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Crisis decision making

Sarah Carter Narendorf, Michelle R Munson, Micki Washburn, Nicole Fedoravicius, Richard Wagner, Sara K Flores
Young adults have low rates of outpatient service utilization and higher rates of emergency service use compared to older adults. This study explored pathways to crisis service use for uninsured young adults who accessed emergency psychiatric treatment. Participants were 55 young adults (ages 18-25) who were on an inpatient short-term stabilization unit and had qualifying diagnoses for outpatient services (bipolar, major depression, or schizophrenia). Semistructured qualitative interviews were conducted to understand decision-making and the events that led to service use...
October 24, 2016: American Journal of Orthopsychiatry
Steven Steinhubl
Despite having the basic tools necessary to appropriately identify and manage individuals with hypertension for over half a century it remains the single greatest contributing risk factor to morbidity and mortality worldwide today. Since diagnosis and effective treatment availability are not issues, this major failing in care can be attributed to inadequate systems of care: systems that have led to only <20% of hypertensive individuals globally having their blood pressure adequately controlled. Even in the US, where it is one of the most common reasons for a primary care visit, and with over $42...
September 2016: Journal of Hypertension
Andrea L Murphy, Ruth Martin-Misener, Stan P Kutcher, Claire L O'Reilly, Timothy F Chen, David M Gardner
BACKGROUND: The role of community pharmacists is changing globally with pharmacists engaging in more clinically-oriented roles, including in mental health care. Pharmacists' interventions have been shown to improve mental health related outcomes but various barriers can limit pharmacists in their care of patients. We aimed to explore the experiences of people with lived experience of mental illness and addictions in community pharmacies to generate findings to inform practice improvements...
October 12, 2016: BMC Health Services Research
Jennifer L Weidhaas, Andrea M Dietrich, Nathan J DeYonker, R Ryan Dupont, William T Foreman, Daniel Gallagher, Jennifer E G Gallagher, Andrew J Whelton, William A Alexander
Chemical spills and accidents contaminate the environment and disrupt societies and economies around the globe. In the United States there were approximately 172,000 chemical spills that affected US waterbodies from 2004 to 2014. More than 8000 of these spills involved non-petroleum-related chemicals. Traditional emergency responses or incident command structures (ICSs) that respond to chemical spills require coordinated efforts by predominantly government personnel from multiple disciplines, including disaster management, public health, and environmental protection...
September 2016: Journal of Environmental Quality
X T Zeng, G H Huang, Y P Li, J L Zhang, Y P Cai, Z P Liu, L R Liu
This study developed a fuzzy-stochastic programming with Green Z-score criterion (FSGZ) method for water resources allocation and water quality management with a trading-mechanism (WAQT) under uncertainties. FSGZ can handle uncertainties expressed as probability distributions, and it can also quantify objective/subjective fuzziness in the decision-making process. Risk-averse attitudes and robustness coefficient are joined to express the relationship between the expected target and outcome under various risk preferences of decision makers and systemic robustness...
September 29, 2016: Environmental Science and Pollution Research International
Rana Pishva
: The premise of parent-centred programmes for parents of anxious children is to educate and train caregivers in the sustainable implementation of cognitive behaviour therapy (CBT) in the home. The existing operationalization of parent involvement, however, does not address the systemic, parent or child factors that could influence this process. The qualitative approach of grounded theory was employed to examine patterns of action and interaction involved in the complex process of carrying out CBT with one's child in one's home...
September 29, 2016: Clinical Psychology & Psychotherapy
Luz María Peña-Longobardo, Juan Oliva-Moreno, Sandra García-Armesto, Cristina Hernández-Quevedo
At the end of 2006, a new System for Promotion of Personal Autonomy and Assistance for Persons in a Situation of Dependency (SAAD) was established in Spain through the approval of the Act 39/2006 of 14th December (the Dependency Act, DA). The DA acknowledged the universal entitlement of Spanish citizens to social services. The recent economic crisis added degrees of uncertainty to several dimensions of the SAAD implementation process. Firstly, the political consensus on which its foundation rested upon has weakened...
September 9, 2016: Health Policy
Luis Roque Reis, Rita Lameiras, Pedro Cavilhas, Pedro Escada
INTRODUCTION: Vertigo is one of the most frequent motives in seeking specialized medical care in an emergency. The aim of this study was to evaluate the relevance of balance disorders in the Otorhinolaryngology urgency, the epidemiological characteristics and the possible seasonality. It was used a sample of patients who were assisted in a health care emergency department of this specialty, of a universitary hospital and during a period of four years. MATERIAL AND METHODS: The project was conceived as a descriptive epidemiological study of population type, retrospective, during the period from 2010 to 2013...
May 2016: Acta Médica Portuguesa
Steven Steinhubl
Despite having the basic tools necessary to appropriately identify and manage individuals with hypertension for over half a century it remains the single greatest contributing risk factor to morbidity and mortality worldwide today. Since diagnosis and effective treatment availability are not issues, this major failing in care can be attributed to inadequate systems of care: systems that have led to only <20% of hypertensive individuals globally having their blood pressure adequately controlled. Even in the US, where it is one of the most common reasons for a primary care visit, and with over $42...
September 2016: Journal of Hypertension
Kaori Murase
To minimize the damage resulting from a long-term environmental disaster such as the 2011 Fukushima nuclear accident in Japan, early disclosure of research data by scientists and prompt decision making by government authorities are required in place of careful, time-consuming research and deliberation about the consequences and cause of the accident. A Bayesian approach with flexible statistical modeling helps scientists and encourages government authorities to make decisions based on environmental data available in the early stages of a disaster...
October 2016: Integrated Environmental Assessment and Management
Ciara McGlade, Edel Daly, Joan McCarthy, Nicola Cornally, Elizabeth Weathers, Rónán O'Caoimh, D William Molloy
BACKGROUND: A high prevalence of cognitive impairment and frailty complicates the feasibility of advance care planning in the long-term-care population. RESEARCH AIM: To identify challenges in implementing the 'Let Me Decide' advance care planning programme in long-term-care. RESEARCH DESIGN: This feasibility study had two phases: (1) staff education on advance care planning and (2) structured advance care planning by staff with residents and families...
September 16, 2016: Nursing Ethics
G L Drusano
Because of our current crisis of resistance, particularly in nosocomial pathogens, the discovery and development of new antimicrobial agents has become a societal imperative. Changes in regulatory pathways by the Food and Drug Administration and the European Medicines Agency place great emphasis on the use of preclinical models coupled with pharmacokinetic/pharmacodynamic analysis to rapidly and safely move new molecular entities with activity against multi-resistant pathogens through the approval process and into the treatment of patients...
August 27, 2016: Bioorganic & Medicinal Chemistry
Kimberley Horspool, Sarah J Drabble, Alicia O'Cathain
BACKGROUND: Street Triage is a collaborative service between mental health workers and police which aims to improve the emergency response to individuals experiencing crisis, but peer reviewed evidence of the effectiveness of these services is limited. We examined the design and potential impact of two services, along with factors that hindered and facilitated the implementation of the services. METHODS: We conducted 14 semi-structured interviews with mental health and police stakeholders with experience of a Street Triage service in two locations of the UK...
2016: BMC Psychiatry
Federica Liliana Ottolini, Laura Buggio, Edgardo Somigliana, Paolo Vercellini
In a period of generalized economic crisis, it seems particularly appropriate to try to manage a continuing growing sector such as healthcare in the best possible way. The crucial aim of optimization of available healthcare resources is obtaining the maximum possible benefit with the minimum expenditure. This has important social implications, whether individual citizens or tax-funded national health services eventually have to pay the bill. The keyword here is efficiency, which means either, maximizing the benefit from a fixed sum of money, or minimizing the resources required for a defined benefit...
August 27, 2016: European Journal of Internal Medicine
Ricardo S Kuchenbecker, Daniel M Mota
BACKGROUND: Brazil recently approved synthetic phosphoetanolamine, a popularly dubbed 'cancer pill', a substance that has been shown to kill cancer cells in lab animal models but was not yet formally accessed in humans, and thus despite the existence of any evidence of its efficacy and safety. METHODS: The authors describe the recent decision of Brazil to aprove phosphoetanolamine in the context of growing 'judicialization' to promote access to medicines and thus reinforcing a growing sense of legal uncertainty...
August 26, 2016: Journal of Oncology Pharmacy Practice
Alexis D Rivero-Romero, Ana I Moreno-Calles, Alejandro Casas, Alicia Castillo, Andrés Camou-Guerrero
BACKGROUND: Traditional climate knowledge is a comprehensive system of insights, experiences and practices used by peasant communities to deal with the uncertainties of climate conditions affecting their livelihood. This knowledge is today as relevant in the Mesoamerican and Andean regions as it is in Europe and Asia. Our research sought to analyze the traditional knowledge about the weather and climate in a rural village of the state of Tlaxcala, Mexico, and its importance in decision-making in agriculture...
2016: Journal of Ethnobiology and Ethnomedicine
Trine Nohr, Eli Kristin Langset
Democratic rights are granted by its nations legislation and systems, but needs enforcement by its institutions to be effective. This also relates to Universal Design. The refugee crisis in Europe raises questions as to how planning in the societies can be designed and implemented to include the new groups of the population. The Norwegian Planning and Building Act (PBA) put weight on the individual's or a group's right to influence public assessment and decision making processes. In this article a case from the Veitvet-Sletteløkka area in the ward of Bjerke, Oslo, is presented to show how these principles can be put into practice...
2016: Studies in Health Technology and Informatics
David G Angeler
With global environmental sustainability at the crossroads, approaches are needed to build an ecologically literate culture for collective societal navigation through the intricacies of swift environmental change. This paper demonstrates a transdisciplinary approach, grounded at the intersection between the arts and sciences, to increase awareness and understanding of the current biodiversity crisis. It focuses on one aspect of biodiversity, beta diversity, which examines how sets of animal and plant species differ between habitats...
2016: SpringerPlus
Huixin Wu, Dianxu Ren, Glenn R Zinsmeister, Gretchen E Zewe, Patricia K Tuite
PURPOSE/OBJECTIVES: The aims of this study were to develop, implement, and evaluate the impact of early intensive care unit (ICU) nurse-led family meetings on nurse-family communication, family decision making, and satisfaction of family members. BACKGROUND: Intensive care unit nurses are in an ideal position to meet family needs, and family members may cope better with the crisis of an ICU admission if consistent honest information is provided by nurses; however, there are no early ICU family meetings led by bedside nurses...
September 2016: Dimensions of Critical Care Nursing: DCCN
Selim Suner
Initial stage of a disaster is managed with existing resources. The following stages of disaster response often involve assistance from outside of the disaster zone. This may consist of mutual aid from neighboring communities for small-scale incidents but in major disasters, the response is from federal or international agencies or often both. Rapid needs assessment after an incident is a collaborative effort between responding agencies and local emergency preparedness and health authorities. Ideally, a team from responding agencies with intimate knowledge and experience regarding the capabilities and assets of the responding entity along with local authorities, with decision making capacity, who have knowledge of the community, the limitations of the responding agencies and can obtain near real-time information about the incident and subject matter experts (engineering, medical, law enforcement, etc...
October 2015: Turkish Journal of Emergency Medicine
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