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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]

Purpose: This viewpoint piece will highlight the contribution of trained lay community health workers to the integrated workforce in rural, remote and island settings, drawing on experience from a system strengthening project involving community health agents (CHAs) in four municipalities in Litoral Norte, a remote coastal and island region in the state of São Paulo, Brazil. Design/methodology/approach: This viewpoint reflects on experiential learning from a unique north–south collaboration that spanned the period of a global pandemic. It adds to the international literature on the value of community health workers in public health and chronic disease management and highlights their potential pivotal role as integrators at point of care. Findings: CHAs took forward actions that touched the lives of thousands of vulnerable families with low income and complex needs in communities with high levels of social and health inequalities. They acted as a bridge between patients and families at home, primary healthcare professionals and wider community partners and services. Their valuable insight into the healthcare issues and social challenges experienced by the community informed and supported family centred practice and population health goals. The CHAs rapidly pivoted to became an essential public health workforce during the Covid-19 pandemic. Practical implications: As the authors establish integrated care systems and embrace proactive care and population health, the conditions are favourable for introducing a similar role in the UK. For psychological safety and avoidance of burnout people in such new roles will require training, supervision and full integration within community teams. Originality/value: This viewpoint reflects experiential learning from a unique north–south collaboration that spanned the period of a global pandemic. It adds to the international literature on the value of community health workers in public health and chronic disease management and highlights their potential pivotal role as integrators at point of care. [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]

Introduction: A qualitative exploration into the views, opinions and decision-making of paramedics involved in undertaking pre-hospital 12-lead electrocardiograms (PHECGs) for stroke patients was undertaken, in order to gain a deeper understanding of the clinical and occupational context that the paramedics work within, the acceptability of the paramedics in using PHECGs for stroke patients and the consequences and influences of their decision-making. Methods: Data were collected via semi-structured interviews and analysed using the framework method, with the underpinning theoretical framework of cognitive continuum theory. A purposive sample of 14 paramedics was recruited and interviewed. Results: Five themes were generated from the analysis of the interviews: (1) ‘time is brain’: minimising delays and rapid transport to definitive care; (2) barriers and facilitators to undertaking PHECGs for stroke patients; (3) recognising and gaining cues; (4) maintaining patient dignity, self-protection and fully informed consent; and (5) education, experience and engagement with evidence. Conclusion: The study showed mixed views on the usefulness of PHECGs, but all participants agreed that PHECGs should not cause additional delays. Paramedic decision-making on recording PHECGs relies on intuitive and quasi-rational cognitive modes, and requires a number of clinical, logistical and ethical considerations. The findings suggest careful consideration is needed of the benefits and potential drawbacks of incorporating PHECGs into pre-hospital stroke care. [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]

Purpose: The purpose of this paper is to discuss the response of the relevant authorities to evidence that female primary schoolteachers have an elevated suicide risk in the UK. The paper situates the recent tragic death of a primary school head teacher, following an Ofsted inspection at her school, within the wider context of teacher suicide deaths and asks what, if any, action the authorities have taken to prevent avoidable suicide deaths from occurring. Design/methodology/approach: The paper examines a recent case of suicide by a primary head teacher within the wider context of statistical data on suicides by primary schoolteachers and in relation to previous cases of suicide linked to a school inspection. Findings: The paper suggests that the relevant authorities have failed to act in relation to evidence of high suicide risk amongst female primary schoolteachers and to previous suicide deaths linked to the impact of a school inspection. Without learning from suicide deaths and acting on available evidence, there is a risk that preventable suicide deaths will continue to occur. Originality/value: The paper draws together case study evidence and statistical data to make the case for regulatory reform to ensure that work-related suicides are investigated, monitored and prevented. [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]

Purpose: The COVID-19 pandemic significantly disrupted the lives of the deaf community, and the implementation of restrictions on face-to-face meetings resulted in the trial introduction of video remote interpreting (VRI) in a secure psychiatric setting. This study aims to use a qualitative research paradigm to explore user experiences to inform potential future technological developments in this area. Design/methodology/approach: Twelve deaf patients and three interpreters took part in structured face-to-face interviews and discussed their experiences of the use of VRI, with the results being assessed using thematic analysis. Findings: Seven main themes were identified: resource availability, ease of use, technical issues, misunderstandings, medium secure-specific issues, preferences and human factors. All participants agreed that they did not like the VRI technology in the health-care environment in its current format, and their main concern was the difficulty in understanding the information being communicated. It was considered that this had the potential to incur potentially serious medico-legal and safety implications for both staff and patients alike. Practical implications: This study has provided detailed users' feedback about the potential future use in this communication tool and can help guide service developers to review the technology design to tailor it towards the users' needs. While the existing technology is not currently suitable for this deaf population, particularly because of the potential for error, there is potential scope for further research in this area. Originality/value: The COVID-19 pandemic provided a unique opportunity to explore the potential use of VRI for a deaf patient population within a secure psychiatric setting, where such technology is unlikely to have otherwise been used. [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]

BACKGROUND: The choice of the "right" methodology to carry out the occupational accident investigation process is not an easy task. Each methodology has different conceptual and practical characteristics. The choice will depend to a large extent on the conceptual accident model being used. OBJECTIVE: The aim of this study has been to evaluate and compare a set of nine methodologies recognised as the most widely used in the field of occupational accident investigation. METHODS: For this purpose, six evaluation criteria are used which have already been applied and validated by the scientific community with a clear emphasis on the holistic nature of these methodologies. RESULTS: The results show a detailed analysis of the conceptual, methodological and practical characteristics of the nine selected occupational accident investigation methodologies. The conceptual framework of each of the methodologies, their holistic characteristics in terms of whether they cover the complete information cycle and its possible interrelation, reliability and validity of the methodologies, the experience required for their application, the flexibility in terms of being able to be used in different work environments and finally the ability of the methodology to motivate organisational improvement are presented. CONCLUSIONS: From this study, it is clear that the analysis of occupational accident investigation it is becoming increasingly necessary to employ scientific methodologies with a clear proactive approach in order to meet the challenges of changing socio-technical systems. [ABSTRACT FROM AUTHOR]

Scarlet fever is a mild, but highly contagious disease caused by Group A Streptococcus (GAS) bacteria. Scarlet fever begins with flu-like symptoms and, within the first 12-48 hours, it is common for a rash to develop that feels like sandpaper to the touch. In rare cases, GAS bacteria can cause an invasive infection that can be fatal. Invasive GAS (iGAS) infection occurs when the bacteria are in a place of the body where they are not normally found, such as the blood stream. Scarlet fever is usually treated with antibiotics, which can reduce the chances of the patient developing iGAS and reduce the risk of them spreading the infection to others. The World Health Organization and UK Health Security Agency have announced that the number of scarlet fever and iGAS cases observed in children has been several times higher than pre-pandemic levels for the equivalent period of time. As healthcare professionals, it is important that the dental team understand key aspects of scarlet fever. Here, scarlet fever symptoms, transmission, clinical manifestations, antibiotic treatment, and risks to the dental team are reviewed. CPD/Clinical Relevance: To describe epidemiology of scarlet fever and discuss the implications for the dental team. [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]

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]

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]

Summary: Nitrous oxide is a common choice of labour analgesia in many countries. However, its use is associated with significant cost to the environment as well as potential risks of long‐term occupational exposure. Our hospital is one of a small number of healthcare providers in the United Kingdom trialling technology which catalytically destroys ('cracks') nitrous oxide to reduce greenhouse gas emissions and occupational exposure. When used in the setting of inhaled analgesia, cracking technology relies on capturing the patient's exhaled breath via a facemask or mouthpiece, a technique which requires some user skill and may be challenging for patients. In this report, we present the case of a primiparous 35‐year‐old consultant anaesthetist, who used nitrous oxide cracking technology with inhaled nitrous oxide analgesia (via a facemask) during labour. We present the patient's experiences and discuss the implications of using such technology on ambient nitrous oxide levels in the delivery room. Notably, despite this patient's professional expertise and familiarity with facemask use, nitrous oxide remained detectable throughout her labour, although generally at low levels. This illustrates that whilst this technology has the potential to reduce ambient nitrous oxide levels, its efficacy may vary depending on how it is used, with implications for patient education and support. [ABSTRACT FROM AUTHOR]

This article highlights the weakness of the UK's occupational health and safety infrastructure exposed by the COVID‐19 pandemic. Utilising a political economy perspective, it captures the critical role of workplace union safety representatives in mitigating risk and contesting the expropriation of health and recommodification of labour, specifically inadequate sick pay. [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]

With today's increasingly dynamic and competitive business environment, creativity is critical for enterprises to enhance their competitiveness. Companies today invest and seek new ways to enhance creativity of employees within the organization. Our study describes the effects of servant leadership, psychological safety, and employee well-being on creativity under the conservation of resources theory. We used a sample of 252 full-time employees in the United Kingdom who had been recruited online and collected their data for analysis. We conducted confirmatory factor analyses to test the validity of the measurement model and regression to evaluate the direct effects. Subsequently, we used bootstrapping to confirm mediation and serial mediation effects. The results showed that servant leadership was positively related to creativity and that psychological safety and employee well-being were serial mediators between them. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to examine how work-related suicides are monitored, investigated and regulated in the UK, examining a small selection of cases and drawing on international comparison with other countries. Effective data collection and regulation are the cornerstone of suicide prevention, and this paper aims to consider whether the UK's current regulatory framework provides an effective basis for preventing work-related suicides. Design/methodology/approach: This study draws on qualitative sociological methods and is based on an in-depth analysis of 12 suicide cases occurring between 2015 and 2020. In each case, work-related causal factors had been previously identified by at least one official source (police enquiry, coroner or employer's investigation). This study analysed multiple sources of documentation and undertook interviews with individuals close to each suicide case. The aim of this study was to consider the organisational response of three stakeholder organisations to the suicides: the Health and Safety Executive (HSE), the coroner and the employer. Findings: The study points to serious shortcomings in the UK's regulatory response to work-related suicides. Suicides are currently not recorded, investigated or regulated. Whereas the fracture of an arm or leg in the workplace needs to be reported to the HSE for further investigation, a suicide occurring in the workplace or that is work-related does not need to be reported to any public agency. Employers are not required to investigate an employee suicide or make any changes to workplace policies and practices in the aftermath of a suicide. The work-related factors that may have caused one suicide may, therefore, continue to pose health and safety risks to other employees. Originality/value: Whereas some recent studies have examined work-related suicides within specific occupations in the UK, to the best of the authors' knowledge, this is the first study to analyse the UK's regulatory framework for work-related suicides. The study on which the paper is based produced a set of recommendations that were targeted at key stakeholder organisations. [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]

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]

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]

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]

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).

Do accidents where users are injured or killed by unsafe products reveal underlying weaknesses in the safety culture of the responsible organisations? While manufacturing firms have long been concerned with organizational culture factors that relate to product quality, there has been much less attention to the relationship with consumer safety. Product safety culture can be defined as the attitudes, norms, beliefs and behaviours of staff in manufacturing organisations that affect the integrity of a product in relation to the well-being of its users. There has been limited research into this type of safety culture, with the exception of several studies from the food industry. This exploratory study in one large company adopted a qualitative approach to identify the dimensions of product safety culture in the manufacture of engineered products. Study 1 consisted of phone interviews (8 managers, 2 workforce). Study 2 was on two UK manufacturing sites where interviews and focus groups were conducted (46 participants in total: 7 managers, 39 workforce). The transcriptions were coded using inductive thematic analysis to identify the main components of product safety culture. The findings indicated six principal dimensions: management commitment to product safety, communication, safety systems, trust, understanding of safety systems and product safety ethic. The first five dimensions are well-established components of culture relating to worker and process safety. The last dimension appears to be a distinctive component (compared to other types of safety culture) relating to an employee's moral and ethical stance toward product safety, where user well-being is considered during product manufacture. This ethical component is a more novel feature which suggests that fostering concern for unknown product users may be an additional facet of product safety culture worth investigating in the effort to reduce the risks to consumers. [ABSTRACT FROM AUTHOR]

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]

A qualitative study [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]

Introduction: Home assessments are integral to the occupational therapy role, providing opportunities to personalise and integrate care. However, they are resource intensive and declining in number. A 3-month service development within one United Kingdom National Health Service acute hospital setting explored the concept of using digital technology to undertake remote home assessments. Methods: Four work streams explored the concept's feasibility and acceptability: real-world testing; user consultations; narrative case study collection; traditional visit resource use exploration. Project participants were occupational therapists and patient and public representatives recruited via snowball sampling or critical case sampling. Qualitative data were thematically analysed identifying key themes. Analysis of quantitative data provided descriptive statistics. Findings: The remote home visit concept was feasible within four specific contexts. Qualitative themes suggest acceptability depends on visitor safety, visitor training, visitor induction and standardisation of practice. Consultees perceived the approach to have potential for resource savings, personalisation and integration of care. Barriers to acceptance included data security, data governance, technology failure and threat to occupational therapists' role and skills. Conclusion: Applying digital technology to occupational therapy home assessment appears feasible and acceptable within a specific context. Further research is recommended to develop the technology, and test and investigate perceived benefits within wider contexts and stakeholder groups. [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]

With increasing numbers of self-employed persons in the United Kingdom (UK) struggling to protect themselves via personal savings or private insurance against work-related social risks (an issue that has gained further importance in light of the Covid-19 pandemic), this article first discusses self-employment as a type of work that implies intrinsically privatised forms of risk management. Secondly, current social policy interventions towards vulnerable self-employed persons in the United Kingdom (UK) are analysed to identify the mix of instruments used for, on the one hand, investment and support and, on the other hand, conditionality, coercion and activation. Finally, we explore how responsibilities for risk management manifest themselves and argue that the expansion of activation and conditionality increases pressures upon self-employed workers with insufficient incomes and thus indicates a far-reaching risk privatisation, while undermining the idea of a meaningful social investment approach. [ABSTRACT FROM AUTHOR]