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Over the past 15 years, there have been numerous fatalities related to working with animal slurry. Working with cattle slurry releases toxic gases, in particular, hydrogen sulphide (H2S), which can cause acute central nervous system toxicity, breathing difficulties, and death if exposed to high concentrations. Real-time measurements of H2S gas were taken over distance and time, during the stirring of cattle slurry on farms. Gas was measured at eight slurry stores with differing typical configurations of indoor or outdoor stores and with or without slatted flooring. Highest H2S gas levels were measured from indoor stores under slatted floors, and generally at positions closest to the stirrer or the point of maximum stirring, with levels decreasing with distance from source. Most of the data indicate H2S gas levels increase very rapidly after stirring starts, and mostly decline to baseline levels within 30 min post start of stirring. There were, however, circumstances where gas levels remained high and only started to decline once the stirrer had stopped. H2S gas levels at all farms, at all positions measured were consistently below 10 ppm within 30 min of the stirrer being stopped. The current data highlight areas of the farm and ways of working that have the potential for workers and others to be at risk of exposure to toxic slurry gases. The area should be left to ventilate naturally for at least 30 min after the stirrer has been stopped before re-entering buildings. Influencing the design of stirring equipment and future slurry stores would likely reduce the risk of worker exposure to slurry gases. [ABSTRACT FROM AUTHOR]

Did government mines inspectors in late Victorian Britain display overt bias towards employers when assigning blame for fatal underground explosions? Inspectors were closer to managers and coal owners than they were to miners or mine supervisors in terms of status, background, and engineering experience. That inspectors had more in common with management could have led to favouritism or regulatory capture, as was suggested at the time by miners and more recently by historians. To adjudicate these claims, this article applies the technique of qualitative content analysis to the comments of mines inspectors in their published annual reports. The findings reveal that inspectors frequently condemned employers and their representatives, especially after gas and coal dust explosions that took 10 or more lives. By contrast, following blasting explosions, which typically killed only one person, they usually blamed the miners themselves. The available evidence therefore suggests that any discernible pro-employer bias on the part of the inspectorate was limited to smaller explosions where it was easier to ignore systemic factors and deem individual workmen to be at fault. [ABSTRACT FROM AUTHOR]

Current evidence suggests understaffing is related to poor quality and missed care in a global context, but this relationship is complex. There is also a research gap for quality in mental health care in the United Kingdom that includes a wider set of patient outcomes. This paper aims to investigate RMN's perception of quality of care on their last shift, their self‐reported reasons for compromised care and potential impact on patient outcomes. A mixed methods approach, we used descriptive statistics to create a framework within which to qualitatively analyse data from the 2017 Royal College of Nursing (RCN) employment survey to consider the complex relationship between understaffing and care quality. We established three themes: 'Understaffing', 'Professional Code Expectations and Moral Distress' and 'Management'. In line with the current evidence; lack of resources and understaffing were consistently present throughout. Nurses also felt pressure from the Nursing and Midwifery Council (NMC) code of conduct which in turn instilled shame and fear for their registration when they were unable to achieve the standards expected. This was further exacerbated by poor management and supervision; leading nurses to reflect on poor outcomes for patients which compromised not only legal rights but safety of patients and staff alike. We conclude that focusing on staffing numbers alone is unlikely to improve care quality. [ABSTRACT FROM AUTHOR]

Aims: The study aimed to (1) discover workers' attitudes toward the use of novel video screens to improve hand sanitization in the workplace and (2) discover what workers' preferences are for hand hygiene (HH) messaging style and tone and reasons for their preferences. Background: Practicing good HH in non-medical office settings is vital to curb the spread of a range of common and infectious diseases. Despite this, workers are rarely consulting in the construction of HH messages. The qualitative views of users can provide us with the "why" rather than the "what" and can highlight areas of cynicism, concern and overall attitudes to HH. Methods: A survey was completed by 520 UK workers concerning attitudes and views toward HH messaging and the use of a video-based hand sanitizer unit. Analysis consisted of both qualitative and quantitative methods. Results: Workers were skeptical toward the use of digital technologies within HH interventions, and there were misgivings about the role that video could play. Results demonstrated a strong preference for positive and supportive messages. Educational and trustworthy qualities were well rated. Messages that emphasized surveillance, previously successful in a clinical setting, or guilt, were not well received. Visual approaches that utilized serious illustration were valued. Conclusion: This study highlights how consulting workers before the design of HH initiatives is important in guiding the design process. The resultant user-centered criteria promotes the use of positive, motivational, thought-provoking, surprising, and visual approaches to HH messaging. [ABSTRACT FROM AUTHOR]

Background: Studies have reported evidence on sharps injuries among nursing, medical and dental students but little is known about the amount, type and causes of sharps injuries affecting other healthcare students. Aim: The aim of the narrative review was to identify the extent, type and causes of sharps injuries sustained by healthcare students, especially those not in those fields. Method: Eight databases were searched using keywords to identify studies published between 1980 and March 2023. Findings: This narrative review highlights that some groups of healthcare students, including those studying pharmacy, physiotherapy and radiography, sustain sharps injuries from similar devices as reported in research on such injuries in nursing, medical and nursing students. Sharps injuries happen in a range of healthcare environments, and many were not reported by students. The main cause of a sharps injury identified was a lack of knowledge. Conclusion: More research is needed on the extent of sharps injuries in healthcare students in European countries and the UK as well as on their physical and psychological effects. Education and training in sharps use and disposal are essential. [ABSTRACT FROM AUTHOR]

A surge in measles cases has prompted the UK Health Security Agency (UKHSA) to declare a national incident. Agency chief executive Jenny Harries says the UK is on a ‘trajectory for everything getting much worse’ because of low vaccination uptake. Nurses have described the situation as frustrating because the virus is preventable with two doses of the measles, mumps and rubella (MMR) vaccine. [ABSTRACT FROM AUTHOR]

While there is a lot of emphasis on the need for good infection prevention and control practices and acute care, the increasing complexity of patients being cared for in their own homes means that there is an increased risk for infection. Good practice is required by community nurses to minimise this risk. Patients' own homes can present particular challenges in complying with good practice and this article looks at some of the barriers to optimum infection prevention and control precautions in this setting. [ABSTRACT FROM AUTHOR]

The article discusses keynotes from the 2023 Inhaled Particles and Nanomaterials and Occupational and Environmental Health (NanOEH) conference. Topics include the influence of ultrafine/nano particle toxicology on occupational safety and health, measurements of air pollutants and their impact on health, carbon nanotube carcinogenesis, the link between air pollution and mortality, and challenges in characterizing microplastic exposure and hazards.

Team case formulation on acute psychiatric wards aims to support staff to manage significant levels of challenging behaviour. However, there is limited research on staff experience of case formulation in this setting. This study aimed to investigate staff experience of team case formulation sessions on acute psychiatric wards and their impact on staff wellbeing. Eighteen multidisciplinary staff (nurses, doctors, occupational therapists, support workers, activities coordinators) from five acute wards at a South London psychiatric hospital completed a semi-structured interview and visual analogue scales on their experience of attending case formulation. Thematic analysis was employed to analyse qualitative data. Participants reported that case formulation supported staff to develop a holistic understanding of service users, provided a safe space for staff to discuss the impact of challenging behaviour and improved teamwork and communication. Participants reported that these benefits increased their ability to identify and support the needs of service users and improved therapeutic relationships. Challenges with establishing continuity of care were highlighted. Team case formulation is an important intervention to support ward staff and has significant benefits to staff wellbeing and quality of care. Greater integration with existing ward practices may benefit both staff and service users. [ABSTRACT FROM AUTHOR]

Whooping cough (pertussis) cases are on the rise in England and young children can be particularly vulnerable to the condition. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To learn about some adaptations to practice adopted by a low secure mental health unit during the COVID-19 pandemic • To be aware of interventions used to enable staff to continue to support patients during the COVID-19 pandemic • To appreciate that staff's experience of the adaptations to practice and the well-being support offered to them during the pandemic can be used to inform post-pandemic practice The coronavirus disease 2019 (COVID-19) pandemic significantly disrupted the work of healthcare professionals in forensic mental health settings, but also prompted them to adopt new ways of working that have benefits and challenges. A low secure mental health unit in the UK adapted its ways of working during the pandemic by providing staff who could work remotely with the necessary equipment. The unit also implemented a stepped psychological response, as recommended by The British Psychological Society, to assist its staff to continue to support patients. This article describes the unit's response to the pandemic and discusses the findings of two evaluations – staff experiences of remote working and of a group relaxation session. The findings could help inform post-pandemic practice in forensic mental health settings. [ABSTRACT FROM AUTHOR]

Aims: To use nurses' descriptions of what would have improved their working lives during the first peak of the COVID‐19 pandemic in the UK. Design: Analysis of free‐text responses from a cross‐sectional survey of the UK nursing and midwifery workforce. Methods: Between 2 and 14 April 2020, 3299 nurses and midwives completed an online survey, as part of the 'Impact of COVID‐19 on Nurses' (ICON) study. 2205 (67%) gave answers to a question asking for the top three things that the government or their employer could do to improve their working lives. Each participants' response was coded using thematic and content analysis. Multiple response analysis quantified the frequency of different issues and themes and examined variation by employer. Results: Most (77%) were employed by the National Health Service (77%) and worked at staff or senior staff nurse levels (55%). 5938 codable responses were generated. Personal protective equipment/staff safety (60.0%), support to workforce (28.6%) and better communication (21.9%) were the most cited themes. Within 'personal protective equipment', responses focussed most on available supply. Only 2.8% stated that nothing further could be done. Patterns were similar in both NHS and non‐NHS settings. Conclusions: The analysis provided valuable insight into key changes required to improve the work lives of nurses during a pandemic. Urgent improvements in provision and quality of personal protective equipment were needed for the safety of both workforce and patients. Impact Failure to meet nurses needs to be safe at work appears to have damaged morale in this vital workforce. We identified key strategies that, if implemented by the Government and employers, could have improved the working lives of the nursing and midwifery workforce during the early stages of the COVID‐19 pandemic and could prevent the pandemic from having a longer‐term negative impact on the retention of this vital workforce. Patient or Public Contribution: No Patient or Public Contribution, due to the COVID‐19 Pandemic, urgency of the work and the target population being health and social care staff. [ABSTRACT FROM AUTHOR]

Construction is a high-risk industry, and worker capability has been identified as a contributing factor to construction accidents. However, many construction workers do not receive adequate safety training, leading to a lack of knowledge and skill. Effective training programs are essential to increase workers' safety competence and reduce accidents. Trainings facilitated by emerging visualization technologies (VT) are gaining attention due to their participatory nature and high engagement, which are missing components in traditional classroom-based safety training. This study explored the opportunities for adopting VT in safety training to improve employee training outcomes. Interviews were conducted with construction professionals in the U.S. and U.K., who had experience with safety training. The participants identified a number of training opportunities that would be appropriate for adopting VT. Interviewees valued VT for its technological versatility and positive impact on safety behavior, and they identified challenges in using VT related to cost, nature of technology, organizational barriers, and industry culture. The findings suggest the construction industry is still in the early stage of applying VT in safety training but many potential opportunities for using VT warrant further exploration. The implications point to the need to bridge academic research and its practical application to support VT's adoption in industry. [ABSTRACT FROM AUTHOR]

Background: Increased demand for nurse practitioners emphasizes the importance of consistent and ongoing collection of data to provide a better understanding of the NNP workforce and to promote retention and recruitment of NNPs. Purpose: To understand how work environment and work hours influence job or career satisfaction. Methodology: The National Association of Neonatal Nurse Practitioners in collaboration with the National Certification Corporation emailed an online survey to all 6,558 certified neonatal nurse practitioners (NNPs) in 2020 with 845 (12.8%) responding. Subjects included those with responsibilities in direct patient care, transport NPs, faculty/directors, and advanced practice registered nurse coordinators/managers/administrators. Results: Satisfaction with career choice as an NNP was reported as very satisfied by 58% (n = 493) and mostly satisfied by 37% (n = 310). Satisfaction with current job as an NNP was reported as very satisfied for 30% (n = 252), with 51% being mostly satisfied (n = 435). Age influenced satisfaction scores, with NNPs aged 61 years or older having a higher mean score than NNPs aged 31-40 years (p =.041). The majority of NNPs did not use all of their available paid time off (72%; n = 609) and respondents worked an additional 248 extra hours per year. NNPs experience bullying (58%) and/or lateral violence (32%). Seventeen percent have called in sick for mental health reasons (n = 147). Conclusions: Neonatal nurse practitioners' satisfaction is multifactorial. Those who reported taking time off for self-prescribed mental health indicated less job satisfaction, more work hours, poor work/life balance, and a less-than-optimum work environment. Implications: Overall, NNPs are satisfied with their career choice but are less satisfied with their job choice. Understanding factors that influence mental well-being and job satisfaction will improve recruitment and retention of nurse practitioners. [ABSTRACT FROM AUTHOR]

The British Occupational Hygiene Society (BOHS) COVID-19 Working Group developed a control banding matrix to provide guidance for employers and others to help assess the risks of COVID-19 infection during the pandemic. The matrix was based on occupational hygiene principles and the judgement of the occupational health practitioners involved; since objective data on workers' exposure were unavailable. Users of the matrix identify one of five exposure categories based on generic job descriptions and example occupations, and these categories are linked to generic guidance on interventions at source, on the exposure pathway and for individual workers. The risk matrix was published on the BOHS website and the guidance has been downloaded more than 2000 times. The matrix has had limited evaluation for reliability, but the data suggest that the highest exposure ranked jobs were associated with higher age-standardized mortality in Britain during the pandemic. However, there was considerable variability in exposure assignments between assessors, which underlines the need for the control guidance to be precautionary. The BOHS calls on academic researchers to undertake further work to validate the reliability of the tool. [ABSTRACT FROM AUTHOR]

Introduction: Successful adoption of POCTs (Point-of-Care tests) for COVID-19 in care homes requires the identification of ideal use cases and a full understanding of the contextual and usability factors that affect test results and minimise biosafety risks. This paper presents a scoping-usability and test performance study of a microfluidic immunofluorescence assay for COVID-19 in care homes. Methods: A mixed-methods evaluation was conducted in four UK care homes to scope usability and to assess the agreement with qRT-PCR. A dry run with luminescent dye was conducted to explore biosafety issues. Results: The agreement analysis was conducted on 227 asymptomatic participants (159 staff and 68 residents) and 14 symptomatic participants (5 staff and 9 residents). Asymptomatic specimens showed 50% (95% CI:1.3%−98.7%) positive agreement and 96% (95% CI: 92.5%−98.1%) negative agreement with overall prevalence and bias-adjusted Kappa (PABAK) of 0.911 (95% CI: 0.857−0.965). Symptomatic specimens showed 83.3% (95% CI: 35.9%−99.6%) positive agreement and 100% (95% CI: 63.1%−100%) negative agreement with overall prevalence and bias-adjusted Kappa (PABAK) of 0.857 (95% CI: 0.549−1). The dry run highlighted four main sources of contamination that led to the modification of the standard operating procedures. Simulation post-modification showed no further evidence of contamination. Conclusion: Careful consideration of biosafety issues and contextual factors associated with care home are mandatory for safe use the POCT. Whilst POCT may have some utility for ruling out COVID-19, further diagnostic accuracy evaluations are needed to promote effective adoption. [ABSTRACT FROM AUTHOR]

Background: We aimed to establish what core elements were required in a group therapy programme for men who disclose perpetrating intimate partner abuse in a substance use setting and develop, and test the feasibility of delivering an intervention in this setting. Methods: We describe the theoretical development and feasibility testing of an integrated substance use and intimate partner abuse intervention ('ADVANCE') for delivery in substance use services. We employed a comprehensive eight-stage process to guide this development applying the 'COM-B' ('capability', 'opportunity', 'motivation' and 'behaviour') model for intervention design which specifies the following: (1) define the problem, (2) select the target behaviour, (3) specify the target behaviour, (4) identify what needs to change, (5) identify intervention functions, (6) identify policy categories, (7) select behaviour change techniques, and (8) design a mode of delivery. The development was informed by primary research conducted by the authors, consulting with organisation steering groups and by those with personal experiences. The identified targets for intervention and mode and method of delivery were then refined over 4 intervention development meetings, using the nominal group technique with the ADVANCE experts, then further refined following consultation with service user groups and wider expert groups via a learning alliance meetings. Results: Our final intervention, the ADVANCE intervention consisted of a group intervention comprising of up to four pre-group individual interviews, followed by 12 × 2-h group sessions supported by integrated safety work for victim/survivors, and risk and safety support and integrity support for the professionals. The main targets for change were personal goal planning, self-regulation, and attitudes and beliefs supporting intimate partner abuse. The intervention was regarded as very acceptable to both staff and clients in substance use services, with group attendees reported positive behaviour changes and development of new skills. Conclusion: We have demonstrated the ability to employ a structured eight-step process to develop an integrated intervention to address substance use-related intimate partner abuse that is acceptable to staff and clients in substance use services. This led to a feasibility study (ISRCTN 79435190) involving 104 men and 30 staff at three different locations across the UK was conducted to assess the feasibility and acceptability of the intervention and to refine the content and approach to delivery (BMC Public Health, 21: 980, 2021). [ABSTRACT FROM AUTHOR]

Background: We aimed to establish what core elements were required in a group therapy programme for men who disclose perpetrating intimate partner abuse in a substance use setting and develop, and test the feasibility of delivering an intervention in this setting. Methods: We describe the theoretical development and feasibility testing of an integrated substance use and intimate partner abuse intervention ('ADVANCE') for delivery in substance use services. We employed a comprehensive eight-stage process to guide this development applying the 'COM-B' ('capability', 'opportunity', 'motivation' and 'behaviour') model for intervention design which specifies the following: (1) define the problem, (2) select the target behaviour, (3) specify the target behaviour, (4) identify what needs to change, (5) identify intervention functions, (6) identify policy categories, (7) select behaviour change techniques, and (8) design a mode of delivery. The development was informed by primary research conducted by the authors, consulting with organisation steering groups and by those with personal experiences. The identified targets for intervention and mode and method of delivery were then refined over 4 intervention development meetings, using the nominal group technique with the ADVANCE experts, then further refined following consultation with service user groups and wider expert groups via a learning alliance meetings. Results: Our final intervention, the ADVANCE intervention consisted of a group intervention comprising of up to four pre-group individual interviews, followed by 12 × 2-h group sessions supported by integrated safety work for victim/survivors, and risk and safety support and integrity support for the professionals. The main targets for change were personal goal planning, self-regulation, and attitudes and beliefs supporting intimate partner abuse. The intervention was regarded as very acceptable to both staff and clients in substance use services, with group attendees reported positive behaviour changes and development of new skills. Conclusion: We have demonstrated the ability to employ a structured eight-step process to develop an integrated intervention to address substance use-related intimate partner abuse that is acceptable to staff and clients in substance use services. This led to a feasibility study (ISRCTN 79435190) involving 104 men and 30 staff at three different locations across the UK was conducted to assess the feasibility and acceptability of the intervention and to refine the content and approach to delivery (BMC Public Health, 21: 980, 2021). [ABSTRACT FROM AUTHOR]

This study explored the perceptions of NHS employees working within a UK mental health trust in relation to the social impacts of the COVID‐19 pandemic. Questioning focussed on social isolation and desire to interact with others before and since COVID‐19; effects of safety measures including personal protective equipment and social distancing; and perceived influences of the pandemic on service users and social aspects of service delivery. All employees at an English NHS mental health service were invited to complete an anonymous online questionnaire (July–September 2020), resulting in 464 completed questionnaires. Response frequencies were summed across the total sample, and the influence of patient contact, age, and vulnerability to COVID‐19 were explored using pairwise comparisons. Approximately two thirds of employees felt there had been a fundamental change in how they felt about interacting with others, and many had lost confidence in their ability to relate emotionally to others. Respondents were keen to adhere to safety guidance, but the majority believed that face masks and social distancing could have a detrimental effect on communication and rapport within the workplace. Other concerns included passing on the virus, social isolation of employees and service users, and a reduction in community services. COVID‐19 safety measures may impact morale, communication, empathy, and the provision of client‐centred care. More generally, the pandemic has changed the attitudes of mental health workers towards social interaction, with younger employees reporting more mental health difficulties that may be linked to concerns about longer term social change. [ABSTRACT FROM AUTHOR]

A simple framework for setting risk tolerability limits is proposed following a literature review of risk acceptance in fire safety engineering and a feedback round with international fire safety professionals. The framework provides practical guidance for the application of international fire safety guidance, such as the recently published UK guidance document on probabilistic risk assessment for the fire design of buildings, PD 7974-7:2019, which provides a state-of-the-art framework to assess adequate safety for complex fire engineering designs. However, the application of this guidance document is hindered by two main constraints: (1) PD7974-7:2019 requires risk tolerability limits to be set, but lacks guidance on defining them for a specific building project, and (2) no reference case studies are given that demonstrate the application of PRA methods to fire engineering design. In order to help fill this gap, a risk tolerability framework is developed and proposed herein. Finally, it is applied to a reference case study of a UK office building. Considering the developed framework, further research needs are identified. It is expected that the proposed risk tolerability framework and the presented reference case study can support the application of PRA to fire engineering design and ease stakeholder communication on setting risk tolerability limits. [ABSTRACT FROM AUTHOR]

Aims: To explore the experiences of strategic leads for nurse education as they sought to respond to the COVID‐19 pandemic. Design: We utilised a qualitative interpretative approach to explore education leaders' experiences of leading during the early months of the pandemic. Methods: Nineteen leaders with significant strategic responsibility for nurse education in Australia, Canada, New Zealand, Singapore and the United Kingdom were identified via purposive sampling and agreed to participate. Interviews were held between May and July 2020. Results: Four overarching themes arose from the analysis: (1) Crisis driven adaptability & flexibility; (2) Responsive, complex and changing communication; (3) Making decisions for student and staff safety; (4) Looking to the future; stronger partnerships. Conclusion: Internationally, while nursing education leaders faced different problems, they shared a common goal amidst the crisis to remain student‐centred. They demonstrated they were able to face major challenges, respond to large scale logistical problems and make decisions under significant and ongoing pressure. Impact: In responding to the pandemic, nurse leaders shared knowledge and offered mutual support. This bodes well for future collaboration. The move to online learning accelerated an existing trend and it seems likely that this will continue. Given the pressures they experienced over an extended period, the sector may wish to consider how it prepares and supports existing and future leaders. [ABSTRACT FROM AUTHOR]

The article focuses on the limitations to Contingency Measures, and offers Reflections from COVID-19 Surges in the Grate Britain. Topics discussed include the authors provides a helpful framework for reflecting on the experiences of healthcare staff during COVID-19 to develop a more robust contingency phase; and the government's strategy was to keep case load manageably within the capacity of the National Health Service (NHS).

Background: As a response to the acute strain placed on the National Health Service during the first wave of coronavirus disease 2019 in the UK, a number of junior doctors including ENT trainees were redeployed to other clinical specialties. This presented these trainees with novel challenges and opportunities. Methods: A qualitative study was performed to explore these experiences, undertaking semi-structured interviews with ENT trainees between 17th and 30th July. Participants were recruited through purposeful sampling. Interview transcripts underwent thematic analysis using Dedoose software. Results: Seven ENT trainees were interviewed, ranging from specialty trainee years four to eight ('ST4' to 'ST8') in grade. Six core themes were identified: organisation of redeployment, utilisation of skill set, emotional impact of redeployment, redeployed team dynamics, concerns about safety and impact on training. Conclusion: The ENT trainees' experiences of redeployment described highlight some important lessons and considerations for future redeployments. [ABSTRACT FROM AUTHOR]

We conducted 3 studies to investigate how poor quality sleep relates to work injuries. First, using a sample of employed people living in the United Kingdom (N = 4,238; Study 1), we found that poor quality sleep was related to more frequent workplace injuries via negative affect rather than cognitive failures. Second, we again compared parallel pathways using a sample of USA employees (N = 202; Study 2): poor quality sleep was related to more frequent work injuries via work-related negative affect but not work-related cognitive failures. Third, we used a 2-wave sample of employees from the United Kingdom (N = 71; Study 3) finding that poor quality sleep was related to more frequent work injuries 7 weeks later via negative affect. Comparing high arousal and low arousal negative affect as competing pathways showed that there was a significant indirect effect of the former on the poor quality sleep-work injuries relationship but not the latter. Across 3 studies, we implicated the role of self-control failure stemming from poor quality sleep in predicting more frequent work injuries and suggested initiatives targeting high arousal negative affect as a way of reducing work injuries. [ABSTRACT FROM AUTHOR]

The first discussions relating to the regulation of recombinant DNA technology in the UK occurred in 1970, and were independent of similar discussions happening in the US from 1973. UK regulatory authorities were differently motivated by the range of concerns around risk posed by the new technology. UK authorities implemented a framework that was informed by a specific culture that had roots in scientific and laboratory work practices. The paper reflects on the early close relationships between UK biotechnology industry and university laboratory spaces, and the central concern around laboratory safety and workers rights. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization declared coronavirus disease 2019 a pandemic on 11th March 2020. There is concern regarding performing endonasal surgical procedures because of a high viral load in the nasopharynx. This paper describes our experience in conducting emergency and urgent endonasal operations during the peak of the coronavirus disease 2019 pandemic in the UK. Objectives: To show the outcome of endonasal surgery during the peak of the coronavirus disease 2019 pandemic and to assess the post-operative rate of nosocomial coronavirus disease 2019 infection. Methods: A retrospective cohort study was conducted of all patients who underwent high priority endoscopic nasal surgery or anterior skull base surgery between 23rd March and 15th June 2020 at University Hospitals Birmingham NHS Trust. Results: Twenty-four patients underwent endonasal surgery during the study period, 12 were males and 12 were females. There was no coronavirus-related morbidity in any patient. Conclusion: This observational study found that it is possible to safely undertake urgent endonasal surgery; the nosocomial risk of coronavirus disease 2019 can be mitigated with appropriate peri-operative precautions. [ABSTRACT FROM AUTHOR]

The first cases of Coronavirus (COVID-19) were reported in Wuhan, China in December 2019. Globally millions of people have been diagnosed with the virus whilst thousands have died. As the virus kept spreading health and social care frontline workers (HSCFW) were faced with difficulties when discharging their duties. This paper was set out to explore the challenges faced by different frontline workers in health and social care during the COVID-19 pandemic. The research utilized an explorative qualitative approach. A total of forty (N = 40) in-depth one-to-one semi-structured interviews were undertaken with HSCFW who included support workers (n = 15), nurses (n = 15), and managers (N = 10). Health and social care workers were drawn from domiciliary care and care homes (with and without nursing services). All the interviews were done online. The data were thematically analyzed, and the emergent themes were supported by quotes from the interviews held with participants. Following data analysis the research study found that lack of pandemic preparedness, shortage of Personal Protective Equipment (PPE), anxiety and fear amongst professionals, challenges in enforcing social distancing, challenges in fulfilling social shielding responsibility, anxiety and fear amongst residents and service users, delay in testing, evolving PPE guidance and shortage of staff were challenges faced by frontline health and social care workers during COVID-19 pandemic. The results of the current study point to a need for adequate pandemic preparedness within the health and social care sector to protect both frontline workers and the individuals they look after. [ABSTRACT FROM AUTHOR]

A safety huddle is a meeting held among district nurses, allied health professionals, specialist nurses, administrative staff, community matrons and healthcare assistants, also known as the wider multidisciplinary team. This article aims to identify and discuss the importance of safety huddles within a community nursing team. The author, a Specialist Community Practitioner District Nurse (SCPDN), explores why safety huddles were introduced and the implications of staff and patient safety if a safety huddle is not performed. The article also discusses the role of the SCPDN, how patient harm is sustained when communication failures occur within a team, new technologies implemented into practice and the implementation of safety huddles electronically. [ABSTRACT FROM AUTHOR]

We describe the London community testing programme developed for COVID-19, audit its effectiveness and report patient acceptability and patient adherence to isolation guidance, based upon a survey conducted with participants. Any patients meeting the Public Health England (PHE) case definition for COVID-19 who did not require hospital admission were eligible for community testing. 2, 053 patients with suspected COVID-19 were tested in the community between January and March 2020. Of those tested, 75 (3.6%) were positive. 88% of patients that completed a patient survey felt safe and 82% agreed that community testing was preferable to hospital admission. 97% were able to remain within their own home during the isolation period but just 41% were able to reliably isolate from other members of their household. The London community testing programme allowed widespread testing for COVID-19 while minimising patient transport, hospital admissions and staff exposures. Community testing was acceptable to patients and preferable to admission to hospital. Patients were able to reliably isolate in their home but not from household contacts. The authors believe in the importance, feasibility and acceptability of community testing for COVID-19 as a part of a package of interventions to mitigate a second wave of infection. [ABSTRACT FROM AUTHOR]

The article informs that how media reports are highlighting the exceptional contributions and sacrifices being made by nurses and other professionals and suggest these are being recognized by the public and by politicians in Italy. It reports that the fact that the media continues to highlight shortages of equipment to protect nurses and other staff suggests that there is some way to go for politicians to enact the appreciative sentiments they express in the media.

Background: Chemical restraint (CR) (also known as rapid tranquilisation) is the forced (non‐consenting) administration of medications to manage uncontrolled aggression, anxiety, or violence in people who are likely to cause harm to themselves or others. Our population of interest was adults with mental health disorders (with/without substance abuse). There has been a growing international movement over the past 22 years towards reducing/eliminating restrictive practices such as CR. It is appropriate to summarise the research that has been published over this time, identify trends and gaps in knowledge, and highlight areas for new research to inform practice. Aims: To undertake a comprehensive systematic search to identify, and describe, the volume and nature of primary international research into CR published since 1995. Methods: This paper reports the processes and overall findings of a systematic search for all available primary research on CR published between 1 January 1996 and 31 July 2018. It describes the current evidence base by hierarchy of evidence, country (ies) producing the research, CR definitions, study purpose, and outcome measures. Results: This review identified 311 relevant primary studies (21 RCTs; 46 non‐controlled experimental or prospective observational studies; 77 cross‐sectional studies; 69 retrospective studies; 67 opinion pieces, position or policy statements; and 31 qualitative studies). The USA, UK, and Australia contributed over half the research, whilst cross‐country collaborations comprised 6% of it. The most common research settings comprised acute psychiatric wards (23.3%), general psychiatric wards (21.6%), and general hospital emergency departments (19.0%). Discussion A key lesson learnt whilst compiling this database of research into CR was to ensure that all papers described non‐consenting administration of medications to manage adults with uncontrolled aggression, anxiety, or violence. There were tensions in the literature between using effective CR without producing adverse events, and how to decide when CR was needed (compared with choosing non‐chemical intervention for behavioural emergencies), respecting patients' dignity whilst safeguarding their safety, and preserving safe workplaces for staff, and care environments for other patients. The range of outcome measures suggests opportunities to standardise future research. [ABSTRACT FROM AUTHOR]

This article conceptualises the role of emotion in social work home visits. It draws on findings from a qualitative study of initial child protection home visits in the United Kingdom. The research used narrative interviews and focus groups to examine how emotions arising from visits were registered in social workers' narratives. These visits were often challenging; social workers needed to manage their own emotions and those of the family, while at the same time investigating concerns and assessing need. This article identifies seven key emotional experiences associated with the home visit from the perspective of the social worker: going into the unknown; being intrusive; being disliked; fear of harm to self; fear of causing or allowing harm; pain, disgust, and distress; and "absorbing" emotion. It is argued that emotion plays a central role in home visiting and that professionals' emotional responses have important implications for the way they make sense of, and manage, home visits. Emotion is therefore conceptualized as both a potential resource and risk for social workers' professional judgement and practice. [ABSTRACT FROM AUTHOR]

• The number of serious injuries and fatalities (SIFs) have remained static (r2 = 0.002) for 32 years. • Temporary Disabilities in Industry reduced by 66 percent in the same period (r2 = 0.90). • Safety culture & CSR) exerted a clear impact on the UKs Industrial injuries. • The science under-pinning safety culture & CSR to apply lessons learned is explored. • A concerted effort from safety scientists is required to reduce the number of SIFs. Neither a formal scientific literature review or research study this opinion piece examines safety science constructs applied to industrial safety in the UK over the past three decades to learn what may be useful to reduce serious injuries & fatalities (SIFs) and address other safety challenges arising from the 4th Industrial revolution. The key questions asked were: [1] what impact has safety science had on industrial injury statistics; [2] what is the quality of the science behind those with a demonstrably positive effect, and [3] where does safety science go next as we head deeper into the 21st century? Data driven results show the rate of decline in the UKs serious injuries & fatalities (SIFs) in the past 32 years has been negligible (r2 = 0.002), whereas temporary disabilities (r2 = 0.90) declined by around 66 percent. This result suggests safety science has not, and is not (in its current form), impacting the numbers killed or maimed at work in the UK at least, with other countries showing similar patterns in their injury experience. Examining the influence of a range of safety science constructs, legislative changes, and voluntary initiatives on injury reduction during this period, it is notable that only the safety culture and corporate social responsibility (CSR) constructs exerted clear impacts. An exploration of the science underpinning the safety culture and CSR constructs possibly provides insight that safety scientists and practitioners may find useful as safety science faces the future. [ABSTRACT FROM AUTHOR]

The last 15 years has witnessed a surge in rail-related human factors research but little has examined the Track Worker role. Track work often takes place whilst trains are running under the protection of Lookouts who provide warning of approaching trains. Despite—or perhaps because of—these measures, there is a notable prevalence of incidents involving Lookouts, warranting a closer look at the nature of their task and the wider sociotechnical system (STS) to identify what may be learned for railway safety management. A systematic review of incident reports involving Lookouts was undertaken on Australian and UK rail incidents from 2006 to mid-2018 with a qualitative meta-analysis (n = 31) revealing nine factors corresponding with STS dimensions at the organisational, social, task and individual level. Much of the risk lay in the set up and implementation of Lookout working, and in Track Worker group dynamics—factors endemic to working whilst trains are running—rather than specific to the Lookout, with such factors arguably applicable across other Track Worker groups. Findings point to a need for more targeted research into the STS aspects of track working, as well as improving the training and/or procedures of those managing the Lookout protection system of work. [ABSTRACT FROM AUTHOR]

Traumatic brain injury (TBI) is the most common cause of death and disability in those aged under 40 years in the UK. Higher rates of morbidity and mortality are seen in low-income and middle-income countries making it a global health challenge. There has been a secular trend towards reduced incidence of severe TBI in the first world, driven by public health interventions such as seatbelt legislation, helmet use, and workplace health and safety regulations. This has paralleled improved outcomes following TBI delivered in a large part by the widespread establishment of specialised neurointensive care. This update will focus on three key areas of advances in TBI management and research in moderate and severe TBI: refining neurointensive care protocolized therapies, the recent evidence base for decompressive craniectomy and novel pharmacological therapies. In each section, we review the developing evidence base as well as exploring future trajectories of TBI research. [ABSTRACT FROM AUTHOR]

In the article, the author discusses the working time laws in Great Britain like the 1998 Working Time Regulations, as well as their impact/s to community nursing. Also cited are the laws' aim to prevent accidents due to fatigue of health professionals, the common law duty of employers to provide safe equipment and systems at work, as well as the National Health Service's (NHS) 2019 Long Term Plan.

Domestic violence and abuse (DVA) can include physical, psychological, sexual, emotional or financial abuses, and is a globally widespread problem across all age groups, cultures and socioeconomic groups. Alongside the impacts of DVA experienced by survivors, there is a growing recognition that other people, who form the support network of survivors, may also be affected by the situation. Domestic violence organisations such as helplines are important third sector services supporting survivors. However, there has been little research into the impact on those providing the support. This qualitative study of domestic violence helpline workers explored their needs and well‐being. We used qualitative methodology, conducting interviews with staff recruited from a selection of different helplines who all undertook direct client‐focused work. The interviews used a semi‐structured format and followed a topic guide covering the training received before commencing work, self‐care strategies, the impact of work on their daily life and support offered by their employer. Ten helpline staff were interviewed, all female. Following analysis of the qualitative data, a number of themes emerged. Participants disclosed numerous ways in which their work challenged their well‐being, including burnout, impact on personal relationships, and lack of training and support at work. Participants used some self‐care strategies in order to "switch off" from work, but they also wanted clinical supervision to support them with the difficulties they experienced at work. This study suggests that helpline staff should receive more education about trauma triggers, and ongoing support to reduce the impact on their home and social life, thus improving mental well‐being and job satisfaction. This work begins the debate on the well‐being needs of frontline helpline workers, and whether better meeting these needs can facilitate the provision of better support. [ABSTRACT FROM AUTHOR]

This paper studies the effects of immigration on the allocation of occupational physical burden and work injury risks. Using data for England and Wales from the Labour Force Survey (2003–2013), we find that, on average, immigration leads to a reallocation of UK-born workers towards jobs characterised by lower physical burden and injury risk. The results also show important differences across skill groups. Immigration reduces the average physical burden of UK-born workers with medium levels of education, but has no significant effect on those with low levels. We also find that that immigration led to an improvement self-reported measures of native workers' health. These findings, together with the evidence that immigrants report lower injury rates than natives, suggest that the reallocation of tasks could reduce overall health care costs and the human and financial costs typically associated with workplace injuries. [ABSTRACT FROM AUTHOR]

Many large construction organisations use safety observation reporting (SOR) as part of their safety management system on sites, although research around their effectiveness in practice is limited. During an ethnographically-informed research project, the lead author spent three years working with the health and safety team on a large (+£500 m) construction project in the United Kingdom with such a system in place. The SOR system encouraged everyone on site to report unsafe acts or conditions, either via computer or handwritten cards, for subsequent action by the health and safety team. Despite good intentions, problems with the SOR system emerged. These included: significantly increased administration to deliver predictable data; poor data quality; an unwelcome focus on the number rather than content of the reports; their use as a tool to ascribe individual or organisational blame; and the perception that the SOR forms were being censored before they reached the health and safety team, which ultimately eroded trust between the workforce and management. Overall, the system as implemented on this site had the potential to cause more harm than good, and both disengage the workforce and frustrate the health and safety team. Although presented as a case study, it is suggested that the research methods used here have been able to expose and illuminate issues that would otherwise go unreported. It is recommended that these issues be considered within the design and implementation of such SOR systems in the future. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is available in the text Objective: To examine determinants of firefighting simulation test performance. Methods: Sixty-eight (63 male; 5 female) firefighters completed a firefighting simulation (eg, equipment carry, casualty evacuation) previously validated to test occupational fitness among UK firefighters. Multiple linear regression methods were used to determine physiological and physical attributes that best predicted completion time. Results: Mean (±SD) time taken to complete the simulation was 610 (±79) seconds. The prediction model combining absolute cardiorespiratory capacity (L min−1) and fat mass explained the greatest variance in performance and elicited the least random error ( R  = 0.765, R 2 = 0.585, standard error of the estimate [SEE]: ±52 seconds). Higher fitness and lower fat mass were associated with faster performance. Conclusions: Firefighter simulation test performance is associated with absolute cardiorespiratory fitness and fat mass. Fitter and leaner individuals perform the task more quickly. Work-based interventions should enhance these attributes to promote safe and effective operational performance. [ABSTRACT FROM AUTHOR]

Restraint in mental health care has negative consequences, and guidelines/policies calling for its reduction have emerged internationally. However, there is tension between reducing restraint and maintaining safety. In order to reduce restraint, it is important to gain an understanding of the experience for all involved. The aim of the present study was to improve understanding of the experience of restraint for patients and staff with direct experience and witnesses. Interviews were conducted with 13 patients and 22 staff members from one UK National Health Service trust. The overarching theme, 'is restraint a necessary evil?', contained subthemes fitting into two ideas represented in the quote: 'it never is very nice but...it's a necessary evil'. It 'never is very nice' was demonstrated by the predominantly negative emotional and relational outcomes reported (distress, fear, dehumanizing, negative impact on staff/patient relationships, decreased job satisfaction). However, a common theme from both staff and patients was that, while restraint is 'never very nice', it is a 'necessary evil' when used as a last resort due to safety concerns. Mental health-care providers are under political pressure from national governments to reduce restraint, which is important in terms of reducing its negative outcomes for patients and staff; however, more research is needed into alternatives to restraint, while addressing the safety concerns of all parties. We need to ensure that by reducing or eliminating restraint, mental health wards neither become, nor feel, unsafe to patients or staff. [ABSTRACT FROM AUTHOR]

This article explores the immediate adverse effects experienced by nurses during the administration of systemic anti-cancer therapy (SACT), specifically cytotoxic chemotherapy, and whether closed systems are being used to minimise exposure risk. Many SACT agents are known to be carcinogenic, teratogenic and mutagenic and this has led to concerns relating to the increased number of healthcare workers potentially exposed to these agents. An anonymous online survey was designed, made up of four questions, to elicit whether adverse effects were experienced by nurses during preparation, administration or following administration of chemotherapy. A total of 46% of respondents stated that they experienced some form of adverse effect either during preparation, administration or following administration of SACT. More formal research is required in this area to explore the relationship between exposure to SACT and perceived adverse effects in healthcare workers administering SACT. [ABSTRACT FROM AUTHOR]

A 3-month evaluation was undertaken at the Kent Oncology Centre’s chemotherapy day unit (CDU) to trial an air-tight sealing disposal system for cytotoxic waste management. Research has identified the potential risk to staff who handle waste products that are hazardous to health. Staff safety was a driving force behind a trial of a new way of working. This article provides an overview of the evaluation of the Pactosafe system in one clinical area, examining reviews by oncology healthcare workers, the practicalities in the clinical setting, training, cost effectiveness and the environmental benefits. [ABSTRACT FROM AUTHOR]