Implementation of Lymphedema Education Toolkit for Nurse Coordinators

Problem: Lymphedema is a chronic condition that develops secondary to cancer treatments such as chemotherapy, radiation, and surgical removal of affected lymph nodes. This swelling in patient’s limbs can cause discomfort and limit mobility, however lymphedema is often not detected until later stages, delaying treatment and patient education. Context: This quality improvement project was conducted at Hospital S Women’s Cancer Center, an outpatient center specializing in advanced treatments for breast and gynecological cancers. This center has a multidisciplinary team focusing on both the medical and surgical aspects of oncology treatment. Interventions: An evidence-based lymphedema education toolkit was created for nurse coordinators at Hospital S Women’s Cancer Center to utilize and refer to when educating patients on lymphedema, standardizing the quantity and quality of education patients receive. Measures: An identical pre- and post- survey was administered to nursing staff prior to and following implementation of our lymphedema education toolkit. This survey assessed nurse coordinators’ current knowledge of lymphedema, aiming to see if there was an increase in knowledge following implementation. Results: Implementation of the lymphedema education toolkit showed an average 12% improvement of lymphedema knowledge amongst the 40% of nurse coordinators on staff in our microsystem who participated in both the pre- and post- assessment surveys (n=6). This data indicates an enhanced understanding and ability to educate patients with lymphedema on their diagnosis, risk factors, prevention, and treatment options compared to the current practice. Conclusion: This quality improvement project has positive implications in improving early interventions for patients with lymphedema

Anger Management: Aggression and Punishment in the Provision of Public Goods

The ability to punish free-riders can increase the provision of public goods. However, sometimes the benefit of increased public good provision is outweighed by the costs of punishments. One reason a group may punish to the point that net welfare is reduced is that punishment can express anger about free-riding. If this is the case, then tools that regulate emotions could decrease the use of punishments while keeping welfare high, possibly depending on pre-existing levels of aggression. In this lab experiment, we find that adopting an objective attitude (Objective), through a form of emotion regulation called cognitive reappraisal, decreases the use of punishments and makes a statistically insignificant improvement to both net earnings and self-reported emotions compared to a control condition (Natural). Although the interaction between the emotion regulation treatment and level of aggression is not significant, only low aggression types reduce their punishments; the results are of the same direction but statistically insignificant for high aggression types. Overall, our findings suggest that pairing emotion regulation with punishments can decrease the use of punishments without harming monetary and mental welfare

Pathways towards integrated cross-border marine spatial planning (MSP): insights from Germany, Poland and the island of Ireland

Marine Spatial Planning is labelled as ‘an idea whose time has come’ based on its applicability to address spatial conflicts and deliver sustainable use. Legislation such as the EU MSP Directive 2014/89/EU and the UK Marine and Coastal Access Act 2009 requires that neighbouring marine spatial plans are coherent and coordinated to address cross-border issues. However, the implementation of MSP in cross-border areas is complex due to different administrative processes, fiscal and legislative procedures. This study argues that cross-border MSP is challenging in areas that are faced with historically contested borders which limit effective delivery of the UN Sustainable Development Goals. Two contested case study regions: Germany, Poland and the island of Ireland are compared. To help understand contemporary issues, a bespoke theoretical evaluative framework, the ‘Wheel of Integration and Adaptation’ is used to identify the challenges of cross-border MSP. An in-depth review of planning documents, policies, legislation was undertaken alongside interviews. This demonstrated that in contested areas, cross-border MSP must contend with the following challenges: ‘inter alia’ geographical peripheries syndrome, schema overload, limited transparency and blue justice, diplomatic consultation processes and differences in planning philosophies. This paper concludes by presenting five interventions as steps toward advancing cross-border MSP

Do workplace fish tanks influence employee wellbeing and cognitive performance? An embedded mixed-methods study

Evidence from “pet-friendly” workplaces highlights potential benefits associated with taking companion animals to work, including reduced stress among employees. Ornamental fishes carry a much lower risk than other companion animals and may be a suitable alternative in situations where other animals would introduce too great a risk (e.g., allergy, accidental injury). The aim of this study was to investigate whether watching an aquarium during the working day influenced employee wellbeing through the reduction of stress and improvements in stress-related outcomes. An embedded mixed-methods study was conducted, comprising two within-subjects trials (Trials A and B) and a qualitative follow-up. Participants were university employees and research students who participated during their working day. In Trial A (n = 30), the immediate effects of watching live fishes on mood, physiological stress, and cognitive performance were compared with the effects of watching a fish video or resting quietly. Although some outcomes improved from pre- to post-activity, there was no evidence that watching fishes (live or video) had greater effects than resting quietly. In Trial B (n = 27), the effects of repeatedly engaging in the same three activities over several weeks were examined. Watching fish videos was associated with improvements in “high pleasure-low arousal” and overall job-related affective wellbeing, but no further effects of condition were found. Qualitative follow-up data collected from a subset of participants from the experimental trials (n = 13) indicated that all three activities may be beneficial as leaving their desks provided detachment from work for a short period. Qualitative data suggested that live fishes were perceived as more engaging, but this did not translate to quantitative findings. Locating fish aquaria within offices (rather than a separate workplace location) may promote wellbeing by encouraging “microbreaks”; further research is needed to investigate this hypothesis

Observing and Promoting Normative Developmental Outcomes: Reciprocity is Key

Background: Occupational therapists focus on caregiver-infant reciprocity, which is influenced by a host of biopsychosocial factors and is predictive of developmental outcomes across domains. It is important for early intervention professions to understand how different forms of reciprocity may predict infant development in salient domains (i.e., language, mobility, and co-occupation). Therefore, the purpose of this study was to investigate associations among related measures of development in and across age, while also exploring how reciprocity influences the acquisition of developmental milestones. Method: We examined these important areas of development in relation to novel caregiver-infant co-occupational constructs in addition to well-established domains of reciprocity (i.e., language, touch, and emotional sensitivity). In a cohort of 16 caregiver-infant dyads, we investigated infant language, motor, and affective development at 8, 12, and 16 months of age in relation to caregiver-infant reciprocity in the same domains. Results: Findings identify relations among domains, as well as novel, bidirectional associations among these domains, and caregiver-infant reciprocity. In particular, infant utterances, standing, and positive affect were related to caregiver sensitivity and responsivity to infant affect, touch, and/or physicality. Conclusion: These findings suggest that aspects of caregiver-infant reciprocity may predict development in several important domains

Do Workplace Fish Tanks Influence Employee Wellbeing and Cognitive Performance? An Embedded Mixed-Methods Study

Evidence from “pet-friendly” workplaces highlights potential benefits associated with taking companion animals to work, including reduced stress among employees. Ornamental fishes carry a much lower risk than other companion animals and may be a suitable alternative in situations where other animals would introduce too great a risk (e.g., allergy, accidental injury). The aim of this study was to investigate whether watching an aquarium during the working day influenced employee wellbeing through the reduction of stress and improvements in stress-related outcomes. An embedded mixed-methods study was conducted, comprising two within-subjects trials (Trials A and B) and a qualitative follow-up. Participants were university employees and research students who participated during their working day. In Trial A (n = 30), the immediate effects of watching live fishes on mood, physiological stress, and cognitive performance were compared with the effects of watching a fish video or resting quietly. Although some outcomes improved from pre- to post-activity, there was no evidence that watching fishes (live or video) had greater effects than resting quietly. In Trial B (n = 27), the effects of repeatedly engaging in the same three activities over several weeks were examined. Watching fish videos was associated with improvements in “high pleasure-low arousal” and overall job-related affective wellbeing, but no further effects of condition were found. Qualitative follow-up data collected from a subset of participants from the experimental trials (n = 13) indicated that all three activities may be beneficial as leaving their desks provided detachment from work for a short period. Qualitative data suggested that live fishes were perceived as more engaging, but this did not translate to quantitative findings. Locating fish aquaria within offices (rather than a separate workplace location) may promote wellbeing by encouraging “microbreaks”; further research is needed to investigate this hypothesis

Companion animal type and level of engagement matter: a mixed-methods study examining links between companion animal guardianship, loneliness and well-being during the covid-19 pandemic

To reduce the spread of COVID-19, countries worldwide placed limitations on social interaction, which is anticipated to have severe psychological consequences. Although findings are inconsistent, prior research has suggested that companion animals may positively influence human well-being and reduce loneliness. In the context of COVID-19, this has important implications, as companion animal guardians may be less negatively affected by the pandemic. The primary aim of this research was to investigate the influence of companion animals on mental well-being and loneliness during the pandemic, with specific interest in the role of ornamental fishes. A mixed-methods study was conducted, using an international sample. Quantitative data were collected via an online survey (n = 1199) and analysed using robust hierarchical multiple regression analyses; the influence of level of engagement with companion animals was examined for dogs, cats and ornamental fishes. There was no evidence that companion animal guardianship was associated with loneliness and mental well-being during the pandemic but spending more time engaging physically or socially with dogs (and to a lesser extent cats) was generally associated with poorer outcomes. Qualitative data were collected through open-ended survey responses (n = 757) and semi-structured interviews (n = 25) and analysed using reflexive thematic analysis. Two themes were developed—one related to companion animals as providers of social and emotional support, and the other to companion animals as providers of purpose and perspective. Concerns regarding the impact of the pandemic on animal welfare were also identified. Compared to other animal types, more participants expressed indifference regarding the impact of their fishes on their well-being during the pandemic, possibly because fishes cannot provide comfort via physical touch. The findings of this study reflect the wider field of human–animal interaction; although qualitative data suggest guardians believe their companion animals are a positive influence in their lives, there is little convincing quantitative data to support these beliefs. This highlights the need to refine theories regarding which aspects of companion animal guardianship may influence human well-being; the findings from this research may be useful in the refinement of such theories

The effects of interacting with fish in aquariums on human health and well-being: a systematic review

BackgroundMost research into the health benefits of human-animal interaction has focused on species that interact physically with humans, such as dogs. This may be unsuitable for certain populations for reasons including accessibility and the risk of negative consequences to both the person and the animal. However, some research has associated viewing fish in aquariums with positive well-being outcomes; as there is no physical contact with the animal, this form of interaction carries less risk. At present, little is known about the specific benefits of human-fish interaction.ObjectivesTo explore current evidence relating to the psychological and physiological benefits of interacting with fish in aquariums.MethodsSystematic searches were conducted to identify relevant primary research of any design. All forms of interaction were considered, including keeping fish as companion animals and fish aquarium-based interventions. “Non-live” alternatives, such as videos, were also considered. This review was conducted according to a registered protocol (PROSPERO ID: CRD42018090466).ResultsNineteen studies were included. Two provided tentative evidence that keeping home aquaria is associated with relaxation. The remaining studies involved novel interactions with fish in home or public aquariums. Outcomes relating to anxiety, relaxation and/or physiological stress were commonly assessed; evidence was mixed with both positive and null findings. Preliminary support was found for effects on mood, pain, nutritional intake and body weight, but not loneliness. All studies had methodological issues and risk of bias was either high or unclear.ConclusionsReview findings suggest that interacting with fish in aquariums has the potential to benefit human well-being, although research on this topic is currently limited. Future research should aim to address gaps in the evidence, such as whether and how the type of human-fish interaction can influence well-being outcomes. Researchers should also aim to address the methodological concerns highlighted in this review

Physiological Considerations to Support Podium Performance in Para-Athletes

The twenty-first century has seen an increase in para-sport participation and the number of research publications on para-sport and the para-athlete. Unfortunately, the majority of publications are case reports/case series or study single impairment types in isolation. Indeed, an overview of how each International Paralympic Committee classifiable impairment type impact athlete physiology, health, and performance has not been forthcoming in the literature. This can make it challenging for practitioners to appropriately support para-athletes and implement evidence-based research in their daily practice. Moreover, the lack of a cohesive publication that reviews all classifiable impairment types through a physiological lens can make it challenging for researchers new to the field to gain an understanding of unique physiological challenges facing para-athletes and to appreciate the nuances of how various impairment types differentially impact para-athlete physiology. As such, the purpose of this review is to (1) summarize how International Paralympic Committee classifiable impairments alter the normal physiological responses to exercise; (2) provide an overview of “quick win” physiological interventions targeted toward specific para-athlete populations; (3) discuss unique practical considerations for the para-sport practitioner; (4) discuss research gaps and highlight areas for future research and innovation, and (5) provide suggestions for knowledge translation and knowledge sharing strategies to advance the field of para-sport research and its application by para-sport practitioners