants will be randomly assigned in a 1:1 ratio to either the ultrasound or control group. In the ultrasonography group, the decision regarding PS administration will be based on a combination of lung ultrasonography and clinical manifestations, whereas in the control group, it will be determined solely by clinical signs and chest x-rays. The primary outcome measure will be the mechanical ventilation duration. Statistical analysis will employ independent sample t-tests with a significance level set at α = 0.05 and a power of 80%. The study requires 30 infants per group (in total 60 infants). This study aims to demonstrate that determining PS application based on a combination of LUS and clinical indicators is superior to traditional approaches. This approach may enhance the accuracy of NRDS diagnosis and facilitate early prediction of PS requirements, thereby reducing the duration of mechanical ventilation. The findings of this research may contribute valuable insights into the use of LUS to guide PS administration.

Postoperative hemorrhages in vestibular schwannoma surgery pontine hemorrhage. Clinical case report

Vestibular schwannoma (acoustic neuroma) is a benign tumor that develops from Schwann cells and can be life-threatening. Nowadays, surgical treatment is the method of choice in the management of patients with this type of tumor. We present a clinical case report of 71 y.o. patient with vestibular schwannoma (Koos grade IV, Samii grade 4B) with severe compression of the pons and the left cerebellar hemisphere. Microsurgical removal of the tumor was performed via the retrosigmoid approach. Starting from postoperative day 1, signs of respiratory distress developed. Control multislice spiral computed tomography (MSCT) of the brain revealed the area of hemorrhage in the left regions of the pons. On postoperative day 24 the patient's condition rapidly worsened progressing to coma with pronounced arterial hypotonia and cardiac arrest. Hemorrhage in the brain stem structures is a rare and life-threatening postoperative complication in vestibular schwannoma surgery. The incidence of postoperative hemorrhage is 2–11% of cases. Vascular complications are the leading cause of mortality. The key predisposing factors are older age, large and giant size of the tumor, tumor invasion into the pia mater of the brainstem, and vascularization of the tumor stroma. Comprehensive assessment of the tumor blood supply status, the state of the brainstem, intra- and postoperative clinical and neurophysiological monitoring, careful and thorough dissection of the tumor capsule and strict control of blood pressure in the postoperative period are the basis for the prevention of these complications.

P-792 Human endometrial organoids embedded in hybrid endometrial-derived hydrogels as a biocompatible treatment for endometrial pathologies in preclinical models

Abstract Study question Are human endometrial organoids (hEOs) labelled with Molday-ION Rhodamine B (MIRB) within hybrid endometrial-derived hydrogels a biocompatible approach to treat endometrial pathologies in immunocompetent mice? Summary answer The direct intrauterine injection of hEOs labelled with MIRB within hybrid endometrial-derived hydrogels demonstrated xenogeneic biocompatibility in preclinical models over a 2-week period. What is known already The lack of effective treatments for endometrial pathologies emphasizes the urgent need for novel bioengineering approaches. In this context, hEOs are presented as promising candidates for tissue regeneration, since they offer a native and partially undifferentiated cellular source with high proliferative capacity, which is fostered after its culture within hybrid endometrial-derived hydrogels (Gómez-Álvarez et al. 2023). Their concurrent injection aims to enhance proliferation and differentiation through its rich biochemical composition. No prior study has successfully labelled and injected hEOs in immunocompetent models, which is crucial to discern whether the therapeutic effect operates at paracrine level or involves direct tissue regeneration. Study design, size, duration This study was approved by an ethics committee. Decellularized porcine endometrium was used to create endometrial-derived hydrogels as previously described and then mixed with PuraMatrix to obtain the hybrid endometrial-derived hydrogel. After 7 days of culture, hEOs (passages 6-7) were labelled with MIRB for final tracking. Finally, hEOs were mixed with the hybrid hydrogel and injected into the uterine horns in immunocompetent mice (n = 3). After two weeks, biocompatibility was evaluated through blood and macroscopical analyses. Participants/materials, setting, methods After 7 days, hEOs were collected and labelled with MIRB (50 µg/ml) for their final tracking in the murine endometrium. Endometrial-derived hydrogel (8 mg/ml) was mixed with PuraMatrix 1% (50:50 ratio) to generate the hybrid hydrogel. After its characterization and in vitro validation (Gómez-Álvarez et al. 2023), it was used as the bioactive carrier. Each animal received a single intrauterine injection (50 µl, ∼100.000 cells). Blood, spleen, and uterus were collected after 2-week period. Main results and the role of chance Hybrid endometrial-derived hydrogels demonstrated biocompatibility and in vivo stability in mice over a 2-week period (Gómez-Álvarez et al. 2023). In this study, we aim to use this hybrid hydrogel with hEOs as a biocompatible treatment in preclinical models. After 7 days of culture, hEOs were successfully labelled with MIRB (∼85% efficacy), which was confirmed under fluorescence microscopy. The single intrauterine injection (50 µl, ∼100.000 cells) did not cause apparent adverse immune reactions in mice (n = 3) during the 2-week period. All mice exhibited no signs of distress and their behavior remained within normal parameters. Furthermore, the macroscopic examination of uterine horns revealed normal appearance, characterized by the absence of anomalies and tumors. At day 14 post-injection, haematocrit analyses showed normal white blood cell count: 0.89 ± 0.53 · 109/L neutrophils; 7.82 ± 2.23 · 109/L lymphocytes; 0.21 ± 0.13 · 109/L monocytes; 0.04 ± 0.04 · 109/L eosinophils; 0.00 ± 0.00 · 109/L basophils. In addition, no significant changes in red blood cells (9.31 ± 0.54 · 1012/L) and platelets (1063.00 ± 318.58 · 109/L) were observed. Histological analyses will be perform to assess the presence of hEOs labelled with MIRB in the murine endometrium and dilucidate their mechanism of action. Limitations, reasons for caution This study has been carried out in healthy C57BL/6 mice. To confirm the scope of this technique, the next step is to explore the regenerative potential of hEOs labelled with MIRB within hybrid endometrial-derived hydrogels in murine models with endometrial damage. Wider implications of the findings These findings demonstrate the biocompatibility of hEOs labelled with MIRB within hybrid endometrial-derived hydrogels in immunocompetent C57BL/6 mice. This bioengineering approach holds the potential to improve the treatment landscape for specific endometrial pathologies. Trial registration number Not applicable

Factors influencing meconium-stained amniotic fluid in West Guji, Oromia, Ethiopia: A cross-sectional study

BackgroundMeconium-stained amniotic fluid is an obstetric problem that occurs when a baby passes their first stool into the amniotic fluid before childbirth. It can indicate that the infant is under stress while the mother is giving birth. In addition to increasing the mother's risk of morbidity, meconium-stained amniotic fluid is linked to poor neonatal outcomes such as stillbirth, neonatal death, and meconium aspiration syndrome. However, there is currently little data on this issue. Therefore, the research aimed to determine the percentage of meconium-stained amniotic fluid and the contributing factors among women who gave birth at West Guji hospitals in Oromia, Ethiopia. MethodWe surveyed 314 systematically selected women who gave birth between June 1st and July 30th, 2022. We collected information from their medical records and interviewed them. To code and enter the collected data, Epi Data version 4.6 was utilized. For both descriptive statistics and multivariable logistic regression analysis, SPSS version 25 was used. Statistical significance was declared at a p-value less than 0.05, a 95 % confidence interval, and an adjusted odd ratio. ResultsIn the current study, out of 314, 99 (29.4 %, 95 % CI = 24.6–34.6) women have meconium-stained amniotic fluid. Obstetric factors like premature rupture of membranes (AOR = 3.24, 95 % CI = 1.79–5.88), pregnancy-induced hypertension (AOR = 5.08, 95 % CI = 2.76–9.35), and non-reassuring fetal heart rate (AOR = 2.96, 95 % CI = 1.27–6.91) influenced meconium-stained amniotic fluid. ConclusionThe results of the current study emphasize the significance of close observation to identify possible signs of fetal distress during pregnancy and delivery. To protect the baby's health, pregnant women who have an early rupture of the membranes, high blood pressure, or a non-reassuring fetal heart rate should be closely observed. Early identification of these factors can help health care providers take steps to prevent or minimize complications related to meconium-stained amniotic fluid.

Surgical management of brachycephalic obstructive airway syndrome: An update on options and outcomes.

Dogs with a brachycephalic conformation often experience a collection of abnormalities related to their craniofacial conformation, which can lead to a variety of clinical signs such as stertor, exercise intolerance, respiratory distress, and gastrointestinal signs such as regurgitation, among others. This collection of abnormalities is termed brachycephalic obstructive airway syndrome (BOAS). With the rise in popularity of several brachycephalic breeds, veterinarians and veterinary surgery specialists are seeing these dogs with increasing frequency for surgical and medical treatment of these clinical signs, leading to an increased interest in developing surgical techniques for dogs with BOAS and evaluating objective methods of determining outcome after surgery. Advances in anesthetic management including standardized protocols and use of local nerve blocks to decrease opiate use may decrease postoperative complications. A variety of new or modified surgical techniques to manage hyperplastic soft palate and stenotic nares, among other BOAS components, have been developed and studied in recent years. Newer studies have also focused on risk factors for development of major complications in the postoperative period and on objective measurements that may help determine which patients will receive the most benefit from BOAS surgery. In this review, the newest studies focused on updates in anesthetic management, surgical techniques, and postoperative care will be discussed. Additionally, updated information on complication rates and outcomes for dogs undergoing surgical management of BOAS will be included.

Predicting inmate suicidal behavior with an interpretable ensemble machine learning approach in smart prisons.

The convergence of smart technologies and predictive modelling in prisons presents an exciting opportunity to revolutionize the monitoring of inmate behaviour, allowing for the early detection of signs of distress and the effective mitigation of suicide risks. While machine learning algorithms have been extensively employed in predicting suicidal behaviour, a critical aspect that has often been overlooked is the interoperability of these models. Most of the work done on model interpretations for suicide predictions often limits itself to feature reduction and highlighting important contributing features only. To address this research gap, we used Anchor explanations for creating human-readable statements based on simple rules, which, to our knowledge, have never been used before for suicide prediction models. We also overcome the limitation of anchor explanations, which create weak rules on high-dimensionality datasets, by first reducing data features with the help of SHapley Additive exPlanations (SHAP). We further reduce data features through anchor interpretations for the final ensemble model of XGBoost and random forest. Our results indicate significant improvement when compared with state-of-the-art models, having an accuracy and precision of 98.6% and 98.9%, respectively. The F1-score for the best suicide ideation model appeared to be 96.7%.

Successful Management of Trypanosomiais in a Cow

A 6-year-old Jersey cow was presented with signs of respiratory distress and sternal recumbency at the Madras Veterinary College Outpatient Unit. Physical examination revealed congested mucous membrane, enlarged prescapular lymph node and severe dehydration. Musculo skeletal examination was done and the orthopaedic involvement was ruled out. Thrombocytopenia, decreased packed cell volume, and haemoglobin levels were noticed. Peripheral blood smear confirmed the presence of Trypanosoma evansi. The animal was treated with isometamidium chloride. The animal had uneventful recovery and was able to walk. Keywords: Jersey cow, Trypanosomiasis, Isometamidium chloride .

Effect of Feeding Methods on Respiratory Efforts in Neonate with Congenital Heart Defect

Background: Congenital heart disease (CHD) encompasses heart or blood vessel abnormalities arising during fetal development, affecting around 9 per 1,000 live births annually, totaling approximately 1.35 million infants. CHD is clinically classified as either cyanotic or acyanotic and often coincides with malnutrition and failure to thrive. Infants with CHD are at an increased risk of developing oropharyngeal dysphagia, characterized by difficulties in swallowing. Pediatric nurses play a crucial role in monitoring CHD, including respiratory rates and overall health, with particular attention to assessing nasal flaring for signs of respiratory distress as chest retractions and cyanosis. Objectives: Study aims to Assess variations in respiratory rate across different feeding methods and their impact on neonates with CHD at various time intervals. Methodology: A prospective observational study was carried out at the neonatal unit of Karbala Teaching Hospital for Children in Iraq. Fifty neonates, aged less than 28 days and diagnosed with CHD, were purposively recruited for the study. Inclusion criteria targeted neonates who were undergoing enteral feeding. Results: Analysis of records from 50 neonates revealed significant variations in respiratory rate across distinct feeding periods (p=0.027). and unveils noteworthy variations in nasal flaring throughout distinct feeding periods (p=0.001). And no significant differences in chest retraction across distinct feeding periods (p=1.000), no significant differences between breastfeeding, bottle-feeding and tube-feeding across time intervals of neonates feeding. Conclusions: Respiratory rate demonstrates significant variations across feeding periods. There are no significant differences in respiratory rates before-after feeding among breastfeeding, bottle-feeding, and tube-feeding.

Obstetric factors and neonatal outcomes of depressed skull fractures in newborns

PurposeTo determine the obstetric factors affecting the development of depressed skull fracture in neonates.Materials and methodsThis was a retrospectively cohort study on neonates born between July 2016 and August 2021. Neonates diagnosed with depressed skull fractures within one week of birth through X-ray and/or brain ultrasonography were included, and their mothers' obstetric characteristics were reviewed.ResultsThere were 12 cases in 6791 live births. Five women were over 35 years old. All except two were nulliparous. Five cases were delivered from labor induction and others presented with spontaneous labor. Except for two cases, delivery occurred within an hour after full cervical dilatation. Two cases were assisted by vacuum. None displayed fetal distress signs such as low Apgar scores below 7, meconium staining, and umbilical cord pH under 7.2. All depressed fractures were found in the right parietal area. Three cases resulted in focal hyperechoic lesion in brain ultrasonography and two of them showed small hemorrhage-like lesion in magnetic resonance imaging. All depressed skull fractures improved within 6 months in followed X-rays or ultrasonography.ConclusionsThere was no definitely associated obstetric condition for depressed skull fracture of neonates although nulliparous women were majority of the affected cases.

Psychosocial stress and its consequences among modern university students: the megalopolis factor

BACKGROUND: Students, who comprise a significant proportion of society, are a vulnerable group that often experiences high levels of stress, affecting their psychological well-being. At the same time, students’ stress has to be assessed comprehensively, taking into account various factors such as living conditions and academic demands, AIM: To assess the psychosocial stress and psychological well-being of students, taking into account the characteristics of the university and the urban environment, whether it is a megalopolis or a regional center. MATERIAL AND METHODS: A cross-sectional study was conducted among students from St. Petersburg State University (SPbSU) and Belgorod State University (BSU) using an online survey method with a snowball sampling technology. The survey questionnaire aimed to gather both qualitative and quantitative data on key stressors, indicators of psychosocial maladaptation and mental health issues using the DASS-21 scale. The collected data was analyzed using IBM SPSS Statistics v. 27. RESULTS: Students at SPbSU exhibited more pronounced signs of psychological distress, such as anxiety, stress, depression, loneliness, fatigue, and a need for psychological assistance. They also, reported facing challenges in in their daily lives, including issues with nutrition and transportation. Additionally, they were more likely to use nonproductive coping mechanisms, such as excessive use of social media and engaging in addictive behaviors. On the other hand, the students at BSU demonstrated a closer and more trusting relationship with their parents, as well as and higher level of financial dependence on their families. However, as for main indicators of academic stress, particularly in relation to the use of online technologies during the pandemic, there were no significant differences between the students of both universities. CONCLUSION: The influence of living in a megalopolis is likely to be the primary factor contributing to the observed disparities in psychosocial maladaptation among the surveyed student populations. More attention should be paid to the adaptation of students to life in large cities, with a focus on support from families and university administrations.

WOMEN SAFETY APP

The Women Safety App operates on a multifaceted approach, incorporating real-time assistance, precise location tracking, and immediate access to emergency services. By capitalizing on the ubiquity of smartphones, this project strives to provide a swift and effective response to potential threats that women may encounter in various situations. The core features of the app include a panic button for instant distress signals, live location sharing to facilitate timely assistance, and a streamlined communication channel with emergency services. These elements collectively contribute to fostering a safer environment for women, instilling a sense of confidence and security as they navigate their daily lives. The Women Safety App project addresses the critical issue of women's safety by leveraging technology to provide a reliable and accessible solution. In today's society, incidents of gender-based violence, harassment, and discrimination underscore the urgent need for effective measures to protect women's well-being and security. Existing safety mechanisms often fall short, relying on manual interventions and traditional communication channels that may not provide immediate assistance during emergencies. The Women Safety App aims to bridge this gap by offering real-time assistance, location tracking, and emergency services through a mobile application. Its key advantage lies in delivering instant distress signals, enabling quick alerts to trusted contacts and emergency responders in threatening situations. Additionally, live location tracking allows users to share their whereabouts for added safety.

A importância da ultrassonografia gestacional em cadelas: Revisão integrativa

Introduction: pregnancy is an important period in the development of fetuses, it is necessary to always pay attention to any problems that the female or the fetuses may develop, for this it is recommended to carry out gestational monitoring through ultrasound and x-ray examinations. Methodology; This is an integrative literature review conducted by the databases: Latin American and Caribbean Health Sciences Literature and Brazilian Journals in Veterinary Medicine and Animal Science Database (VETINDEX), Latin American and Caribbean Literature in Sciences for health (LILACS), VETTESES and VETINDEX-Express in publications from 2012 to 2022. Objective: To analyze the importance of prenatal care in dogs using ultrasound technology. Results: The benefits of gestational ultrasound aim to estimate gestational age, analyze the development of fetal organs, fetal sexing, evaluate signs of fetal distress and estimate the patient's referral to a cesarean section. Conclusion: Monitoring with gestational ultrasound presents high reliability in gestational monitoring, in prenatal care it is an important diagnostic tool for owners, breeders and veterinarians

Stilbocrea banihashemiana, an emerging fungal pathogen associated with canker and dieback diseases in walnut trees

Persian walnut (Juglans regia L.), a globally significant and economically important tree, is cultivated worldwide for its valuable wood and nutritious nuts. In this study, we conducted a comprehensive survey of the trees exhibiting signs of distress, such as trunk and branch cankers, dieback, and wood discoloration, in the central region of Fars Province in Iran. Initial morphological identification indicated that the fungal isolates recovered from the canker symptoms belonged to a newly emerged ascomycete pathogen, Stilbocrea banihashemiana. The identification was further confirmed by utilizing species-specific primer pairs for S. banihashemiana. Pathogenicity assessments on detached shoots and one-year-old saplings revealed the isolates' ability to induce wood necrosis symptoms. The cross-pathogenicity test with isolates of S. banihashemiana from walnut and other reported hosts, including fig, loquat, and pomegranate was performed on detached branches. The results indicated varying levels of aggressiveness of the isolates across the different host species examined. To our knowledge, this is the first global confirmation of the isolation of S. banihashemiana from infected Persian walnut trees and the assessment of its pathogenicity on this new host.

Bayesian Network를 이용한 수상 레저사고 위험 요인 분석

Since 2016, the incidence of marine leisure accidents has doubled approximately. In response to the growing societal call for accident prevention, the Central Marine Safety Tribunal and the Maritime Police Agency have been systematically managing safety accidents by publishing marine safety tribunal decisions, annual reports, and statistical data. In this study, based on these tribunal decisions, Bayesian Network analysis and accident fault ratios were utilized to analyze the risk factors contributing to accidents. The analysis revealed that in accidents involving collisions, negligence of boundaries (0.444) showed the highest priority, while accidents involving capsizing identified non-compliance with safe speed (0.384) and absence of distress signal equipment (0.384) as high priorities. In accidents leading to sinking, negligence of boundaries (0.8) was highlighted. For future, more detailed accident prevention plans in marine leisure activities, there is a need for legal and institutional research to improve marine accident tribunal decisions and restore data reliability

Distress among healthcare providers who provided end-of-life care during the COVID-19 pandemic: a longitudinal survey study (the CO-LIVE study)

IntroductionThe COVID-19 pandemic had a significant impact on care at the end-of-life due to restrictions and other circumstances such as high workload and uncertainty about the disease. The objective of this study is to describe the degree of various signs experienced by healthcare providers throughout the first 18 months of the pandemic and to assess what provider’s characteristics and care circumstances related to COVID-19 are associated with distress.MethodsA longitudinal survey study among healthcare providers from different healthcare settings who provided end-of-life care during the pandemic’s first 18 months. Data of four time periods were analyzed using descriptive statistics, logistic regression analysis and Generalized Estimating Equation.ResultsOf the respondents (n=302) the majority had a nursing background (71.8%) and most worked in a hospital (30.3%). Although reported distress was highest in the first period, during the first wave of COVID-19 pandemic, healthcare providers reported signs of distress in all four time periods. Being more stressed than usual and being regularly exhausted were the most common signs of distress. Healthcare providers working in nursing homes and hospitals were more likely to experience signs of distress, compared to healthcare providers working in hospice facilities, during the whole period of 1.5 years. When HCPs were restricted in providing post-death care, they were more likely to feel more stressed than usual and find their work more often emotionally demanding.ConclusionA substantial amount of healthcare providers reported signs of distress during the first 1.5 years of the COVID-19 pandemic. A cause of distress appears to be that healthcare providers cannot provide the care they desire due the pandemic. Even though the pandemic is over, this remains an important and relevant finding, as high workload can sometimes force healthcare providers to make choices about how they provide care. Given that this can cause prolonged stress and this can lead to burnout (and HCPs leaving their current positions), it is now especially important to continue observing the long term developments of the well-being of our healthcare providers in palliative care and provide timely and adequate support where needed.