MUSCULOSKELETAL DISORDERS DURING COVID-19 INFECTION: A SURVEY OF HEALTHCARE WORKERS

BackgroundCOVID-19 infection has revealed a considerable number of extra-pulmonary manifestations, especially rheumatological. The detection of these manifestations, which herald the infection, is of great value in the early diagnosis of the disease, especially in health care workers (HCWs) who are at considerable risk of infection. Although myalgia is a common clinical feature of COVID-19, other musculoskeletal disorders (MSDs) have been rarely described.ObjectivesTo describe MSDs during SARS-COV2 infection in HCWs.MethodsProspective descriptive study conducted at the department of occupational pathology and fitness for work of Charles Nicolle Hospital in Tunis, having included the HCWs affected by COVID-19 during the period from 01 September 2020 to 28 February 2021. Data collection was carried out by regular telephone follow-up during the containment period using a pre-established form.ResultsDuring the study period, 656 HCWs were infected with SARS COV 2, of whom 134 (20.4%) had at least one musculoskeletal event. The mean age was 42±9 years with a sex ratio (M/F) of 0.2. The most represented occupational category was nurses (33.6%) followed by health technicians (23.1%). The median professional length of service was 12 [7;20] years. The presence of comorbidity was noted in 58.2% of HCWs. A pre-existing osteoarticular disease was found in 8.2% of cases. Obesity was noted in 25.4% of the population. Active smoking was reported by 14.3% of respondents. A known vitamin D deficiency was noted in 16.5% of patients. Spinal pain was the most reported MSD, present in 87.3% of cases. Low back pain was the most frequent spinal pain (56.7%) followed by back pain (37.4%) and neck pain (5.9%). MSDs of the lower limbs were found in 12.7% of patients. They were represented by gonalgia in 11.9% of cases, ankle pain in 5.2% of cases and hip pain in 4.3% of cases. MSDs of the upper limbs were described by 7.5% of the patients, 92.5% of whom presented with shoulder pain. The median duration of MSDs during COVID-19 was 5 [3;8] days. These manifestations were persistent on return to work in 21.1% of cases.ConclusionKnowledge of the frequency and consequences of musculoskeletal manifestations related to COVID-19 infection is of great importance, particularly in HCWs, in order to optimise management and ensure a rapid return to work.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.

Embracing DDMT Teaching Model and Design Thinking for Organization Development

The multi-generational workforce presents challenges for organizations, as the needs and expectations of employees vary greatly between different age groups. To address this, organizations need to adapt their development and learning principles to better suit the changing workforce. The DDMT Teaching Model of Tsing Hua STEAM School, which integrates design thinking methodology, aims to address this challenge. DDMT stands for Discover, Define, Model & Modeling, and Transfer. The main aim of this study is to identify the organization development practices (OD) and gaps through interdisciplinary models such as DDMT and design thinking. In collaboration with a healthcare nursing home service provider, a proof of concept using the DDMT-DT model was conducted to understand the challenges in employment and retention of support employees between nursing homes under the healthcare organization. The paper highlights the rapid change in human experiences and mindsets in the work culture and the need for a design curriculum that is more relevant to the current and future workforce. The DDMT-DT approach can help organizations address these challenges by providing a framework for HR personnel to design training curricula that are more effective in addressing the issues of hiring and employee retention. By applying the DDMT-DT model, HR personnel can better understand the needs and motivations of the workforce and design training programs that are more relevant to their needs. The proof-of-concept research pilot project conducted with the healthcare nursing home service provider demonstrated the effectiveness of the DDMT-DT model in addressing the issues of hiring and employee retention. The project provides a valuable case study for other organizations looking to implement the DDMT-DT model in their HR practices. Overall, the paper highlights the importance of adapting HR practices to better suit the changing workforce. The DDMT-DT model provides a useful framework for organizations looking to improve their HR practices and better address the needs of their workforce.

Pandemic Challenges and Opportunities for Gender Equity in Clinical Research

In the arena of clinical research, gender equity accelerates research excellence: we need multiple perspectives and all the brain power we can muster to maximize research productivity and quality. [...]women physician investigators enhance enrollment of women as participants in clinical trials, which is crucial to our ability to generalize from the data and to maintain the health of women. Women are underrepresented among academic grand rounds speakers,14 speakers at medical conferences15, and award recipients from medical specialty societies.16 Time pressure is especially intense on young women faculty. Besides spending more time on domestic chores, they spend more time at work on teaching, service, and mentoring. Female primary care physicians spend more time with patients.22 Elderly hospitalized patients treated by female internists experience lower mortality and readmission rates.23 Patients undergoing coronary artery bypass grafting had shorter hospital length of stay when treated by an all-female physician team as compared with an all-male team.24 Female patients treated by male physicians following acute myocardial infarction have higher mortality than those treated by female physicians.25 Sex discordance between patient and surgeon is associated with increased likelihood of adverse postoperative outcomes-and that observation that is driven by worse outcomes for female patients treated by male physicians.26 Clinical trials play a fundamental role in bringing new medications and interventions to our patients, yet women have often been excluded from participation. Among 60 randomized controlled trials (RCTs) of lipidlowering therapies reported between 1990 and 2018, there was a modest increase in enrollment of women over time, but women remain underrepresented compared with the relative burden of disease.30 In another study of 317 RCTs of heart failure with reduced ejection fraction published in highimpact journals over the past 20 years, only 25% of participants overall were female, and females were under-enrolled in 72% of these trials.

New development: A ‘journey of personal and professional emotions'—emergency ambulance professionals during Covid-19

IMPACTThis article explores the consequences of emotional labour on UK NHS ambulance staff and their response to the Covid-19 pandemic. It highlights the challenges faced by ambulance crews while dealing with their emotional labour within the context of organizational settings. Research findings also explain the importance of emergency responders' psychosocial wellbeing. The article has clear relevance as to how frontline staff manage their emotional labour in other emergency service settings, such as the police and fire and rescue services.Alternate :Managing emotions are essential aspect of many jobs, and frontline healthcare workers have to manage and control their emotions while caring for critically ill patients and working in an emotionally-charged dynamic environment;this was particularly the case during Covid-19. Ambulance workers are an important group in this respect but they are currently under-researched. Evidence behind this article comes from data collected from an NHS ambulance trust in England. One of the key contributions of this article is to highlight how frontline ambulance professionals manage their emotional labour while working within the stipulations of organizational constraints.

Emotional risk work during the pandemic: Healthcare professionals' perceptions from a COVID-19 ward

In March 2020, COVID-19 wards were established in hospitals in Denmark. Healthcare professionals from a variety of specialities and wards were transferred to these new wards to care for patients admitted with severe COVID-19 infections. Based on ethnographic fieldwork in a COVID-19 ward at a hospital in Copenhagen, Denmark, including focus group interviews with nursing staff, we intended to explore practices in a COVID-19 ward by seeking insight into the relation between the work carried out and the professionals' ways of talking about it. We used a performative approach of studying how the institutional ways of handling pandemic risk work comes into being and relates to the health professionals' emerging responses. The empirical analysis pointed at emotional responses by the nursing staff providing COVID-19 care as central. To explore these emotional responses we draw on the work of Mary Douglas and Deborah Lupton's concept of the ‘emotion-risk-assemblage'. Our analysis provides insight into how emotions are contextually produced and linked to institutional risk understandings. We show that work in the COVID-19 ward was based on an institutional order that was disrupted during the pandemic, producing significant emotions of insecurity. Although these emotions are structurally produced, they are simultaneously internalised as feelings of incompetence and shame.

THE LABOR OF MEDICAL WORKERS IN THE USA: A SOCIAL ASPECT

The shortage of medical personnel is becoming a heavy burden on modern healthcare systems around the world. All countries, without exception, turned out to be vulnerable, regardless of the level of income and available forms of medical care. This study addresses the issue of staffing at the time of transition to a new technological level of the healthcare system in the United States. The paper shows that at the present stage in the country there is a need for fundamental changes in the personnel policy in the medical field. The challenges caused by the COVID-19 pandemic not only exposed all the vulnerabilities of the national health system, but also opened up opportunities considering the lessons learned to rethink the long-term vision of solving the workforce problems directly related to the use of new technologies. Based on the analysis of statistical data and sociological research, the author identified the latest trends of overcoming barriers in the field of training and retraining of personnel in the context of the transition to digital medicine. Overexertion among medical personnel associated with increased workload has exacerbated the problem of their professional burnout. The mass protests of physicians necessitated the development of new approaches to the labor protection of employees in the medical field. Solution of such important social problems will require a long time and financial costs and is possible only through the joint efforts of the state and the entire community as a whole. © 2023, Russian Academy of Sciences.

Assessment of Psychological Needs in an Egyptian Sample of Healthcare Providers during the COVID-19 Pandemic

Objectives: The current study aims to identify the psychosocial needs of frontline Healthcare Workers (HCWs) during the COVID-19 pandemic and investigate the factors contributing to their psychosocial well-being. Methods: We conducted a cross-sectional study using an online survey designed specifically for the aim of this study. Data was collected from 315 frontline healthcare workers during the COVID-19 pandemic. Results: Up to 90 % of the responders reported a range of symptoms related to psychological distress such as worry, insomnia, lack of motivation, negative thoughts, inability to achieve goals, and burnout. Psychological support, religion-based support, communicating with family, and good sleep are among the stress-relieving factors most mentioned by HCWs. The change in work conditions and increased awareness of the need to use different strategies to overcome stress was associated with decreased levels of perceived stress among health care providers. Conclusion: The change in work conditions, the increased awareness of HCWs to their needs, and the use of different strategies to overcome were associated with decreased levels of perceived stress among HCWs. The increased number of working hours per day and younger age of the participants were the only significant independent variables detecting the need for psychological support. This research is a call for designing and implementing tailored needs-based interventions that address the different aspects of HCWs' well-being during public health emergencies. [ FROM AUTHOR] Copyright of Arab Journal of Psychiatry is the property of Arab Federation of Psychiatrists and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

The Wuhan Lockdown

The book's middle chapters examine the various bold and careful acts of Wuhan residents during the lockdown. A scrupulous student of China's internet, Yang devotes most of his attention to analyzing China's fast-changing internet culture through the lens of the Wuhan lockdown. After the Wuhan lockdown in early 2020, China imposed lockdown in every city where there was an outbreak, until it lifted the zero COVID policy in December 2022. [Extracted from the article] Copyright of Journal of Asian Studies is the property of Duke University Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Attitudes among physicians toward vaccine mandates for emerging infectious disease: the case of the COVID-19 vaccine

Objectives: The outbreak of SARS-CoV-2 resulted in a global pandemic. Vaccine mandates were implemented in several countries, including in Taiwan, and often targeted health-care workers in particular. This study investigated attitudes among Taiwanese physicians toward such policies and how ethical beliefs and logic influenced attitudes. Methods: A total of 16 physicians were recruited by using the snowball method from hospitals in northern Taiwan. Data were collected through semi-structured interviews. Results: Physicians tended not to support mandatory vaccination. Five themes emerged: (1) Individual rights, including violation of autonomy and labor rights;(2) vaccine performance, including safety and efficacy;(3) institutional norms, including the degree of relevancy of the policy-issuing unit and the employment relationship between physicians and institutions;(4) social and workplace stigma resulting from coercive policies in different job categories or departments;and (5) professional ethics of physicians. Conclusions: Autonomy and professional ethics among physicians influence attitudes toward vaccine mandates. Vaccine performance, institutional norms, and stigma also influence attitudes toward vaccine mandates and decision-making. Even with high ethical awareness, the study participants tended not to support vaccine mandates. The government should formulate mandatory vaccination policy means for healthcare workers that can be used by hospitals. Each hospital should assess their unique risks and implement policies that best suit their needs. (Taiwan J Public Health. 2023;42(1):75-87)

The establishment of a national federation representing health workers from ethnic minorities

ContextThe Federation of Ethnic Minority Healthcare Organisations (FEMHO) was established in 2022 in light of the disproportionate inequalities experienced by this group before, during and after the COVID-19 pandemic.The FEMHO is as a multidisciplinary consortium representing Ethic Minority organisations and individuals within the health and social care in the UK. At the time of writing, FEMHO represents over 55,000 individual members, covering various disciplines, specialisms and levels of seniority, spanning across 43 organisations and interest groups. As a self-governed union, FEMHO encourages organisations to collaborate and work collectively to achieve better outcomes through the implementation of improved policies and opinion formers as well regulators and commissioners both locally and nationally.Issue/ChallengeOf the 1.2 million staff employed by NHS, 20.7% belong to Black, Asian and minority ethnic (BAME) background. However, analysis of deaths of NHS Staff during the pandemic showed that 64% of those who died belonged to a BAME background. Such disproportionate impacts were seen when the number of deaths amongst doctors and nurses were further analysed, where 20% of nursing staff identified as BAME yet 64% of nurses who died were BAME and 44% of medical staff identified as BAME and 95% of doctors who died were BAME.Doctors from BAME backgrounds also reported:Feeling less confident that appropriate adjustments had been made to mitigate riskFeeling less confident about PPE provision and feeling safe to report PPE shortagesHigher rates of bullying and harassment during the pandemic periodSuch inequalities are believed to be as a result of a number of structural inequalities that existed well beyond the pandemic. it also hypothesised that several inequalities may persist well beyond the pandemic, such as the disproportionate impact of long-covid of health workers from an ethnic minority, which is currently being investigated by researchers at the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre.In view of these challenges, the FEMHO was established as a method of collaborating and co-ordinating the efforts of grassroots organisations, policy makers, regulators and commissioners to ensure that the lived experiences and potential solutions offered by organisations and individuals within this group can be better heard and acted upon.Assessment of issue and analysis of its causesThe FEMHO was established to promote a more concerted approach for the advocacy for health workers from ethnic minority backgrounds, with the aim of reducing the inequalities experienced by this group. A two pronged approach of galvanising grassroots organisations already working tirelessly to support ethnic minority health workers along with lobbying and collating interests amongst policy makers, commissioners and regulators was utilised.For grassroots organisations, a mixed methodology of targeted invitations and open advertisement of opportunities for membership was utilised. Several mediums were used to spread the word of such opportunities, including social media posts, word of mouth and email.For policy makers and systems leaders, a more targeted approach was adopted to acquire their support. A targeted email campaign was developed to raise awareness of FEMHO's work with the aim of acquiring their official support, particularly in the form of endorsing FEMHO's call for the inclusion of race inequality in the COVID-19 public enquiry.ImpactAt the time of writing, the FEMHO has been successful in galvanising the membership and support of both grassroots organisations and policy makers respectively at a national level.FEMHO now represents over 55,000 individual members, covering various disciplines, specialisms and levels of seniority, spanning across 43 organisations and interest groups.The targeted email campaign saw the achievement of 39 cross party MPs officially supporting FEMHO's call for inclusion of race inequality in the COVID-19 public enquiry.An inaugural meeting was also held within th Houses of Parliament, where grassroot organisation leads as well as MPs were invited to discuss the strategic priorities and direction of the organisation such as the organisations contribution to the COVID-19 public enquiry, to ensure that inequality is truly at the ‘forefront' of issues.Feedback acquired during the inaugural meeting from MPs and front-line workers was incredibly positive, with attendees welcoming this concerted approach to effect change.Challenges faced in this process largely themed around the limited time availability of the several individuals involved with this project. Executive members of the union as well as grassroots member leads largely worked full time in a variety of demanding healthcare professionals, making communication, organisation and prioritisation of voluntary roles such as contribution to FEMHO work difficult at times.InterventionThe intervention, being the development of a national union equipped with the lived experience and expertise of members who are able to effectively advocate for the interests for health workers from ethnic minority backgrounds, has had numerous positive outcomes:A shared space for grassroots organisations to share best practice for support of healthcare workers from ethnic minority backgroundsA concerted voice to contribute to policy change to address the structural inequalities that adversely impact healthcare workers from ethnic minority backgroundsFrom this experience thus far I have learnt that leadership, with regards to solving complex problems, can often be a journey of harnessing the voices, expertise and influence of several individuals and organisations to effect change. Such a journey can come with numerous hurdles: from stakeholder mapping to initiatives to promote cross-specialty, cross-seniority, cross-political party discussions. But I have learnt, particularly from the exec leadership team, made up Ade Adeyemi MBE (a Global Health Policy Expert) and Professor JS Bamrah CBE (Chair, British Association of Physicians of Indian Origin), and other notable individuals, that such efforts to galvanise individuals who have seemingly different priorities is often possible when you are able to see beyond this as a leader and define, clarify and communicate where such individuals share interests and focuses in common.Involvement of stakeholders, such as patients, carers or family members:As mentioned, the main stakeholders that had to be consulted within this process were front-line care workers from ethnic minority backgrounds and any relevant organisations who may work at a grassroots level to support them.Such stakeholders were involved through the establishment of communication channels as well as feedback sessions to ensure that the FEMHO was sufficiently and accurately representing the interests of the group in question.Key MessagesSolving complex problems as a leader requires the ability to create a collaborative environment that often sees the development, nurturing or new relationships at both an individuals and organisation levelLeaders are able to harness human energy through the development and forecast of a vision and mission that is inspiring and compelling, encouraging individuals to sacrifice their time for a matter bigger than themChange that is sustainable and impactful can often be slow, as seen with the policy changes we continue to advocate for as an organisation, but leaders must be patient.Lessons learntAs mentioned, I have learnt that to effect change, one must be patient as a leader. Our policy activities has taken a great deal of time to be heard and seen, and it can often be tempting to grow impatient and quit.Future barriers to our work include the degree to which can promote regular communication and collaboration amongst member organisations who are often time poor, competing with a number of other priorities such as a demanding full time career in healthcare. Other barriers include maintaining political interest from policy makers, commissioners, MPs, many of which may not hold positions for a long-term basis, as a r sult of the political nature of many of their positions.Measurement of improvementWe will measure the effect of our initiative through a series of feedback forms, particularly of member organisations and their members to assess the degree to which front-line care workers from ethnic minority backgrounds feel that progress in being made in the level of advocacy and campaigning on their behalf. Additionally, we will seek to gather feedback on our members perception of ways of working and any suggestions to ensure that all member organisations feel empowered to influence the direction of the federationStrategy for improvementAfter each feedback round, held on a quarterly basis, executive members of the FEMHO will analyse findings and implement changes accordingly where possible

Unfolding Outbreak Scenarios Can Be a Bite-Size Treat and Other Lessons From New Zealand's First Online Environmental Health Conference

The New Zealand Institute of Environmental Health (NZIEH) is a nongovernmental institute for all environmental health professionals in New Zealand. In 2021, NZIEH held its annual conference as an online virtual event for the first time. One inclusion to the program was an evolving outbreak scenario delivered in installments including "injects" of information (i.e., inserts of information relevant to the scenario) that mimic the evolution of a real-life epidemiological outbreak investigation. Questions were posed to attendees related to each added information inject. The scenario also included discussion in virtual breakout rooms that allowed attendees to network and reach consensus before responding to questions;discussions were also initiated by the scenario facilitators. Details of the scenario, its aims, evaluation of success, and limitations of this approach are discussed.

Coronavirus (COVID-19) pandemic implications on nursing care: A short review

The Coronavirus (COVID-19) disease is a global pandemic infectious disease caused by a novel coronavirus, which affects all age groups with a higher incidence in the geriatric population and people with chronic diseases. The outbreak of the virus is a serious public health challenge including to nurses at the various health care facilities around the world. The outbreak of the coronavirus has been a huge threat to nursing and nursing care globally. Nurses are experiencing a high level of daily emotional stress in their activities in preventing disease infections, promoting health, and saving lives. Many nurses have lost their lives to the deadly disease in their fight to save their patients, many feel stressed and burnout, and many feeling discouraged because of the protracted effects of the disease. The psychological health of the nurses as frontline health care workers should be safeguarded owing to their crucial roles in mitigating disease pandemics. Thus, adequate training of nurses would better equip them with the necessary information regarding the preventive measures, and management approaches to foster the mitigation of the disease, mitigate the disease burden on healthcare facilities, and enhance the recovery rate of the infected populations. Andfurther better prepare nurses on prioritizing personal psychological health.

Occupational Stress in Healthcare During Covid 19

Several studies dedicated to the risk of work-related stress have already shown for some time that healthcare workers are subjected to multiple sources of stress. Recent literature has shown that the SARS CoV 2 pandemic has subjected healthcare workers in emergency/urgent departments and Covid −19 departments to work-related stress risk. In a Sicilian hospital, a sample of 50 health workers (25 men/25 women) was given the "INAIL questionnaire work-related stress risk” structured in 35 items to investigate 7 dimensions of occupational stress (1) Question, (2) Control, (3) Management support, (4) Support from colleagues, (5) Relationships, (6) Role, (7) Change. The results show in 27% of the sample a high level of occupational stress and in 62% an average level of occupational stress with little control and emotional exhaustion, especially in women. In conclusion, to avoid the chronicization of dysfunctional pictures, health institutions must provide staff with psychosocial support services to protect them from the risk of work-related stress. AD -, Messina, Italy ;, Messina, Italy

Getting it right in the pandemic

In a research paper that warrants close scrutiny by hospital administrators everywhere, Min Liu and colleagues find that none of 420 healthcare workers deployed to a hospital in Wuhan were infected with the virus, despite caring for severely ill patients and performing aerosol generating procedures over 6-8 weeks.3 The workers wore surgical masks and N95 respirators as well as protective suits and gowns, goggles, gloves, and face shields. The US and the UK missed the just right "Goldilocks zone” of hospital capacity by building temporary hospitals that remained mostly empty.6 How did this happen? "Bad modelling based on insufficient data,” says one expert. Missing the Goldilocks zone of hospital capacity during covid-19.

Organisational strategies to support NHS staff in response to the COVID-19 pandemic

ContextThis case series aims to assess the organisational strategies utilised by two NHS trusts (trust A and B) in North West England in order to improve the well-being of their Healthcare workers (HW) during the time period from December 2019 to March 2021. In the context of existing clinical leadership theory, we investigated what organisational strategies leaders and managers in English hospitals can use to improve the well-being of HWs in response to the COVID-19 pandemic.Establish what strategies are being used by trusts to improve the mental well–being of healthcare workersAscertain which risk factors are associated with poor mental health during the COVID–19 pandemic in NHS healthcare workersExamine whether strategies can be designed using limited resources to meet the challenging mental healthIssue/ChallengeA higher prevalence of mental health issues (MHI) such as depression, burnout, post-traumatic stress disorder (PTSD) and anxiety is observed during epidemics and pandemics. In May 2020, during the COVID-19 Pandemic, Mental health Illnesses (MHI) accounted for 28.3% of all sickness leave in the UK NHS. The highest sickness absence rate (SAR) in the United Kingdom (UK) was reported in the North West England (NWE) at 4.9%;with MHI being consistently responsible for sickness absence, accounting for 31.8% of all sickness leave in June 2020, placing a huge strain on limited resources and patient safety and care.Assessment of issue and analysis of its causesFollowing written, informed consent, semi-structured, 60 minute interviews were conducted via video-conferencing with six participants (clinical managers or directors) of two NHS Trusts in NWE. Interviews were recorded and transcribed verbatim. The transcripts were then read, and Coding was done using NVivo software in an iterative process which used a leadership framework oriented around the interview questions.We also conducted a retrospective data collection on the average monthly percentage of Full Time Equivalent (FTE) days lost to mental health issues from the trusts' databases between 1st December 2019 and 1st March 2021 in order to triangulate strategies impact on sickness absence rate.ImpactTo date, there is no case study research on the strategies implemented in NHS trusts that address the consequences of the COVID-19 pandemic on HW's mental health and wellbeing which utilise absence data.InterventionTrust A had a higher Sickness absence rate versus Trust B, despite the greater funding and larger wellbeing team utilised in Trust A. Understanding early on, via surveys, the needs of HW in Trust B, contributed to their effective response and target of resources. The practical support offered by Trust B may have acted as preventative and proactive measure for poor mental health. Trusts psychological support approach may have only benefitted HW in later stages of MHI, such as PTSD. Nevertheless, Trust B is a significantly smaller trust, with fewer replacements, consequently, HW may feel less comfortable or less able to take sickness absence.The least engagement in wellbeing strategies was seen in both Trusts amongst Black And Minority Ethnic (BAME) groups. Raising concerns in Trust A and Trust B was aided with BAME ‘listening events' and a ‘BAME network' forum respectively. The latter formed part of the ‘governance structure' of Trust B, ensuring that official reports were acted upon. Trust A also introduced ‘outreach calls' for nursing staff off sick due to MHI to check in on them with referrals to the Greater Manchester resilience hub and did regular health checks for early prevention of unhealthy behavioural patterns.Both Trusts highlighted the importance of measuring the efficacy of strategies implemented. However, Trust B reported that due to the ‘fast-paced nature of the start of the pandemic, evaluation was not as important then. Contrarily, Trust A submits quarterly reports on engagement with services, outcomes and feedback as part of their service delivery which they are constantly amending.Key MessagesBoth NHS trusts in NWE identified similar risk factors for developing mental health issues and reported similar challenges in implementing wellbeing initiatives. Organisational strategies were dependent on each trust’s needs and outcomes. Our study suggests that practical support may be more effective for stress and fatigue management during the peaks of pandemics in contrast to psychological support which may be more suitable during recovery phases. Screening for psychological issues may highlight areas of support and may enhance engagement with services, particularly in vulnerable population groups (BAME). Ultimately, a whole-systems leadership approach involving the aforementioned systemic change to organisational culture is needed in order to meet the well-being needs of healthcare workers.Lessons learntAn organisational, rather than individual, approach to re-building team cohesion should be preferred. Furthermore, the focus of interventions in both trusts was individual psychotherapy, with minimal exploration of organisational cultural factors. Even though practical support was seen as superior to psychological interventions in Trust B, both wellbeing strategies may help improve overworked occupational culture.Self-care coping mechanisms were emphasised more during the peaks of the pandemic. Similarly, according to Avero et.al. 2003 wellbeing initiatives during the peaks of pandemics should help HW cope with stress and trauma, whereas during recovery phases of pandemics they should help with processing psychological trauma.Identifying common manifestations such as unhealthy eating, smoking and alcohol consumption may be more effective than relying on HW self-reporting. Nevertheless, this system relies on open and honest conversations with HW.

Enhancing palliative care at home: a generalist community nursing case study

What this paper adds: * This case study demonstrated that facilitating ongoing education opportunities that draw on the expertise of local palliative care champions or internal specialists can enhance care provision. * Nurse care managers believe the value of generalist services, particularly home care services, in the generalist-specialist palliative care partnership, needs to be understood and respected. * Tailored investment in home care to provide a general palliative approach would be beneficial given the unique challenges of this mobile workforce. Keywords: Palliative care;home care services;Education, Nursing;qualitative research;Nurse Practitioner BACKGROUND Palliative care focuses on improving the quality of life of people affected by life-threatening illnesses, including the prevention and relief of suffering through identification, assessment and treatment.1 This care extends to family members, and encompasses physical, psychological, social and spiritual support. Home nursing and care organisations are key providers of community-based palliative care, with staff often the linchpin, in supporting palliative clients, organising and providing care, coordinating the input of other professionals and of specialist equipment.5 Previous research has identified the difficulties faced by home care nurses in meeting their clients' palliative care needs, such as symptom management and communication, as well as requirements for further training to enhance their knowledge and confidence of caring for palliative clients.5-7 In this context, generalist palliative care is delivered by health and care professionals with broad clinical responsibilities who provide primary, ongoing care;and have established relationships with the person and their care community.2 This is distinct from specialist palliative care services which support complex needs through multidisciplinary teams with specialised palliative care training. FINDINGS AND DISCUSSION Thematic analysis identified the following overarching themes: 1) targeted education increased staff knowledge and confidence, but more is needed;2) collaborative teamwork with effective communication and information sharing underpins a successful generalist-specialist partnership;3) the home care setting is unique and requires accessible systems and processes.

The impact of perceived organizational support on professional commitment: a moderation of burnout and mediation of well-being

PurposeIn today's challenging world, achieving professional commitment among healthcare workers is becoming the need of time. Drawing on self-determination theory, the current study examines how and under which boundary conditions perceived organizational support affects professional commitment.Design/methodology/approachData was collected from doctors and nurses employed in public and private sector hospitals by employing a split-questionnaire design.FindingsThe authors' study findings demonstrate that perceived organizational support has a positive and indirect effect on the professional commitment of nurses and doctors via mediating the role of subjective well-being. The authors also found that these findings depend on healthcare workers' burnout levels. The positive relationship between perceived organizational support and subjective well-being is attenuated by burnout syndrome.Practical implicationsThe current study poses implications for policymakers and administrators of healthcare institutions as well as to develop a supportive culture to evoke more professional commitment among healthcare workers. Implications for nursing managers and policymakers are discussed in light of the study findings.Originality/valueHealthcare institutions are increasingly paying attention to raising the professional commitment of their workforce, especially in the wake of a crisis like the COVID-19 outbreak. The current study will add to the body of literature on nursing management, healthcare studies and organizational psychology in the South Asian context by explaining the relationship between POS and professional commitment, drawing on self-determination theory.

BMA threatens legal action over coroner's advice over death verification

If a suitable response isn't received in good time, the BMA said it will consider legal action in the form of a judicial review. Mark Sanford-Wood, deputy chair of the BMA's GP committee, said, "For years, GPs and their local coroners have worked together to ensure a sensible and sensitive approach to certifying deaths. [...]it's incredibly disappointing to see coroners during this pandemic taking it upon themselves to put themselves ahead of the law, making unrealistic and unsafe demands.” Covid-19: death certification and cremation. www.bma.org.uk/advice-and-support/covid-19/adapting-to-covid/covid-19-death-certification-and-cremation. 2 NHS England NHS Improvement.

How Pharmaceutical Innovation Is Saving the World

Before New Year's Day, mil-ions of Americans had received the vaccine, including front-line physicians, health care providers, and nursing home patients, our most vulnerable citizens. David Pride, MD, a microbiologist at the University of California San Diego, estimates that vaccines typically take 10-15 years to develop. [...]the COVID-19 pandemic, the fastest development timeline was four years, for the mumps vaccine. * Many government systems moved quickly to lessen the burden of onerous regulations, and provide funding so that vaccines could be developed quickly, but with still rigorous standards. After health care workers and our most vulnerable citizens, other frontline workers will be next.

The Relevance of Statistical Knowledge for Teaching to Health Care Professionals: Reflections on a COVID-19 Press Briefing

Statistics is an important component of the knowledge base for health care professionals. In this essay, it is argued that statistical knowledge for teaching (SKT) should be considered an important component of their preparation as well. Health care professionals often must help others understand the statistical basis for recommendations they make. A COVID-19 press briefing is used to illustrate the need for SKT when making high-stakes recommendations related to public health. It is conjectured that efforts to educate the public during the press briefing would have been enhanced if the presenters had deeper knowledge of the general public's common statistical thinking patterns, the typical statistics curriculum experienced by members of their audience, and contemporary tools for teaching statistics. The importance of such knowledge to support smaller-scale individual interactions is also discussed. A call for SKT-centered partnerships between educational researchers and medical researchers is made;such partnerships could be mutually beneficial to the development of both fields and to society at large.