Hospital staff experiences of their relationships with adults who self-harm: a meta-synthesis

Purpose This review aimed to synthesize qualitative literature exploring inpatient hospital staff experiences of their relationships with people who self-harm. Methods Nine studies were identified from a systematic search of five research databases. Papers included the experiences of physical health and mental health staff working in inpatient settings. The studies employed various qualitative research methods and were appraised using an adapted quality assessment tool (Tong, Sainsbury, & Craig, 2007). A meta-synthesis was conducted using traditional qualitative analysis methods including coding and categorizing data into themes. Results Three main themes derived from the data. ‘The impact of the system’ influenced the extent to which staff were ‘Fearing the harm from self-harm’, or were ‘Working alongside the whole person’. A fear-based relationship occurred across mental health and physical health settings despite differences in training; however, ‘Working alongside the whole person’ primarily emerged from mental health staff experiences. Systemic factors provided either an inhibitory or facilitative influence on the relational process. Conclusions Staff experiences of their relationship with people who self-harm were highlighted to have an important impact on the delivery and outcome of care. Increasing support for staff with a focus on distress tolerance, managing relational issues, and developing self-awareness within the relationship may lead to a more mutually beneficial experience of care. Equally, structure, clarity, and support within inpatient systems may empower staff to feel more confident in utilizing their existing skills. Practitioner points •Working with people who self-harm can be emotionally challenging and how staff cope with this can significantly impact on the engagement of staff and patients. •Increasing the skills of staff in managing relational issues and tolerating distress, as well as providing support and reflective practice groups may be useful in managing emotional responses to working with people who self-harm. •Refining the supportive, procedural, and environmental structures surrounding the caregiving relationship may help enable better integration of physical and mental health care

Climate change and disaster impact reduction

Based on papers presented at the 'UK - South Asia Young Scientists and Practitioners Seminar on Climate Change and Disaster Impact Reduction' held at Kathmandu, Nepal on 5-6 June, 2008

International Society for Disease Surveillance Conference 2011: Building the Future of Public Health Surveillance: Building the Future of Public Health Surveillance

Daniel Reidpath - ORCID: 0000-0002-8796-0420 https://orcid.org/0000-0002-8796-04204pubpub1117

Biothreat and policy pathways: influences upon current bioterrorism policies in the UK

The threat of terrorism, and in particular the threat of terrorists using biological weapons, has grown since the early 1990s, over the decade the assessment and perception of threat escalated despite an absence of biological weapons use. This research explores policy responses to the threat from bioterrorism in the UK between 1990 and 2005. A case study approach is used to examine the emergence and rise of the bioterrorism threat, and the institutional arrangement in place to confront that threat. The dissertation further investigates the construction of the threat narrative. The policy area of bioterrorism is obscured by secrecy. Therefore, this dissertation looks towards policy responses to pandemic influenza, and uses responses to pandemic influenza as a heuristic device to illustrate the difficulties of risk assessment and the accompanying institutional complexity. The study posits that traditional, academic risk assessment methodologies do not appear to have as large an influence as the narratives. Furthermore, the prevailing conceptualisation of the bioterrorism threat is the product of the confluence of three threat narratives. These narratives have become entangled and subsequently embedded in the institutional response. Moreover, a number of events have influenced and shaped the threat narrative of bioterrorism. First, a change in perception (sarin, 1995); then a jolt to the political and institutional structures (September 11, 2001); and finally, further bombings and plots have augmented the threat narrative (Madrid & London). This study is positioned at the intersection of policy studies and risk assessment, contributing to an understanding of the formation of institutional threat perception

Proposal for a standard course for senior personnel involved in the carriage of dangerous goods in packaged form

The International Maritime Organization, IMO, is the specialized agency of the United Nations for the marine mode of transport. IMO has a wide range of activities concerning the safety of life at sea, among them is the transport of dangerous goods in packaged form. The organization has issued regulations, recommendations and codes of safe practices in order to ensure the safety of life at sea and protection of the marine environment. These rules are divided into technical requirements and statutes. IMO has recognized that maritime training and education is the backbone for improving safety. As a result of this, Annex-2 of Resolution A.537(13) was adopted on November 17, 1983 (Recommendation on Training of Officers and Ratings Responsible for Cargo Handling on Ships Carrying Dangerous Goods and Hazardous Substances in Packaged Form). The introduction of Resolution A.537(13) is a positive step to reduce the risks and to increase the safety in the transport of dangerous goods. The senior personnel involved in the transport of dangerous goods in packaged form are the decision-makers and they are responsible for the performance of their employee. It is necessary that the interface between the various sectors of the industry should be clearly defined so that all senior personnel will understand the duties and the responsibilities of the other sectors. Additional training and education will improve their ability and increase their knowledge. The objective of this thesis was to make proposal for a standard course for senior personnel involved in the transport of dangerous goods by the marine mode