Intensive care unit physicians' challenges on occupational safety and health during the COVID-19 pandemic: a scoping review

IntroductionDemand exceeded capacity during COVID ‘surges' in certain intensive care units around the world, resulting in avoidable deaths, workload pressures on staff, longer and more intensive care, and an increased risk of staff infection during intensive interventions. A limited number of studies examined intensive care physicians' experiences and perceptions during the COVID-19 pandemic. This review summarises the available published articles related to the challenges faced by ICU consultants during the COVID-19 pandemic from an occupational safety and health perspective.Material and MethodsThe PRISMA-ScR guidelines were applied to four online databases, including Medline, Scopus, Web of Science (WOS), and PsycINFO, to identify articles published between January 2020 and October 2022. During the COVID-19 pandemic, ICU consultants' experiences and perspectives on occupational safety and health as a primary outcome are examined.ResultsThe full texts 61 articles were then considered;25 articles met the inclusion criteria, which include English language full texts of available articles, qualitative studies, and ICU consultants. Eight main themes emerged from the synthesis: COVID-19 infection, psychosocial distress, moral distress, physical distress, workplace violence, social stigma, structural and organisational issues, and risk communication. Phenomenological studies make up the majority of the qualitative research, followed by grounded theory studies and case studies.ConclusionsThe global impact of the COVID-19 pandemic on intensive care services has been catastrophic. The key to maintaining ICU services during a pandemic is preparedness, adaptation, and mitigation. Consequently, it is essential to acknowledge the ICU consultant's perspective in order to mitigate all potential ICU service disruptions. However, anticipating action for a variety of issues or challenges is best explored through a qualitative interpretive description study directed at ICU consultants with on-the-ground experience.

Therapist Voices on a Youth Mental Health Pilot: Responsiveness to Diversity and Therapy Modality.

This article explores therapists' views on a large youth mental health pilot project (for 18-25-year-olds), which included an individual cognitive behavior therapy (CBT)-informed individual therapy component. Therapists' views on cultural responsiveness, therapy (delivery, modality and duration) and working with LGBTQIA+ youth were explored using two surveys, individual interviews and focus groups at various stages of the life of the pilot. Some therapists saw the CBT approach as imposed on them, preferring familiar therapy modalities. Many therapists were positive toward CBT for its client-centered approach and reported using CBT-informed approaches with many of their clients to good effect. Some therapists felt pressured by their workplace to see clients for fewer sessions than they needed. Therapists wanted to see a more culturally diverse workforce, to increase their cultural competence through training and to have more easily available cultural supervision. There was some acknowledgement of the importance of training therapists to work competently with LGBTQIA+ young people. Involving therapists in co-design of services from the outset will likely benefit future service development.

"It's All Just Marketing", a Qualitative Analysis of Consumer Perceptions and Understandings of Nutrition Content and Health Claims in New Zealand.

Nutrition content and health claims are widely used globally on both food labels and in food advertising. This study explored how New Zealand consumers understand, perceive, and use nutrition content and health claims on food labels. A qualitative approach was used with semi-structured in-depth online interviews and in-person focus groups including 49 participants, aged ≥25 years responsible for household food shopping. Transcripts were analysed using reflexive thematic analysis using inductive coding, with development of five themes-(1) aware of claims but did not use, (2) mistrust and scepticism, (3) confusion and misinterpretation, (4) using claims to guide food choice, and (5) not all claims are equal. For theme 1, price and habit were found to be the most influential in driving food choice. Underlying theme 2 was the perception by most of nutrition and health claims as marketing. Scepticism was exacerbated when nutrient claims were displayed on inherently unhealthy products. However participants with specific dietary requirements did find claims helpful. Restricting nutrient claims to foods meeting a healthy nutrient profile aligned to the existing Health Star Rating system, education about regulation and supporting claims with more contextual information may increase trust, the perceived value of claims and therefore their utility.