Association between social phobia and the risk of arrhythmia using the Korean National Sample Cohort: a retrospective cohort study

Background Social phobia shares symptoms with arrhythmias, such as palpitations and chest discomfort. However, it is unclear how social phobia is associated with the actual risk of arrhythmia. This study aimed to investigate whether social phobia is associated with the risk of arrhythmia using a nationally representative sample cohort. Methods This retrospective cohort study assessed data from the 2002–2013 Korean National Health Insurance Service National Sample Cohort. Using 1:3 propensity score matching for sex, age, income, and insurance status, 1514 patients with social phobia and 4542 control group patients were included in the study. Social phobia and arrhythmia were defined per the International Classification of Diseases, 10th revision. Using cox proportional hazard regression, hazard ratios (HRs) were calculated to estimate the risk of arrhythmia in patients with social phobia. Results There were statistically significant associations between social phobia history and elevated risks of arrhythmia. Patients with social phobia had a higher risk of arrhythmia after adjusting with covariates (HR = 1.78, 95%CI = 1.25–2.55). Among different types of arrhythmias, atrial fibrillation and flutter presented the highest risk (HR = 2.20, CI = 1.06–4.57) compared to paroxysmal tachycardia (HR = 1.07, CI = 0.39–2.91) and other cardiac arrhythmias (HR = 1.83, CI = 1.16–2.89). Conclusion This study identified the association between social phobia and the risk of arrhythmia in a South Korean representative cohort. These results suggest that social phobia should be treated properly to reduce arrhythmia risks.

Threat Assessment in Community Colleges

Threat assessment and management in higher education is still in the early stages of development. Little is noted in the research literature about the practices of threat assessment teams in this environment, particularly in community colleges. To fill this knowledge gap, a random national sample of 15% (n = 148) of public community colleges were surveyed as to: (a) threat assessment practices, (b) continuing education needs, and (c) training delivery preferences. Lead threat assessment practitioners were surveyed from those institutions. A total of 113 participants returned a completed survey. This number represented a return rate of 76%. A post hoc power analysis reported an actual power (i.e., 1-β error probability) of 0.84. The professional breakdown of respondents was law enforcement/security (n = 52), college administration (n = 55) and other (n = 6). The vast majority (73%) of the community colleges operated with a formalized threat assessment team, yet 67% of respondents reported fewer than 40 hours of threat assessment training. The leading types of team composition were: (a) employees only (57%), and (b) mix of employees and outside personnel (32%). Most college threat assessment teams addressed more than just students as threat sources (69%). The top continuing education needs reported ranged from legal implications to advanced training of threat assessment and management. Inferential statistical analyses revealed that, in reference to their professional background, threat assessment practitioners similarly rank their: (a) continuing education needs, and (b) training delivery preferences (i.e., in person vs. online). Implications for both research and practice were discussed.

Planning Adaptation: Accommodating Complexity in the Built Environment

Obsolescence and vacancy are part of the traditional building life cycle, as tenants leave properties and move to new ones. Flux, a period of uncertainty before the establishment of new direction, can be considered part of building DNA. What is new, due to structural disruptions in the way we work, is the rate and regularity of flux, reflected in obsolescence, vacancy, and impermanent use. Covid-19 has instantly accelerated this disruption. Retail failure has increased with even more consumers moving online. While employees have been working from home, rendering the traditional office building in the central business district, at least temporarily, obsolete. This article reflects on the situation by reporting findings from an 18-month research project into the practice of planning adaptation in the English built environment. Original findings based on interviews with a national sample of local authority planners, combined with an institutional analysis of planning practice since the 1947 Town and Country Planning Act, suggest that the discipline of planning in England is struggling with the reality of flux. There is a demand for planning to act faster, due to the speed of change in the built environment, and liberal political concerns with planning regulation. This is reflected in relaxations to permitted development rules and building use categories. However, participants also indicate that there is a concurrent need for the planning system to operate in a more measured way, to plan the nuanced complexity of a built environment no longer striated by singular use categories at the local level. This notion of flux suggests a process of perpetual change, turbulence, and volatility. However, our findings suggest that within this process, there is a temporal dialectic between an accelerating rate of change in the built environment and a concomitant need to plan in a careful way to accommodate adaptation. We situate these findings in a novel reading of the complex adaptive systems literature, arguing that planning practice needs to embrace uncertainty, rather than eradicate it, in order to enable built environment adaptation. These findings are significant because they offer a framework for understanding how successful building adaptation can be enabled in England, moving beyond the negativity associated with the adaptation of buildings in recent years. This is achieved by recognizing the complex interactions involved in the adaptation process between respective stakeholders and offering an insight into how respective scales of planning governance can coexist successfully.

Caregiving in a Pandemic: COVID-19 and the Well-Being of Family Caregivers 55+ in the United States

Little is known about the effects of Coronavirus disease 2019 (COVID-19) on older family caregivers. Using data from a national sample of 2,485 U.S. adults aged ≥55, we aimed to describe the magnitude of disruptions to family care arrangements during the initial wave of the COVID-19 pandemic, and the associations between these disruptions and the mental health outcomes (depression, anxiety, loneliness, and self-rated health) and employment outcomes (job loss or furlough, hours or wages reduced, transition to work-from-home) of family caregivers. We found that COVID-19 disrupted over half of family caregiving arrangements, and that care disruptions were associated with increased depression, anxiety, and loneliness among caregivers, compared with both noncaregivers and caregivers who did not experience disruptions. Family caregivers who experienced pandemic-related employment disruptions were providing more care than caregivers who did not experience disruptions. These findings highlight the impact of the pandemic on an essential and vulnerable health care workforce.

Determining levels of nurse burnout during the COVID-19 pandemic and Lebanon’s political and financial collapse

Background The COVID-19 pandemic compounded political and financial pressures on the nursing workforce in Lebanon. The government resigned in October 2019 in response to the popular uprising that called for an end to corruption and economic mismanagement 5 months before the first COVID-19 case appeared in the country. The continuing crises and the added stress of COVID-19 has increased the risk of occupational burnout and turnover in the nursing workforce. Therefore, valid and reliable measurement is imperative to determine burnout levels, prioritize intervention, and inform evidence-based workforce policy and practice. The primary aim of the study was to delineate burnout levels and cut-points in a national sample of nurses to inform workforce policies and prioritize interventions. Methods Multidimensional and unidimensional Rasch analyses of burnout data collected from a national convenience sample of 457 hospital nurses 9–12 months after Lebanon’s political and economic collapse began. The data were collected in July–October 2020. Results Multidimensional Rasch analysis confirmed that the Copenhagen Burnout Inventory has three highly correlated unidimensional scales that measure personal burnout, work-related burnout, and client-related burnout. Except for a ceiling effect of ~ 2%, the three scales have excellent measurement properties. For each scale, Rasch rating scale analysis confirmed five statistically different nurse burnout levels. The mean personal burnout scores and work-related burnout scores (50.24, 51.11 respectively) were not higher than those reported in the international literature. However, the mean client-related burnout score of 50.3 was higher than reported for other countries. Compared with a baseline study conducted at the beginning of Lebanon’s political and economic crises, only client-related burnout scores were higher p. <.01. Conclusions The CBI scales are reliable and valid measures for monitoring nurse burnout in crises torn countries. Stakeholders can use the CBI scales to monitor nurse burnout and prioritize burnout interventions. Urgent action is needed to reduce levels of client-related burnout in Lebanon’s nursing workforce.

Cognitive predictors of vaccine hesitancy and COVID-19 mitigation behaviors in a population representative sample

With the continued threat of COVID-19, predictors of vaccination hesitancy and mitigation behaviors are critical to identify. Prior studies have found that cognitive factors are associated with some COVID-19 mitigation behaviors, but few studies employ representative samples and to our knowledge no prior studies have examined cognitive predictors of vaccine hesitancy. The purpose of the present study, conducted among a large national sample of Canadian adults, was to examine associations between cognitive variables (executive function, delay discounting, and temporal orientation) and COVID-19 mitigation behaviors (vaccination, mask wearing, social distancing, and hand hygiene). Findings revealed that individuals with few executive function deficits, limited delay discounting and who adopted a generally future-orientation mindset were more likely to be double-vaccinated and to report performing COVID-19 mitigation behaviors with high consistency. The most reliable findings were for delay discounting and future orientation, with executive function deficits predicting mask wearing and hand hygiene behaviors but not distancing and vaccination. These findings identify candidate mediators and moderators for health communication messages targeting COVID-19 mitigation behaviors and vaccine hesitancy.

The prevalence and psychological relation of problem shopping: data from a large-scale sample from Turkey

Background The purpose of the present study was to comprehensively examine the measurement aspects, the prevalence, and the psychological correlates of problem shopping among a large-scale national sample of Turkish adults. Result Participants (N = 24,380, 50% men, M age = 31.79 years, age range = 18–81 years) completed a questionnaire that comprised the Shopping Addiction Risk Questionnaire, the Brief Symptom Inventory, the Positive and Negative Affect Schedule, and the Experiences in Close Relationships-Revised. Results showed that 1.8% of the participants had probable shopping addiction. Being female, being younger, psychiatric distress, positive affect, negative affect, anxious attachment, and avoidant attachment were positive correlates of problem shopping. Conclusion The results of this large sample size study suggest that shopping addiction is not a rare condition in Turkey. Further research is needed to understand different motives that underlie the problematic shopping behavior in the young and female population in comparison to older and male populations. Preventive programs or any interventions for people with PSB needs to address regulation difficulties and development of healthy strategies to cope with psychiatric distress.

Changes in the Frequency of Moderate-to-Vigorous Physical Activity and Subsequent Risk of All-Cause and Cardiovascular Disease Mortality

We investigated the association of changes in the frequency of moderate-to-vigorous physical activity (MVPA) and the risks of all-cause and cardiovascular disease (CVD) mortality. This study used the nationally representative National Health Insurance Service-National Sample Cohort database. We included 286,402 individuals aged ≥20 years and estimated changes in the frequency of MVPA over a two-year period. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazard regression models. The HRs (95% CIs) for the risk of all-cause and CVD mortality for an increased frequency of MVPA from physical inactivity compared with continual physical inactivity were 0.82 and 0.68 (0.73–0.92 and 0.51–0.91) for 1–2, 0.72 and 0.48 (0.62–0.84 and 0.31–0.74) for 3–4, and 0.73 and 0.70 (0.63–0.85 and 0.50–0.98) for ≥5 sessions of MVPA/week. The HRs (95% CIs) for the risk of all-cause and CVD mortality were 1.28 and 1.58 (1.07–1.53 and 1.01–2.46), 1.25 and 2.17 (1.01–1.57 and 1.14–4.12), and 1.43 and 1.44 (1.15–1.77 and 0.84–2.47) for changes from 1–2, 3–4, and ≥5 sessions of MVPA/week to physical inactivity, respectively. This study showed the beneficial effect of increasing physical activity, particularly for those who were physically inactive at baseline, as well as the increased risk of all-cause and CVD mortality after adapting a physically inactive lifestyle regardless of their baseline physical activity status.