A comprehensive qualitative investigation of the factors that affect surgical site infection prevention in cardiac surgery in England using observations and interviews.

BACKGROUND: Interview and questionnaire studies have identified barriers and challenges to preventing surgical site infections (SSIs) by focusing on compliance with recommendations and care bundles using interviews, questionnaires and expert panels. This study proposes a more comprehensive investigation by using observations of clinical practice plus interviews which will enable a wider focus. AIM: To comprehensively identify the factors which affect SSI prevention using cardiac surgery as an exemplar. METHODS: The study consisted of 130 h of observed clinical practice followed by individual semi-structured interviews with 16 surgeons, anaesthetists, theatre staff, and nurses at four cardiac centres in England. Data were analysed thematically. FINDINGS: The factors were complex and existed at the level of the intervention, the individual, the team, the organization, and even the wider society. Factors included: the attributes of the intervention; the relationship between evidence, personal beliefs, and perceived risk; power and hierarchy; leadership and culture; resources; infrastructure; supplies; organization and planning; patient engagement and power; hospital administration; workforce shortages; COVID-19 pandemic; 'Brexit'; and the war in Ukraine. CONCLUSION: This is one of the first studies to provide a comprehensive overview of the factors affecting SSI prevention. The factors are complex and need to be fully understood when trying to reduce SSIs. A strong evidence base was insufficient to ensure implementation of an intervention.

A framework for mapping and monitoring human-ocean interactions in near real-time during COVID-19 and beyond.

The human response to the COVID-19 pandemic set in motion an unprecedented shift in human activity with unknown long-term effects. The impacts in marine systems are expected to be highly dynamic at local and global scales. However, in comparison to terrestrial ecosystems, we are not well-prepared to document these changes in marine and coastal environments. The problems are two-fold: 1) manual and siloed data collection and processing, and 2) reliance on marine professionals for observation and analysis. These problems are relevant beyond the pandemic and are a barrier to understanding rapidly evolving blue economies, the impacts of climate change, and the many other changes our modern-day oceans are undergoing. The "Our Ocean in COVID-19″ project, which aims to track human-ocean interactions throughout the pandemic, uses the new eOceans platform (eOceans.app) to overcome these barriers. Working at local scales, a global network of ocean scientists and citizen scientists are collaborating to monitor the ocean in near real-time. The purpose of this paper is to bring this project to the attention of the marine conservation community, researchers, and the public wanting to track changes in their area. As our team continues to grow, this project will provide important baselines and temporal patterns for ocean conservation, policy, and innovation as society transitions towards a new normal. It may also provide a proof-of-concept for real-time, collaborative ocean monitoring that breaks down silos between academia, government, and at-sea stakeholders to create a stronger and more democratic blue economy with communities more resilient to ocean and global change.

A comprehensive model of women's social cognition and responsiveness to infant crying: Integrating personality, emotion, executive function, and sleep.

Disparate lines of research suggest that women's (a) emotion regulation and personality, (b) executive function and (c) sleep may be important predictors of mothers' cry responding in part through their effects on social cognition. However, the extent to which each contributes to cry responding independently remains unknown. We examined this question in a convenience sample of 109 nulliparous undergraduate women. Women completed online surveys to assess personality and emotion dysregulation traits, then visited the lab for a testing session during which they reported on sleep the night before and reactions to videotapes of crying infants and completed computerized working memory and inhibitory control tasks under challenging noise conditions (exposure to traffic and cry sounds). Results indicate that women's positive personality and higher working memory were associated with higher levels of infant-oriented cry processing (i.e., accurate distress detection, empathy and situational/emotional attributions about distress), which in turn was associated with higher intended responsiveness to infant crying. Emotion dysregulation and deficits in inhibitory control were associated with higher levels of self-oriented cry processing (i.e., anger, anxiety, negative and emotion minimizing attributions in response to infant distress), which in turn was associated with lower cry responsiveness. Short-term sleep deprivation was associated with lower intended responsiveness via the above path from poorer inhibitory control to heightened self-oriented cry processing. Findings suggest that sleep, emotional and cognitive factors are associated with cry processing and subsequent responsiveness independent of one another.