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An implantable left ventricular assist device (LVAD) is indicated as a bridge to transplantation or recovery in the United Kingdom (UK). The mechanism of action of the LVAD results in a unique state of haemodynamic stability with diminished arterial pulsatility. The clinical assessment of an LVAD recipient can be challenging because non-invasive blood pressure, pulse and oxygen saturation measurements may be hard to obtain. As a result of this unusual situation and complex interplay between the device and the native circulation, resuscitation of LVAD recipients requires bespoke guidelines. Through collaboration with key UK stakeholders, we assessed the current evidence base and developed guidelines for the recognition of clinical deterioration, inadequate circulation and time-critical interventions. Such guidelines, intended for use in transplant centres, are designed to be deployed by those providing immediate care of LVAD patients under conditions of precipitous clinical deterioration. In summary, the Joint British Societies and Transplant Centres LVAD Working Group present the UK guideline on management of emergencies in implantable LVAD recipients for use in advanced heart failure centres. These recommendations have been made with a UK resuscitation focus but are widely applicable to professionals regularly managing patients with implantable LVADs. [ABSTRACT FROM AUTHOR]

Introduction: We consider the UK Independent Scientific Pandemic Insights Group on Behaviours' (SPI‐B) support for fear messaging during the global COVID‐19 pandemic, evaluate the consequences and make recommendations for the future. Analysis: Using evidence from published documents, we show that SPI‐B supported the use of fear messaging during the COVID‐19 pandemic. This is inconsistent with the extant psychological literature and contrary to the disaster planning literature. The recommendations regarding fear messaging may have had harmful ramifications and impacts, especially for young people. Conclusion: We recommend that a wider multidisciplinary expertise is employed to deal effectively, ethically and holistically with future crises. Plans for future pandemics must include meaningful engagement with the public, particularly children and young people. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic placed significant demand on the NHS, including ambulance services, but it is unclear how this affected ambulance service staff and paramedics in other clinical settings (e.g. urgent and primary care, armed services, prisons). This study aimed to measure the self-perceived preparedness and impact of the first wave of the pandemic on paramedics’ psychological stress and perceived ability to deliver care. Methods: Ambulance clinicians and paramedics working in other healthcare settings were invited to participate in a three-phase sequential online survey during the acceleration (April 2020), peak (May 2020) and deceleration (September/October 2020) phases of the first wave of COVID-19 in the United Kingdom. Recruitment used social media, Trust internal bulletins and the College of Paramedics’ communication channels, employing a convenience sampling strategy. Data were collected using purposively developed open- and closed-ended questions and the validated general health questionnaire-12 (GHQ-12). Data were analysed using multi-level linear and logistic regression models. Results: Phase 1 recruited 3717 participants, reducing to 2709 (73%) by phase 2 and 2159 (58%) by phase 3. Participants were mostly male (58%, n = 2148) and registered paramedics (n = 1992, 54%). Mean (standard deviation) GHQ-12 scores were 16.5 (5.2) during phase 1, reducing to 15.2 (6.7) by phase 3. A total of 84% of participants (n = 3112) had a GHQ-12 score ≥ 12 during the first phase, indicating psychological distress. Participants that had higher GHQ-12 scores were feeling unprepared for the pandemic, and reported a lack of confidence in using personal protective equipment and managing cardiac arrests in confirmed or suspected COVID-19 patients. Conclusions: Most participants reported psychological distress, the reasons for which are multi-factorial. Ambulance managers need to be aware of the risks to staff mental health and take action to mitigate these, to support staff in the delivery of unscheduled, emergency and urgent care under these additional pressures. [ABSTRACT FROM AUTHOR]

Recent unprecedented events worldwide, such as floods in Dubai, recurring heavy rainfall in Santo Domingo, and abrupt temperature changes in the United Kingdom (UK), underscore the tangible impacts of climate change. In response to escalating threats from natural disasters, global communities prioritise resilience and effective disaster management systems. This paper addresses best practices for managing abnormal floods, laying the foundation for the next generation of preparedness and mitigation plans. Focusing on flood risk in Santo Domingo, the study employs the Community Disaster Resilience Framework, conducting a workshop with over 100 stakeholders from government, private, and academic sectors. The assessment spans physical, economic, environmental, and social aspects, revealing common challenges in infrastructure upkeep, public awareness, urban planning, drainage, and economic disparities. The paper proposes technological solutions like predictive maintenance and smart drainage systems, emphasising the potential for implementation. Recognising the importance of community involvement and preparedness, insights from the United Kingdom guide initial steps in strategy development. The conclusions advocate for collaborative efforts among government, academia, and society to navigate the complexities of disaster management and community resilience, ultimately proposing a framework to address these challenges. Further research is suggested in expanding online platforms for disaster risk reduction education in the Caribbean region. [ABSTRACT FROM AUTHOR]

Background: Young carers are children or young people aged up to 25 years old who undertake unpaid caring responsibilities for a friend or family member. Young carers faced significant challenges brought on by the COVID-19 pandemic. We explored the impact of the pandemic and associated restrictions on mental health, wellbeing and access to support in young carers in the United Kingdom (UK) to understand how to improve services, as well as support this population in future health emergencies. Method: We conducted 22 qualitative semi-structured interviews from May to November 2021 with 14 young carers and eight staff working in organisations that supported them. Interviews took place remotely over video or telephone call and explored participant experiences of the pandemic and its impact on their health, wellbeing and caring responsibilities. We used reflexive thematic analysis to analyse interview transcripts. Results: We identified four overarching themes pertaining to the impact of the pandemic and associated restrictions on mental health, wellbeing and access to support in young carers in the UK: (1) challenges in protecting loved ones from the virus, (2) changes to and loss of routine, (3) reduced access to pre-pandemic informal and formal support structures and (4) better understanding of inner resilience and goals. Many participants struggled with their mental health and wellbeing as a result of pandemic related restrictions which impacted on support structures for themselves and the individual they cared for. However, positive impacts pertained to additional support provided by local authority and third sector organisations. Conclusions: Our findings highlight some of the changes that affected young carers during the COVID-19 pandemic. The impact of changes to routine and a reduction in pre-pandemic support were the greatest concerns reported by participants in this study. The additional support provided by local authority and third sector organisations during social restrictions suggests such organisations could play a greater role in supporting this population going forward and that schools and Governments may wish to put in additional strategies and provisions to protect young carers in the future. [ABSTRACT FROM AUTHOR]

The article presents the discussion on systematic framework for risk and crisis communication in public health emergencies. Topics include UK's experience during COVID-19, which was marked by tensions between the devolved regional governments; and environments reveals a tradeoff between inclusivity and understandability versus effectiveness in risk and crisis communication.

Purpose: Governments around the world have shown poor capabilities in responding effectively to the COVID-19 health emergency outbreaks. After the declaration of COVID-19 as an international pandemic by the World Health Organization on January 31, 2020, three countries experienced the greatest initial impact in Europe. Sequentially Italy, Spain and the United Kingdom (UK) were hit by the highest numbers of contagion and death in the first few months in Europe. The aim of this paper is to assess how information channels and sources influenced the public's evaluation of the three government's communication response strategies. Design/methodology/approach: An online survey was conducted between March 14 and April 14, 2020, during the first wave of lockdowns and declarations of States of Emergency in the three countries. Findings: Findings show particularities for the different countries, but also similarities in response and reactions of the public in the three scenarios. The response strategy of the UK Government was the most untrusted and criticized by citizens. In contrast, the Italian and Spanish Governments, which both chose to respond with the severest restrictions, attracted more support from citizens, especially in Italy, which was the first to close borders and impose lockdowns for the population. Research limitations/implications: Despite the national differences in the preference of information channels and sources, overall, an empirical relationship between government communication assessment and media use were found in all the scenarios. Practical implications: This empirical study has theoretical and practical implications. Theoretically, findings will add evidence of implications of the Channel Complementary Theory to the field of risk, crisis and emergency communication. The results also provide insights for communication practitioners in the public sector on how forms of information and trust in sources influence the public's assessment of authorities' communication. Originality/value: Implications for theory and empirical research about communication during a health pandemic are identified and discussed. Highlights: Citizens engage at a high level and synchronize their use of multiple media and platforms in all the three national scenarios. Stronger criticism is provided by online media, especially social media and online press in the different national contexts. Results corroborate that factors related to media choice need to be operationalized for risk and crisis communication research. When public health depends on people understanding the actions they need to take, the possibility of disobedience is highly dependent on trust. Compared with Spain and the United Kingdom (UK), trust in government institutions in Italy was stronger and could be explained by the higher use of owned media for information-seeking. [ABSTRACT FROM AUTHOR]

Objectives When it comes to controlling workplace transmission of SARS-CoV-2, the virus that causes COVID-19, different workplaces and industrial sectors face different challenges, both in terms of likely transmission routes and which control measures can be practically, economically, and effectively implemented. This article considers a large body of research in the United Kingdom across different work sectors and time points during the COVID-19 pandemic to better understand mitigation measures, challenges to mitigating the risk of SARS-COV-2 transmission, knowledge gaps, and barriers and enablers to control viral transmission. Methods Data is drawn from 2 phases of research. Phase 1 gathered data from an interactive workshop (April 2022) where PROTECT researchers working across 8 work sectors shared knowledge and expertise from research conducted between 2020 and 2022. Phase 2 revisited 6 of these sectors to explore participants' views on the "living with COVID" phase of the pandemic (February–October 2022) through qualitative interviews. Results Our findings emphasise the importance of considering the characteristics of each work sector (and their sub-sectors), relative to the physical workplace and workforce, the ways organisations operate, and how they interact with the public. Study findings show that participant's views and organisational practices changed quickly and significantly over the course of the pandemic. Most participants initially perceived that the majority of risk mitigations would remain in place for the foreseeable future. However, following the change in Government Guidance towards "living with COVID", most mitigation measures were quickly removed and it had become necessary for sectors/organisations to restore normal operations, thereby treating the COVID-19 virus like any other illness, while remaining prepared for future health emergencies that may arise. Conclusion We suggest that national policy makers and organisational leaders remain mindful of the lessons learned and knowledge gained at all levels (national, regional, local, organisational, and individual) during the COVID-19 pandemic. We make recommendations in support of recovery as sectors/organisations continue "living with COVID" and other respiratory diseases; balanced with longer term planning for the next public health crisis. [ABSTRACT FROM AUTHOR]

The spread of false information online has increased dramatically in recent years. Around the COVID-19 pandemic, a digital epidemic of misinformation, or "infodemic," has arisen. Since the beginning of 2020, digital platforms have served as both a source of and a remedy for Disinformation. After a few months of the epidemic, it is clear that ensuring health professionals access to necessary medical equipment and supplies is less crucial than fighting falsehoods online. Actions such as (a) urging social media firms to delete material about the epidemic that is contentious, (b) putting up special forces to counteract propaganda and false information (e.g., E.U., U.K.), and (c) incarcerating suspicious coronavirus false claims, including in connection to the public health interventions, were high priorities for many government agencies around the world in response to COVID-19. State of emergency measures used early on shaped future debates on how to strike a fair balance between free speech and censorship on the internet by, among other things, restricting access to news and encouraging journalists to hold back on their reporting. [ABSTRACT FROM AUTHOR]

A substantive body of work in project studies argues that an "information flow" lens is very useful in exploring the project management of construction. This paper posits that this is even more applicable to disaster construction projects and, furthermore, lean information flow may play a role in swiftly delivering the disaster construction project. The paper uses the qualitative empirics of the delivery of the UK's Covid surge hospital projects to demonstrate that lean information flows were employed in these projects and assisted in enabling delivery at speed. The paper also describes the autopoietic governance conditions that are necessary for lean information flows to flourish in disaster construction projects and the role that trust may play in these conditions. It warns against some of the drawbacks in enabling lean communication through autopoietic governance. [ABSTRACT FROM AUTHOR]

A study analyzed the speeches made by UK government spokespeople during press conferences from March 3, 2020, to February 21, 2022, to assess whether they effectively communicated the specific symptoms of COVID-19 that required public action. The study found that only 22.8% of press conferences mentioned the specific symptoms, and this mainly occurred at the beginning of the pandemic. When analyzing individual speeches, only 8.9% mentioned at least one specific symptom. The study concludes that government spokespeople rarely described the specific symptoms that the public needed to be aware of, and in future outbreaks, it is important to convey these basic facts to enable the public to take appropriate action when symptomatic. [Extracted from the article]

Disaster management is a neglected area of British business history. Industrial disasters led to significant loss of life and imposed considerable costs on firms involved. This article examines the emergence of a network of mine rescue stations across UK coalfields in the early twentieth century, making use of previously overlooked records of mine rescue station boards. Pioneering mine rescue stations were established in Yorkshire at coalowners' initiative in 1901 and 1902, a few years before provision of rescue stations and breathing apparatus became mandatory. As well as rescue operations, these facilities were used to put out colliery fires and restore damaged mines. The involvement of coalowners in mine rescue also signalled that the industry was interested in miner safety at a time of growing unrest. The article concludes that there is scope for much more research into the early years of disaster management in the mines and in other industries. [ABSTRACT FROM AUTHOR]

Following the finding of the World Breastfeeding Trends Initiative 2016 assessment that infant feeding is not mentioned in United Kingdom emergency planning guidance, in 2017 information was sought about Local Resilience Forum (LRF) planning. This research covered both guidance for parents on LRF websites and local planning. Considerable variation between areas and a dependence on the existing knowledge and experience of frontline staff was found. In 2020−2022 LRF websites in England and Wales were revisited and information requested about rest centre facilities, procurement of items needed by evacuated parents, provision of skilled support and staff training. Twenty‐nine of the 42 LRFs replied, partially or fully, directly or through their local authorities. The variation between areas found in 2017 was confirmed. Areas endeavour to provide for the needs of families but specific training in infant feeding was lacking, although several requested relevant resources or responded that the lack of training would now be reviewed. A short leaflet was produced and circulated to LRFs that had responded to aid training. Using established international guidance to include infant feeding in United Kingdom emergency planning guidance, implemented by national coordinators, would improve consistency between LRFs and better protect infant, child and maternal health and well‐being. [ABSTRACT FROM AUTHOR]

In June 2023, the UK began official hearings for its independent investigation into pandemic preparedness. Thus far, the inquiry has been told that planning has been wholly inadequate and that a future outbreak is inevitable. We present here four key problems that contributed to significant morbidity and mortality during the Coronavirus 2019 (COVID-19) pandemic over the past 3 years in the UK -- and which will contribute to excess morbidity and mortality in the next outbreak. First, there was misunderstanding about what procedures were deemed as aerosol generating. Aerosol transmission has always been a component of respiratory viruses; however, no specific aerosol-generating procedures are required to transmit any respiratory pathogens over long distances. Second, policy-makers were too binary in their answers to the public in terms of questions about severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2). This meant that, as evidence evolved and different conclusions were drawn, the public lost faith in both the UK Government and science. Third, public health guidance did not take into account that certain groups would be impacted differentially by public health guidelines and instead used a one-size-fits-all approach to non-pharmaceutical interventions. Finally, there was worsening of existing inequalities, especially in ethnic minority groups, that resulted in excessive numbers within certain cohorts becoming infected. [ABSTRACT FROM AUTHOR]

Medical students providing support to clinical teams during Covid-19 may have been an opportunity for service and learning. We aimed to understand why the reported educational impact has been mixed to inform future placements. We conducted a cross-sectional survey of medical students at UK medical schools during the first Covid-19 'lockdown' period in the UK (March–July 2020). Analysis was informed by the conceptual framework of service and learning. 1245 medical students from 37 UK medical schools responded. 57% of respondents provided clinical support across a variety of roles and reported benefits including increased preparedness for foundation year one compared to those who did not (p < 0.0001). However, not every individual's experience was equal. For some, roles complemented the curriculum and provided opportunities for clinical skill development, reflection, and meaningful contribution to the health service. For others, the relevance of their role to their education was limited; these roles typically focused on service provision, with few opportunities to develop. The conceptual framework of service and learning can help explain why student experiences have been heterogeneous. We highlight how this conceptual framework can be used to inform clinical placements in the future, in particular the risks, benefits, and structures. Practice points There was a benefit for most students who provided clinical support compared to those who did not during Covid-19. Most students found clinical support roles more beneficial than clinical placements and most final years wanted their final year clinical placements replaced by a formal role within a clinical team. Not every student's experience of clinical support was equal. The conceptual framework of service and learning can help explain this heterogeneity. The most beneficial roles for students complemented the curriculum and provided opportunities for clinical skill development, reflective practice, and meaningful contribution to the health service. There is an added benefit of combining service and learning if done correctly, and we can use this to inform the structure of clinical placements going forwards. However, there are risks, and we discuss principles of good practice and provide our own considerations. [ABSTRACT FROM AUTHOR]

The article offers information on the lessons learned from the COVID-19 pandemic regarding infection prevention and control (IPC). Topics discussed include the challenges faced during the pandemic, the importance of IPC education, and the need for improved planning and preparedness for future pandemics.

The role of 'class strategies' in policy formation is sometimes unseen as plans are unrealised in practice over long periods of historical time. 'Subterranean class strategies' are an extension of existing work on class to consider 'class work' on policy in the 'long unenacted'. Using the example of emergency feeding in a national crisis, the stark difference in school meal planning for post-World War 2 emergencies when compared to the COVID-19 crisis is discussed. Through an analysis of archival records, it is shown that 'subterranean class strategies' - the devaluation of school catering expertise by the army and the private sector, the lack of co-operation of independent schools, and localisation and privatisation - diminished the role of schools in emergency feeding. The paper concludes by considering how the concept of 'subterranean class strategies' could inform work on educational think tanks, privatisation and subsumption, and intersectional areas such as race. [ABSTRACT FROM AUTHOR]

Our case study explored a Local Resilience Forum's (LRF) civil contingency response to COVID‐19 in the United Kingdom. We undertook 19 semistructured ethnographic longitudinal interviews, between March 25, 2020 and February 17, 2021, with a Director of a Civil Contingencies Unit and a Chief Fire Officer who both played key roles within their LRF. Within these interviews, we focused on their strategic level decision‐making and how their relationship with national government impacted on local processes and outcomes. Using a form of grounded theory, our data describe the chronological evolution of an increasingly effective localized approach toward outbreak control and a growing resilience in dealing with concurrent emergency incidents. However, we also highlight how national government organizations imposed central control on aspects of the response in ways that undermined or misaligned with local preparedness. Thus, during emergencies, central governments can undermine the principle of subsidiarity and damage the ways in which LRFs can help scaffold local resilience. Our work contributes to the theoretical understanding of the social psychological factors that can shape the behaviour of responder agencies during a prolonged crisis. In particular, the implications of our analysis for advancing our conceptual understanding of strategic decision‐making during emergencies are discussed. [ABSTRACT FROM AUTHOR]

The February 2014 extratropical cyclonic storm chain, which impacted the English Channel (UK) and Dawlish in particular, caused significant damage to the main railway connecting the south-west region to the rest of the UK. The incident caused the line to be closed for two months, £50 million of damage and an estimated £1.2bn of economic loss. In this study, we collate eyewitness accounts, analyse sea level data and conduct numerical modelling in order to decipher the destructive forces of the storm. Our analysis reveals that the disaster management of the event was successful and efficient with immediate actions taken to save lives and property before and during the storm. Wave buoy analysis showed that a complex triple peak sea state with periods at 4–8, 8–12 and 20–25 s was present, while tide gauge records indicated that significant surge of up to 0.8 m and wave components of up to 1.5 m amplitude combined as likely contributing factors in the event. Significant impulsive wave force of up to 286 KN was the most likely initiating cause of the damage. Reflections off the vertical wall caused constructive interference of the wave amplitudes that led to increased wave height and significant overtopping of up to 16.1 m3/s/m (per metre width of wall). With this information and our engineering judgement, we conclude that the most probable sequence of multi-hazard cascading failure during this incident was: wave impact force leading to masonry failure, loss of infill and failure of the structure following successive tides. [ABSTRACT FROM AUTHOR]

Background Local outbreak control plans (LOCPs) are statutory documents produced by local authorities (LAs) across England. LOCPs outline LAs' response to Coronavirus Disease 19 (COVID19) outbreaks and the coordination of local resources, data and communication to support outbreak response. LOCPs are therefore crucial in the nation's response to COVID-19. However, there has been no previous systematic assessment of these documents. We performed this study to systematically assess the quality of LOCPs and to offer recommendations of good practice. Methods All published LOCPs were assessed for basic characteristics. A framework based on Department of Health and Social Care guidelines was used to assess a random sample of LOCPs. Qualitative analysis was undertaken for LOCPs with highest completeness. Results Hundred and thirty-seven of 150 LAs publicly published a full LOCP; 9 were drafts. Statistical analysis demonstrated the significant difference between reporting of mainstream schools, care homes and the homeless population and other educational settings, high-risk settings and other vulnerable groups. LOCPs varied in approach when structuring outbreak response information and focused on different areas of outbreak management. Conclusions The majority of LAs are publicly accessible. There is significant variation between the reporting of high-risk settings and groups. Suggested recommendations may help to improve future LOCP updates. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic generated a series of profound and unprecedented challenges for health and social care systems and those frontline clinicians responsible for delivering services including nurses. One consequence has been the rapid and widespread introduction of a range of digital tools, solutions, and initiatives. In the United Kingdom, this has required clinical leadership to drive implementation and adoption of digital innovations across the system, ranging from those in senior executive board level positions to those on the frontline. Findings: This commentary presents a framework highlighting the breadth of digital transformations which emerged as a consequence of the U.K. health and social care systems' response to the COVID-19 crisis. The framework outlines the different levels of digital transformation, ranging from what we have termed "ceremonial adoption" to isolated automation, organizational integration, and full systems integration. We reflect on the nursing leadership practices that need to be in place to support these changes. Conclusion: Whilst acknowledging the extraordinary results achieved by the COVID-19 driven tsunami of digital transformation, we reflect on the essential steps required to translate these nascent, isolated efforts into fully integrated, long-term solutions. We also offer recommendations for clinical digital leaders and suggest steps that will be crucial to translate the temporary and/or limited interventions into effective, permanent features of our health and social care systems, while also providing a platform on which to build future digital capabilities. We will inevitably continue to see an increase in the use of technology in everyday clinical practice, and nurses are well positioned to take a lead in its widespread adoption. [ABSTRACT FROM AUTHOR]

The term resilience is being more widely adopted in fire safety engineering, however, its comprehensive description is not clearly explained or correctly applied in practice. This study, therefore, defines the categories, dimensions, characteristics, capacities, objectives and missions possessed by resilience to provide a holistic understanding of the term. This is followed by an analysis and classification of the UK Standards and Codes addressing resilience considering their administrative and engineering features of resilience, and their resilience dimensions with definitions of fire resilience measures and approaches. A practical example of a fire resilience framework is applied in educational buildings considering internal resilience for a safe facility, risk reduction and disaster management, and external resilience involving redundancy of resources and community support. Finally, a fire resilience design framework is created in which structural and fire safety engineering are considered clarifying the steps to follow in a comprehensive design process based on a flow chart. This paper will contribute to the creation of a unified terminology and understanding of the concept linked to resilience to be adopted in various disciplines. [ABSTRACT FROM AUTHOR]

Strategic planning in response to disasters is distinctly different from strategic planning in normal situations. The experience of the coronavirus disease 2019 (COVID-19) pandemic has shown that a vaccine rollout program as a disaster response requires a different approach from current routine vaccination and disaster response frameworks. A holistic conceptual framework for planning vaccine rollout disaster response programs is proposed, building on the experience of COVID-19. The customizable framework was developed to have high dynamicity, flexibility, and applicability, incorporating key decision-making factors and suitable time frames (phases and transitions), based on roadmapping principles and techniques. In this research, we focus on the COVID-19 pandemic vaccine rollout program in the United Kingdom (UK) as a representative case of disaster response planning due to the availability of public data and access to the relevant stakeholders. We applied Platts' process approach as a methodology and used various sources of information including an extensive literature review, expert interviews, and retrospective roadmapping (mapping past experience). As a result, we propose a strategic roadmapping framework for the COVID-19 vaccine rollout program to support visual planning of time-based strategies with the integration of various resources and demand environments. Apart from this practical contribution, we demonstrate that the concept of roadmapping can be applied beyond technology and innovation management domains to a novel research domain such as disaster response. [ABSTRACT FROM AUTHOR]

The cybersecurity of organizations is a subject of perennial concern as they are subject to mounting threats in an increasingly digitalized world. While commercial and charitable organizations have been the objects of cybersecurity research, social enterprises (SEs) have remained unexplored. As SEs have become increasingly important features of social and economic development, so their prominence as potential targets of cybercrime also increases. In order to address this knowledge gap, this article examines the factors that influence the cyber-preparedness of SEs in the U.K. Through the use of semistructured interviews with SE owner-managers, these factors are found to comprise the characteristics of the enterprise, the characteristics of the enterprise management, resource constraints, experience of cyberattacks, usage of IT, and awareness of cybersecurity schemes and resources. These insights provide valuable guidance for SE owner-managers, SE support agencies, and policy-makers when considering the cybersecurity of SEs. These findings are of immediate concern to SEs but also to other organizations that are engaged in partnerships with them as SEs may afford “gateway” opportunities to those with malicious intent. [ABSTRACT FROM AUTHOR]

Background: Public health scholars have long called for preparedness to help better negotiate ethical issues that emerge during public health emergencies. In this paper we argue that the concept of ethical preparedness has much to offer other areas of health beyond pandemic emergencies, particularly in areas where rapid technological developments have the potential to transform aspects of health research and care, as well as the relationship between them. We do this by viewing the ethical decision-making process as a behaviour, and conceptualising ethical preparedness as providing a health research/care setting that can facilitate the promotion of this behaviour. We draw on an implementation science and behaviour change model, COM-B, to demonstrate that to be ethically prepared requires having the capability (ability), opportunity, and motivation (willingness) to work in an ethically prepared way.Methods: We use two case examples from our empirical research-one pandemic and one non-pandemic related-to illustrate how our conceptualisation of ethical preparedness can be applied in practice. The first case study was of the UK NHSX COVID-19 contact tracing application case study involved eight in-depth interviews with people involved with the development/governance of this application. The second case involved a complex case regarding familial communication discussed at the UK Genethics Forum. We used deductive qualitative analysis based on the COM-B model categories to analyse the transcripbed data from each case study.Results: Our analysis highlighted that being ethically prepared needs to go beyond merely equipping health professionals with skills and knowledge, or providing research governance actors with ethical principles and/or frameworks. To allow or support these different actors to utilise their skills and knowledge (or principles and frameworks), a focus on the physical and social opportunity is important, as is a better understanding the role of motivation.Conclusions: To understand ethical preparedness, we need to view the process of ethical decision-making as a behaviour. We have provided insight into the specific factors that are needed to promote this behaviour-using examples from both in the pandemic context as well as in areas of health research and medicine where there have been rapid technological developments. This offers a useful starting point for further conceptual work around the notion of being ethically prepared. [ABSTRACT FROM AUTHOR]

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To assess patient socio-demographic and disease characteristics associated with the initiation, timing, and completion of emergency care and treatment planning in a large UK-based hospital trust. Secondary retrospective analysis of data across 32 months extracted from digitally stored Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) plans within the electronic health record system of an acute hospital trust in England, UK. Data analysed from ReSPECT plans (n = 23,729), indicate an increase in the proportion of admissions having a plan created from 4.2% in January 2019 to 6.9% in August 2021 (mean = 8.1%). Forms were completed a median of 41 days before death (a median of 58 days for patients with capacity, and 21 days for patients without capacity). Do not attempt cardiopulmonary resuscitation was more likely to be recorded for patients lacking capacity, with increasing age (notably for patients aged over 74 years), being female and the presence of multiple disease groups. 'Do not attempt cardiopulmonary resuscitation' was less likely to be recorded for patients having ethnicity recorded as Asian or Asian British and Black or Black British compared to White. Having a preferred place of death recorded as 'hospital' led to a five-fold increase in the likelihood of dying in hospital. Variation in the initiation, timing, and completion of ReSPECT plans was identified by applying an evaluation framework. Digital storage of ReSPECT plan data presents opportunities for assessing trends and completion of the ReSPECT planning process and benchmarking across sites. Further research is required to monitor and understand any inequity in the implementation of the ReSPECT process in routine care. [ABSTRACT FROM AUTHOR]

Objective: This study aims to compare the differences in COVID-19 prevention and control policies adopted by the United Kingdom (UK) during the first wave (31 January 2020 to 6 September 2020) and the second wave (7 September 2020 to 12 April 2021), and analyze the effectiveness of the policies, so as to provide empirical experience for the prevention and control of COVID-19. Methods We systematically summarized the pandemic prevention and control policies of the UK from official websites and government documents, collated the epidemiological data from 31 January 2020 to 12 April 2021, and analyzed the effectiveness of the two waves of pandemic prevention and control policies. Results: The main pandemic prevention and control policies adopted by the UK include surveillance and testing measures, border control measures, community and social measures, blockade measures, health care measures, COVID-19 vaccination measure, and relaxed pandemic prevention measures. The new cases per day curve showed only one peak in the first wave and two peaks in the second wave. The number of new cases per million in the second wave was much higher than that in the first wave, and the curve fluctuated less. The difference between mortality per million was small, and the curve fluctuated widely. Conclusion: During the first and second waves of COVID-19, the UK implemented three lockdowns and managed to slow the spread of the pandemic. The UK's experience in mitigating the second wave proves that advancing COVID-19 vaccination needs to be accompanied by ongoing implementation of non-pharmacological interventions to reduce the transmission rate of infection. And a stricter lockdown ensures that the containment effect is maximized during the lockdown period. In addition, these three lockdowns featured distinct mitigation strategies and the UK's response to COVID-19 is mitigation strategy that reduce new cases in the short term, but with the risk of the pandemic rebound. [ABSTRACT FROM AUTHOR]

This project report outlines the findings of an initial exploratory study of the impact of the coronavirus (COVID-19) pandemic on the demand, capacity, and capability of the police within the United Kingdom. Freedom of information requests provide data regarding employees affected by COVID-19, including those working from home. A survey of police employees adds richness by exploring the departments and specialist capabilities affected. Preliminary results indicate a shift in demand away from property-related and violent crime, to online criminality, and disorders such as anti-social behavior and breaches of coronavirus legislation. Combined with high volumes of absent employees throughout 2020, the study postulates a reduction in police satisfaction, trust, and confidence may have occurred in the response to cyber investigation and policing anti-social behavior. Investment in agile technology to increase workforce flexibility and improved contingency planning are identified as requirements to prepare for future pandemics and avoid repetition. [ABSTRACT FROM AUTHOR]

Nipah virus is an acute febrile illness that can cause fatal encephalitis. It is an emerging zoonotic paramyxovirus endemic to south-east Asia and the western Pacific, and can be transmitted by its primary reservoir of fruit bats, through intermediate animal vectors and by human-to-human spread. Outbreaks of Nipah virus encephalitis have occurred in Malaysia, Singapore, Philippines, India and Bangladesh, with the most recent outbreak occurring in Kerala, India in late 2021. Extremely high case fatality rates have been reported from these outbreaks, and to date no vaccines or therapeutic management options are available. Combining this with its propensity to present non-specifically, Nipah virus encephalitis presents a challenging diagnosis that should not be missed in patients returning from endemic regions. Raising awareness of the epidemiology, clinical presentation and risk factors of contracting Nipah virus is vital to recognise and manage potential outbreaks of this disease in the UK. [ABSTRACT FROM AUTHOR]

Past research has found that employees who view themselves as overqualified for their jobs tend to hold negative job attitudes and be unwilling to go beyond the call of duty. In challenging situations such as during the COVID‐19 crisis, when having "all hands‐on deck" may be important to an organization's survival, mitigating the negative tendencies of these employees becomes important. Adopting a sensemaking perspective on crisis management, we examine whether supervisors' self‐sacrificial leadership can mitigate these negative tendencies. First, we propose that employee perceived overqualification is associated with lower levels of felt obligation to the organization and thereby lower levels of extra‐role behaviors (i.e., helping and proactivity). We next propose that supervisors' self‐sacrificial leadership during the COVID‐19 crisis can evoke, especially when COVID‐19 more strongly impacts the organization, a sense of collectivism toward the organization, which mitigates the negative association of perceived overqualification with felt obligation and thus extra‐role behaviors. We tested our theorizing in samples from the UK (n = 121, pilot study) and US (n = 382, main study) in studies with a multi‐wave, time‐lagged design. Findings from both studies provide support for our theorizing. We discuss implications for research and practice concerning perceived overqualification during a crisis. [ABSTRACT FROM AUTHOR]

The stockpiling behaviors during the COVID‐19 pandemic emerged as an example for situations where cooperation is inhibited by lack of trust, media exposure, and increased anxiety. In this paper, I test the hypothesis that stockpiling results from social psychological factors that prevent psychological groupness and cooperation (e.g., low trust in governments and other citizens, high frequency of news exposure, high pandemic anxiety), rather than being an inherently selfish and uncontrollable panic behavior. Specifically, I hypothesized that lower levels of satisfaction with the governments' COVID‐19 policies, lower trust in people in following physical distancing rules, and more frequent media exposure would predict higher stockpiling behaviors through increased pandemic‐related anxiety. In a cross‐sectional survey study conducted in Turkey and the UK during the first‐wave of the pandemic (N = 5137), I tested a conceptual model via SEM. Findings showed that lower trust in people, lower satisfaction with governments' COVID‐19 policies, and high exposure to news predicted higher pandemic related anxiety which predicted higher stockpiling in both countries. I discussed that governments policies and media in both countries may be the reason for mass stockpiling behaviors by decreasing predictability and trust. [ABSTRACT FROM AUTHOR]

In the article, the authors discuss how the concept of heroism has emerged in the public and private responses to the Covid-19 pandemic, particularly in the United Kingdom (UK). Also cited are how the poor responses by the UK government to the pandemic resulted in a decline in governmental authority, and how the notions of heroism promoted a military view of medicine.

The complex and evolving nature of the SARS-CoV-2 pandemic poses significant challenges to national and international emergency preparedness and response. Governments must navigate streams of emerging data in real time, synthesising knowledge from diverse sources to inform policy. The UK government drew on experiences from earlier pandemics to bridge perceived gaps between social science research and policy through the secondment of early-career academics as embedded scientists. In this article, we present comparative ethnographic data describing embedded social scientists' contributions to UK COVID-19 preparedness and response. We find that the liminal position, loose identities, and high degree of autonomy of embedded scientists allowed these individuals to navigate multiple networks to strengthen and legitimise the role of social science within policy debates. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic resulted in catastrophic levels of morbidity and mortality for care home residents. Despite this, research platforms for COVID-19 in care homes arrived late in the pandemic compared with other care settings. The Prophylactic Therapy in Care Homes Trial (PROTECT-CH) was established to provide a platform to deliver multi-centre cluster-randomized clinical trials of investigational medicinal products for COVID-19 prophylaxis in UK care homes. Commencing set-up in January 2021, this involved the design and development of novel infrastructure for contracting and recruitment, remote consent, staff training, research insurance, eligibility screening, prescribing, dispensing and adverse event reporting; such infrastructure being previously absent. By the time this infrastructure was in place, the widespread uptake of vaccination in care homes had changed the epidemiology of COVID-19 rendering the trial unfeasible. While some of the resources developed through PROTECT-CH will enable the future establishment of care home platform research, the near absence of care home trial infrastructure and nationally linked databases involving the care home sector will continue to significantly hamper progress. These issues are replicated in most other countries. Beyond COVID-19, there are many other research questions that require addressing to provide better care to people living in care homes. PROTECT-CH has exposed a clear need for research funders to invest in, and legislate for, an effective care home research infrastructure as part of national pandemic preparedness planning. Doing so would also invigorate care home research in the interim, leading to improved healthcare delivery specific to those living in this sector. [ABSTRACT FROM AUTHOR]

People have a fair idea of how they are supposed to behave to slow down the spread of COVID-19. But what about people's perception of their own compared to others' adherence to the guidelines? Building on prior research on self-enhancement biases, we predicted that people perceive themselves to adhere more strictly to the COVID-19 guidelines than others. To test this hypothesis, we conducted a large-scale online experiment (N = 1,102), using a sample from four countries (UK, US, Germany, Sweden). As predicted, people perceived themselves to adhere to the COVID-19 guidelines more strictly than both the average citizen of their country and their close friends. These findings were robust across countries. Furthermore, findings were not moderated by whether people first thought about themselves or about others. In conclusion, our study provides a robust demonstration of how a long-standing psychological effect perseveres, even during a once-in-a-lifetime health crisis. [ABSTRACT FROM AUTHOR]

The article presents the discussion on infectious diseases spread becoming pandemics throughout history. Topics include pandemic underlining the importance of working together accomplishing the overriding goals of controlling the virus, restoring health services, and restoring economic stability; and shortage of beds, inadequate supplies of resources such as ventilators and personal protective equipment (PPE).

Flooding is now becoming one of the most frequent and widely distributed natural hazards, with significant losses to human lives and property around the world. Evacuation of pedestrians during flooding events is a crucial factor in flood risk management, in addition to saving people's lives and increasing time for rescue. The key objective of this work is to propose a shortest evacuation path planning algorithm by considering the evacuable areas and human instability during floods. A shortest route optimization algorithm based on cellular automata is established while using diagonal distance calculation methods in heuristic search algorithms. The Morpeth flood event that occurred in 2008 in the UK is used as a case study, and a highly accurate and efficient 2D hydrodynamic model is adopted to discuss the flood characteristics in flood plains. Two flood hazard assessment approaches [i.e., empirical and mechanics-based and experimental calibrated (M&E)] are chosen to study human instability. A comprehensive analysis shows that extreme events are better identified with mechanics-based and experimental calibration methods than with an empirical method. The result of M&E is used as the initial condition for the Morpeth evacuation scenario. Evacuation path planning in Morpeth shows that this algorithm can realize shortest route planning with multiple starting points and ending points at the microscale. These findings are of significance for flood risk management and emergency evacuation research. [ABSTRACT FROM AUTHOR]

The Covid‐19 crises in the United Kingdom and the United States show how democracies may struggle to confront disasters that are increasingly impinging on the Global North. This paper highlights the extent to which disasters are now 'coming home' to Western democracies and it looks at some of the principal reasons why democracy has not been especially protective, at least in the case of the UK and the US. These include: reconceptualising disaster as a good thing (via 'herd immunity'); the influence of neoliberalism; and the limitations in the circulation of information. A key pandemic‐related danger is the conclusion that democracy itself is discredited. Disasters, though, call for a reinvigoration of democracy, not a knee‐jerk invocation of autocratic 'emergency' rule. A fundamental problem in the UK and US is that these countries were not democratic enough. The paper underlines the risk of a move towards a disaster‐producing system that is self‐reinforcing rather than self‐correcting. [ABSTRACT FROM AUTHOR]

This article provides a comparative study of the labour market and social policy measures introduced in light of the COVID-19 crisis in Denmark, France, Germany, Italy and the United Kingdom between March 2020 and January 2021. Its main aim is to understand whether the crisis response has changed the structures of the welfare states concerned. Focusing in particular on the differences regarding the crisis measures taken for individuals in 'standard employment' and 'non-standard workers' in each country, it argues that, although extensive temporary protection instruments were introduced for both groups during the crisis, these did not lead to an immediate convergence as regards these groups' social protection. Rather than changing the underlying structures of welfare systems, many of the measures in fact highlighted the specific vulnerabilities of large segments of Europe's labour markets. States have, however, granted social compensation at unprecedented levels, which could result in improved infrastructures and a clearer understanding of the responsibility of the welfare state in future emergencies. [ABSTRACT FROM AUTHOR]

In an era when public faith in politicians is dwindling, yet trust in scientists remains relatively high, governments are increasingly emphasizing the role of science based policy-making in response to challenges such as climate change and global pandemics. In this paper we question the quality of some scientific advice given to governments and the robustness and transparency of the entire framework which envelopes such advice, all of which raise serious ethical concerns. In particular we focus on the so-called Imperial Model which heavily influenced the government of the United Kingdom in devising its response to the COVID-19 crisis. We focus on and highlight several fundamental methodological flaws of the model, raise concerns as to the robustness of the system which permitted these to remain unchallenged, and discuss the relevant ethical consequences. [ABSTRACT FROM AUTHOR]