Urinary incontinence affects the physical, psychological, social and well-being of older adult women and requires adaptation. This study aimed to explain the inhibiting factors of adaptation to urinary incontinence in community-dwelling older adult women. A qualitative content analysis approach was adopted. Participants were 15 older women with urinary incontinence, three family members, and three healthcare team members. Data were collected by individual, in-depth semistructured interviews and analysed using the Graneheim and Lundman approach. The data analysis yielded the theme of neglecting urinary incontinence and the older adult, with four categories of \"s silence-inducing beliefs\", \"worthlessness for the family\", \"non-adaptation of urban spaces\", and \"deficiencies in the healthcare service structure\". Elucidating the inhibiting factors for older women\'s adaptation to urinary incontinence will lead to a change in the attitude of social policymakers and healthcare officials. This changes will then facilitate the establishment and adjustment of the necessary infrastructure to overcome these barriers.

As the primary source of carbon emissions, enterprises must work hard to save energy, reduce emissions, and disclose timely carbon information to the public. As a key means of communicating carbon management performance to stakeholders, carbon information disclosure is directly tied to the future sustainability of enterprises. Based on panel data of 118 listed firms in the automotive manufacturing industry from 2017 to 2021, this study rates the sample companies\' quality of carbon information disclosure. The impact of the government, creditors, media, employees, and suppliers on such disclosure is also examined from the stakeholders\' standpoint. The findings reveal that: (1) Although there has been a gradual increase in the degree of disclosure, overall levels are still low, and the willingness to voluntarily disclose is insufficient. (2) When other variables are neglected, the government, creditors, media, and employees all assist enterprises in disclosing carbon information, but the influence of suppliers will inhibit such disclosure. In the context of a complex economic system, the level of carbon disclosure is positively correlated with the government, the media, and employees, while negatively correlated with creditors. The influence of suppliers is not significant. These findings may aid in formulating related policies from different dimensions, directing enterprises to publish carbon information actively and strengthening carbon management.

Nitrogen removal from landfill leachate (LL) using microalgae is a promising method and can realize CO2 mitigation. But the performances are usually inhibited by high chromaticity, high free ammonia (FAN) and some complex macro molecular organic matter (MOM) in the LL. To achieve efficient nitrogen removal from LL, this study firstly pretreated the mature LL with ozone, decolorizer and activated sludge (AS) respectively, and then inoculated with mixed microalgae. The results showed that the synergistic effect of ozonation and microalgae was the best among the three, with 99.7% ammonia removal, 0.77 g/L (dry weight) microalgae biomass, and a maximum growth rate of 160 mg/L/d. Ozonation pretreatment significantly reduced the chromaticity and macromolecular organic matter of LL, with the chromaticity reduced from 2225 to 225 times and the 3D fluorescence intensity representing MOM reduced from 4089 a.u. to 986.1 a.u.. And it was found that the mixed microalgae grown after pretreatment by three different methods all were mostly Chlorella and very few Microcystis, and the density of microalgal populations (number of cells per unit volume) after ozonation was up to 10,650 cells/μL. This work provides a feasible and an economical way to remove ammonia nitrogen (NH+ 4-N) from landfill leachate.

BACKGROUND: There has been increasing interest in integrating patient-reported outcomes (PROs) into routine oncological practice. To date, however, PROs have rarely been implemented in Germany. Currently, PROs are being used as performance measures in colorectal cancer centers in Germany. This content analysis identified factors that may inhibit or facilitate the additional use of PROMs for individual patient management.
METHODS: The analysis follows an exploratory approach. Out of 103 centers that participated in a multicentric PRO quality management and benchmarking program in Germany, twelve oncological health-care providers from eight certified colorectal cancer centers were interviewed using a semi-structured interview guide. The interviewees were clinicians (physicians, nurses, psycho-oncologist and physician assistant) who care for colorectal cancer patients. This analysis evaluated whether and how PROs that are primarily collected for quality management/benchmarking reasons could also be used for the management of individual patients. The data was analyzed using a content-analysis approach.
RESULTS: The interviewees were not using PRO in their routine clinical work, but they recognized its added value and pointed out potential example uses. Identified inhibiting factors for the use of PROs in clinical routine work were effortful access to PRO reports, lacking coordinating structures, time delays and time points of measurements as well as redundancy with other instruments. Facilitating factors for the use of PROs in clinical routine work that were identified included access via electronic patient records, implementation of coordinating structures for PRO processes in the center, clear PRO reports that are easy to interpret, and measurements at relevant time points.
CONCLUSIONS: Clinicians had quite a positive attitude toward PROs and recognized their added value. Inhibiting and facilitating factors of an organizational and technical nature were identified.
CONCLUSIONS: These findings indicate how PROs used for quality management purposes may also be used for the management of individual patients. Therefore, existing structures and processes in the certified colorectal cancer centers, as well as lessons learned from the literature on the implementation of PROs monitoring individual patients need to be taken into account.

The aim of this study was to explore the factors influencing registered nurses\' pursuit of postgraduate education in specialty nursing practice in Australia. Despite the increased requirement for postgraduate education for advanced practice, little has been reported on the contributory factors involved in the decision to undertake further education. The Nurses\' Attitudes Towards Postgraduate Education instrument was administered to 1632 registered nurses from the Nurses and Midwives e-Cohort Study across Australia, with a response rate of 35.9% (n = 568). Data reduction techniques using principal component analysis with varimax rotation were used. The analysis identified a three-factor solution for 14 items, accounting for 52.5% of the variance of the scale: \"facilitators,\" \"professional recognition,\" and \"inhibiting factors.\" Facilitators of postgraduate education accounted for 28.5% of the variance, including: (i) improves knowledge; (ii) increases nurses\' confidence in clinical decision-making; (iii) enhances nurses\' careers; (iv) improves critical thinking; (v) improves nurses\' clinical skill; and (vi) increased job satisfaction. This new instrument has potential clinical and research applications to support registered nurses\' pursuit of postgraduate education.