BACKGROUND: This study explores intersectionality in moral distress and turnover intention among healthcare workers (HCWs) in British Columbia, focusing on race and gender dynamics. It addresses gaps in research on how these factors affect healthcare workforce composition and experiences.
METHODS: Our cross-sectional observational study utilized a structured online survey. Participants included doctors, nurses, and in-home/community care providers. The survey measured moral distress using established scales, assessed coping mechanisms, and evaluated turnover intentions. Statistical analysis examined the relationships between race, gender, moral distress, and turnover intention, focusing on identifying disparities across different healthcare roles. Complex interactions were examined through Classification and Regression Trees.
RESULTS: Racialized and gender minority groups faced higher levels of moral distress. Profession played a significant role in these experiences. White women reported a higher intention to leave due to moral distress compared to other groups, especially white men. Nurses and care providers experienced higher moral distress and turnover intentions than physicians. Furthermore, coping strategies varied across different racial and gender identities.
CONCLUSIONS: Targeted interventions are required to mitigate moral distress and reduce turnover, especially among healthcare workers facing intersectional inequities.

This article presents an open proposal on how to include questions that capture different gender identities and sexual orientations in quantitative research. Our theoretical framework is feminist theory and the evolution of feminist debates on identity categories, where the introduction of an intersectional gender perspective has been an important paradigm shift. We have compiled different previous categorization proposals and consider the consequences of not including categories that reflect identity diversity in surveys in order to finally offer our proposal for operationalizing identities. The proposal aims to ensure comparability in longitudinal studies and, at the same time, to incorporate new identity frameworks and an intersectional perspective in quantitative methodology research.

UNASSIGNED: Registered nurses working on the frontline during the COVID-19 pandemic encountered significant challenges, including exposure to critical incidents. Critical incidents refer to sudden unexpected clinical events that surpass an individual\'s ability to cope, leading to considerable psychological distress, which could potentially result in the development of post-traumatic stress disorder symptoms. Research has shown a high prevalence of post-traumatic stress disorder symptoms among healthcare workers, particularly those in close contact with COVID-19 patients.
UNASSIGNED: To assess the levels of post-traumatic stress symptoms among registered nurses in relation to exposure to working conditions during the COVID-19 pandemic, such as how much their work was affected by the pandemic, re-deployment, working hours hindering sufficient recovery between shifts and critical incidents.
UNASSIGNED: Cross sectional study.
UNASSIGNED: The registered nurses working in multiple health care services covering all 21 geographic regions in Sweden.
UNASSIGNED: A total of 1,923 registered nurses, who are part of a Swedish national cohort and have been followed since their nursing education, were invited to participate in a survey in late September 2021 (15 to 19 years post graduation).
UNASSIGNED: The data were analyzed using descriptive statistics, unpaired t-tests, and one-way analysis of variance. Cohen\'s d was employed to quantify differences in mean levels between subgroups.
UNASSIGNED: The response rate were 56.5 %. Over 50 % of experienced registered nurses reported significant disruptions to their work environments. In total, 85 % of registered nurses were exposed to at least one critical incident in their work during the pandemic, with 60 % facing organisational changes and nearly 50 % experiencing emotionally distressing situations. The exposure to work situations involving critical incidents consistently demonstrated strong associations with higher levels of post-traumatic stress disorder symptoms compared to those not exposed, with effect sizes ranging from moderate to high.
UNASSIGNED: This study underscores the profound impact that working conditions, such as redeployment and exposure to critical incidents, have on the mental health of registered nurses. We offer valuable insights into registered nurses\' pandemic-related challenges, highlighting the need for support and interventions to prevent and manage critical incidents, ultimately promoting their well-being. We also highlight the significance of thorough workforce readiness planning for future pandemics and other challenging health care scenarios, such as staff shortage.

BACKGROUND: The transition to college life can impact the mental health of students. There are mental health care strategies that promote connection with the body\'s internal signals, which can help to improve mental well-being, manage emotions, and reduce the risk of suicide in university students.
OBJECTIVE: This study aimed to examine the association between interoceptive body awareness variables and suicidal orientation in a sample of 169 undergraduate students in Colombia.
METHODS: An observational, cross-sectional study was conducted in 2023 with Colombian students as the participants.
RESULTS: The findings revealed a significant and moderately negative correlation between the Multidimensional Assessment of Interoceptive Awareness (MAIA) total score and the Inventory of Suicide Orientation (ISO-30) total score (r = -0.54, p < 0.001). Confidence and self-regulation were identified as the most influential factors in the relationship between MAIA and ISO-30. Significant correlations were observed (p < 0.001), indicating moderate correlation values ranging from -0.43 to -0.57.
CONCLUSIONS: Our findings support the existence of a negative correlation between interoceptive body awareness and suicidal orientation. Further research is needed to better understand this relationship and to develop specific interventions based on body awareness to prevent suicide orientation.
CONCLUSIONS: There are practical implications associated with recognizing the importance of body awareness in relation to decreasing suicidal orientation, and multidisciplinary teams addressing mental health can incorporate this knowledge.

Long-term environmental loading of microplastics (MPs) causes alarming exposure risks for a variety of species worldwide, considered a planetary threat to the well-being of ecosystems. Robust quantitative estimates of MP extents and featured diversity are the basis for comprehending their environmental implications precisely, and of these methods, membrane-based characterizations predominate with respect to MP inspections. However, though crucial to filter-based MP quantification, aggregation statuses of retained MPs on these substrates remain poorly understood, leaving us a \"blind box\" that exaggerates uncertainty in quantitive strategies of preselected areas without knowing overview loading structure. To clarify this uncertainty and estimate their impacts on MP counting, using MP imaging data assembled from peer-reviewed studies through a systematic review, here we analyze the particle-specific profiles of MPs retained on various substrates according to their centre of mass with a fast-random forests algorithm. We visualize the formation of distinct galaxy-like MP aggregation-similar to the solar system and Milky Way System comprised of countless stars-across the pristine and environmental samples by leveraging two spatial parameters developed in this study. This unique pattern greatly challenges the homogeneously or randomly distributed MP presumption adopted extensively for simplified membrane-based quantification purposes and selective ROI (region of interest) estimates for smaller-sized plastics down to the nano-range, as well as the compatibility theory using pristine MPs as the standard to quantify the presence of environmental MPs. Furthermore, our evaluation with exemplified numeration cases confirms these location-specific and area-dependent biases in many imaging analyses of a selective filter area, ascribed to the minimum possibility of reaching an ideal turnover point for the selective quantitive strategies. Consequently, disproportionate MP schemes on loading substrates yield great uncertainty in their quantification processing, highlighting the prompt need to include pattern-resolved calibration prior to quantification. Our findings substantially advance our understanding of the structure, behavior, and formation of these MP aggregating statuses on filtering substrates, addressing a fundamental question puzzling scientists as to why reproducible MP quantification is barely achievable even for subsamples. This study inspires the following studies to reconsider the impacts of aggregating patterns on the effective counting protocols and target-specific removal of retained MP aggregates through membrane separation techniques.

BACKGROUND: Patient safety is one of the cornerstones of high-quality healthcare systems. Evidence-based practice is one way to improve patient safety from the nursing perspective. Another aspect of care that directly influences patient safety is missed nursing care. However, research on possible associations between evidence-based practice and missed nursing care is lacking.
OBJECTIVE: The aim of this study was to examine associations between registered nurses\' educational level, the capability beliefs and use of evidence-based practice, and missed nursing care.
METHODS: This study had a cross-sectional design. A total of 228 registered nurses from adult inpatient wards at a university hospital participated. Data were collected with the MISSCARE Survey-Swedish version of Evidence-Based Practice Capabilities Beliefs Scale.
RESULTS: Most missed nursing care was reported within the subscales Basic Care and Planning. Nurses holding a higher educational level and being low evidence-based practice users reported significantly more missed nursing care. They also scored significantly higher on the Evidence-based Practice Capabilities Beliefs Scale. The analyses showed a limited explanation of the variance of missed nursing care and revealed that being a high user of evidence-based practice indicated less reported missed nursing care, while a higher educational level meant more reported missed nursing care.
CONCLUSIONS: Most missed nursing care was reported within the subscales Planning and Basic Care. Thus, nursing activities are deprioritized in comparison to medical activities. Nurses holding a higher education reported more missed nursing care, indicating that higher education entails deeper knowledge of the consequences when rationing nursing care. They also reported varied use of evidence-based practice, showing that higher education is not the only factor that matters. To decrease missed nursing care in clinical practice, and thereby increase the quality of care, educational level, use of evidence-based practice, and organizational factors must be considered.

BACKGROUND: Nursing care left undone occurs when nurses omit activities because of resource shortfalls. Higher levels of nursing care left undone are associated with worse nurse staffing and organizational factors. Plentiful evidence from acute, long-term and community care supports such associations; however, mental healthcare settings are under-studied.
OBJECTIVE: The aim of the study was to describe nursing care left undone\'s frequency in mental health inpatient settings and explore its association with nurse staffing levels.
METHODS: As part of the multi-centre cross-sectional MatchRN Psychiatry study, data were collected by questionnaire from 114 units in 13 Swiss psychiatric hospitals. Nursing care left undone was analysed describing frequencies descriptively and used linear mixed models to assess its association with staffing.
RESULTS: Data from 994 nurses were analysed. The most commonly omitted activities were evaluating nursing processes (30.5%), formulating nursing diagnoses (27.4%) and defining care objectives (22.7%). Nursing care left undone was higher in units with low staffing levels.
CONCLUSIONS: As in somatic care settings, in psychiatric hospitals, \'indirect\' care activities are most commonly omitted.
CONCLUSIONS: This study highlights factors affecting the frequency of nursing care left undone, including staffing levels and perceived leadership. The findings emphasize the importance of nurse managers taking action to improve work environment factors.

Inclusive postsecondary education (IPSE) programs support adults with intellectual disabilities\' participation in higher education. Students in IPSE programs may have limited knowledge of sexuality, relationships, and social skills, which can be addressed through sexuality and relationship education (SRE). This project evaluated the effect of the Positive Choices© curriculum on the SRE knowledge of 7 students attending an IPSE program in the southeastern United States. Students attended 15 weekly classes taught by two graduate assistants and faculty supervisor during spring 2020; half of course meetings occurred in person and half via Zoom due to COVID-19 restrictions. The authors analyzed results of pre-post one sample t-test of student scores on five instructor-created assessments. All students showed statistically significant increases in knowledge for each assessment and overall. Future research should assess the effect of other curricula in use in IPSE programs and evaluate the need for and use of supplemental materials for instruction.

In this paper we sought to explore health and social care professionals\' self-rated confidence in helping older adults with mental ill-health in non-psychiatric care settings. A cross-sectional survey study was performed exploring the participants\' (n = 480) confidence in helping. Confidence in helping was analyzed together with background characteristics and selected explanatory variables, such as the workplace and work experience of the participants, their personal experiences of and attitudes to mental ill-health, as well as their knowledge in mental ill-health among older adults, by means of descriptive statistics and logistic regression analysis. We found that approximately half (55%) of the participants were confident in helping older adults with mental ill-health. The odds ratios for being confident in helping were significantly associated to the workplace of the professionals, professionals\' attitude to and experience of mental ill-health, and knowledge of mental health among older adults. To increase confidence in helping older adults with mental ill-health, we recommend confidence-building interventions, for example, educational programs, through which knowledge of mental health among older adults is increased and negative attitudes are challenged, especially within the context of specialist somatic healthcare.

Researchers rely on metadata systems to prepare data for analysis. As the complexity of data sets increases and the breadth of data analysis practices grow, existing metadata systems can limit the efficiency and quality of data preparation. This article describes the redesign of a metadata system supporting the Fragile Families and Child Wellbeing Study on the basis of the experiences of participants in the Fragile Families Challenge. The authors demonstrate how treating metadata as data (i.e., releasing comprehensive information about variables in a format amenable to both automated and manual processing) can make the task of data preparation less arduous and less error prone for all types of data analysis. The authors hope that their work will facilitate new applications of machine-learning methods to longitudinal surveys and inspire research on data preparation in the social sciences. The authors have open-sourced the tools they created so that others can use and improve them.