“If it is not made easy for me, I will just not bother”. Barriers and Facilitators to Recycling Plastics

Millions of tonnes of plastic are ending up in our oceans and creating a global environmental hazard. Around 50 percent of plastics are designed for single use, mainly for food packaging. Plastic waste is often found discarded as litter, despite significant investment over the last 20-30 years to increase recycling facilities and kerbside collection of waste materials. While there is a substantive body of literature about general recycling behaviour, few insights exist that may help us understand why a sizeable number of consumers and householders are failing to sort plastics for recycling at optimal levels. As a consequence, used plastic is ending up in landfill and is polluting the environment. This current study used in-depth qualitative interviews within a framework that seeks to identify underlying opportunities, motivations and capabilities of individuals when it comes to plastic recycling. The principle findings are that the respondents are generally positive about recycling and express a degree of environmental concern about the damage plastic waste causes to the natural world. However, this concern does not translate into efforts to obtain accurate information about plastics disposal. Efforts are lower when visual reminders of its harmful impact are absent, and when faced with a confusing array of packaging that combines several types of plastics. Householders believe the responsibility for making plastic recycling easier rests heavily with local government and manufacturers. Until greater uniformity in packaging is achieved, plastics recycling rates may struggle to reach optimal levels.

Seeing Proof of Townsmen on the Move: Coats of Arms, Chivalric Badges, and Travel in the Later Middle Ages

In the later Middle Ages, traveling to sacred places and foreign courts promised honor, not least to residents of cities keen to advance their status within and beyond urban society. But the symbolic capital promised by travel had to be rendered recognizable. To this end, the inhabitants of German-speaking cities also relied on coats of arms and badges of chivalric orders, as this essay will show by looking at travel accounts, visual sources, and material remains. Analogous to noble customs, these signs were meant to record the presence of townsmen abroad and to commemorate their achievements as travelers once back in their hometowns. From town houses and church decorations to conspicuous dress, the urban space was filled with visual reminders of spatial mobility displayed for the purpose of social mobility. As it becomes clear that contemporaries were acutely aware of travelers’ ambitions, the heraldic and para-heraldic communication of travel emerges as a prominent and at times contested element of urban visual and material culture.

Barriers and Facilitators to Guideline-Adherent Pulse Oximetry Use in Bronchiolitis

METHODS: This multicenter qualitative study took place in the context of the Eliminating Monitor Overuse (EMO) SpO2 study, a cross-sectional study to establish rates of cSpO2 in bronchiolitis. We conducted semistructured interviews, informed by the Consolidated Framework for Implementation Research, with a purposive sample of stakeholders at sites with high and low cSpO2 use rates to identify barriers and facilitators to addressing cSpO2 overuse. Interviews were audio recorded and transcribed. Analyses were conducted using an integrated approach. RESULTS: Participants (n = 56) included EMO study site principal investigators (n = 12), hospital administrators (n = 8), physicians (n = 15), nurses (n = 12), and respiratory therapists (n = 9) from 12 hospitals. Results suggest that leadership buy-in, clear authoritative guidelines for SpO2 use incorporated into electronic order sets, regular education about cSpO2 in bronchiolitis, and visual reminders may be needed to reduce cSpO2 utilization. Parental perceptions and individual clinician comfort affect cSpO2 practice. CONCLUSION: We identified barriers and facilitators to deimplementation of cSpO2 for stable patients with bronchiolitis across children’s hospitals with high- and low-cSpO2 use. Based on these data, future deimplementation efforts should focus on clear protocols for cSpO2, EHR changes, and education for hospital staff on bronchiolitis features and rationale for reducing cSpO2. Journal of Hospital Medicine 2020;15:XXX-XXX. © 2020 Society of Hospital Medicine

How Can We Improve Hand Hygiene Compliance and its Clinical Implications in Healthcare Professionals?

Hand washing is one of the most important things that an individual can do to help prevent and control, the spread of bacteria, infections, and many illnesses from occurring. This study aimed to investigate the importance of hand hygiene compliance in nurses who practice at Rhode Island Hospital (RIH) in Rhode Island. The research in this study focuses on the compliance of hand hygiene created by the nursing staff. The branches of RIH target the Neurosurgery, Pulmonary, Dermatology, and the Dialysis Unit, to examine whether the implementation of visual reminders (i.e., "healthy hands" posters) create awareness amongst the nurses in each department. In this mixed-method, prospective, and quasi-experimental study, self-reporting was used to study the frequency of handwashing before and after the implementation of visual reminders. An additional method was created to measure the amount of Germ X Hand Sanitizer used in collaboration with visual reminders in a pre and post-intervention. A Focus Group Discussion was also conducted with the participants to obtain feedback that would increase hand hygiene awareness and its compliance. The results indicated that visual reminders create awareness and increase handwashing frequency among Rhode Island Hospital nurses. The implementation of visual reminders provided nurses with the knowledge and understanding of the importance of the issue.

The role of screening, SIRS and qSOFA in Head and Neck Sepsis: An Audit of 104 Patients

Key Points • Sepsis is associated with high morbidity and mortality and is a known complication of infections of the head and neck. Screening for sepsis should be conducted on admission in order to identify patients at risk and provide early intervention. • Our audit on an ENT ward in a district general hospital found that sepsis screening is poor, however this can be improved further by education and visual reminders such as poster or a clerking proforma. • The most common head and neck infections admitted to a district general hospital were tonsillitis, peritonsillar cellulitis and peritonsillar abscesses. • The incidence of sepsis as a complication of head and neck infections is very rare if diagnosed according to the updated qSOFA criteria. • Using SIRS criteria may result in falsely high rates of diagnosis of sepsis and may lead to excessive and inappropriate clinical management in patients who could otherwise be managed less aggressively.

Demand for Information on Environmental Health Risk, Mode of Delivery, and Behavioral Change: Evidence from Sonargaon, Bangladesh

Millions of villagers in Bangladesh are exposed to arsenic by drinking contaminated water from private wells. Testing for arsenic can encourage switching from unsafe wells to safer sources. This study describes results from a cluster randomized controlled trial conducted in 112 villages in Bangladesh to evaluate the effectiveness of different test selling schemes at inducing switching from unsafe wells. At a price of about US0.60, only one in four households purchased a test. Sales were not increased by informal inter-household agreements to share water from wells found to be safe, or by visual reminders of well status in the form of metal placards mounted on the well pump. However, switching away from unsafe wells almost doubled in response to agreements or placards relative to the one in three proportion of households that switched away from an unsafe well with simple individual sales.

Eating with our eyes (closed): Effects of visually associating animals with meat on antivegan/vegetarian attitudes and meat consumption willingness

Negative attitudes toward vegetarians/vegans (i.e., veg*ns) are common, particularly among those who desire/like/consume meat more. In two studies, we replicated and extended past work, showing that visual reminders of meat’s animal origins (vs. images of meat alone) decreased meat consumption willingness via increased empathy for animals, distress about meat consumption, and disgust for meat. We also assessed how animal–meat reminders influence antiveg*n attitudes. In Study 1 ( N = 299) experimental animal–meat reminders (vs. meat-alone images) indirectly reduced negative attitudes toward veg*ns via increased empathy and distress (together, but not independently). The same manipulation in Study 2 ( N = 280) lowered antiveg*n attitudes through greater empathy and lowered veg*n threat through greater distress. Implications for promoting less antiveg*n attitudes are discussed.