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Crisis decision making

Chiara Lombardo, Mónica Santos, Tine Van Bortel, Robert Croos, Ella Arensman, Manaan Kar Ray
Aims and methodThe aim of the study is to improve patient safety by identifying factors influencing gatekeeping decisions by crisis resolution and home treatment teams. A theoretical sampling method was used to recruit clinicians. Semi-structured interviews to elicit various aspects of clinical decision-making were carried out. The transcripts were thematically analysed using a grounded theory approach. RESULTS: Patient needs (safety and treatment) was the primary driver behind decisions. The research also revealed that information gathered was processed using heuristics...
November 19, 2018: BJPsych Bulletin
Aymo Brunetti
This paper analyses the role of economists in advising political agents. Based on the experience in the recent financial crisis, it starts with the important role of expectations management. Economists should make clear that precise forecasts are not possible but that application of economic principles and careful analysis of data and historical events can substantially improve political decisions. In order to be effective, economic advisors have to be aware of the first best as well as of the political feasibility of proposals...
2018: Swiss journal of economics and statistics
Marinus H Van Ijzendoorn, Miriam Steele, Pehr Granqvist
In the service of children's best interests, we argue for a sharpening of the evidentiary standards used in family court decision making, from preponderance of (occasionally substandard) evidence to "beyond a reasonable doubt." Second, we call for a move in child protection cases from static diagnoses (e.g., attachment classifications) to assessments of the potential for enhanced parenting. Finally, informed by the implications of the replication crisis in the biomedical and psychological sciences, we applaud the move of the attachment field forward to large-scale, collective research agendas and goals...
November 2018: Infant Mental Health Journal
Xiao-Tian Wang
Food, money, and time are exchangeable resources essential for survival and reproduction. Individuals live within finite budgets of these resources and make tradeoffs between money and time when making intertemporal choices between an immediate smaller reward and a delayed lager reward. In this paper, I examine signaling functions of blood glucose in regulating behaviors related to resource regulations beyond caloric metabolisms. These behavioral regulations include choices between energy expenditure and energy conservation, monetary intertemporal choices, and self-control in overcoming temptations...
2018: Frontiers in Psychology
Matthew K Laing, Kenneth W Tupper, Nadia Fairbairn
Adulteration of illicit drug supplies with synthetic opioids such as fentanyl has contributed to a dramatic rise in overdose morbidity and mortality in North America. One promising response to this crisis is the implementation of "drug checking" services. Drug checking encompasses a range of interventions used to assess the constituents of illicit drug samples, such as colour-spot testing, gas or liquid chromatography, and various methods of spectroscopy. Testing may be performed on-site at events or harm reduction service locales, performed independently by consumers, or sent to a centralized lab for analysis...
October 22, 2018: International Journal on Drug Policy
Stéphane Duhem, Sofian Berrouiguet, Christophe Debien, François Ducrocq, Anne Laure Demarty, Antoine Messiah, Philippe Courtet, Louis Jehel, Pierre Thomas, Dominique Deplanque, Thierry Danel, Michel Walter, Charles-Edouard Notredame, Guillaume Vaiva
INTRODUCTION: The early postattempt period is considered to be one of the most at-risk time windows for suicide reattempt or completion. Among the postcrisis prevention programmes developed to compensate for this risk, brief contact interventions (BCIs) have been proven to be efficient but not equally for each subpopulation of attempters. VigilanS is a region-wide programme that relies on an algorithmic system to tailor surveillance and BCI provisions to individuals discharged from the hospital after a suicide attempt...
October 23, 2018: BMJ Open
Cameron Kaiser, Ramon Leon, Karen Craven
INTRODUCTION: Disasters with substantial impacts to the health care and public health systems can have multiple reverberating effects, including the need to alter the medical standard of care as well as centrally control scarce medical resources. A current crisis care plan can help to establish an ethical and operational framework for stakeholders before such a disaster takes place. However, there are few examples of such a plan that cover large areas and health jurisdictions. This article describes the process of developing such a "Crisis Care Plan...
October 1, 2018: PLoS Currents
Thomas J Papadimos, Evadne G Marcolini, Mehrnaz Hadian, George E Hardart, Nicholas Ward, Mitchell M Levy, Stanislaw P Stawicki, Judy E Davidson
OBJECTIVES: Continue the dialogue presented in Ethics of Outbreaks Position Statement. Part 1, with a focus on strategies for provision of family-centered care in critical illness during Pubic Health Emergency of International Concern. DESIGN: Development of a Society of Critical Care Medicine position statement using literature review, expert consensus from the Society of Critical Care Medicine Ethics Committee. A family member of a patient who was critically ill during a natural disaster served on the writing panel and provided validation from a family perspective to the recommendations...
November 2018: Critical Care Medicine
Marc J Kahn, Benjamin P Sachs
By their very nature both man-made and natural disasters are unpredictable, and so we recommend that all health-care institutions be prepared. In this paper, the authors describe and make a number of recommendations, regarding the importance of crisis and turnaround management using as a model the New Orleans public health system and Tulane University Medical School post-Hurricane Katrina. Leadership skills, articulation of vision, nimble decision making, and teamwork are all crucial elements of a successful recovery from disaster...
October 4, 2018: Rambam Maimonides Medical Journal
Andrew Clifton, Jo Higman, John Stephenson, Alfonso R Navarro, Nikki Welyczko
The UK nursing workforce is facing a crisis. More nurses are leaving than entering the profession, and there are tens of thousands of unfilled vacancies. Political factors are having a significant impact on numbers, in particular the decision to withdraw bursaries for nursing undergraduates, and a steep decline in EU nurses registering to work in the UK post-Brexit. Against this backdrop, there is a stark gender imbalance in the workforce, with only around 11% of registered nurses being male. We surveyed UK higher education institutions to try to identify whether the gendered nature of nursing was considered a concern and whether steps were being taken to address it...
September 19, 2018: Nurse Education Today
Jennifer E Johnson, Kent Key
PROBLEM: Larger societal forces created a narrative about Flint's water emergency that cast African American Flint community members primarily as victims, underplaying their extensive efforts toward solutions. This narrative exacerbates, rather than ameliorates, the emergency's root cause: disregard for their perspectives. PURPOSE: This article describes 1) the largely unsung efforts of African American community members to identify and resolve the emergency, and 2) the development of the Narrative Group as a way to document community perspectives and promote change through equitable inclusion of community in decision making...
2018: Progress in Community Health Partnerships: Research, Education, and Action
Federica D'Asta, Joseph Homsi, Idanna Sforzi, David Wilson, Marco de Luca
Acute management of a severely burned patient is an infrequent and stressful situation that requires medical knowledge as well as immediate coordinated action. Many adverse events in health care result from issues related to the application of 'non-technical' skills such as communication, teamwork, leadership and decision making rather than lack of medical knowledge. Training in these skills is known as Crisis Resource Management (CRM) training. In order to create well-prepared burn teams, it is critical to teach CRM principles through high-fidelity simulation (HFS)...
September 26, 2018: Burns: Journal of the International Society for Burn Injuries
Guillaume Vaiva, Sofian Berrouiguet, Michel Walter, Philippe Courtet, François Ducrocq, Vincent Jardon, Mark E Larsen, Lionel Cailhol, Carole Godesense, Christophe Couturier, Anjali Mathur, Virginie Lagree, Catherine Pichene, David Travers, Cedric Lemogne, Jean Marc Henry, Frederic Jover, Francoise Chastang, Olivier Prudhomme, Philippe Lestavel, Catherine Thevenon Gignac, Stéphane Duhem, Anne Laure Demarty, Catherine Mesmeur, Frank Bellivier, Julien Labreuche, Alain Duhamel, Patrick Goldstein
BACKGROUND: There is growing evidence in the literature that brief contact interventions (BCIs) might be reliable suicide prevention strategies. OBJECTIVE: To assess the effectiveness of a decision-making algorithm for suicide prevention (ALGOS) combining existing BCIs in reducing suicide reattempts in patients discharged after a suicide attempt. METHODS: A randomized, multicenter, controlled, parallel trial was conducted in 23 hospitals. The study was conducted from January 26, 2010, to February 28, 2013...
September 25, 2018: Journal of Clinical Psychiatry
Leif Inge Magnussen, Eric Carlstrøm, Ann-Kristin Berge, Frode Wegger, Jarle Løwe Sørensen
The aim of this exploratory case study was to examine whether sensemaking processes may influence decision-making of emergency call center dispatchers when dealing with maritime crises. This article focuses on sensemaking and decision-making in an emergency services context using Norwegian operators as a case and reports on data collected from five focus-group interviews with emergency dispatchers at five different locations. Each focus group consisted of three dispatchers, representing the three main Norwegian emergency response dispatch centers: police, fire and rescue, and the Emergency Medical Communication Centre (AMK)...
July 2018: Journal of Emergency Management: JEM
Runa Acharya, Mashaal Dhir, Rupal Bandi, Linwah Yip, Sue Challinor
BACKGROUND: Management of patients with bilateral adrenal masses and ACTH-independent Cushing's syndrome (AICS) is challenging, as bilateral adrenalectomy can lead to steroid dependence and lifelong risk of adrenal crisis. Adrenal venous sampling (AVS) has been previously reported to facilitate lateralization for guiding adrenalectomy. The aim of the current study was to investigate the utility of AVS using protocol from study by Young et al. in the management of patients with bilateral adrenal masses and AICS...
September 19, 2018: World Journal of Surgery
Kahina Abdesselam, Matthew James Dann, Ramona Alwis, Julie Laroche, Samuel Ileka-Priouzeau
The incidence of opioid-related overdoses is increasing at an alarming pace, largely driven by the increased use of fentanyl and its analogues. The need for sound and reliable sources of data on opioid use is crucial in order to make decisions on implementing efficient interventions, and develop appropriate policies and guidelines to mitigate the burden of opioid use. This article highlights initiatives undertaken by federal partners to address the opioid crisis in Canada. The need for novel surveillance approaches that improve the collection and harmonization of drug-related data is also discussed...
September 2018: Health Promotion and Chronic Disease Prevention in Canada
Cheryl S Al-Mateen, Kathryn Jones, Julie Linker, Dorothy O'Keefe, Valentina Cimolai
Although suicide is a leading cause of death for children and adolescents, there is a dearth of literature on clinician responses to suicides in that age group. However, most psychiatrists experience the death of a patient by suicide, with resulting grief reactions including shock, isolation, rumination, self-doubt, and impact on clinical decision making. The impact is more pronounced in trainee clinicians. Postvention is the clinical, administrative, legal, and emotional processes following a suicide. These processes are discussed in detail, with recommendations for policies and training that assist clinicians with this tragic, but common, professional crisis...
October 2018: Child and Adolescent Psychiatric Clinics of North America
Marie-Laurence Tremblay
Objective. To describe strategies for implementation of simulation-based crisis resource management (CRM) in pharmacy education and present students' appreciation of an interdisciplinary CRM training at a university in Canada. Methods. In fall 2016, third-year undergraduate pharmacy students at Laval University and pharmacy technician students from Fierbourg school participated in a CRM activity and completed a five-item survey to assess the quality of the CRM activity they had just experienced. Paired t-tests were computed to detect differences of appreciation between pharmacy technician students and pharmacy students...
August 2018: American Journal of Pharmaceutical Education
Simone Frigerio, Luca Schenato, Giulia Bossi, Matteo Mantovani, Gianluca Marcato, Alessandro Pasuto
There is evidence that the toll of death and destruction caused by natural hazards is rising. This is often ascribed to the impact of climate change that resulted in an increased frequency of extreme meteorological events. As a consequence, it is realistic to expect that the casualties and damages caused by floods will increase in the near future. Advanced weather forecast is a fundamental tool to predict the occurrence of floods and structural mitigation measures are crucial for flood protection. However, these strategies should be associate with tools to promote and increase natural-disaster awareness and nonstructural mitigation measures in the exposed population...
September 4, 2018: International Journal of Environmental Research and Public Health
Ali Khaji, Bagher Larijani, Seyed Mohammad Ghodsi, Mohammad A Mohagheghi, Hammid R Khankeh, Soheil Saadat, Seyed Mahmoud Tabatabaei, Davoud Khorasani-Zavareh
Background: Industrialization could bring risk of Technological Disaster (TD) such as happened in Chernobyl, Bhopal and Fukushima crisis. Little has been discussed about its related ethical issues. In this study, we aimed to investigate ethical issues have been stated for technological disasters. Methods: A systematic search was conducted on the main international literature databases including Pubmed, Embase, Scopus and ISI (Jan 1, 2000 to Jan 1, 2018). From 64articles were eligible for investigation of ethical issues in Natural disaster, 6 was related to Technological Disaster...
July 2018: Archives of Bone and Joint Surgery
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