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Crisis decision making

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https://www.readbyqxmd.com/read/29325025/towards-an-understanding-of-resilience-responding-to-health-systems-shocks
#1
Johanna Hanefeld, Susannah Mayhew, Helena Legido-Quigley, Frederick Martineau, Marina Karanikolos, Karl Blanchet, Marco Liverani, Esther Yei Mokuwa, Gillian McKay, Dina Balabanova
The recent outbreak of Ebola Virus Disease (EVD) in West Africa has drawn attention to the role and responsiveness of health systems in the face of shock. It brought into sharp focus the idea that health systems need not only to be stronger but also more 'resilient'. In this article, we argue that responding to shocks is an important aspect of resilience, examining the health system behaviour in the face of four types of contemporary shocks: the financial crisis in Europe from 2008 onwards; climate change disasters; the EVD outbreak in West Africa 2013-16; and the recent refugee and migration crisis in Europe...
January 9, 2018: Health Policy and Planning
https://www.readbyqxmd.com/read/29244105/the-gendered-health-workforce-mixed-methods-analysis-from-four-fragile-and-post-conflict-contexts
#2
Sophie Witter, Justine Namakula, Haja Wurie, Yotamu Chirwa, Sovanarith So, Sreytouch Vong, Bandeth Ros, Stephen Buzuzi, Sally Theobald
It is well known that the health workforce composition is influenced by gender relations. However, little research has been done which examines the experiences of health workers through a gender lens, especially in fragile and post-conflict states. In these contexts, there may not only be opportunities to (re)shape occupational norms and responsibilities in the light of challenges in the health workforce, but also threats that put pressure on resources and undermine gender balance, diversity and gender responsive human resources for health (HRH)...
December 1, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/29238549/rapid-extirpation-of-a-north-american-frog-coincides-with-an-increase-in-fungal-pathogen-prevalence-historical-analysis-and-implications-for-reintroduction
#3
Andrea J Adams, Allan P Pessier, Cheryl J Briggs
As extinctions continue across the globe, conservation biologists are turning to species reintroduction programs as one optimistic tool for addressing the biodiversity crisis. For repatriation to become a viable strategy, fundamental prerequisites include determining the causes of declines and assessing whether the causes persist in the environment. Invasive species-especially pathogens-are an increasingly significant factor contributing to biodiversity loss. We hypothesized that Batrachochytrium dendrobatidis (Bd), the causative agent of the deadly amphibian disease chytridiomycosis, was important in the rapid (<10 years) localized extirpation of a North American frog (Rana boylii) and that Bd remains widespread among extant amphibians in the region of extirpation...
December 2017: Ecology and Evolution
https://www.readbyqxmd.com/read/29233172/the-effects-of-austerity-measures-on-quality-of-healthcare-services-a-national-survey-of-physicians-in-the-public-and-private-sectors-in-portugal
#4
Tiago Correia, Graça Carapinheiro, Helena Carvalho, José Manuel Silva, Gilles Dussault
BACKGROUND: The European Union member countries reacted differently to the 2008 economic and financial crisis. However, few countries have monitored the outcomes of their policy responses, and there is therefore little evidence as to whether or not savings undermined the performance of health systems. We discuss the situation in Portugal, where a financial adjustment program was implemented between 2011 and 2014, and explore the views of health workers on the effects of austerity measures on quality of care delivery...
December 12, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/29224888/anthropogenic-eutrophication-affects-the-body-size-of-cymodocea-nodosa-in-the-north-aegean-sea-a-long-term-scale-based-approach
#5
Papathanasiou Vasileios, Orfanidis Sotiris
The variation of eleven Cymodocea nodosa metrics was studied along two anthropogenic gradients in the North Aegean Sea, in two separate periods (July 2004 and July 2013). The aim was to specify existing monitoring programs on different kind of human-induced or natural stress for a better decision-making support. Key water variables (N-NO2, N-NO3, N-NH4, P-PO4, Chl-a, attenuation coefficient-K, and suspended solids) along with the stress index MALUSI were also estimated in each sampling effort. All metrics (except one) showed significant differences (p<0...
December 7, 2017: Marine Pollution Bulletin
https://www.readbyqxmd.com/read/29219894/crisis-management-simulation-establishing-a-dual-neurosurgery-and-anesthesia-training-experience
#6
Jeremy Ciporen, Haley Gillham, Michele Noles, Dawn Dillman, Mark Baskerville, Caleb Haley, Donn Spight, Ryan C Turner, Brandon P Lucke-Wold
BACKGROUND: Simulation training has been shown to be an effective teaching tool. Learner management of an intraoperative crisis such as a major cerebrovascular bleed requires effective teamwork, communication, and implementation of key skill sets at appropriate time points. This study establishes a first of a kind simulation experience in a neurosurgery/anesthesia resident (learners) team working together to manage an intraoperative crisis. METHODS: Using a cadaveric cavernous carotid injury perfusion model, 7 neurosurgery and 6 anesthesia learners, were trained on appropriate vascular injury management using an endonasal endoscopic technique...
January 2018: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29217721/insights-from-australians-with-respiratory-disease-living-in-the-community-with-experience-of-self-managing-through-an-emergency-department-near-miss-for-breathlessness-a-strengths-based-qualitative-study
#7
Tim Luckett, Jane Phillips, Miriam Johnson, Maja Garcia, Priyanka Bhattarai, Virginia Carrieri-Kohlman, Anne Hutchinson, Rebecca T Disler, David Currow, Meera Agar, Serra Ivynian, Richard Chye, Phillip J Newton, Patricia M Davidson
OBJECTIVES: Breathlessness 'crises' in people with chronic respiratory conditions are a common precipitant for emergency department (ED) presentations, many of which might be avoided through improved self-management and support. This study sought insights from people with experience of ED 'near misses' where they considered going to the ED but successfully self-managed instead. DESIGN AND METHODS: A qualitative approach was used with a phenomenological orientation...
December 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/29190404/sex-ed-by-brown-med-a-student-run-curriculum-and-its-impact-on-sexual-health-knowledge
#8
Erica Duh, Sheyla P Medina, Nathan Coppersmith, Naomi Adjei, Mary B Roberts, Susanna Magee
BACKGROUND AND OBJECTIVES: Risky sexual behavior among adolescents is a public health crisis. We describe a novel approach to sexual health education where medical students manage a curriculum for an entire seventh grade in one Rhode Island city to better equip students with comprehensive knowledge about sexual health. METHODS: Medical students were trained to teach 12 sessions to seventh-grade students under the supervision of the classroom teacher using a curriculum designed by medical students and faculty (modeled on the Family Life and Sexual Health [FLASH] curriculum but tailored to meet the community's needs)...
November 2017: Family Medicine
https://www.readbyqxmd.com/read/29187803/the-financial-crisis-and-the-european-parliament-an-analysis-of-the-two-pack-legislation
#9
Léa Roger, Simon Otjes, Harmen van der Veer
The left-right line of conflict has been the dominant dimension of decision-making in the European Parliament since 1979. A pro-/anti-European Union integration dimension is of secondary importance. Limited evidence exists on the conditions under which these different dimensions matter. This study examines parliamentary decision-making about the so-called Two-Pack, which moved responsibilities about budgetary decision-making to the European Commission. The article uses in-depth interviews, textual analysis of committee debates and roll call voting analysis in order to determine which lines of conflict matter at which stage of decision-making...
December 2017: European Union Politics
https://www.readbyqxmd.com/read/29170693/from-crisis-to-de-escalation-an-examination-of-politics-in-a-u-s-high-school-steroid-testing-program
#10
Brennan K Berg, Kathryn Winsley, Rhema D Fuller, Michael Hutchinson
Preventing the use of performance enhancing drugs in sport has long been a concern for policymakers. In the United States, amidst national attention the state of Texas constructed the country's largest steroid testing program for high school athletes. However, resource allocation steadily declined until the program was defunded in 2015. Using escalation of commitment theory as a framework, this conceptual paper examines the critical, but less studied, role of politics and de-escalation behavior that directed this distinct sport situation...
2017: International Journal of Exercise Science
https://www.readbyqxmd.com/read/29094662/the-duty-of-mind-ethical-capacity-in-a-time-of-crisis
#11
Caitlin Ryus, Jay Baruch
In a disaster, physicians are forced to make challenging and heartbreaking ethical decisions under conditions of physical and emotional exhaustion. Evidence shows that the conditions of stress that mark disasters can undermine the process of ethical decision-making. This results in biased allocation of scarce resources, fewer utilitarian and altruistic decisions, and a wider variation in decisions. Stress also predisposes clinicians to decision strategy errors, such as premature closure, that lead to poor outcomes...
November 2, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/29092694/reducing-antibiotic-prescribing-in-australian-general-practice-time-for-a-national-strategy
#12
REVIEW
Christopher B Del Mar, Anna Mae Scott, Paul P Glasziou, Tammy Hoffmann, Mieke L van Driel, Elaine Beller, Susan M Phillips, Jonathan Dartnell
In Australia, the antibiotic resistance crisis may be partly alleviated by reducing antibiotic use in general practice, which has relatively high prescribing rates - antibiotics are mostly prescribed for acute respiratory infections, for which they provide only minor benefits. Current surveillance is inadequate for monitoring community antibiotic resistance rates, prescribing rates by indication, and serious complications of acute respiratory infections (which antibiotic use earlier in the infection may have averted), making target setting difficult...
November 6, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/29040811/mobile-emergency-simulation-training-for-rural-health-providers
#13
Douglas Martin, Brent Bekiaris, Gregory Hansen
INTRODUCTION: Mobile emergency simulation offers innovative continuing medical educational support to regions that may lack access to such opportunities. Furthermore, satisfaction is a critical element for active learning. Together, the authors evaluated Canadian rural healthcare providers' satisfaction from high fidelity emergency simulation training using a modified motorhome as a mobile education unit (MEU). METHODS: Over a 5-month period, data was collected during 14 educational sessions in nine different southern Manitoban communities...
July 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/28974071/impact-of-sleep-deprivation-on-anaesthesia-residents-non-technical-skills-a-pilot-simulation-based-prospective-randomized-trial
#14
A Neuschwander, A Job, A Younes, A Mignon, C Delgoulet, P Cabon, J Mantz, A Tesniere
Background: Sleep deprivation is common in anaesthesia residents, but its impact on performance remains uncertain. Non-technical skills (team working, situation awareness, decision making, and task management) are key components of quality of care in anaesthesia, particularly in crisis situations occurring in the operating room. The impact of sleep deprivation on non-technical skills is unknown. We tested the hypothesis that in anaesthesia residents sleep deprivation is associated with impaired non-technical skills...
July 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28967323/effect-of-crisis-response-planning-on-patient-mood-and-clinician-decision-making-a-clinical-trial-with-suicidal-u-s-soldiers
#15
Craig J Bryan, Jim Mintz, Tracy A Clemans, T Scott Burch, Bruce Leeson, Sean Williams, M David Rudd
OBJECTIVE: The study examined the immediate effect of crisis interventions on the emotional state of acutely suicidal soldiers and clinician decision making. METHODS: Soldiers (N=97) presenting to a military emergency department or behavioral health clinic were randomly assigned to receive a contract for safety (N=32), standard crisis response plan (S-CRP; N=32), or enhanced crisis response plan (E-CRP; N=33). Soldiers completed self-report scales before and after the intervention...
October 2, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28949838/the-interactions-of-canadian-ethics-consultants-with-health-care-managers-and-governing-boards-during-times-of-crisis
#16
Chris Kaposy, Victor Maddalena, Fern Brunger, Daryl Pullman, Richard Singleton
BACKGROUND: Health care organizations can be very complex, and are often the setting for crisis situations. In recent years, Canadian health care organizations have faced large-scale systemic medical errors, a nation-wide generic injectable drug shortage, iatrogenic infectious disease outbreaks, and myriad other crises. These situations often have an ethical component that ethics consultants may be able to address. Organizational leaders such as health care managers and governing boards have responsibilities to oversee and direct the response to crisis situations...
April 2017: AJOB Empirical Bioethics
https://www.readbyqxmd.com/read/28903810/effective-crisis-decision-making
#17
Holger Kaschner
When an organisation's reputation is at stake, crisis decision-making (CDM) is challenging and prone to failure. Most CDM schemes are strong at certain aspects of the overall CDM process, but almost none are strong at all of them. This paper defines criteria for good CDM schemes, analyses common approaches and introduces an alternative, stakeholder-driven scheme. Focusing on the most important stakeholders and directing any actions to preserve the relationships with them is crucial. When doing so, the interdependencies between the stakeholders must be identified and considered...
January 1, 2017: Journal of Business Continuity & Emergency Planning
https://www.readbyqxmd.com/read/28903809/decision-making-in-crisis-applying-a-healthcare-triage-methodology-to-business-continuity-management
#18
Bethany Moore, Eric A Bone
The concept of triage in healthcare has been around for centuries and continues to be applied today so that scarce resources are allocated according to need. A business impact analysis (BIA) is a form of triage in that it identifies which processes are most critical, which to address first and how to allocate limited resources. On its own, however, the BIA provides only a roadmap of the impacts and interdependencies of an event. When disaster strikes, organisational decision-makers often face difficult decisions with regard to allocating limited resources between multiple 'mission-critical' functions...
January 1, 2017: Journal of Business Continuity & Emergency Planning
https://www.readbyqxmd.com/read/28870193/mapping-infectious-disease-hospital-surge-threats-to-lessons-learnt-in-singapore-a-systems-analysis-and-development-of-a-framework-to-inform-how-to-decide-on-planning-and-response-strategies
#19
Shweta R Singh, Richard Coker, Hubertus J-M Vrijhoef, Yee Sin Leo, Angela Chow, Poh Lian Lim, Qinghui Tan, Mark I-Cheng Chen, Zoe Jane-Lara Hildon
BACKGROUND: Hospital usage and service demand during an Infectious Disease (ID) outbreak can tax the health system in different ways. Herein we conceptualize hospital surge elements, and lessons learnt from such events, to help build appropriately matched responses to future ID surge threats. METHODS: We used the Interpretive Descriptive qualitative approach. Interviews (n = 35) were conducted with governance and public health specialists; hospital based staff; and General Practitioners...
September 4, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28808090/the-wisdom-of-crowds-regulating-cell-function-through-condensed-states-of-living-matter
#20
REVIEW
Simon Alberti
Our understanding of cells has progressed rapidly in recent years, mainly because of technological advances. Modern technology now allows us to observe molecular processes in living cells with high spatial and temporal resolution. At the same time, we are beginning to compile the molecular parts list of cells. However, how all these parts work together to yield complex cellular behavior is still unclear. In addition, the established paradigm of molecular biology, which sees proteins as well-folded enzymes that undergo specific lock-and-key type interactions, is increasingly being challenged...
September 1, 2017: Journal of Cell Science
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