This study used a mixed methods approach to examine pathways to suicidal behavior by identifying cognitive warning signs that occurred within 1 day of a suicide attempt. Transcripts of cognitive therapy sessions from 35 patients who attempted suicide were analyzed using a modified grounded theory approach. Cognitive themes emerging from these transcripts included: state hopelessness, focus on escape, suicide as a solution, fixation on suicide, and aloneness. Differences in demographic and baseline diagnostic and symptom data were explored in relation to each cognitive theme. We propose a potential conceptual model of cognitive warning signs for suicide attempts that requires further testing.

Little is known about how psychosocial work factors such as work stress, supervisor fairness, and language barriers affect risk of occupational injury among Latino farmworkers. This study attempts to address these questions. Surveys were administered via interviews to 225 Latino thoroughbred farmworkers. Multivariable logistic regression analyses were performed to calculate odds ratios (OR) and 95% confidence intervals (CI) of occupational injury in the past year in relation to occupational characteristics. Work stress (OR 6.70, 95% CI 1.84-24.31), supervisor unfairness (OR 3.34, 95% CI 1.14-9.73), longer tenure at farm (OR 2.67, 95% CI 1.13-6.34), and supervisor inability to speak Spanish (OR 2.29, 95% CI 1.05-5.00) were significantly associated with increased odds of occupational injury. Due to the associations between work stress, supervisor unfairness, supervisor inability to speak Spanish and injury, supervisor training to improve Spanish language ability and equitable management practices is merited. Future research is needed to understand the antecedents of work stress for Latino farmworkers.

We systematically reviewed the literature to describe how community health workers (CHWs) are involved in occupational health and safety research and to identify areas for future research and research practice strategies. We searched five electronic databases from July 2015 through July 2016. Inclusion criteria were as follows: (1) study took place in the United States, (2) published as a full peer-review manuscript in English, (3) conducted occupational health and safety research, and (4) CHWs were involved in the research. The majority of 17 included studies took place in the agriculture industry (76%). CHWs were often involved in study implementation/design and research participant contact. Rationale for CHW involvement in research was due to local connections/acceptance, existing knowledge/skills, communication ability, and access to participants. Barriers to CHW involvement in research included competing demands on CHWs, recruitment and training difficulties, problems about research rigor and issues with proper data collection. Involving CHWs in occupational health and safety research has potential for improving inclusion of diverse, vulnerable and geographically isolated populations. Further research is needed to assess the challenges and opportunities of involving CHWs in this research and to develop evidence-based training strategies to teach CHWs to be lay-health researchers.

Horse breeding farms are hazardous. Yet, little is known about the injuries of Latino horse workers. This study assesses Latino horse workers' injury prevalence, describes their injuries, and analyzes differences between injuries receiving medical versus those receiving first aid care. Data were gathered from 225 Latino thoroughbred workers via a community-based purposive sampling strategy. Questions included injury experiences in the past year and details about each person's two most severe injuries. Univariate and bivariate analyses were conducted. Nearly half of workers experienced an injury in the past year, often involving a horse. Bruises and sprains/strains were most common, as were injuries to upper/lower appendages. Head/face injuries more often resulted in medical care. The injury burden in this Latino worker population is high. Personal protective equipment (PPE) and training is advised due to the high prevalence of horse-related injuries. Future research should investigate aspects of the work environment that may influence injury risk.

PurposeThe difference in cost of Anti‐vascular endothelial growth factor (anti‐VEGF) injections is significant. Prices, according to the British National Formulary (BNF), are: ranibizumab; £742 per single injection vial, aflibercept; £816 per single injection vial, and bevacizumab £242.66, but in standard practice each vial is divided into 20 injections, giving a price of £12.13 per injection. Because patients require repeated injections these costs are multiplied many times over.We hypothesised the majority of injections would be with the less expensive drug, bevacizumab. We therefore performed a survey of all United Kingdom (UK) NHS ophthalmological units.MethodsA freedom of information (FOI) request was submitted to all UK NHS Trusts and Health Boards requesting the number and cost of intravitreal injections of ranibizumab, aflibercept, and bevacizumab prescribed during the month of January 2015. Non‐NHS units were excluded.Costs per month were determined by multiplying injection numbers with BNF (British National Formulary) prices and then by 12 for yearly costs.ResultsA total of 189 FOI requests were sent. The overall response rate was 95.8%.Ranibizumab was used 30,634 times (61%), Aflibercept 18,095 (36%) and Avastin was only 1410 (3%).Costs per month were: £27,276,514 for Ranibizumab, £17,683,373 for Aflibercept, £20,530 for Bevacizumab.Total monthly costs were: £44,980,416.00. Estimated annual costs were: £539,764,992.00.ConclusionsThese results show the anti‐VEGF injection cost to the NHS. Contrary to hypothesis the vast majority (97%) were still with the more expensive drugs ranibizumab and aflibercept. If all injections used divided bevacizumab, the estimated drug cost would be £607,749 (£729,500 incl. VAT) saving the NHS £449,196,354 (£539,035,492 incl. VAT) per year. With 5% remaining unaccounted for the savings may be greater.