scholarly journals Moral injury and well-being in essential workers during the COVID-19 pandemic: local survey findings

BMJ Leader ◽  
2022 ◽  
pp. leader-2021-000518
Author(s):  
Catherine Guy ◽  
Edward Kunonga ◽  
Angela Kennedy ◽  
Paras Patel
Keyword(s):  
National Health Service ◽  
Well Being ◽  
Moral Injury ◽  
Staff Retention ◽  
Median Score ◽  
Workplace Injuries ◽  
Employment Sector ◽  
Working Together ◽  
Underlying Causes ◽  
Difficult Situations

BackgroundEssential workers have faced many difficult situations working during the pandemic. Staff may feel that they, or other people, have acted wrongly and be distressed by this. This represents moral injury, which has been linked with significant mental ill health.MethodsThis survey asked essential workers in County Durham and Darlington about their experiences during the first wave of the pandemic and anything they felt would help. Well-being and moral injury were rated using sliders.ResultsThere were 566 responses. A majority of respondents reported feeling troubled by other people’s actions they felt were wrong (60% scored over 40, where 0 is ‘not at all troubled’ and 100 ‘very troubled’, median score=52.5). Respondents were generally less troubled by their own actions (median score=3). Well-being and moral injury scores varied by employment sector (eg, National Health Service (NHS) staff were more troubled by the actions of others than non-NHS staff).Staff suggestions included regular supervisor check-ins, ensuring kindness from everyone, fair rules and enforcement and improving communication and processes. Respondents offered simple, practical actions that could be taken by leaders at team, organisation, societal and governmental levels to tackle moral injury and the underlying causes of moral injurious environments.ConclusionUsing these findings to develop a strategy to address moral injury is important, not only for staff well-being, but staff retention and continued delivery of vital services in these challenging times. Working together, we can seek to reduce and mitigate ‘moral injury’ the same way we do for other physical workplace ‘injuries’.

scholarly journals Moral injury and wellbeing in essential workers during the Covid-19 pandemic: Local survey findings

2021 ◽  
Author(s):  
Catherine Anne Guy ◽  
Edward Kunonga ◽  
Angela Kennedy ◽  
Paras Patel
Keyword(s):  
Government Policy ◽  
Moral Injury ◽  
Staff Retention ◽  
Median Score ◽  
Physical Injuries ◽  
Employment Sector ◽  
Working Together ◽  
Underlying Causes ◽  
Staff Wellbeing ◽  
Difficult Situations

Essential workers have faced many difficult situations working during in the pandemic. Staff may feel that they, or other people, have acted wrongly and be distressed by this. This represents moral injury, which has been linked with significant mental ill health. This survey asked essential workers in County Durham and Darlington about their experiences during the first wave of the pandemic and anything they felt would help. Wellbeing and moral injury were rated using sliders. There were 566 responses. A majority of respondents reported feeling troubled by other people's actions they felt were wrong (60% scored over 40, where 0 is 'not at all troubled' and 100 'very troubled', median score=52.5). Respondents were generally less troubled by their own actions (median score=3). Wellbeing and moral injury scores varied by employment sector (e.g. NHS staff were more troubled by the actions of others than non-NHS staff). Staff suggestions included regular supervisor check-ins, ensuring kindness from everyone, fair rules and enforcement and improving communication and processes. Respondents offered simple, practical actions that could be taken by leaders at team, organisation, societal and government policy levels to tackle moral injury and the underlying causes of moral injurious environments. Using these findings to develop a strategy to address moral injury is important, not only for staff wellbeing, but staff retention and continued delivery of vital services in these challenging times. Working together, we can seek to reduce and mitigate 'moral injury' the same way we do for other physical 'injuries' in the workplace.

Changing Places

2019 ◽  
Author(s):  
John MacDonald ◽  
Charles Branas ◽  
Robert Stokes
Keyword(s):  
Open Space ◽  
Urban Landscape ◽  
Health And Safety ◽  
Well Being ◽  
City Life ◽  
New Science ◽  
Science And Art ◽  
Working Together ◽  
Scientific Testing ◽  
Large Groups

The design of every aspect of the urban landscape—from streets and sidewalks to green spaces, mass transit, and housing—fundamentally influences the health and safety of the communities who live there. It can affect people's stress levels and determine whether they walk or drive, the quality of the air they breathe, and how free they are from crime. This book provides a compelling look at the new science and art of urban planning, showing how scientists, planners, and citizens can work together to reshape city life in measurably positive ways. It demonstrates how well-designed changes to place can significantly improve the well-being of large groups of people. The book argues that there is a disconnect between those who implement place-based changes, such as planners and developers, and the urban scientists who are now able to rigorously evaluate these changes through testing and experimentation. It covers a broad range of structural interventions, such as building and housing, land and open space, transportation and street environments, and entertainment and recreation centers. Science shows we can enhance people's health and safety by changing neighborhoods block-by-block. The book explains why planners and developers need to recognize the value of scientific testing, and why scientists need to embrace the indispensable know-how of planners and developers. It reveals how these professionals, working together and with urban residents, can create place-based interventions that are simple, affordable, and scalable to entire cities.

Consular Protection and Solidarity across Borders

2018 ◽  
Author(s):  
Alexandra Délano Alonso
Keyword(s):  
United States ◽  
Latin American ◽  
Legal Status ◽  
Well Being ◽  
The United States ◽  
Migrant Populations ◽  
Policy Goals ◽  
Large Populations ◽  
Mexican Government ◽  
Working Together

This chapter demonstrates how Latin American governments with large populations of migrants with precarious legal status in the United States are working together to promote policies focusing on their well-being and integration. It identifies the context in which these processes of policy diffusion and collaboration have taken place as well as their limitations. Notwithstanding the differences in capacities and motivations based on the domestic political and economic contexts, there is a convergence of practices and policies of diaspora engagement among Latin American countries driven by the common challenges faced by their migrant populations in the United States and by the Latino population more generally. These policies, framed as an issue of rights protection and the promotion of migrants’ well-being, are presented as a form of regional solidarity and unity, and are also mobilized by the Mexican government as a political instrument serving its foreign policy goals.

Moral Disability, Moral Injury, and the Flight from Vulnerability

2018 ◽  
Author(s):  
Virginia L. Warren
Keyword(s):  
Sense Of Self ◽  
Well Being ◽  
Moral Injury ◽  
Controversial Issues ◽  
Moral Reflection ◽  
Moral Value ◽  
Self Identity ◽  
Moral Conviction ◽  
Moral Importance

This chapter explores the concept of moral disability, identifying two types. The first type involves disabling conditions that distort one’s process of moral reflection. Examples include the incapacity to consider the long-term future, to feel empathy for others, and to be honest with oneself. A noteworthy example of self-deception is systematically denying one’s own—and humanity’s—vulnerability to the power of others, to accidents, and to having one’s well-being linked to that of others and the eco-system. Acknowledging vulnerability often requires a new sense of self. The second type includes incapacities directly resulting from ‘moral injury’—debilitating, self-inflicted harms when one violates a deeply held moral conviction, even if trying to remain true to another moral value. Examining moral disabilities highlights the moral importance of self-identity. More progress may be made on controversial issues if we discuss who we are, how we connect, and how we can heal.

Formalization as a tool for environmental peacebuilding? Artisanal and small-scale mining in Liberia and Sierra Leone

2021 ◽  
Vol 97 (1) ◽  
pp. 35-55
Author(s):  
Christina Ankenbrand ◽  
Abrina Welter ◽  
Nina Engwicht
Keyword(s):  
Sierra Leone ◽  
Well Being ◽  
Small Scale ◽  
Transformative Change ◽  
Community Based ◽  
Community Benefits ◽  
Sustainable Peace ◽  
Underlying Causes ◽  
Ethical Sourcing ◽  
The Ideal

Abstract Artisanal and small-scale mining (ASM) has long been a vital source of livelihoods for rural populations in the global South. Yet, it has also been linked to a host of social, political and environmental adversities, including violent conflict. As environmental peacebuilding increasingly stresses the importance of livelihood improvement as a means of fostering peace in conflict-affected extractive societies, ASM formalization has been identified as a solution to mitigate the sector's challenges, thereby addressing underlying causes of conflict. This article critically investigates the contribution of ASM formalization to sustainable peace by focusing on its impact on the livelihood dimension of peacebuilding. It analyses the livelihood impact of three formalization interventions in the diamond sectors of two countries: cooperatives in Liberia, and, in Sierra Leone, ethical sourcing schemes and a community-based natural resource management initiative. In line with calls for a paradigm shift from a narrow legalization-centred understanding of formalization to a broader approach that accounts for livelihood quality, the analysis presented here focuses on interventions that were informed by the ideal of improving the well-being of ASM workers and communities. We propose three pathways through which ASM formalization could potentially contribute to livelihood enhancement: income security, working conditions and community benefits. Based on fieldwork, this article highlights the challenges of generating livelihood improvements through formalization. Even when specifically designed to address the needs of ASM communities, during implementation, they risk prioritizing a narrow conceptualization of formalization and thus failing to become a conductor of transformative change.

The Evidence Base for the Benefits of Functional Septorhinoplasty and its Future Post COVID-19

2021 ◽  
Author(s):  
Samit N. Unadkat ◽  
Alfonso Luca Pendolino ◽  
Deborah Auer ◽  
Sadie Khwaja ◽  
Premjit S. Randhawa ◽  
...  
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Congenital Malformations ◽  
Well Being ◽  
Evidence Base ◽  
Health Conditions ◽  
Clinical Value ◽  
The United Kingdom ◽  
Additional Funding ◽  
Aesthetic Rhinoplasty

AbstractEver since the introduction of the concept of Procedures of Limited Clinical Value (PoLCV), procedures such as functional septorhinoplasty have been subject to additional funding restrictions within the British National Health Service. Recent publications have suggested that 10% of Clinical Commissioning Groups in the United Kingdom no longer fund septorhinoplasty surgery irrespective of the indications, including congenital malformations or post-trauma, and despite the strong evidence available in the literature in treating a range of health conditions. Thus, inequity exists across the country. At present functional septorhinoplasty surgery is frequently but incorrectly grouped together with aesthetic rhinoplasty, both of which are deemed to be cosmetic interventions. Moreover, as we exit the peak of the current coronavirus disease 2019 (COVID-19) pandemic, procedures deemed to be of lower clinical priority will potentially be at risk throughout Europe. The purpose of this review is twofold; the first is to put forward the evidence to commissioners in favor of functional septorhinoplasty surgery on patient well-being and mental health; the second is to demonstrate why functional septorhinoplasty surgery is a distinct procedure from aesthetic rhinoplasty and why it ought not to be classified as a procedure of limited clinical value.

scholarly journals One Health, emerging infectious diseases and wildlife: two decades of progress?

2017 ◽  
Vol 372 (1725) ◽  
pp. 20160167 ◽  
Author(s):  
Andrew A. Cunningham ◽  
Peter Daszak ◽  
James L. N. Wood
Keyword(s):  
Infectious Diseases ◽  
Wildlife Conservation ◽  
One Health ◽  
Emerging Infectious Diseases ◽  
Well Being ◽  
Wildlife Habitat ◽  
Health And Wellbeing ◽  
Underlying Causes ◽  
Wide Scale ◽  
Multiple Species

Infectious diseases affect people, domestic animals and wildlife alike, with many pathogens being able to infect multiple species. Fifty years ago, following the wide-scale manufacture and use of antibiotics and vaccines, it seemed that the battle against infections was being won for the human population. Since then, however, and in addition to increasing antimicrobial resistance among bacterial pathogens, there has been an increase in the emergence of, mostly viral, zoonotic diseases from wildlife, sometimes causing fatal outbreaks of epidemic proportions. Concurrently, infectious disease has been identified as an increasing threat to wildlife conservation. A synthesis published in 2000 showed common anthropogenic drivers of disease threats to biodiversity and human health, including encroachment and destruction of wildlife habitat and the human-assisted spread of pathogens. Almost two decades later, the situation has not changed and, despite improved knowledge of the underlying causes, little has been done at the policy level to address these threats. For the sake of public health and wellbeing, human-kind needs to work better to conserve nature and preserve the ecosystem services, including disease regulation, that biodiversity provides while also understanding and mitigating activities which lead to disease emergence. We consider that holistic, One Health approaches to the management and mitigation of the risks of emerging infectious diseases have the greatest chance of success. This article is part of the themed issue ‘One Health for a changing world: zoonoses, ecosystems and human well-being’.

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