Evaluating emergency service response to COVID-19: A scoping review.

INTRODUCTION: The issue of how emergency services (police, fire, ambulance, local authorities) respond to pandemics has received greater research focus recently in relation to the COVID-19 outbreak, which saw agencies going beyond usual roles to support communities for prolonged periods. A critical appraisal is needed of this published evidence to take stock of what is known about the effectiveness of emergency service response to Covid-19. METHOD: A scoping review of scientific and grey literature identified 17 qualitative (N = 9), quantitative (N = 6), or mixed methods (N = 2) studies from across the UK and internationally that focus on the effectiveness of emergency service response to the Covid-19 outbreak. A narrative review was conducted using an interpretive approach. Papers were read, summarised, and then sorted into inductive themes that addressed some aspect of the review question. Eight critical themes emerged from the narrative review. RESULTS: Across countries, emergency services were required to quickly adapt working practices to reduce spread of infection, support partner agencies facing unprecedented demands, and make effective use of limited resources. Use of technology, access to timely, accurate and relevant information, strong leadership, prior experience, and emergency training were critical to this. However, most research is descriptive rather than evaluative. CONCLUSIONS: Overall, findings highlight the need for further research that examines what mechanisms facilitate and hinder emergency response to pandemics. This scoping review provides a knowledge framework for informing future research that can support emergency services in preparing for events of national and international significance.

Occupational therapists' experiences of career progression following promotion.

BACKGROUND/AIM: The recruitment and retention of a skilled occupational therapy workforce is highlighted as a key issue for the profession, and yet there have been relatively few studies into the career progression of occupational therapists. METHODS: A qualitative, naturalistic approach was adopted to answer the research question, using semi-structured interviews to gather data. Eleven purposefully selected participants at an Australian health service were interviewed as part of this study. Categories representing the most common themes and topics supplied by participants within their individual interviews were identified and consolidated by the research team. The trustworthiness of this study was supported by strategies to maximise its credibility, dependability and confirmability. RESULTS: Four main themes were elicited from the data - (i) Readiness for progression, (ii) Tools and processes, (iii) Expectations and (iv) What I wish I had known first. Within these themes, related findings were also identified by both Grade 2 and Grade 3 staff. CONCLUSIONS: This study indicates that the readiness of occupational therapists to climb the career ladder is influenced by the tools and processes they can utilise, and the expectations they have around the realities of their new position. With hindsight, participants highlighted some things they wish they had known at the time of transition, which appeared to have been implicit. SIGNIFICANCE OF STUDY: This study is the first to address the common issues for occupational therapy staff around progression between grade levels. It therefore provides a basis for further research in other practice settings and for the development of supports for therapists climbing the career ladder.

Estimating the economic burden attributable to online only child sexual abuse offenders: implications for police strategy.

Evidence is beginning to emerge of the serious negative effects online only child sexual abuse (OOCSA) can have on victims. Establishing the scale and nature of the problem could assist police in prioritizing suspects. In study 1, scoping review identified eleven studies that examined OOCSA's impact on victims. Five themes emerged from narrative review; definitional issues, a new normal, OOCSA grooming processes, comparisons with offline CSA, mechanisms between OOCSA and harm. In study 2, OOCSA national prevalence was estimated by applying 2.9% rate of OOCSA observed from original police data to a lower bound ("sexual communication with a child" crimes recorded by the police), middle (scaling up to estimate undetected offenses) and upper bound estimate of the national offender pool (self-reported sexual solicitation offenders). Recent UK Home Office figures were adapted to establish economic costs. Lifetime costs estimates attributable to OOCSA are £7.4 million (police reports), £59.6 million (including undetected offenders) and £1.4 billion (national prevalence estimates). Over 75% of this is non-financial costs borne by victims in terms of emotional harm and lost output. Government bears around 20% of the cost burden, mostly non-financial costs for police forces. Findings are discussed in relation to evidence-led recommendations for prioritization and wider police actions that can be taken to avoid the considerable economic and social burden associated with OOCSA offenses.

Hazardous, harmful, and dependent alcohol use in healthcare professionals: a systematic review and meta-analysis.

Background: Healthcare professionals work in high-pressured and demanding environments, which has been linked to the use of alcohol as a coping strategy. This international review aimed (i) to determine the pooled prevalence of hazardous, harmful, dependent, and frequent binge drinking in healthcare professionals, and (ii) to explore factors associated with variation in these outcomes. Methods: Scopus, MEDLINE, and PsycINFO were searched from 2003 to 17th November 2022, for studies reporting a prevalence estimate for any outcome among healthcare professionals. Random-effects meta-analyses determined pooled prevalence estimates. Sub-group analyses were conducted, stratifying the meta-analyses by pandemic period vs pre-pandemic period. Meta-regressions explored factors that were associated with variation in the outcomes. PROSPERO (CRD42020173119). Results: After screening 9,108 records, 64 studies were identified as eligible. The pooled prevalence was 19.98% [95% Confidence Intervals [CI]: 16.05-24.23%] for hazardous alcohol use (K = 52), 3.17% [95% CI: 0.95-6.58%] for harmful drinking (K = 8), 14.59% [95% CI: 7.16-25.05%] for dependent drinking (K = 7), and 17.71% [95% CI: 8.34-29.63%] for frequent binge drinking (K = 11). The prevalence of hazardous drinking was greater during the pandemic (28.19%) compared with pre-pandemic estimates (17.95%), though this was not statistically significant (p = 0.049). Studies including all hospital staff (32.04%) showed higher prevalence estimates for hazardous drinking compared with studies of doctors (16.78%) and nurses (27.02%). Conclusion: Approximately one fifth of healthcare professionals drink to hazardous levels, with higher prevalence estimates observed during the COVID-19 pandemic. It may be that healthcare professionals used alcohol to cope with the additional trauma and stressors. Further research is needed to investigate whether this is sustained in the post-pandemic period.

"Dare to Share": Improving Information Sharing and Risk Assessment in Multiteam Systems Managing Offender Probation.

Managing offenders released from prison requires a multiteam system (MTS) approach, with teams from across police, probation, and other criminal justice agencies. However, public inquiries highlight current approaches are impaired by poor information sharing that compromises risk assessment and recall decisions, which can allow serious further offences to occur. Little research has focused on the causes of these information sharing difficulties. The current study draws on the perspectives and experiences of probation and police officers to improve understanding of causes of information sharing difficulties. The research is conducted within the context of a new enhanced information sharing 'Direct Access' initiative implemented in one region of the UK (Devon and Cornwall) that permits probation to directly access police information technology systems. This provides a novel opportunity to cross validate MTS theory to the real-world context of offender management and considers what works in practise to overcome information sharing challenges. Eleven semi-structured interviews were conducted with police (N = 4) and probation (N = 7) officers. Thematic analysis revealed six themes: i) information sharing difficulties and impact; ii) causes of information sharing difficulties; iii) impact of 'Direct Access' on information sharing practices; iv) workload inequality; v) training; and vi) evolution of 'Direct Access'. Overall, findings highlight that information sharing difficulties are causes by not knowing what information to request or share, limited resources, lack of clarity about General Data Protection Regulation and concern about consequences of breaching this. These barriers can result in delays and failures to share information, which hinders the accuracy of risk assessments and ability to safeguard. Findings also highlight that providing statutory partners with 'Direct Access' to I.T systems can improve the relevance and timeliness of information. However, 'daring to share' is not enough to address trust issues without also clarifying expectations regarding information use and perceived workload inequalities.

Rapid Evidence Assessment of Mental Health Outcomes of Pandemics for Health Care Workers: Implications for the Covid-19 Pandemic.

Background: Little is known about the long-term mental health (MH) impact of the Covid-19 pandemic on health care workers (HCWs). However, synthesizing knowledge from past pandemics can help to anticipate this, along with identifying interventions required, when, and target populations most in need. This paper provides a balanced evaluation of what is currently known about short- and long-term MH impacts of pandemics on HCWs and effect of methodological limitations on knowledge claims. Method: A rapid evidence assessment (REA) was conducted on 41 studies published in the past two decades that examined MH outcomes for HCWs in relation to pandemics. Results: Findings of literary synthesis highlight common MH outcomes across pandemics, including increased stress, distress, burnout, and anxiety in the short-term, and post-traumatic stress and depression in the long-term. Findings also show the key role that organizations and public health bodies play in promoting adaptive coping and reducing health worries and the emotional and psychological distress caused by this. Evidence highlights particular groups at risk of developing MH issues (contact with patients that are infected, having children), and time points where risk may increase (initial response phase, when quarantined). However, inconsistencies in measures, analysis, and reporting all create limitations for pooling data. Conclusions: Findings can be used by researchers to provide a knowledge framework to inform future research that will assist HCWs in responding to pandemics, and by policy makers and service planners to provide an evidence-led brief about direction and evidence base for related policy initiatives, interventions or service programmes.

Prioritizing Indecent Image Offenders: A Systematic Review and Economic Approach to Understand the Benefits of Evidence-Based Policing Strategies.

In 2013, there were an estimated 50,000 individuals involved in downloading and sharing indecent images of children (IIOC) in the United Kingdom (UK). This poses challenges for limited police resources. We argue that police officers can make most effective use of limited resources by prioritizing those offenders who pose the greatest risk of contact offending, by nature of demonstrable pedophilia, hebephilia or dual offending status and thus, those at highest risk must be dealt with first. What is currently lacking is a clear idea of the potential scale of the problem in socio-economic terms and why, therefore, it is so important that evidence-based approaches to offender detection and investigation continue to be a top priority for funders and policy makers. A systematic literature review was undertaken to address two related questions. First, what is the scale of the problem in the UK, in terms of the number of pedophilic and hebephilic individuals who pose a risk of contact offending against a child? Second, what is the potential socio-economic burden generated by the national IIOC suspect pool if left unattended to by targeted police action? Applying population estimates of pedophilia and hebephilia to the male population (16-89 years), we estimate there are between 2,365-5,991 males with paedophila and 12,218-30,952 males with hebephilia who are likely contact offenders. Applying average prevalence and incidence based costing methods to a conservative estimate of one victim per offender, the combined socio-economic burden from these persons could amount to £236-£597 million (incident costs) increasing to £2.9-£7.3 billion (lifetime costs; £3.3-£8.3 billion including QALY measures). Applying the same costs to CEOP (2013) estimate of 50,000 IIOC offenders we estimate that between 6,000 and 27,500 dual offenders could have already committed past contact offenses, contributing an economic burden of between £97-£445 million (incident costs) increasing to £1.2-£5.4 billion (lifetime costs; £1.4-£6.2 billion including QALY measures). Future contact offenses could contribute a further burden of £16-£18.6 million (incident costs) increasing to £198-£227 million (lifetime costs; £226-£260 million including QALY measures). Drawing upon these findings, we argue for the benefits of a research-informed prioritization approach to target IIOC offenders.

An Economic Evaluation of the Impact of Using Rapport-Based Interviewing Approaches With Child Sexual Abuse Suspects.

Two studies examined whether rapport-based interviewing with child sexual abuse (CSA) suspects provides greater interview yield that could result in overall cost-savings to the investigation. First, multi-level modelling was applied to 35 naturalistic CSA suspect interviews to establish whether rapport-based interviewing techniques increase "yield" - defined as information of investigative value. The Observing Rapport Based Interviewing Technique (ORBIT coding manual was used to code interviews; it includes an assessment of both interpersonal adaptive and maladaptive rapport-based interviewer engagement as well as motivational interviewing (MI) strategies. The impact of these two strands (interpersonal and MI) on extracting information of investigative value (including strengthening a case for court and safeguarding) were examined. Adaptive interpersonal strategies increased case strengthening and safeguarding yield, with motivational interviewing having the largest impact on safeguarding yield. Both strategies increase the likelihood of gaining additional types of economic yield. Maladaptive interviewer strategies reduced case strengthening and different types of economic yield. In study two, literature-based economic estimates were applied to establish the potential cost benefits from following national ORBIT rapport training. Further training in adaptive and motivational interviewing could contribute cost savings between £19 and £78 million (annual unit costs) increasing to £238-£972 million (lifetime costs) for online CSA across England and Wales; and £157-£639 million (annual unit costs) increasing to £2-£8 billion (lifetime costs) for all CSA. Failure to commit training resource to this, or an alternative strategy, could mean the cost burden attributable to maladaptive interviewing (between £1 and £6 million for online CSA and £12 and £48 million for all CSA) is not successfully averted.

Building Bridges: Describing a Process for Indigenous Engagement in Epidemiology.

BACKGROUND: Processes for epidemiology embedded with Indigenous methodology are needed. Building Bridges was developed to engage Indigenous peoples in epidemiology to address health issues relevant to them. OBJECTIVES: We describe our process for meaningfully engaging Indigenous leaders and peoples living with human immunodeficiency virus (HIV) in epidemiology research. METHODS: As a community-based research (CBR) project, Indigenous methodologies and leadership ensured the quality and relevance of findings. Study phases included 1) advisory board formation, 2) recruitment, 3) research question identification, 4) data analysis from the Canadian HIV Observational Cohort (CANOC) collaboration, 5) data interpretation and contextualization, and 6) knowledge translation and exchange. LESSONS LEARNED: Support and guidance from Indigenous team members, Spiritual Leaders and Elders along with meaningful relationships with allied academic researchers were pivotal. Expertise and lived experiences in Indigenous culture, HIV, epidemiology and services enabled multidirectional learning. CONCLUSIONS: Building Bridges' success hinged on ongoing co-learning and engagement of Indigenous peoples, service providers and researchers.

Development of the Translating Allied Health Knowledge (TAHK) Framework.

BACKGROUND: While evidence-based practice is a familiar concept to allied health clinicians, knowledge translation (KT) is less well known and understood. The need for a framework that enables allied health clinicians to access and engage with KT was identified. The aim of this paper is to describe the development of the Translating Allied Health Knowledge (TAHK) Framework. METHODS: An iterative and collaborative process involving clinician and academic knowledge partners was utilised to develop the TAHK Framework. Multiple methods were utilised during this process, including a systematic literature review, steering committee consultation, mixed methods survey, benchmarking and measurement property analysis. RESULTS: The TAHK Framework has now been finalised, and is described in detail. The framework is structured around four domains - Doing Knowledge Translation, Social Capital for Knowledge Translation, Sustaining Knowledge Translation and Inclusive Knowledge Translation - under which 14 factors known to influence allied health KT are classified. The formulation of the framework to date has laid a rigorous foundation for further developments, including clinician support and outcome measurement. CONCLUSION: The method of development adopted for the TAHK Framework has ensured it is both evidence and practice based, and further amendments and modifications are anticipated as new knowledge becomes available. The Framework will enable allied health clinicians to build on their existing capacities for KT, and approach this complex process in a rigorous and systematic manner. The TAHK Framework offers a unique focus on how knowledge is translated by allied health clinicians in multidisciplinary settings.

Female Sex Offenders: An Analysis of Crime Scene Behaviors.

The concept of the female sex offender (FSO) is a relatively new phenomenon within the social research literature. Studies of female rape, male rape, pedophilia, and juvenile sex offenders have suggested that different styles of offending are reflected in the different types of behaviors committed by offenders at the crime scene. These studies suggest that there are three distinct themes of behavior: Hostility, Impersonal, and Involvement. Multidimensional analysis is carried out on 35 crime scene behaviors of 73 FSOs from U.K. and U.S. law reports. The proposed framework was found to be a useful way of classifying FSOs with 84% displaying a dominant theme. These resulted in 52% classified as displaying Involvement, 17% as Control, and 15% as Hostility. Finally, the implications and suggestions for future research are discussed.

Improving the transport of urgent specimens to an off-site laboratory using a novel sticker-tracker.

Obtaining results for urgent microbiology specimens in an efficient manner is imperative to ensure that patients receive appropriate antibiotic therapy. A previous audit carried out in the Paediatric department of a central teaching hospital and a number of clinical incidents, highlighted a delay in transport of specimens (exceeding eight hours) and 'missing' specimens. This results in empirical antibiotic treatment of infection, with delay in confirming microbiology result and unnecessary, distressing repeat investigation. As an initial step we sought staff opinion to further explore the problem. A sticker was designed for the microbiology specimen bag to assign accountability, track each step in the transport process and to raise awareness of the problem. The sticker required the member of staff responsible at each stage of the process to time, date and sign it, to allow tracking of potential delays. The new sticker tracking system was promoted and launched in the Paediatric department. Initial challenges included lack of awareness of the protocol and lack of pods for sending urgent specimens. The team met regularly and completed stickers were analysed weekly to identify on-going issues and to devise solutions. Consequently total transport time was reduced to an average of 69 minutes by September (within four hr target). Our intervention improved the efficiency and reliability of urgent specimen transport. This is likely to result in safer antibiotic use and avoid the need for repeat investigation. The system is now also used in the Neonatal department and has lead to the development of a new 'Central Specimens Reception'.