Responding to eruptive transitions during the 2020-2021 eruption of La Soufrière volcano, St. Vincent.

A critical challenge during volcanic emergencies is responding to rapid changes in eruptive behaviour. Actionable advice, essential in times of rising uncertainty, demands the rapid synthesis and communication of multiple datasets with prognoses. The 2020-2021 eruption of La Soufrière volcano exemplifies these challenges: a series of explosions from 9-22 April 2021 was preceded by three months of effusive activity, which commenced with a remarkably low level of detected unrest. Here we show how the development of an evolving conceptual model, and the expression of uncertainties via both elicitation and scenarios associated with this model, were key to anticipating this transition. This not only required input from multiple monitoring datasets but contextualisation via state-of-the-art hazard assessments, and evidence-based knowledge of critical decision-making timescales and community needs. In addition, we share strategies employed as a consequence of constraints on recognising and responding to eruptive transitions in a resource-constrained setting, which may guide similarly challenged volcano observatories worldwide.

Obstacles to compassion-giving among nursing and midwifery managers: an international study.

AIM: To explore nursing and midwifery managers' views regarding obstacles to compassion-giving across country cultures. BACKGROUND: The benefit of compassionate leadership is being advocated, but despite the fact that health care is invariably conducted within culturally diverse workplaces, the interconnection of culture, compassion and leadership is rarely addressed. Furthermore, evidence on how cultural factors hinder the expression of compassion among nursing and midwifery managers is lacking. METHODS: Cross-sectional, exploratory, international online survey involving 1 217 participants from 17 countries. Managers' responses on open-ended questions related to barriers for providing compassion were entered and thematically analysed through NVivo. RESULTS: Three key themes related to compassion-giving obstacles emerged across countries: 1. related to the managers' personal characteristics and experiences; 2. system-related; and 3. staff-related. CONCLUSIONS: Obstacles to compassion-giving among managers vary across countries. An understanding of the variations across countries and cultures of what impedes compassion to flourish in health care is important. IMPLICATIONS FOR NURSING PRACTICE AND POLICY: Nursing mangers should wisely use their power by adopting leadership styles that promote culturally competent and compassionate workplaces with respect for human rights. Policymakers should identify training and mentoring needs to enable the development of managers' practical wisdom. Appropriate national and international policies should facilitate the establishment of standards and guidelines for compassionate leadership, in the face of distorted organizational cultures and system-related obstacles to compassion-giving.

Investigating the level of glaucoma awareness and perception of its risk factors in Anambra State, Nigeria.

OBJECTIVES: The purpose of this study was to investigate the level of awareness of glaucoma and perception of its risk factors in Anambra State, and to examine and evaluate the health seeking behaviour of this target population and its relationship with the development glaucoma. STUDY DESIGN: This is a qualitative study that utilised face-to-face semi-structured interviews to investigate the level of glaucoma awareness in the state. METHODS: Purposive, non-random sampling technique was used to recruit the participants, and data were collected from 28 participants [aged 21-73 years] using semi-structured interview. The resulting data were analysed using Nvivo 10 software and Interpretative phenomenological analysis framework. RESULTS: Of the 28 interviewees, 15 (53.6%) live in urban areas, and 13 (46.4%) live in the rural areas; 11 (39.3%) of the participants were male and 17 (60.7%) were females. In this study, people with more education, and people that live in the urban areas tend to have heard about glaucoma compared with people with less education, and who live in the rural areas; although this sample was too small to make substantive claims. Glaucoma was perceived as 'a dangerous eye disease that can cause blindness if not treated early; serious eye problem; an incurable eye problem that can eventually result to blindness, and a dangerous eye problem that can easily render a person blind'. Four a priori themes and ten emergent themes were identified. CONCLUSIONS: There is low awareness of glaucoma in this population, and this encourages people to indulge in certain risk behaviours that could predispose them to glaucoma. Therefore, providing sustained health promotion programmes and improved eye care services could help this population immensely in the current struggle against glaucoma blindness.

International study on nurses' views and experiences of compassion.

BACKGROUND: Compassion is considered the cornerstone of nursing practice. However, the recent failures in delivering high-quality compassionate nursing care in the UK's National Health Service have brought the topic of compassion to the attention of the public, service providers, policy makers and academics. AIM: The aim of this study was to explore the nurses' views and experiences of a number of compassion-related issues in nursing and describe similarities and differences at an international level as well as from the different nursing roles of the participating nurses. METHODS: An exploratory, cross-sectional descriptive study, using the International Online Compassion Questionnaire. A total of 1323 nurses from 15 countries completed the questionnaire. RESULTS: The majority of participants (59.5%) defined compassion as "Deep awareness of the suffering of others and wish to alleviate it" but definitions of compassion varied by country. Of participants, 69.6% thought compassion was very important in nursing and more than half (59.6%) of them argued that compassion could be taught. However, only 26.8% reported that the correct amount and level of teaching is provided. The majority of the participants (82.6%) stated that their patients prefer knowledgeable nurses with good interpersonal skills. Only 4.3% noted that they are receiving compassion from their managers. A significant relationship was found between nurses' experiences of compassion and their views about teaching of compassion. CONCLUSION: Our study is unique in identifying the views and experiences of nurses from 15 different countries worldwide. The findings reveal that compassion is neither addressed adequately in nursing education nor supported in the practice environment by managers. LIMITATIONS: Self-report bias was inherent to our survey study design. Furthermore, the individual cultural differences and similarities in the findings are difficult to extrapolate owing to the fact that our analysis was at country level, as well as at the level of the participating nurses. IMPLICATIONS FOR NURSING POLICY: Understanding the influence of culture on nurses' views about compassion is critical in the current multicultural healthcare environment and merits further research. This will potentially drive changes in nursing education (ensuring that compassion is taught to nurses) and in the way healthcare leaders and managers foster a compassionate culture within their organizations (e.g. by leading by example and compassionate to their staff).

Intercultural education of nurses and health professionals in Europe (IENE).

AIMS: The study aimed to explore the perceived learning and teaching needs of students and practitioners of health-care professions in relation to preparation for working in another European country and/or in a multicultural environment. The participating countries were: Belgium, Bulgaria, Germany, Romania and the UK. METHODS: Questionnaires, consisting of open questions, were completed by a total of 118 participants. Data analysis adopted both a priori and inductive approaches. The predetermined constructs of cultural awareness, cultural knowledge, cultural sensitivity and cultural competence were used to structure suggestions for theoretical input and practical activities and experiences. Inductive analysis revealed other emergent themes that underpin all four of these constructs. RESULTS: Practical experiences form a fundamental part of preparation for labour mobility and/or for practice within a multicultural environment. However, health-care practitioners need to be adequately prepared for such experiences and value the opportunity to learn about culture, to explore values and beliefs, and to practise intercultural skills within the safe environment of an educational establishment, facilitated by skilled teachers.

Occurrence of Clostridium perfringens from different cultivated soils.

The occurrence of Clostridium perfringens was estimated in 750 samples originated from a variety of soils bearing various bulb crops: Brawnica oderacea (vegetable), Olea europaea, Daucus carota (carote), Solanum tuberosum (potato), Phaseolus vulgaris (green haricot), Beta vulgaris var. rapaceum (beetroot), Cucurbita pepo (squash), Allium cepa (onion), Cucumis sativus (cucumber) and Capsicum annum (pepper). All isolated strains were tested for their antimicrobial activities to amoxicillin, penicillin G, kanamycin, tetracycline, streptomycin, erythromycin, chloramphenicol and metronidazole. When considering the type of the bulb production, it was observed increased number of C. perfringens spore densities in the most undersurface bulb soils. Moreover, C. perfringens spore are likely to occur in particularly large numbers in soil contaminated by fecal matter. Additionally, there is a close relationship between the spore amount and nature of organic content. Presence of C. perfringens was associated with acidic soil. Most of our strains showed resistance to the studied antibiotics applied usually for human and veterinary care. A systematic monitoring of the cultivated soil ecosystems must include bacteriological parameters together with chemical indices of organic pollution in order to obtain information adequate for assessing their overall quality.

Quantitative expression analysis and prognostic significance of L-DOPA decarboxylase in colorectal adenocarcinoma.

BACKGROUND: L-DOPA decarboxylase (DDC) is an enzyme that catalyses, mainly, the decarboxylation of L-DOPA to dopamine and was found to be involved in many malignancies. The aim of this study was to investigate the mRNA expression levels of the DDC gene and to evaluate its clinical utility in tissues with colorectal adenocarcinoma. METHODS: Total RNA was isolated from colorectal adenocarcinoma tissues of 95 patients. After having tested RNA quality, we prepared cDNA by reverse transcription. Highly sensitive quantitative real-time PCR method for DDC mRNA quantification was developed using the SYBR Green chemistry. GAPDH served as a housekeeping gene. Relative quantification analysis was performed using the comparative C(T) method (2(-DeltaDeltaC(T))). RESULTS: DDC mRNA expression varied remarkably among colorectal tumours examined in this study. High DDC mRNA expression levels were found in well-differentiated and Dukes' stage A and B tumours. Kaplan-Meier survival curves showed that patients with DDC-positive tumours have significantly longer disease-free survival (P=0.009) and overall survival (P=0.027). In Cox regression analysis of the entire cohort of patients, negative DDC proved to be a significant predictor of reduced disease-free (P=0.021) and overall survival (P=0.047). CONCLUSIONS: The results of the study suggest that DDC mRNA expression may be regarded as a novel potential tissue biomarker in colorectal adenocarcinoma.

Seasonality of violent suicides in the Athens greater area.

The aim of the study was to ascertain suicide seasonality in the Greek population and to associate this seasonal variation with age, sex, and suicide method. Studying seasonality can be of help in establishing a public health policy, related with suicide prevention. This is an epidemiologic study based on forensic evidence. We studied the deaths caused by self-injury (trauma), namely deaths by violent suicide (not self-poisoning). Statistically significant suicide seasonality was established with a peak in May. This seasonal variation is attributed mainly to males. As for the method, suicide by hanging peaks in June and by shooting in April. It was also observed that seasonality for individuals above the age of 45 peaks in early May.

Towards a theory of quality nursing care for patients with cancer through hermeneutic phenomenology.

AIM: This paper is a report of a study to describe the attributes of quality nursing narrated by a sample of patients with cancer, their advocates and their nurses. BACKGROUND: Quality nursing care is a multifaceted concept which is open to interpretation. Studies show that while nurses are striving to succeed in providing quality care for their patients and the patients are urging for better nursing care, the complexity in understanding the concept often causes confusion among patients and nurses. METHOD: The study was a phenomenological hermeneutical study based on the ideas of the French Philosopher Paul Ricoeur. Twenty-five patients with cancer, six advocates and twenty cancer nurses were recruited in Cyprus by a purposive method. The informants were encouraged to narrate their lived experiences of receiving and providing quality nursing care. A discussion follows whether the findings can be regarded as a theory of quality in cancer care. FINDINGS: Based on the informants' narratives the following six attributes of quality nursing care materialized: a) being valued, b) being respected c) being cared for by communicative and supportive nurses, d) being confirmed, e) being cared for religiously and spiritually and f) belonging. CONCLUSION: The six attributes can be proposed as a descriptive theory of quality nursing care within the tension between empirical data and pre-understanding. The theory emphasizes the existential needs such as communicated with, being respected, and being cared for which should be considered important when providing nursing care to patients with cancer.

Ricoeur's hermeneutic phenomenology: an implication for nursing research.

Researchers and educators are increasingly implementing qualitative research methods to investigate issues of concern and interest. Hermeneutics has risen as an option for the qualitative research paradigm particularly after the 1970s. The precedence of the sciences that have applied hermeneutics as their approach to investigation is provided with special reference to nursing. In the nursing science, hermeneutics have been used extensively as a qualitative research method to investigate a variety of issues, through the lived experiences of the participants. In this paper, we introduce important aspects of the philosophy of Paul Ricoeur and we discuss the reasons why we have applied this approach in our study titled 'Quality Nursing Care: perspectives of patients with cancer and the nursing response'. The arguments that are presented here can be generalised to fit other areas of Nursing Science. Through this paper our aim is not only to familiarise the reader with Ricoeur's work, but also to arrive at an appreciation of his philosophy as a methodological approach for future nursing research.

Listening to the voices of patients with cancer, their advocates and their nurses: A hermeneutic-phenomenological study of quality nursing care.

This article presents the findings from a hermeneutic-phenomenological study looking at the meanings of "quality nursing care" through the experiences of patients with cancer, their advocates and their nurses. Twenty-five patients were interviewed from which fifteen also participated in two focus groups. Six patients' advocates participated in a focus group and twenty nurses were individually interviewed. The informants came from the three major hospitals in Cyprus which provide in-patient cancer care. Patients' advocates came from the two major cancer associations in Cyprus. Having analysed the data, seven major themes were identified: receiving care in easily accessible cancer care services, being cared for by nurses who effectively communicate with them and their families and provide emotional support, being empowered by nurses through information giving, being cared for by clinically competent nurses, nurses addressing their religious and spiritual needs, being cared for in a nursing environment which promotes shared decision-making, and patients being with and involving the family in the care. These findings stress the need to integrate these aspects in the care of patients with cancer. In doing so, nurses will need support and adequate training in order to acquire the relevant skills towards better caring for the patients.

Biomagnetic activity in prostate cancer and BPH.

OBJECTIVE: The aim of this study was to investigate the role of biomagnetic activity measurements in detecting prostate malignancies, in differentiating cancerous from benign prostate lesions and in generally improving our understanding of prostate cancer biology. METHODS: Magnetic recordings were obtained from 47 patients with palpable prostate lesions. Twenty-four had prostate carcinoma and 23 benign prostatic hyperplasia (BPH). RESULTS: The magnetic field recorded in the 2-7 Hz frequency range was of high amplitude in most (95%) malignant lesions 248 +/- 82 Ft/Hz) and of low amplitude in most (95%) benign ones (166 +/-31 Ft/Hz). These findings displayed significant difference (p = 0.0021). CONCLUSIONS: Prostate cancer emits higher biomagnetic activity than BPH. This finding confirms the higher angiogenic activity of prostate cancer. The use of this method is safe and seems promising.

Biomagnetic activity in prostate cancer and BPH / Actividad biomagnética en cáncer de próstata y HBP

Objective: The aim of this study was to investigate the role of biomagnetic activity measurements in detecting prostate malignancies, in differentiating cancerous from benign prostate lesions and in generally improving our understanding of prostate cancer biology. Methods: Magnetic recordings were obtained from 47 patients with palpable prostate lesions. Twenty-four had prostate carcinoma and 23 benign prostatic hyperplasia (BPH). Results: The magnetic field recorded in the 2-7Hz frequency range was of high amplitude in most (95%) malignant lesions 248±82 Ft/√Hz) and of low amplitude in most (95%) benign ones (166±31 Ft/√Hz). These findings displayed significant difference (p=0.0021). Conclusions: Prostate cancer emits higher biomagnetic activity than BPH. This finding confirms the higher angiogenic activity of prostate cancer. The use of this method is safe and seems promising (AU)

Objetivo: Investigar el papel de las mediciones de la actividad biomagnética en la detección de los tumores malignos prostáticos, en la diferenciación entre lesiones cancerígenas y benignas, y en mejorar de forma general nuestro conocimiento de la biología del cáncer de próstata. Métodos: Se obtuvieron registros magnéticos en 47 pacientes con lesiones prostáticas palpables. Veinticuatro tenían cáncer de próstata y 23 hiperplasia benigna de próstata. Resultados: Los campos magnéticos registrados en el rango de frecuencias entre 2-7 fueron de gran amplitud (248±82 Ft/√Hz ) en la mayoría de las lesiones malignas (95%) y de baja amplitud (166±31 Ft/√Hz ) en la mayoría de las benignas (95%). Estos hallazgos tuvieron diferencias significativas (p=0.0021). Conclusiones: Cáncer de próstata emite mayor actividad biomagnética que la HBP. Este hallazgo confirma la mayor actividad angiogénica del cáncer de próstata. La utilización de este método es segura y parece prometedor (AU)

An exploration of the meanings and experiences of cancer of Chinese people living and working in London.

This paper investigates the meanings and experiences of cancer of Chinese people living and working in London, in order to help the future development of culturally sensitive cancer information for Chinese people in the United Kingdom. A focus group interview method was used. Five focus groups (n = 35) were conducted in 2003 in London; these included Chinese health professionals, asylum seekers, immigrants with unknown status, Chinese young adults and Chinese elders. We found that the participants' understanding of cancer reflected Chinese cultural beliefs about health and illness. There are some misunderstandings and lack of knowledge and information about cancer treatments, but they understand cancer to be life threatening. There is also a great reluctance to talk about cancer. The participants suggested that as well as receiving appropriate and early treatment, by either biomedicine or traditional Chinese medicine, or preferably, a combination of the two, an individual's chances of surviving cancer could be enhanced by being provided with spiritual guidance and by being in a happy, positive mood. There is a need to improve knowledge about cancer in the Chinese community through the provision of culturally appropriate and accessible information on a variety of topics, including healthy lifestyles, cancer prevention and treatments, and by encouraging openness about cancer issues.

Autopsy findings from 111 deaths in the 1999 Athens earthquake as a basis for auditing the emergency response.

BACKGROUND: The aim of the study was to assess the emergency response to an earthquake. METHODS: This retrospective study, based on formal autopsy findings from 111 earthquake-related deaths, evaluated demographic data, circumstances of death, rescue time, mechanisms of injury, causes of death, Abbreviated Injury Scale (AIS 90) and Injury Severity Score (ISS) values, vital functions, co-morbidity and preventable deaths. RESULTS: The median extrication time for 99 of 102 victims buried or trapped in collapsed buildings was 2.1 (range 0.1-7.8) days. Deaths were cause by blunt injuries, asphyxia and myocardial infarction. Injuries impaired the airway, breathing, circulation, and brain or spinal functions in 10.5, 61.9, 46.6 and 57.1 per cent of the victims respectively. The 105 injured victims were classified into three main categories. The first comprised 36 victims (34.3 per cent) with injuries not compatible with life (ISS 75), the second included 38 victims (36.2 per cent) who suffered life-threatening injuries (ISS 9-74) but had no evidence of asphyxia, and the third category contained 31 victims (29.5 per cent) with findings of asphyxia and an ISS of 1-18. The reviewers concluded that 13 trauma-related deaths and 31 deaths from asphyxia were potentially preventable. CONCLUSION: A method based on detailed evaluation of deaths provided information with which to audit the emergency response to an earthquake.

Ethiopian refugees in the UK: migration, adaptation and settlement experiences and their relevance to health.

OBJECTIVE: The study explores Ethiopian refugees' and asylum seekers' experiences of migration, adaptation and settlement in the UK and their health beliefs and practices. DESIGN: Data was collected using semi-structured depth interviews and a semi-structured questionnaire. The sample consisted of 106 Ethiopians resident in the UK. RESULTS: The majority of the participants fled Ethiopia due to political reasons. Whilst 65% of them had lived in the UK for over five years only 7% had full refugee status. Many of the participants faced difficulties with the immigration system, housing and social services and felt socially isolated. Many also had problems with gaining employment or employment appropriate to their qualifications, and 29% were unemployed. The majority of the participants believe that happiness is a prerequisite to healthiness and also an indication of healthiness. On the other hand the majority believed that sickness is caused by disease and mental illness is caused by both supernatural and psychosocial causes. Most of the participants sought the help of their GP in the first instance of illness although some had experienced difficulties accessing health services due to language problems and poor understanding of the primary healthcare system. The participants also believed that the stress of adaptation and settlement affected their mental health and led to depression. CONCLUSION: Migration, adaptation and settlement experiences impact on the health of refugees and are dependent on a number of barriers and enablers, both at a personal and societal level. These should be taken into account in the provision of health and social care services, in particular services should be provided in a culturally competent manner.

Early rheumatoid arthritis: does gender influence disease expression?

OBJECTIVE: To investigate whether gender is an independent factor associated with disease expression in early rheumatoid arthritis (RA) patients. METHODS: 438 patients with early RA (disease duration less than one year) were studied. They all were patients with early RA who presented at the Rheumatology Clinic of the University Hospital of Ioannina during the period 1991-2000. All patients fulfilled the American College of Rheumatology criteria for RA. The demographic, clinical, laboratory, radiological and therapeutic characteristics of the disease at diagnosis, and at the last follow-up were analyzed according to gender. RESULTS: We studied 312 women and 126 men with early RA. The female to male ratio was 2.5:1 and the mean age at diagnosis was 49.4 +/- 14.9 years for women and 55.3 +/-15.6 years for men (P < 0.0003). Women had a longer duration of follow-up (P < 0.0003). There were no differences between genders in the general symptoms or the simmetricity of joint involvement at at disease onset. However at disease onset women had a higher erythrocyte sedimentation rate (ESR) (> 30 mm/1st hour), although there were no significant differences between the two groups concerninig the rest of the clinical, laboratory and radiological findings. At the last follow-up women still had a higher ESR (>30 min/1st hour), but no significant differences were found between the two groups concerning the rest of the parameters investigated independently of the follow-up duration. Finally, women and men showed the same degree of radiological changes and functional ability and were treated similarly except for the more frequent use of hydroxychloroquine in women. CONCLUSION: It seems that gender does not signficantly influence the expression of RA.

Cancer and communication: similarities and differences of men with cancer from six different ethnic groups.

This paper reports the communication aspects of a pilot study, which explored the cancer meanings and experiences of six men with cancer and their significant others from different ethnic groups. A case study design was applied using the principles of phenomenology. In-depth semi-structured individual interviews were conducted in participants' own homes, in London, UK. This paper will only deal with the communication aspects of the findings. Ten themes emerged from the comparative analysis of the study's data, with communication as a cross-cutting theme. Further analysis of this theme revealed similarities and differences of the participants' experiences of communicating with health professionals; families or friends; and God/Allah. In addition, similarities and differences in communicating meanings of cancer in different cultures were revealed. The findings revealed similarities in the way that men from these six cultures communicate with health professionals and their families following a diagnosis of cancer, and differences in how they communicated with God/Allah, which depended on their religious beliefs and practices.