The mental health of staff working on intensive care units over the COVID-19 winter surge of 2020 in England: a cross sectional survey.

BACKGROUND: The COVID-19 pandemic generated a surge of critically ill patients greater than the capacity of the UK National Health Service (NHS). There have been multiple well-documented impacts associated with the national COVID-19 pandemic surge on ICU staff, including an increased prevalence of mental health disorders on a scale potentially sufficient to impair high-quality care delivery. We investigated the prevalence of five mental health outcomes; explored demographic and professional predictors of poor mental health outcomes; and describe the prevalence of functional impairment; and explore demographic and professional predictors of functional impairment in ICU staff over the 2020/2021 winter COVID-19 surge in England. METHODS: English ICU staff were surveyed before, during, and after the winter 2020/2021 surge using a survey which comprised validated measures of mental health. RESULTS: A total of 6080 surveys were completed, by ICU nurses (57.5%), doctors (27.9%), and other healthcare staff (14.5%). Reporting probable mental health disorders increased from 51% (before) to 64% (during), and then decreased to 46% (after). Younger, less experienced nursing staff were most likely to report probable mental health disorders. During and after the winter, >50% of participants met threshold criteria for functional impairment. Staff who reported probable post-traumatic stress disorder, anxiety, or depression were more likely to meet threshold criteria for functional impairment. CONCLUSIONS: The winter of 2020/2021 was associated with an increase in poor mental health outcomes and functional impairment amongst ICU staff during a period of peak caseload. These effects are likely to impact on patient care outcomes and the longer-term resilience of the healthcare workforce.

Experiences of working from home: umbrella review.

INTRODUCTION: The concept of "working from home" is extremely topical following the COVID-19 pandemic; therefore, it is unsurprising that there has been an increased interest in collating research related to homeworking. This has been carried out by multiple reviews, all with slightly different research aims and methodologies. Collating the findings from the available reviews is therefore highly beneficial to establish the experience of homeworking to create recommendations for the future of home-based work. METHODS: An umbrella review was carried out. In June 2022, literature searches were conducted across 4 electronic databases. Published reviews of literature that used a systematic process, were focused on working from home populations, and detailed factors that could be related to the personal experience of homeworking (eg, barriers, facilitators, advantages, disadvantages) were included. RESULTS: A total of 1930 records were screened and 6 review articles were included. Results report on the following sections: working environment (eg, workplace design, space conditions), personal impact (eg, satisfaction, career impact), and health (eg, physical health, well-being) including a total of 19 themes. Mixed findings were apparent for nearly all included themes, highlighting the need to consider individual and contextual circumstances when researching working from home. CONCLUSIONS: This review establishes the importance of retaining flexibility while homeworking for employees, managers, and organizations. Essentially, a one-size-fits-all approach to working from home is impractical as individual circumstances limit application. Eight recommendations for the future of working from home are suggested.

Rates of, and factors associated with, common mental disorders in homeworking UK Government response employees' during COVID-19: a cross-sectional survey and secondary data analysis.

INTRODUCTION: Working on the frontline during the COVID-19 pandemic has been associated with increased risk to mental health and wellbeing in multiple occupations and contexts. The current study aimed to provide an insight into the rate of probable mental health problems amongst United Kingdom (UK) Government employees who contributed to the COVID-19 response whilst working from home, and to ascertain what factors and constructs, if any, influence mental health and wellbeing in the sample population. METHOD: This paper reports on the findings from two studies completed by UK Government employees. Study 1: A cross-sectional online survey, containing standardised and validated measures of common mental health disorders of staff who actively contributed to the COVID-19 response from their own homes. Binary logistic regression was used to assess factors associated with mental health outcomes. Study 2: A secondary data analysis of cross-sectional survey data collected across three timepoints (May, June, and August) in 2020 focusing on the wellbeing of employees who worked from home during the COVID-19 pandemic. RESULTS: Study 1: 17.9% of participants met the threshold criteria for a probable moderate anxiety disorder, moderate depression, or post-traumatic stress disorder. Younger, less resilient, less productive individuals, with lower personal wellbeing and less enjoyment of working from home, were more likely to present with poorer mental health. Study 2: Found lower wellbeing was consistently associated with having less opportunities to look after one's physical and mental health, and having unsupportive line managers and colleagues. CONCLUSION: It is important to ensure UK Government employees' psychological needs are met whilst working from home and responding to enhanced incidents. It is recommended that workplaces should be seeking to continually build and improve employee resilience (e.g., through opportunities to increase social ties and support networks), essentially ensuring employees have necessary resources and skills to support themselves and others.

The relationship between homeworking during COVID-19 and both, mental health, and productivity: a systematic review.

BACKGROUND: As of March 2020, the UK public were instructed to work from home where possible and as a result, nearly half of those in employment did so during the following month. Pre-pandemic, around 5% of workers chose to work from home; it was often seen as advantageous, for example due to eliminating commuting time and increasing flexibility. However, homeworking also had negative connotations, for example, blurred boundaries between work and home life due to a sense of constant connectivity to the workplace. Understanding the psychological impact of working from home in an enforced and prolonged manner due to the COVID-19 pandemic is important. Therefore, this review sought to establish the relationship between working from home, mental health, and productivity. METHODS: In January 2022, literature searches were conducted across four electronic databases: Medline, Embase, PsycInfo and Web of Science. In February 2022 grey literature searches were conducted using Google Advanced Search, NHS Evidence; Gov.uk Publications and the British Library directory of online doctoral theses. Published and unpublished literature which collected data after March 2020, included participants who experienced working from home for at least some of their working hours, and detailed the association in terms of mental health or productivity were included. RESULTS: In total 6,906 citations were screened and 25 papers from electronic databases were included. Grey literature searching resulted in two additional papers. Therefore, 27 studies were included in this review. Findings suggest the association between homeworking and both, mental health and productivity varies considerably, suggesting a complex relationship, with many factors (e.g., demographics, occupation) having an influence on the relationship. CONCLUSION: We found that there was no clear consensus as to the association between working from home and mental health or productivity. However, there are indications that those who start homeworking for the first time during a pandemic are at risk of poor productivity, as are those who experience poor mental health. Suggestions for future research are suggested.

"In the office nine to five, five days a week those days are gone": qualitative exploration of diplomatic personnel's experiences of remote working during the COVID-19 pandemic.

BACKGROUND: Many employees had to work remotely during the COVID-19 pandemic. Literature suggests there are both challenges and benefits to remote working and that remote working can have detrimental effects on mental health. This study aimed to explore diplomatic personnel's perceptions and experiences of working from home during the pandemic. METHODS: Twenty-five employees of the Foreign, Commonwealth and Development Office took part in semi-structured interviews. Thematic analysis was carried out to extract recurring themes from the data. RESULTS: Seven main themes emerged from the data: impact of the pandemic on work; relationships with colleagues; benefits of working from home; challenges of working from home; family; moving posts during the pandemic; and perceptions and predictions of post-pandemic work. Participants provided mixed views on how remote working had affected productivity and relationships with colleagues. Benefits of working from home included greater freedom and flexibility; new opportunities; and inclusivity of remote meetings. Challenges included being in different time zones to the countries they were working for; unsuitable home ergonomics; technological issues; and difficulties finding appropriate work-life balance. Those with young children reported difficulties juggling work and childcare. Adjusting to new posts at a time when staff were working remotely appeared particularly challenging. However, most did not want or expect to return to entirely office-based work. They predicted a hybrid model of working in the future, involving both office work and remote work; they stressed the importance of flexibility and suggested there would not be a one-size-fits-all approach to returning to face-to-face work. CONCLUSIONS: Remote working during the COVID-19 pandemic has changed the ways in which employees work, showing them that they do not have to be in the office to successfully achieve their work goals and leaving many wanting flexibility to make their own decisions about working from home (or not). There are both benefits and challenges to remote working; managers can take steps to reduce some of the challenges by being available to support their employees, organising regular remote meetings and allowing employees autonomy in terms of when and where they work.

Synthesis and spermicidal activity of a putative nitric oxide-releasing derivative of nonoxynol-9.

OBJECTIVES: We report on the synthesis of a potential nitric oxide releasing derivative of nonoxynol-9 (N9). METHODS: This derivative was synthesised via AgNO3 mediated nitroxylation of a chloride derivative of a N9 which itself was synthesised by thionyl chloride mediated chlorination of N9. In an initial in vitro study the spermicidal efficacy of the nitric oxide derivative and the parent compound (N9) was examined using boar spermatozoa. Sperm motility and viability were examined. RESULTS: The data showed that nitroxylation of N9 did not disrupt spermicidal activity; both sperm motility and viability were comparable between N9 and its nitroxylated derivative. For both compounds, low doses (1-10 microg/mL) were sufficient to induce significant immobilization of sperm after 1 min, whereas concentrations of 10-100 microg/mL were required to achieve significant increase in membrane permeability. CONCLUSION: The results show that a nitric oxide-releasing derivative of N9 retains the spermicidal activity of the parent compound and may have other beneficial effects associated with the release of NO.

A potential anti-implantation and spermicidal strategy: putative derivatives of nonoxynol-9 and anti-inflammatory agents and their spermicidal activity.

OBJECTIVES: We report the synthesis of novel ester derivatives of nonoxynol-9, an approved spermicidal agent, using the non-steroidal inflammatory drugs (NSAIDs) ibuprofen and indomethacin. Indomethacin has previously been shown to inhibit the implantation of the fertilised ovum into the uterus wall of pregnant rats. It is proposed that nonoxynol-9, in combination with a non-selective NSAID may exhibit both anti-implantation and spermicidal properties. METHODS: Both novel derivatives and nonoxynol-9 were then tested on boar spermatozoa in order to establish if spermicidal activity was retained following the esterification. RESULTS: The results showed that both the ibuprofen and indomethacin derivatives enabled complete cell death of boar spermatozoa at a concentration of 100 microg ml(-1), which is comparable to nonoxynol-9 at the same concentration. CONCLUSIONS: These results indicate that NSAID derivatives of nonoxynol-9 retain the activity of the parent molecule and may have other advantages associated with the molecular incorporation of the NSAID moieties and their anti-implantation activity.