Impact of the design of adult mental health inpatient facilities on healthcare staff: a mixed methods systematic review.

OBJECTIVES: Mental health inpatient facilities are increasingly focusing on creating therapeutic, person-centred care environments. However, research shows that this focus may have unintended consequences for healthcare staff. Designs that do not pay attention to staff needs may risk contributing to stress, burnout, job dissatisfaction and mental exhaustion in the work environment. This systematic review aims to identify and synthesise current research on the design factors of adult mental health inpatient facilities that impact healthcare staff. DESIGN: A mixed method systematic review was conducted to search for empirical, peer-reviewed studies using the databases CINAHL, Embase, PsycINFO, PubMed and Web of Science from their inception up to 5 September 2023. The Joanna Briggs Institute's critical appraisal checklists were used to assess the methodological quality of the eligible studies. Data were extracted and grouped based on the facility design factors. RESULTS: In our review, we included 29 peer-reviewed empirical studies that identified crucial design factors impacting healthcare staff in adult mental health inpatient facilities. Key factors included layouts providing optimal visibility, designated work and respite areas, and centrally located nursing stations. Notably, mixed perceptions regarding the benefits and challenges of open and glass-enclosed nursing stations suggest areas requiring further research. Facilities in geographically remote locations also emerged as a factor influencing staff dynamics. Additionally, although only supported by a limited number of studies, the significance of artwork, sensory rooms for respite, appropriate furniture and equipment, and access to alarms was acknowledged as contributory factors. CONCLUSION: Through the synthesis of existing research, this review identified that the design of mental health facilities significantly impacts staff well-being, satisfaction, performance and perception of safety. Concluding that, in order to create a well-designed therapeutic environment, it is essential to account for both service users and staff user needs. PROSPERO REGISTRATION NUMBER: CRD42022368155.

Partner notification service utilization and associated factors among clients attending anti-retroviral therapy clinics of public health facilities in Gimbi Town, West Ethiopia, 2023: a facility-based mixed-method cross-sectional study.

BACKGROUND: Partner Notification Service is among the strategies used to conduct targeted Human Immunodeficiency Virus Testing Service by obtaining information about sexual contacts of index clients to refer for testing. But most people living with Human Immunodeficiency Virus are still unaware of their status, including Ethiopia. Limited studies are available on the magnitude of partner notification service utilization and associated factors in Ethiopia. OBJECTIVE: The aim of this study was to assess the magnitude of partner notification service utilization and associated factors among people living with Human Immunodeficiency Virus attending anti-retroviral therapy clinics of public health facilities in Gimbi town, West Ethiopia. METHODS: A facility-based mixed-method cross-sectional study design was used. Total of 455 study participants were selected by systematic random sampling for quantitative data and health workers were purposively selected for qualitative data until saturation of ideas was reached. The study was conducted from December 1, 2022 to January 30, 2023. Structured questionnaires and key informant interview guides were used for data collection. Quantitative data were analyzed using Statistical Package for Social Science version 25. Open code 4.02 software was used for qualitative data analysis. Frequencies and proportions were used to summarize descriptive statistics. Bivariable and multivariable logistic regression was used to identify associated factors then variables with a p value < 0.05 were declared to have an association with the dependent variable. RESULT: Exactly 298 (65.5%) of the study participants were notified their HIV status to their sexual partners. Factors associated with Partner Notification Service Utilization were depression AOR: 0.12 (95% CI: 0.07, 0.20), urban settlers AOR: 2.21 (95% CI: 1.2, 3.83), fear of support loss AOR: 0.24 (95% CI: 0.14, 0.40) and intimate partner violence AOR: 0.55 (95% CI: 0.31, 0.97). From qualitative part of this study, factors associated to Partner Notification service utilization were fear of stigma, discrimination and fear of divorce. CONCLUSION: Two-third of the study participants were utilized partner notification service, and efforts are important to prevent depression and intimate partner violence. Local government bodies and stakeholders should implement economic strengthening and strategies to address the rural community for HIV/AIDS prevention. Promotion of supportive and inclusive environment for PLHIV should also considered as way to increase PNS utilization.

Hazard Assessment and Remediation Tool for Simulation-Based Healthcare Facility Design Testing.

OBJECTIVES: To develop an objective, structured observational tool to enable identification and measurement of hazards in the built environment when applied to audiovisual recordings of simulations by trained raters. BACKGROUND: Simulation-based facility design testing is increasingly used to optimize safety of healthcare environments, often relying on participant debriefing or direct observation by human factors experts. METHODS: Hazard categories were defined through participant debriefing and detailed review of pediatric intensive care unit in situ simulation videos. Categories were refined and operational definitions developed through iterative coding and review. Hazard detection was optimized through the use of structured coding protocols and optimized camera angles. RESULTS: Six hazard categories were defined: (1) slip/trip/fall/injury risk, impaired access to (2) patient or (3) equipment, (4) obstructed path, (5) poor visibility, and (6) infection risk. Analysis of paired and individual coding demonstrated strong overall reliability (0.89 and 0.85, Gwet's AC1). Reliability coefficients for each hazard category were >0.8 for all except obstructed path (0.76) for paired raters. Among individual raters, reliability coefficients were >0.8, except for slip/trip/fall/injury risk (0.68) and impaired access to equipment (0.77). CONCLUSIONS: Hazard Assessment and Remediation Tool (HART) provides a framework to identify and quantify hazards in the built environment. The tool is highly reliable when applied to direct video review of simulations by either paired raters or trained single clinical raters. Subsequent work will (1) assess the tool's ability to discriminate between rooms with different physical attributes, (2) develop strategies to apply HART to improve facility design, and (3) assess transferability to non-ICU acute care environments.

Identifying Built Environment Risk Factors to Provider Workflow and Patient Safety Using Simulation-Based Evaluation of a Pediatric ICU Room.

OBJECTIVE: This study aimed to identify latent conditions in a pediatric intensive care unit (PICU) by analyzing characteristics of flow disruptions (FD) during a simulation of a three-phased scenario. BACKGROUND: The built environment of healthcare facilities contributes to FD that can lead to clinical errors and patient harm. In the facility design process, there is an opportunity to identify built environment features that cause FD and pose safety risks. Simulation-based evaluation of proposed designs may help in identifying and mitigating safety concerns before construction and occupancy. METHODOLOGY: During design development for a new 400-bed children's hospital, a series of simulations were conducted using physical mock-ups in a large warehouse. A three-phased scenario, (1) admission and intubation, (2) cardiac arrest, and (3) bedside surgery involving a cannulation to extracorporeal membrane oxygenation, was conducted in a PICU room mock-up. Each scenario was video recorded from four angles. The videos were systematically coded to identify FD. RESULTS: Analysis identified FDs in three ICU zones: respiratory therapists (RT) zone, nurse zone, and head of the patient. Challenges in these zones were related to spatial constraints in the RT zone and head of the bed, equipment positioning in the RT zone and nurse zone, and impeded visibility related to the location of the boom monitor in the nurse zone. CONCLUSION: Simulation-based evaluation of prototypes of patient care spaces can help identify characteristics of minor and major FD related to the built environment and can provide valuable information to inform the iterative design process.

[The facility design and operation effect of control vehicle emissions hazard in test section of automobile assembly workshop].

The hazard of vehicle emissions mainly come from the four wheel positioning, drum test and vehicle emissions test sections in automobile assembly workshop, which can lead to abnormal hemoglobin and hepatic insufficiency in workers. We researched on preventing toxic gases technologies for the vehicle emissions generated by these three sections, designed the ventilation facilities, and then detected and evaluated the operation effect, thereby improving the working environment, ensuring the occupational health of workers, and providing scientific basis for the control of vehicle emissions hazards.

Evaluating the effectiveness of spontaneous vegetation for stormwater mitigation on green roofs.

Green roofs can reduce stormwater runoff in urban areas by capturing rainfall. The extent of this capture is partially influenced by vegetation type and cover, which can be manipulated to optimise run-off reduction. However, in the absence of routine maintenance, planted green roof vegetation is often replaced by 'weedy' spontaneous species with unknown rainfall retention qualities. To better understand the role of spontaneous vegetation in green roof stormwater mitigation, we undertook a 100-day rainfall simulation involving 14 plant species that occur spontaneously on green roofs in Mediterranean-type climates. Green roof modules were filled with either 7 cm (shallow) or 14 cm (deep) substrate. The substrate was either left bare or sown with the spontaneous species community, which established approximately 100 % cover prior to the beginning of the rainfall simulation. During the simulation, modules were subjected to a "dry" and then a "wet" rainfall phase, each based on historical climate records from Melbourne, Australia. The "dry" treatment replicated the timing and depth of the driest rainfall period on record, while the "wet" treatment applied rainfall depths randomly selected from the 90th, 95th, and 99th percentiles of recorded rainfall. Rainfall retention, evapotranspiration, time to initiation of runoff and soil water content was measured for 17 rainfall events. Spontaneous vegetation cover and both species and functional diversity were measured at the end of each rainfall phase, and biomass was measured at the end of the wet phase. During the dry phase, modules with spontaneous vegetation cover retained 88 % of applied rainfall regardless of substrate depth and had 6 % greater retention than bare substrate. During the wet phase, deep substrate modules with spontaneous vegetation cover had 30 % greater retention than other treatment combinations. At the end of the wet phase, spontaneous vegetation in deep substrate had 42 % greater biomass, 19 % greater coverage and more than twofold greater functional richness than in shallow substrate. These findings demonstrate that spontaneous vegetation can increase stormwater retention on green roofs relative to bare substrate and have similar retention performance to commonly utilised species. However, the extent to which stormwater mitigation on green roofs is enhanced by spontaneous vegetation is dependent on factors that are more important for rainfall retention, such as substrate depth and rainfall patterns.

Facility design and worker justice: COVID-19 transmission in meatpacking plants.

BACKGROUND: Meatpacking plants were major sources of COVID-19 outbreaks, posing unprecedented risks to employees, family members, and local communities. The effect on food availability during outbreaks was immediate and staggering: within 2 months, the price of beef increased by almost 7% with documented evidence of significant meat shortages. Meatpacking plant designs, in general, optimize on production; this design approach constrains the ability to enhance worker respiratory protection without reducing output. METHODS: Using agent-based modeling, we simulate the spread of COVID-19 within a typical meatpacking plant design under varying levels of mitigation measures, including combinations of social distancing and masking interventions. RESULTS: Simulations show an average infection rate of close to 99% with no mitigation, 99% with the policies that US companies ultimately adopted, 81% infected with the combination of surgical masks and distancing policies, and 71% infected with N95 masks and distancing. Estimated infection rates were high, reflecting the duration and exertion of the processing activities and lack of fresh airflow in an enclosed space. CONCLUSION: Our results are consistent with anecdotal findings in a recent congressional report, and are much higher than US industry has reported. Our results suggest current processing plant designs made rapid transmission of the virus during the pandemic's early days almost inevitable, and implemented worker protections during COVID-19 did not significantly affect the spread of the virus. We argue current federal policies and regulations are insufficient to ensure the health and safety of workers, creating a justice issue, and jeopardizing food availability in a future pandemic.

Understanding Post-occupancy Evaluation Processes for Public Healthcare Facilities in Australia and Aotearoa New Zealand.

OBJECTIVE: The following research paper seeks to explore how post-occupancy evaluations (POEs) are undertaken in the nine health jurisdictions across Australia and Aotearoa New Zealand and investigate if the process can be strengthened to better inform healthcare design and investment. BACKGROUND: Healthcare expenditure in both nations is increasing, and the rigorous evaluation of healthcare facilities can provide evidence to improve their return on investment. A POE is a research method used to undertake this analysis, usually 12 months after a facility has been occupied. There is limited information available about how POEs are undertaken in each jurisdiction, and there has never been research conducted to understand these processes across the region. METHODS: Focus groups were conducted with participants from the government health organization in each jurisdiction to collect qualitative data regarding various aspects of POE processes and barriers to undertaking POEs. RESULTS: Only five of the nine jurisdictions undertake POEs on healthcare facilities (with varied frequencies), and there is no standardized framework in use. However, every jurisdiction does undertake a "benefits realization" process. There is limited involvement of external consultants in POEs or benefits realization processes. POE benchmarks should be established at project commencement, and POE results should then inform future projects. Top-down support is required for POEs to occur. CONCLUSIONS: The primary conclusion is that strengthening any evaluation process requires a nuanced approach in each jurisdiction to account for their unique context and challenges. Regular rigorous evaluations are required to feed results into the Australasian Health Facility Guidelines and encourage innovative facility design.

Cervical cancer screening utilization and associated factors among female health workers in public health facilities of Hossana town, southern Ethiopia: A mixed method approach.

BACKGROUNDS: Worldwide, a substantial proportion of women have low cervical cancer screening services utilization. There is a paucity of evidence in utilization of cervical cancer screening services among female health workers and inconsistent findings in Ethiopia. This study aimed to assess the utilization of cervical cancer screening services and associated factors among female health workers in public health facilities of Hossana town, Southern Ethiopia. METHODS: Facility-based cross-sectional study design complemented with the qualitative inquiry was conducted among randomly selected 241 study participants in Hossana town from June 1 to July 1, 2021. Logistic regression models were used to determine the association between dependent and independent variables with the assumption of a variable with a p-value < 0.05 was considered statistically significant. Qualitative data were transcribed verbatim then translated to English and analyzed using open code version 4.03. RESULTS: Out of the total study participants, 19.6% was screened for cervical cancer. Having a diploma level of education (AOR = 0.48;95%CI:0.24,0.98), having three or more children (AOR = 3.65;95%CI:1.44,9.21), having multiple sexual partners(AOR = 3.89;95%CI: 1.38,11.01), and knowledge of cervical cancer screening (AOR = 2.66;95% CI:1.19,5.95) were statistically significantly associated with cervical cancer screening utilization. In-depth interviews suggested additional barriers for low screening utilization including lack of health educational materials, limitation of service to a specific area, service interruption, provider incompetency, and miss-trust and lack of attention by a trained provider. CONCLUSION: Utilization of cervical cancer screening service among female health workers is low. Having a diploma level of education, having three or more children, a history of multiple sexual partners, and knowledge about cervical cancer were predictors of cervical cancer screening utilization. Contextualized health talks and promotion through training with a special focus on low level of knowledge, had lower educational level, and the availability of cervical cancer screening services are critical.

Multiple objective immune wolf colony algorithm for solving time-cost-quality trade-off problem.

The importance of the time-cost-quality trade-off problem in construction projects has been widely recognized. Its goal is to minimize time and cost and maximize quality. In this paper, the bonus-penalty mechanism is introduced to improve the traditional time-cost model, and considering the nonlinear relationship between quality and time, a nonlinear time-cost quality model is established. Meanwhile, in order to better solve the time-cost-quality trade-off problem, a multi-objective immune wolf colony optimization algorithm has been proposed. The hybrid method combines the fast convergence of the wolf colony algorithm and the excellent diversity of the immune algorithm to improve the accuracy of the wolf colony search process. Finally, a railway construction project is taken as an example to prove the effectiveness of the method.

Systematic Review of Literature on Speech Intelligibility and Classroom Acoustics in Elementary Schools.

PURPOSE: Good verbal signals and low background noise are key factors for all children to maximize understanding of what is being taught. Classroom shape, surroundings, and even furnishings change how the environment "sounds" and how speech is "heard" in the classroom. Classroom acoustics is perhaps one of the most important, but often least considered, factors when designing a classroom. This systematic review aimed to characterize the relationship between intelligibility of speech and room acoustics in elementary schools based on the available evidence. METHOD: Eligible studies were identified using two computerized databases: PubMed and Scopus. In total, 23 publications met our inclusion criteria: (a) Participants must have been from elementary schools, (b) acoustic characterization of the classroom must have been provided, (c) intelligibility tests must have been performed, and (d) articles were written in English. RESULTS: After identifying the parameters and tests used to quantify the intelligibility of speech, the speech intelligibility scores were analyzed in relation with acoustical parameters found in the articles, particularly signal-to-noise ratio and speech transmission index. Our results highlighted the negative effect on intelligibility associated with poor transmission of the speech and poor classroom acoustics caused by long reverberation times and high background noise. CONCLUSION: Good classroom acoustics is needed to improve speech intelligibility and, therefore, increase children's academic success.

The Role of Healthcare Facility Design on the Mental Health of Healthcare Professionals: A Literature Review.

OBJECTIVE: This study aims to review and synthesize the empirical evidence about the connection between healthcare facility design and the mental health of healthcare professionals by reviewing the relevant literature. BACKGROUND: Mental exhaustion of healthcare professionals is becoming a critical issue in healthcare, especially during the pandemic. The physical design of healthcare facilities has significant potential to reduce and prevent the mental exhaustion of healthcare professionals by removing environmental stressors and providing restorative experiences. However, the built environment is not fully utilized as an intervention to support healthcare professionals. METHODS: Relevant articles were identified from the Medline, PsycINFO, PubMed, and Web of Science databases using a combination of search terms representing environmental design factors and health outcomes. Identified articles were reviewed by their titles, abstracts, and full texts using the inclusion and exclusion criteria. RESULTS: The search yielded 27 empirical articles investigating the relationships between environmental design factors and staff mental health outcomes, including stress, fatigue, job satisfaction, burnout, and well-being. Healthcare design aspects that were investigated in the identified articles include overall facility and perception (e.g., aesthetic appeal and impression, belonging to the surroundings, safety), specific spaces (e.g., patient area, staff workspace), intangible elements (e.g., exterior view, light, sound), and interior space and ergonomics (e.g., material finishes, furniture). CONCLUSIONS: Through the synthesis of the current literature regarding the relationships between healthcare facility design and the mental health of healthcare professionals, this study provides implications for supporting healthcare professionals through the design of the healthcare facility.

Optimization strategies for conservation of traditional dwellings in Hongcun Village, China, based on decay phenomena analysis.

Hongcun traditional dwellings are representative of Huizhou architecture in China, with distinctive cultural and architectural characteristics in terms of layout, material, decoration and other features. Research on Hongcun traditional dwellings has been a matter of ongoing interest in academic circles in China, but there has been no specific focus on the phenomena of decay affecting these structures, even though research on this aspect has the most direct impact on the conservation of traditional dwellings. In this study, abundant and comprehensive fieldwork was carried out to investigate the building information, materials and especially preservation status of traditional dwellings. Furthermore, the decay phenomena of traditional dwellings were identified and described in detail in the Masonry Components and Wooden Components sections, which are based on the collected information and the relevant guidelines. Moreover, the restoration and actual conservation practices for traditional dwellings, which were specifically both government-led and private projects, were examined. In these analyses, the main problems related to the decay phenomena investigation and intervention are systematically summarized, and corresponding solutions are proposed to ensure that optimized conservation strategies are applied to traditional dwellings in Hongcun village.

Visual Sensor Image Deconstruction in Constructing Green Building Design Space Adjustment Construction Strategy.

Since the introduction of green design in China, the space adjustment of green building design has received great attention from architects. Because space adjustment is very important for the pre-construction of a green building, it also represents the effectiveness of the building after its operation. At the same time, the spatial adjustment of green buildings is also a professional level test for architects. In order to obtain more accurate information about various aspects of the building, it is not enough to rely on the naked eye or measuring tools. Because it is impossible to comprehensively inspect the entire building, and the data is too cluttered, it is inconvenient to carry out a one-step construction strategy. Therefore, this study proposes to use visual sensors to analyze the image of a building, so as to achieve the data effect that architects want and to achieve the best effect in space adjustment. In order to prove the applicability of visual sensors, this study takes the current situation of domestic green building projects as a case study and deeply explores the status of domestic green building projects under the current social background. Then, the method of the visual sensor is used to analyze the problem of building space adjustment, and experimental research on the performance of this technology is carried out. The results show that this technology is very suitable for the study of construction strategies for spatial adjustment. In building identification, the error of the algorithm in this study in the measurement range of 1 m to 2 m is obviously smaller than that of other methods, and the accuracy is basically kept within 1 cm. Therefore, in order to better develop the green design, we should focus on the application of visual sensors in this regard.

Analyzing the wastewater treatment facility location/network design problem via system dynamics: Antalya, Turkey case.

Wastewater treatment facility location selection and network design issues have become attractive topics in the field of wastewater management due to increasing human population, resource scarcity, environmental concerns, and rise of necessity for sustainable solutions for future policy designs. Especially in areas where the demand for wastewater treatment increases dramatically over the years because of reasons such as high migration levels, rapid industrialization, and tourism activities, the problem turns out to be more critical and dynamic. The existing studies try to deal with the issue through mathematical modeling approaches based on optimization perspectives, which require significant computational effort. In this study, an alternative approach based on system dynamics (SD) method is proposed to examine the complex dynamic and nonlinear structure of wastewater treatment facility location selection and network design problems. The proposed SD simulation model is designed for a densely populated industrial and tourism spot, the city of Antalya, located on the Mediterranean coast of Turkey. The model is capable of determining where and when to build a new wastewater treatment facility as well as generating the generic wastewater network structure to be built for the five districts situated in the city center based on cost issues for 2015-2040 period. In addition, the impacts of demand level changes for wastewater treatment due to population variations are analyzed via several scenarios to help decision makers to develop sustainable and cost-efficient management policies. Although SD is a frequently utilized approach in the water/wastewater management arena, to the best of our knowledge, this study is the first attempt to examine the complex and dynamic nature of wastewater treatment facility location selection and network design problems through SD approach.

[Analysis of the application of radiotherapy facility construction project evaluation standard in health management institutions].

Objective: To investigate the application of GBZ/T 220.2-2009 "The Specification of Radiological Protection Assessment for Occupational Hazard in Construction Project-Part 2: Radiotherapy Facility" in health management institutions, and to understand the scientificity, practicability and problems existing in the implementation of the standard. Methods: The method of multistage stratified sampling and questionnaire survey were used to collect the standard application status among 96 radiological health managers who had participated in the evaluation of radiotherapy facility construction projects in 6 provinces and cities from November 2020 to April 2021. A descriptive statistical analysis method was used to analyze the basic information of the survey object, the knowledge of the standard, the publicity and implementation of the standard. Results: The radiological health management personnel mainly came from health supervision agencies (62.5%, 60/96) , and 86.5% (83/96) were engaged in the pre-evaluation of radiotherapy device construction project and the approval and supervision of control effect evaluation. The awareness rate and training rate of radiological health managers on GBZ/T 220.2-2009 were 88.5% (85/96) and 31.3% (30/96) , respectively. 89.6% (86/96) managers thought it could meet the needs of radiotherapy facility construction project approval or supervision. 49.0% (47/96) of managers believed that the standard needed to be revised. Conclusion: The content of GBZ/T 220.2-2009 is basically scientific and reasonable, but the publicity, implementation and training of radiological health administrator still need to be strengthened. It is suggested to revise some clauses in the standard that do not meet the requirements.

University Library Space Renovation Based on the User Learning Experience in Two Wuhan Universities.

University library spaces play an important role in the learning experience of students. However, the traditional designs for these learning spaces no longer meet the needs of users, and researchers have been turning their attention to university library space renovation. By combing existing theories and practices, this study determined a framework of six university library space renovation design principles and subsequently conducted a survey to examine university library space user learning experience in two university libraries in Wuhan, China. Data analysis was conducted using SPSS. From the questionnaire-based survey results, this study determined seven design elements that affect the learning experience of university library users. The results of binary logistic regression showed that two elements, indoor physical space comfort and indoor acoustic environment comfort, have positive effects on the frequency and length of visits to the library. Key spatial elements that can promote library space users' learning experience were also identified, thus providing data that can reliably inform future design strategies for the space renovation of university libraries.

Relational security: The impact of facility design on youth custodial staffs' practices and approaches.

BACKGROUND: Constructive relationships between staff and young people in custody are a vital component of a therapeutic youth justice approach, which extends to the maintenance of a safe and secure environment (i.e., relational security). Despite the growing recognition that the physical environment of a facility impacts the procedures within a youth justice environment, as well as the relationships between staff and young people, there is a dearth of research in this area. AIMS: We investigated youth custodial staffs' views on, and approaches to, establishing relationships with young people while maintaining safety and security. The current study reports on the impacts and challenges highlighted by staff relating to the design of the facility. METHODS: We interviewed a total of 26 custodial staff members working at a Youth Justice facility in Melbourne, Australia. The semi-structured interviews were audio recorded and transcribed. NVivo 12 was used for thematic analysis. Two researchers (SO and PT) coded one transcript independently, iteratively creating a coding template using a thematic analysis approach. Once the final set of broad themes was constructed, the transcripts were re-examined, and narrower themes were identified. RESULTS: Thematic analysis revealed that a total of 14 staff (53.8%) identified the design of the custodial facility as impacting upon their ability to practice relational security. Identified design aspects included: unit size, quiet and private spaces, communal areas, green and outside spaces, ambience and spatial characteristics, spatial differentiation, facility and unit lay-out. CONCLUSION: Youth custodial staff identified design aspects of a youth custodial facility that either promoted or impeded the ability to practice relational security approaches. The current study highlights the importance of carefully considering facility design given its impact upon staff-young people relationships, procedures and ways of working within these custodial facilities.

Design and Husbandry Considerations for a Containment Level 2 Aquatic Facility.

The greatly increased use of aquatic species to study disease over the past 20 years necessitates understanding their husbandry and housing requirements to optimize research and welfare and to ensure compliance with regulations. To achieve these goals, aquatic systems have expanded from pet shop and home aquaria to research-grade systems incorporating designs and features to increase their robustness, practicality, and flexibility. Moreover, these last decades have seen the increasing use of aquatic animals for infectious disease research using containment level 2 (CL2)/biosafety level 2 pathogens. In this study, we discuss the facility design requirements and modifications, which must be considered for the planning, construction, and use of an aquatic facility for zebrafish infected with CL2 pathogens. These include decontamination of water and equipment, racking and filtration design, personal protective equipment, and husbandry procedures. This guidance is based on our experience in the design and ongoing management of such facilities.