An Information-Processing Model of Crisis Management.

ERIC Educational Resources Information Center

Egelhoff, William G.; Sen, Falguni

1992-01-01

Develops a contingency model for managing a variety of corporate crises. Views crisis management as an information-processing situation and organizations that must cope with crisis as information-processing systems. Attempts to fit appropriate information-processing mechanisms to different categories of crises. (PRA)

Crisis management, capabilities and preparedness: the case of public hospitals in Iran.

PubMed

Najafbagy, Reza

2010-01-01

Crises occurred in recent decades show that organizations' preparedness to predict and respond to undesired problems is directly related to the degree of their capabilities and preparedness to manage crises in this context, hospitals compared to other organizations are more viable to suffer damages if a crisis occurs. This study investigates the degree of public hospitals capabilities and preparedness to handled possible crises. Responses from hospital managers and directors show that most of them were not familiar with crisis management, while majority of them mentioned that they had crisis management plan and committee in their hospitals. Moreover, most of the respondents believed that if a crisis occurs in the hospital, patients, personnel and documents will be the first victims of the crisis. The study also indicates that having a crisis plan and crisis committee without being familiar with knowledge of crisis management, do not help managers to cope with crisis. Moreover, correlations show that older managers were more familiar with crisis management experiences abroad, and defined responsibilities contributed to setting up crisis committee, and taking crisis seriously.

An Intelligence-Sharing Continuum: Next Generation Requirements for U.S. Counterterrorism Efforts

DTIC Science & Technology

2011-09-01

of Management and Budget, Paperwork Reduction Project (0704-0188) Washington DC 20503. 1. AGENCY USE ONLY (Leave blank) 2. REPORT DATE...for U.S. Counterterrorism Efforts 5. FUNDING NUMBERS 6. AUTHOR(S) David Carabin 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Naval...Postgraduate School Monterey, CA 93943-5000 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING /MONITORING AGENCY NAME(S) AND ADDRESS(ES) N/A

In the Opponent's Shoes: Increasing the Behavioral Validity of Attackers' Judgments in Counterterrorism Models.

PubMed

Sri Bhashyam, Sumitra; Montibeller, Gilberto

2016-04-01

A key objective for policymakers and analysts dealing with terrorist threats is trying to predict the actions that malicious agents may take. A recent trend in counterterrorism risk analysis is to model the terrorists' judgments, as these will guide their choices of such actions. The standard assumptions in most of these models are that terrorists are fully rational, following all the normative desiderata required for rational choices, such as having a set of constant and ordered preferences, being able to perform a cost-benefit analysis of their alternatives, among many others. However, are such assumptions reasonable from a behavioral perspective? In this article, we analyze the types of assumptions made across various counterterrorism analytical models that represent malicious agents' judgments and discuss their suitability from a descriptive point of view. We then suggest how some of these assumptions could be modified to describe terrorists' preferences more accurately, by drawing knowledge from the fields of behavioral decision research, politics, philosophy of choice, public choice, and conflict management in terrorism. Such insight, we hope, might help make the assumptions of these models more behaviorally valid for counterterrorism risk analysis. © 2016 The Authors Wound Repair and Regeneration published by Wiley Periodicals, Inc. on behalf of The Wound Healing Society.

Technological disasters, crisis management and leadership stress.

PubMed

Weisaeth, Lars; Knudsen, Øistein; Tønnessen, Arnfinn

2002-07-01

This paper discusses how psychological stress disturbs decision making during technological crisis and disaster, and how to prevent this from happening. This is exemplified by scientific studies of a Norwegian large scale accident involving hazardous material, and of handling the far-off effects of the nuclear disaster at Chernobyl. The former constitutes an operative level of crisis management, whereas the latter involves crisis management at the strategic and political level. We conclude that stress had a negative effect on decision making in both cases.

Crisis management aspects of bam catastrophic earthquake: review article.

PubMed

Sadeghi-Bazargani, Homayoun; Azami-Aghdash, Saber; Kazemi, Abdolhassan; Ziapour, Behrad

2015-01-01

Bam earthquake was the most catastrophic natural disasters in recent years. The aim of this study was to review different aspects of crisis management during and after the catastrophic earthquake in Bam City, Iran. Data needed for this systematic review were collected through searching PubMed, EMBASE and SID databases, for the period from 2003 to 2011. Keywords included earthquake, Iran and Bam earthquake. The data were summarized and were analyzed using Content Analysis. Out of 422 articles, 25 articles were included in the study. Crisis Management aspects and existing pitfalls were classified into seven categories including planning and organization, human resource management, management of logistics, international humanitarian aids, field performance of the military and security forces, health and medical service provision, and information management. Positive aspects and major pitfalls of crisis management have been introduced in all the mentioned categories. The available evidence indicated poor crisis management during Bam earthquake that resulted in aggravating the losses as well as diminishing the effect of interventions. Thus, concerning the importance of different aspects of the crisis management and the high prevalence of disasters in Iran, the observed vulnerability in disaster management process should be addressed.

Knowledge communication: a key to successful crisis management.

PubMed

Johansson, Anders; Härenstam, Malin

2013-09-01

A winning concept of crisis management can be summarized in 2 words: knowledge communication. If decision makers, communicators, experts, and the public understand what the crisis is about and share their knowledge, the process of handling it will be optimized. Effective crisis communication implies the necessity of an unhindered but purposeful exchange of information within and between authorities, organizations, media, involved individuals, and groups before, during, and after a crisis. This article focuses on the importance of the before, or prevention, part of a crisis since it holds a rich possibility to enhance the chances for successful crisis management of a bioterrorism incident. An extended perspective on crisis communication efficiently links to a more thorough understanding of risk perception with various stakeholders and the public, which also will be helpful for situational awareness. Furthermore, the grounded baseline for the dialogue type of crisis communication suitable in modern society and to modern social media is achieved by linking to those risk communication efforts that are made. The link between risk and crisis should be afforded more attention since, especially in biosecurity, there would be no crisis without risk negligence and poor or malfunctioning preventive efforts.

SARS: Key factors in crisis management.

PubMed

Tseng, Hsin-Chao; Chen, Thai-Form; Chou, Shieu-Ming

2005-03-01

This study was conducted at a single hospital selected in Taipei during the SARS (Severe Acute Respiratory Syndrome) outbreak from March to July, 2003 in Taiwan. During this period of time, 104 SARS patients were admitted to the hospital. There were no negative reports related to the selected hospital despite its being located right in the center of an area struck by the epidemic. The purpose of this study was to identify the key factors enabling the hospital to survive SARS unscathed. Data were collected from in-depth interviews with the nursing directors and nursing managers of the SARS units, along with a review of relevant hospital documents. The five key elements identified as survival factors during this SARS crisis are as follows: 1. good control of timing for crisis management, 2. careful decision-making, 3. thorough implementation, 4. effective communication, and 5. trust between management and employees. The results of this study reconfirmed the selected hospital as a model for good crisis management during the SARS epidemic.

Training Post-9/11 Police Officers with a Counter-Terrorism Reality-Based Training Model: A Case Study

ERIC Educational Resources Information Center

Biddle, Christopher J.

2013-01-01

The purpose of this qualitative holistic multiple-case study was to identify the optimal theoretical approach for a Counter-Terrorism Reality-Based Training (CTRBT) model to train post-9/11 police officers to perform effectively in their counter-terrorism assignments. Post-9/11 police officers assigned to counter-terrorism duties are not trained…

Exploring Crisis Management in U.S. Small Businesses

NASA Astrophysics Data System (ADS)

Williams, Jon

As a critical infrastructure, the US electricity grid supplies electricity to 340 million people within eight separate regions. The power infrastructure is vulnerable to many types of disasters capable of severing supplies of electricity. The impact on the employees and communities when small- and medium-size enterprises are shut down due to disasters can be severe. The purpose of the quantitative comparative study was to explore small- and medium-size enterprises crisis management strategies in the case of power infrastructure vulnerabilities. Perceptions of small business leaders were probed about crisis management planning relevant to three secondary factors: prior experience of crises, threat perceptions, and planning self-efficacy. Participants completed an adapted questionnaire instrument based on a five-point Likert scale for six sub-factors including resilience through planning, financial impact, operational crisis management, the perfect storm, the aftermath of survival, and atrophy. The instrument also measured three additional factors to include, prior experience of crises, threat perceptions, and planning self-efficacy, across seven types of crises. The results of this study indicated that of the 276 respondents, 104 had no crisis plans, but 172 did have crisis plans. Of those who had implemented crisis plans, 19% had specific provisions to address power outages or attacks on the electrical grid. Of the respondents who had not planned for power outages nor experienced significant losses of power, a statistically significant number acknowledged an external threat to their business. The majority of respondents indicated that long-term planning was related to resilience; however, the migration of crisis understanding into the planning process or implementation was not implemented. This heightened awareness of potential crises without the corresponding development and implementation of mitigation crisis plans requires additional research to understand

Stress in crisis managers: evidence from self-report and psychophysiological assessments.

PubMed

Janka, A; Adler, C; Fischer, L; Perakakis, P; Guerra, P; Duschek, S

2015-12-01

Directing disaster operations represents a major professional challenge. Despite its importance to health and professional performance, research on stress in crisis management remains scarce. The present study aimed to investigate self-reported stress and psychophysiological stress responses in crisis managers. For this purpose, 30 crisis managers were compared with 30 managers from other disciplines, in terms of self-reported stress, health status and psychophysiological reactivity to crisis-related and non-specific visual and acoustic aversive stimuli and cognitive challenge. Crisis managers reported lower stress levels, a more positive strain-recuperation-balance, greater social resources, reduced physical symptoms, as well as more physical exercise and less alcohol consumption. They exhibited diminished electrodermal and heart rate responses to crisis-related and non-specific stressors. The results indicate reduced stress and physical complaints, diminished psychophysiological stress reactivity, and a healthier life-style in crisis managers. Improved stress resistance may limit vulnerability to stress-related performance decline and facilitate preparedness for major incidents.

School Crisis Management Manual: Guidelines for Administrators. Second Edition.

ERIC Educational Resources Information Center

Smith, Judie

This three-part manual is intended for principals and other administrators responsible for developing and managing school crisis plans. Part 1, preparation for a school crisis, includes sections on the selection and training of members of the school crisis team, steps in developing a school crisis plan, and four crisis scenarios to train team…

Crisis management with applicability on fire fighting plants

NASA Astrophysics Data System (ADS)

Panaitescu, M.; Panaitescu, F. V.; Voicu, I.; Dumitrescu, L. G.

2017-08-01

The paper presents a case study for a crisis management analysis which address to fire fighting plants. The procedures include the steps of FTA (Failure tree analysis). The purpose of the present paper is to describe this crisis management plan with tools of FTA. The crisis management procedures have applicability on anticipated and emergency situations and help to describe and planning a worst-case scenario plan. For this issue must calculate the probabilities in different situations for fire fighting plants. In the conclusions of paper is analised the block diagram with components of fire fighting plant and are presented the solutions for each possible risk situations.

Teaching the Crisis Management/Communication Course.

ERIC Educational Resources Information Center

Coombs, W. Timothy

2001-01-01

Argues that a course or unit in crisis management/communication is an excellent way of teaching public relations theory, management concepts, information management, problem solving, and communication management. Identifies course objectives, discusses main topics and student evaluation, and concludes with advice and a list of readings. (SR)

Crisis management: an extended reference framework for decision makers.

PubMed

Carone, Alessandro; Iorio, Luigi Di

2013-01-01

The paper discusses a reference framework for capabilities supporting effective crisis management. This framework has been developed by joining experiences in the field and knowledge of organisational models for crisis management, and executives' empowerment, coaching and behavioural analysis. The paper is aimed at offering further insight to executives on critical success factors and means for managing crisis situations by extending the scope of analysis to human behaviour, to emotions and fears and their correlation with decision making. It is further intended to help familiarise them and to facilitate approaching a path towards emotional awareness.

An Analysis of Secondary Schools' Crisis Management Preparedness: National Implications

ERIC Educational Resources Information Center

Adams, Cheantel M.; Kritsonis, William Allan

2006-01-01

The purpose of this study is to analyze crisis management plans of schools that have experienced crisis situations in the past. The plans used by these schools to manage these crisis situations will be evaluated for their effectiveness or ineffectiveness in re-establishing stability to their organization. With such information, other schools may…

Does teaching crisis resource management skills improve resuscitation performance in pediatric residents?*.

PubMed

Blackwood, Jaime; Duff, Jonathan P; Nettel-Aguirre, Alberto; Djogovic, Dennis; Joynt, Chloe

2014-05-01

The effect of teaching crisis resource management skills on the resuscitation performance of pediatric residents is unknown. The primary objective of this pilot study was to determine if teaching crisis resource management to residents leads to improved clinical and crisis resource management performance in simulated pediatric resuscitation scenarios. A prospective, randomized control pilot study. Simulation facility at tertiary pediatric hospital. Junior pediatric residents. Junior pediatric residents were randomized to 1 hour of crisis resource management instruction or no additional training. Time to predetermined resuscitation tasks was noted in simulated resuscitation scenarios immediately after intervention and again 3 months post intervention. Crisis resource management skills were evaluated using the Ottawa Global Rating Scale. Fifteen junior residents participated in the study, of which seven in the intervention group. The intervention crisis resource management group placed monitor leads 24.6 seconds earlier (p = 0.02), placed an IV 47.1 seconds sooner (p = 0.04), called for help 50.4 seconds faster (p = 0.03), and checked for a pulse after noticing a rhythm change 84.9 seconds quicker (p = 0.01). There was no statistically significant difference in time to initiation of cardiopulmonary resuscitation (p = 0.264). The intervention group had overall crisis resource management performance scores 1.15 points higher (Ottawa Global Rating Scale [out of 7]) (p = 0.02). Three months later, these differences between the groups persisted. A 1-hour crisis resource management teaching session improved time to critical initial steps of pediatric resuscitation and crisis resource management performance as measured by the Ottawa Global Rating Scale. The control group did not develop these crisis resource management skills over 3 months of standard training indicating that obtaining these skills requires specific education. Larger studies of crisis resource education are

Do You Have a Crisis Management Plan?

ERIC Educational Resources Information Center

Pleviak, Walter; Milkevitch, Frank

2001-01-01

Although certain crises cannot be prevented, reactions to many can be planned. A crisis-management team should be organized for each building. Critical crisis-plan elements include telephone trees, forms, reference articles, sample letters, and processes for dealing with local media. Spokespersons should have facts straight before speaking. (MLH)

Crisis Management Research Summaries

ERIC Educational Resources Information Center

Brock, Stephen E., Ed.; Zhe, Elizabeth; Torem, Chris; Comeaux, Natashia; Dempsey, Allison

2010-01-01

This article presents a summary of recent crisis management publications. The first research report summarized, "Predictors of PTSD," was a study of predictor variables for responses to the World Trade Center attack. The second paper, "Effective Mental Health Response to Catastrophic Events," looked at effective responses following Hurricane…

Crisis management systems: staff nurses demand more support from their supervisors.

PubMed

Tzeng, Huey-Ming; Yin, Chang-Yi

2008-08-01

This study illustrates the contributions of the necessity, comprehensiveness, and difference (between necessity and comprehensiveness) levels of crisis management systems to participants' general satisfaction with their working institutions' nursing-related crisis management activities. Crisis management systems include strategic, technical/structural, assessment, public communication, and psychological/cultural aspects. An effective institutional crisis management system might help to decrease the number of incidents related to medical disputes or to prevent a crisis from worsening and becoming disastrous. A cross-sectional survey was administered during a nursing conference held in Taipei, Taiwan, on June 27, 2005. Two hundred ninety questionnaires were distributed, and 121 were retrieved (response rate, 41.7%; nursing administrators and staff). Univariate and multivariate analyses were performed. Ordinal logistic regression analyses show that being a public hospital managed by the government and having more difference on the strategic aspect between the necessity and comprehensiveness levels contribute to lower satisfaction with nursing-related crisis management activities (Nagelkerke R(2) = .441). In addition, staff nurses perceive higher necessity levels on all five aspects compared to nursing administrators. This study provides important insights into how the policies and activities of a medical institution's crisis management system can be prioritized and implemented. It is also important for students in nursing programs and for currently employed nurses to learn how to manage disputes related to nursing practice, so that early resolution can be achieved and crises can be avoided. These results suggest that staff nurses demand more support from their supervisors.

Crisis Management's New Role in Educational Settings

ERIC Educational Resources Information Center

Gainey, Barbara S.

2009-01-01

From natural disasters to the financial debacle, it is clear to the educational community that crises know no boundaries. Far from a passing fad, crisis planning must be an integrated part of effective school district leadership. Two studies explore the status of crisis management in selected public school systems and offer recommendations for…

Resource Guide for Crisis Management in Schools.

ERIC Educational Resources Information Center

LaPointe, Richard T.; And Others

A crisis can occur at any time, whether or not a school's staff plans for it. This resource guide is a compilation of user-friendly examples of policies, procedures, guidelines, checklists, and forms to help Virginia schools develop and implement a systematic crisis-management plan. Chapter 1 provides an introductory overview of the essential…

Chief Student Affairs Officers' Perceptions of Institutional Crisis Management, Preparedness, and Response

ERIC Educational Resources Information Center

Studenberg, Heather Nicole Lancin

2017-01-01

This dissertation examined chief student affairs officers' perceptions of institutional crisis management, preparedness, and response. A goal of this study was to uncover findings that can benefit crisis management protocols or best practices regarding crisis management team training, plan communications, and emergency management personnel on…

Wilderness Crisis Management. Explore Magazine Technical Series No. 11.

ERIC Educational Resources Information Center

Raffan, James

This paper deals with managing a crisis in a wilderness situation. The terms "crisis" and "turning point" are used to describe what is more traditionally called an accident. Using these terms introduces the idea that crisis events occur as logical consequences of preceding decisions, errors, or omissions, not as the result of…

Crisis Management Systems: A Case Study for Aspect-Oriented Modeling

NASA Astrophysics Data System (ADS)

Kienzle, Jörg; Guelfi, Nicolas; Mustafiz, Sadaf

The intent of this document is to define a common case study for the aspect-oriented modeling research community. The domain of the case study is crisis management systems, i.e., systems that help in identifying, assessing, and handling a crisis situation by orchestrating the communication between all parties involved in handling the crisis, by allocating and managing resources, and by providing access to relevant crisis-related information to authorized users. This document contains informal requirements of crisis management systems (CMSs) in general, a feature model for a CMS product line, use case models for a car crash CMS (CCCMS), a domain model for the CCCMS, an informal physical architecture description of the CCCMS, as well as some design models of a possible object-oriented implementation of parts of the CCCMS backend. AOM researchers who want to demonstrate the power of their AOM approach or technique can hence apply the approach at the most appropriate level of abstraction.

Influence of the economy crisis on project cost management

NASA Astrophysics Data System (ADS)

Simankina, Tatyana; Ćetković, Jasmina; Verstina, Natalia; Evseev, Evgeny

2017-10-01

Economy crisis significantly affects primarily the project cost management. The article considers the problems of project management in the field of housing under conditions of economy crisis. Project budgets are reduced, their mutual interference grows and framework of risks changes. Apparently, specific approaches are required to be developed to optimize the expenses and guarantee the project implementation within the approved budget. There is considered domestic and foreign experience in terms of project cost management with involvement of BIM technologies.

Crisis Management for Biobanks.

PubMed

Parry-Jones, Alison; Hansen, Jarle; Simeon-Dubach, Daniel; Bjugn, Roger

2017-06-01

All organizations are subject to risk and uncertainty. Adverse events may disrupt normal organizational activity and may even cause complete failure of business operations. Biorepositories are also at risk and there have been instances where multiple samples or entire collections have been destroyed. Biobank guidelines accordingly recommend the establishment of contingency plans to reduce risk to an acceptable level. In this review article, we will use general theory on risk management and illustrate how such principles can be used to establish a practical crisis management plan for any biobank organization.

The Role of Perception in Crisis Management: A Tale of Two Hurricanes

ERIC Educational Resources Information Center

Olaniran, Bolanle A.

2007-01-01

The "anticipatory" model of crisis management draws the attention of crisis practitioners and researchers to the precrisis phase of crisis management. The model views institutions' position as a condition that has implications for peoples' perceptions regarding the lack of control over factors such as policies, human resources,…

Crisis Management for Secondary Education: A Survey of Secondary Education Directors in Greece

ERIC Educational Resources Information Center

Savelides, Socrates; Mihiotis, Athanassios; Koutsoukis, Nikitas-Spiros

2015-01-01

Purpose: The Greek secondary education system lacks a formal crisis management system. The purpose of this paper is to address this problem as follows: elicit current crisis management practices, outline features for designing a formal crisis management system in Greece. Design/methodology/approach: The research is based on a survey conducted with…

A new framework for assessing hospital crisis management based on resilience engineering approach.

PubMed

Shirali, Gh A; Azadian, Sh; Saki, A

2016-06-14

In recent years, an increasing number of natural and man-made disasters have exposed many people and properties to various disasters. This has resulted in approximately 75,000 deaths worldwide every year due to disasters. Crisis management is becoming increasingly important to cope effectively with the magnitude and potential damage resulting from disasters. Hospitals, as the final point in the rescue chain, have a key role in the crisis management and need to be resilient against disasters. The purpose of this paper is to present a new framework for assessing the crisis management based on resilience principles in hospital infrastructure of a developing country. A questionnaire was developed and completed by 310 staff (nurses and managers) of eight hospitals in Iran. The findings indicate that the eight hospitals included in the study have moderate conditions in general, while hospitals X3, X4, and X7 have poor conditions in the crisis management. Consequently, it seems that the crisis management system was not resilient in all these hospitals in general. Using resilience engineering in assessing crisis management can improve and develop the ability of the hospitals' management to cope with any type of disaster.

Toward a Mathematical Theory of Counterterrorism (Proteus USA, Volume 1, Issue 2, December 2007)

DTIC Science & Technology

2007-12-01

Toward a MaTheMaTical Theory of counTerTerrorisM The Proteus Monograph Series Volume 1, Issue 2 December 2007 Report Documentation Page Form...COVERED 00-00-2007 to 00-00-2007 4. TITLE AND SUBTITLE Toward a Mathematical Theory of Counterterrorism 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c...Army War College,Center for Strategic Leadership ,650 Wright Avenue,Carlisle,PA,17013-5049 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING

Crisis management during anaesthesia: the development of an anaesthetic crisis management manual

PubMed Central

Runciman, W; Kluger, M; Morris, R; Paix, A; Watterson, L; Webb, R

2005-01-01

Background: All anaesthetists have to handle life threatening crises with little or no warning. However, some cognitive strategies and work practices that are appropriate for speed and efficiency under normal circumstances may become maladaptive in a crisis. It was judged in a previous study that the use of a structured "core" algorithm (based on the mnemonic COVER ABCD–A SWIFT CHECK) would diagnose and correct the problem in 60% of cases and provide a functional diagnosis in virtually all of the remaining 40%. It was recommended that specific sub-algorithms be developed for managing the problems underlying the remaining 40% of crises and assembled in an easy-to-use manual. Sub-algorithms were therefore developed for these problems so that they could be checked for applicability and validity against the first 4000 anaesthesia incidents reported to the Australian Incident Monitoring Study (AIMS). Methods: The need for 24 specific sub-algorithms was identified. Teams of practising anaesthetists were assembled and sets of incidents relevant to each sub-algorithm were identified from the first 4000 reported to AIMS. Based largely on successful strategies identified in these reports, a set of 24 specific sub-algorithms was developed for trial against the 4000 AIMS reports and assembled into an easy-to-use manual. A process was developed for applying each component of the core algorithm COVER at one of four levels (scan-check-alert/ready-emergency) according to the degree of perceived urgency, and incorporated into the manual. The manual was disseminated at a World Congress and feedback was obtained. Results: Each of the 24 specific crisis management sub-algorithms was tested against the relevant incidents among the first 4000 reported to AIMS and compared with the actual management by the anaesthetist at the time. It was judged that, if the core algorithm had been correctly applied, the appropriate sub-algorithm would have been resolved better and/or faster in one in

Crisis management during anaesthesia: the development of an anaesthetic crisis management manual.

PubMed

Runciman, W B; Kluger, M T; Morris, R W; Paix, A D; Watterson, L M; Webb, R K

2005-06-01

All anaesthetists have to handle life threatening crises with little or no warning. However, some cognitive strategies and work practices that are appropriate for speed and efficiency under normal circumstances may become maladaptive in a crisis. It was judged in a previous study that the use of a structured "core" algorithm (based on the mnemonic COVER ABCD-A SWIFT CHECK) would diagnose and correct the problem in 60% of cases and provide a functional diagnosis in virtually all of the remaining 40%. It was recommended that specific sub-algorithms be developed for managing the problems underlying the remaining 40% of crises and assembled in an easy-to-use manual. Sub-algorithms were therefore developed for these problems so that they could be checked for applicability and validity against the first 4000 anaesthesia incidents reported to the Australian Incident Monitoring Study (AIMS). The need for 24 specific sub-algorithms was identified. Teams of practising anaesthetists were assembled and sets of incidents relevant to each sub-algorithm were identified from the first 4000 reported to AIMS. Based largely on successful strategies identified in these reports, a set of 24 specific sub-algorithms was developed for trial against the 4000 AIMS reports and assembled into an easy-to-use manual. A process was developed for applying each component of the core algorithm COVER at one of four levels (scan-check-alert/ready-emergency) according to the degree of perceived urgency, and incorporated into the manual. The manual was disseminated at a World Congress and feedback was obtained. Each of the 24 specific crisis management sub-algorithms was tested against the relevant incidents among the first 4000 reported to AIMS and compared with the actual management by the anaesthetist at the time. It was judged that, if the core algorithm had been correctly applied, the appropriate sub-algorithm would have been resolved better and/or faster in one in eight of all incidents, and

Crisis prevention and management during SARS outbreak, Singapore.

PubMed

Quah, Stella R; Hin-Peng, Lee

2004-02-01

We discuss crisis prevention and management during the first 3 months of the severe acute respiratory syndrome (SARS) outbreak in Singapore. Four public health issues were considered: prevention measures, self-health evaluation, SARS knowledge, and appraisal of crisis management. We conducted telephone interviews with a representative sample of 1,201 adults, > or = 21 years of age. We found that sex, age, and attitude (anxiety and perception of open communication with authorities) were associated with practicing preventive measures. Analysis of Singapore's outbreak improves our understanding of the social dimensions of infectious disease outbreaks.

Camp Crisis Management: Responding to New Challenges.

ERIC Educational Resources Information Center

Evans, Will

2002-01-01

Camps should have crisis management plans. Steps to formulating a plan include involving appropriate off-site agencies, identifying potential threats, gathering resources, crafting an appropriate response, training via role-playing, managing incoming and outgoing information, and writing it down. Sidebars present resources, successful response…

Dutch guideline for the management of hypertensive crisis -- 2010 revision.

PubMed

van den Born, B J H; Beutler, J J; Gaillard, C A J M; de Gooijer, A; van den Meiracker, A H; Kroon, A A

2011-05-01

Hypertensive crises are divided into hypertensive urgencies and emergencies. Together they form a heterogeneous group of acute hypertensive disorders depending on the presence or type of target organs involved. Despite better treatment options for hypertension, hypertensive crisis and its associated complications remain relatively common. In the Netherlands the number of patients starting renal replacement therapy because of 'malignant hypertension' has increased in the past two decades. In 2003, the first Dutch guideline on hypertensive crisis was released to allow a standardised evidence-based approach for patients presenting with a hypertensive crisis. In this paper we give an overview of the current management of hypertensive crisis and discuss several important changes incorporated in the 2010 revision. These changes include a modification in terminology replacing 'malignant hypertension' with 'hypertensive crisis with retinopathy and reclassification of hypertensive crisis with retinopathy under hypertensive emergencies instead of urgencies. With regard to the treatment of hypertensive emergencies, nicardipine instead of nitroprusside or labetalol is favoured for the management of perioperative hypertension, whereas labetalol has become the drug of choice for the treatment of hypertension associated with pre-eclampsia. For the treatment of hypertensive urgencies, oral administration of nifedipine retard instead of captopril is recommended as first-line therapy. In addition, a section on the management of hypertensive emergencies according to the type of target organ involved has been added. Efforts to increase the awareness and treatment of hypertension in the population at large may lower the incidence of hypertensive crisis and its complications.

Owl Pellets and Crisis Management.

ERIC Educational Resources Information Center

Anderson, Tom

2002-01-01

Describes a press conference that was used as a "teachable moment" when owl pellets being used for instructional purposes were found to be contaminated with Salmonella. The incident highlighted the need for safe handling of owl pellets, having a crisis management plan, and the importance of conveying accurate information to concerned parents.…

Simulation-based crisis resource management training for pediatric critical care medicine: a review for instructors.

PubMed

Cheng, Adam; Donoghue, Aaron; Gilfoyle, Elaine; Eppich, Walter

2012-03-01

To review the essential elements of crisis resource management and provide a resource for instructors by describing how to use simulation-based training to teach crisis resource management principles in pediatric acute care contexts. A MEDLINE-based literature source. OUTLINE OF REVIEW: This review is divided into three main sections: Background, Principles of Crisis Resource Management, and Tools and Resources. The background section provides the brief history and definition of crisis resource management. The next section describes all the essential elements of crisis resource management, including leadership and followership, communication, teamwork, resource use, and situational awareness. This is followed by a review of evidence supporting the use of simulation-based crisis resource management training in health care. The last section provides the resources necessary to develop crisis resource management training using a simulation-based approach. This includes a description of how to design pediatric simulation scenarios, how to effectively debrief, and a list of potential assessment tools that instructors can use to evaluate crisis resource management performance during simulation-based training. Crisis resource management principles form the foundation for efficient team functioning and subsequent error reduction in high-stakes environments such as acute care pediatrics. Effective instructor training is required for those programs wishing to teach these principles using simulation-based learning. Dissemination and integration of these principles into pediatric critical care practice has the potential for a tremendous impact on patient safety and outcomes.

Avoiding School Management Conflicts and Crisis through Formal Communication

ERIC Educational Resources Information Center

Nwogbaga, David M. E.; Nwankwo, Oliver U.; Onwa, Doris O.

2015-01-01

This paper examined how conflicts and crisis can be avoided through formal communication. It was necessitated by the observation that most of the conflicts and crisis which tend to mar school management today are functions of the inconsistencies arising from "grapevines, rumours, and gossips" generated through informal communication…

Abramovo Counterterrorism Training Center

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hayes, Christopher M; Ross, Larry; Lingenfelter, Forrest E

2011-01-01

The U.S. government has been assisting the Russian Federation (RF) Ministry of Defense (MOD) for many years with nuclear weapons transportation security (NWTS) through the provision of specialized guard escort railcars and cargo railcars with integrated physical security and communication systems, armored transport vehicles, and armored escort vehicles. As a natural continuation of the NWTS program, a partnership has been formed to construct a training center that will provide counterterrorism training to personnel in all branches of the RF MOD. The Abramovo Counterterrorism Training Center (ACTC) is a multinational, multiagency project with funding from Canada, RF and the U.S. Departmentsmore » of Defense and Energy. ACTC will be a facility where MOD personnel can conduct basic through advanced training in various security measures to protect Category IA material against the threat of terrorist attack. The training will enhance defense-in-depth principles by integrating MOD guard force personnel into the overall physical protection systems and improving their overall response time and neutralization capabilities. The ACTC project includes infrastructure improvements, renovation of existing buildings, construction of new buildings, construction of new training facilities, and provision of training and other equipment. Classroom training will be conducted in a renovated training building. Basic and intermediate training will be conducted on three different security training areas where various obstacles and static training devices will be constructed. The central element of ACTC, where advanced training will be held, is the 'autodrome,' a 3 km road along which various terrorist events can be staged to challenge MOD personnel in realistic and dynamic nuclear weapons transportation scenarios. This paper will address the ACTC project elements and the vision for training development and integrating this training into actual nuclear weapons transportation operations.« less

What Should This Fight Be Called? Metaphors of Counterterrorism and Their Implications.

PubMed

Kruglanski, Arie W; Crenshaw, Martha; Post, Jerrold M; Victoroff, Jeff

2007-12-01

This monograph examines from a psychological perspective the use of metaphors in framing counterterrorism. Four major counterterrorism metaphors are considered, namely those of war, law enforcement, containment of a social epidemic, and a process of prejudice reduction. The war metaphor is as follows: Wars are fought by states; the enemy is thus an identifiable entity whose interests fundamentally oppose your own. The conflict is zero-sum-the outcome will be victory for one side or the other-and there is no compromise. The war metaphor is totalistic and extreme. Arguably, it was adopted in light of the immensity of damage and national hurt produced by the 9/11 attack. It has insinuated itself into the public discourse about counterterrorism, and it has guided policy, but it has also met challenges because of lack of fit and the availability of counteranalogies with different lessons of history. Some of the drawbacks of the war metaphor are addressable in the law enforcement metaphor of counterterrorism. Unlike war's special status and circumscribed duration, law enforcement is an ongoing concern that must compete for resources with other societal needs. A major advantage of law enforcement over warfare is its focused nature-targeting the actual terrorists, with less likelihood of injuring innocent parties. Yet despite its advantages, the law enforcement metaphor exhibits a partial mismatch with the realities of terrorism. Its complete and uncritical adoption may temporarily hamper terrorists' ability to launch attacks without substantially altering their motivation to do so. The public health epidemiological model was usefully applied to the epidemic of terror that followed the 9/11 attacks. It utilizes a partition between (a) an external agent, (b) a susceptible host, (c) an environment that brings them together, and (d) the vector that enables transmission of the disease. In the specific application to jihadist terrorism, the agent refers to the militant Islamist

Crisis Management Simulation: Establishing a Dual Neurosurgery and Anesthesia Training Experience.

PubMed

Ciporen, Jeremy; Gillham, Haley; Noles, Michele; Dillman, Dawn; Baskerville, Mark; Haley, Caleb; Spight, Donn; Turner, Ryan C; Lucke-Wold, Brandon P

2018-01-01

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. 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. Learners were evaluated on communication skills, crisis management algorithms, and implementation of appropriate skill sets at the right time. A preanatomic and postanatomic examination and postsimulation survey was administered to neurosurgery learners. Anesthesia learners provided posttraining evaluation through a tailored realism and teaching survey. Neurosurgery learners' anatomic examination score improved from presimulation (33.89%) to postsimulation (86.11%). No significant difference between learner specialties was observed for situation awareness, decision making, communications and teamwork, or leadership evaluations. Learners reported the simulation realistic, beneficial, and highly instructive. Realistic, first of kind, clinical simulation scenarios were presented to a neurosurgery/anesthesia resident team who worked together to manage an intraoperative crisis. Learners were effectively trained on crisis management, the importance of communication, and how to develop algorithms for future implementation in difficult scenarios. Learners were highly satisfied with the simulation training experience and requested that it be integrated more consistently into their residency training programs.

Risk Management and Crisis Response: Are You Prepared?

ERIC Educational Resources Information Center

Schirick, Ed

2002-01-01

How a camp responds to a crisis may determine whether it can survive financially. Effective risk management requires total commitment from ownership and management, and staff involvement. Steps in formulating a risk management plan include identifying all potential crises and their frequency and severity potential, developing responses,…

Gangs and Guerrillas: Ideas from Counterinsurgency and Counterterrorism

DTIC Science & Technology

2011-03-01

13. SUPPLEMENTARY NOTES 14. ABSTRACT In a discussion at the Naval Postgraduate School in Monterey, California, it became apparent that there were...Lieutenant Commander, US Navy, Masters Student in the Defense Analysis Department, Naval Postgraduate School Hy Rothstein, Senior Lecturer, Defense...NPS-DA-11-001 NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA GANGS AND GUERRILLAS: Ideas from Counterinsurgency And Counterterrorism Edited

A scoping review of crisis teams managing dementia in older people.

PubMed

Streater, Amy; Coleston-Shields, Donna Maria; Yates, Jennifer; Stanyon, Miriam; Orrell, Martin

2017-01-01

Research on crisis teams for older adults with dementia is limited. This scoping review aimed to 1) conduct a systematic literature review reporting on the effectiveness of crisis interventions for older people with dementia and 2) conduct a scoping survey with dementia crisis teams mapping services across England to understand operational procedures and identify what is currently occurring in practice. For the systematic literature review, included studies were graded using the Critical Appraisal Skills Programme checklist. For the scoping survey, Trusts across England were contacted and relevant services were identified that work with people with dementia experiencing a mental health crisis. The systematic literature review demonstrated limited evidence in support of crisis teams reducing the rate of hospital admissions, and despite the increase in number of studies, methodological limitations remain. For the scoping review, only half (51.8%) of the teams had a care pathway to manage crises and the primary need for referral was behavioral or psychological factors. Evidence in the literature for the effectiveness of crisis teams for older adults with dementia remains limited. Being mainly cohort designs can make it difficult to evaluate the effectiveness of the intervention. In practice, it appears that the pathway for care managing crisis for people with dementia varies widely across services in England. There was a wide range of names given to the provision of teams managing crisis for people with dementia, which may reflect the differences in the setup and procedures of the service. To provide evidence on crisis intervention teams, a comprehensive protocol is required to deliver a standardized care pathway and measurable intervention as part of a large-scale evaluation of effectiveness.

Financial Management during Crisis (For Parents)

MedlinePlus

... can find themselves on the brink of financial free-fall when medical expenses pile up. Even so, maintaining your family's financial health is not impossible. With organization and careful planning, you can learn to manage your money during a medical crisis. Costs of Health Care ...

Surgical Crisis Management Skills Training and Assessment

PubMed Central

Moorthy, Krishna; Munz, Yaron; Forrest, Damien; Pandey, Vikas; Undre, Shabnam; Vincent, Charles; Darzi, Ara

2006-01-01

Background: Intraoperative surgical crisis management is learned in an unstructured manner. In aviation, simulation training allows aircrews to coordinate and standardize recovery strategies. Our aim was to develop a surgical crisis simulation and evaluate its feasibility, realism, and validity of the measures used to assess performance. Methods: Surgical trainees were exposed to a bleeding crisis in a simulated operating theater. Assessment of performance consisted of a trainee’s technical ability to control the bleeding and of their team/human factors skills. This assessment was performed in a blinded manner by 2 surgeons and one human factors expert. Other measures consisted of time measures such as time to diagnose the bleeding (TD), inform team members (TT), achieve control (TC), and close the laceration (TL). Blood loss was used as a surrogate outcome measures. Results: There were considerable variations within both senior (n = 10) and junior (n = 10) trainees for technical and team skills. However, while the senior trainees scored higher than the juniors for technical skills (P = 0.001), there were no differences in human factors skills. There were also significant differences between the 2 groups for TD (P = 0.01), TC (P = 0.001), and TL (0.001). The blood loss was higher in the junior group. Conclusions: We have described the development of a novel simulated setting for the training of crisis management skills and the variability in performance both in between and within the 2 groups. PMID:16794399

Parental management of adrenal crisis in children with congenital adrenal hyperplasia

PubMed Central

Fleming, Louise; Knafl, Kathleen; Knafl, George; Van Riper, Marcia

2018-01-01

Purpose Congenital adrenal hyperplasia (CAH) requires parents to inject their child with hydro-cortisone intramuscularly during times of illness and adrenal crisis. The purpose of this study was to describe circumstances surrounding adrenal crisis events in children with CAH; to explore parents’ perceptions of the consequences of having a child with a life-threatening condition; and to examine a relationship between parents’ perceived management ability and the impact CAH has on the family. Methods In Phase 1 of this mixed-methods, cross-sectional study, 77 parents were asked to complete questionnaires comprising measures of family life in the context of childhood illness. Descriptive statistics were computed with four separate analyses using linear mixed models allowing for correlation between responses from parents of the same family and for the variance to be different for fathers and mothers. The following relationships were examined: (1) parental management ability and type of provider instruction on how to manage adrenal crises; (2) parental management ability and child age; (3) the perceived impact of the condition on the family and management ability; and (4) the age of the child and number of adrenal crisis events. In Phase 2, 16 semi-structured interviews were conducted to elicit detailed descriptions of parents’ experiences in managing crises. Results There was a significant, positive relationship between detailed provider instruction to parents on adrenal crisis management and perceived management ability (p = .02), additionally the stronger the perceived management ability, the less impact CAH had on the family (p < .001). From birth to age 5, parents reported more frequent crisis events and less perceived ability to manage the condition when compared with parents of older children (p = .009). The threat of an adrenal crisis event is a pervasive concern for parents, especially when they are not being properly prepared by providers. Practice

Parental management of adrenal crisis in children with congenital adrenal hyperplasia.

PubMed

Fleming, Louise; Knafl, Kathleen; Knafl, George; Van Riper, Marcia

2017-10-01

Congenital adrenal hyperplasia (CAH) requires parents to inject their child with hydrocortisone intramuscularly during times of illness and adrenal crisis. The purpose of this study was to describe circumstances surrounding adrenal crisis events in children with CAH; to explore parents' perceptions of the consequences of having a child with a life-threatening condition; and to examine a relationship between parents' perceived management ability and the impact CAH has on the family. In Phase 1 of this mixed-methods, cross-sectional study, 77 parents were asked to complete questionnaires comprising measures of family life in the context of childhood illness. Descriptive statistics were computed with four separate analyses using linear mixed models allowing for correlation between responses from parents of the same family and for the variance to be different for fathers and mothers. The following relationships were examined: (1) parental management ability and type of provider instruction on how to manage adrenal crises; (2) parental management ability and child age; (3) the perceived impact of the condition on the family and management ability; and (4) the age of the child and number of adrenal crisis events. In Phase 2, 16 semi-structured interviews were conducted to elicit detailed descriptions of parents' experiences in managing crises. There was a significant, positive relationship between detailed provider instruction to parents on adrenal crisis management and perceived management ability (p = .02), additionally the stronger the perceived management ability, the less impact CAH had on the family (p < .001). From birth to age 5, parents reported more frequent crisis events and less perceived ability to manage the condition when compared with parents of older children (p = .009). The threat of an adrenal crisis event is a pervasive concern for parents, especially when they are not being properly prepared by providers. Provider support is needed for these parents

A scoping review of crisis teams managing dementia in older people

PubMed Central

Streater, Amy; Coleston-Shields, Donna Maria; Yates, Jennifer; Stanyon, Miriam; Orrell, Martin

2017-01-01

Background Research on crisis teams for older adults with dementia is limited. This scoping review aimed to 1) conduct a systematic literature review reporting on the effectiveness of crisis interventions for older people with dementia and 2) conduct a scoping survey with dementia crisis teams mapping services across England to understand operational procedures and identify what is currently occurring in practice. Methods For the systematic literature review, included studies were graded using the Critical Appraisal Skills Programme checklist. For the scoping survey, Trusts across England were contacted and relevant services were identified that work with people with dementia experiencing a mental health crisis. Results The systematic literature review demonstrated limited evidence in support of crisis teams reducing the rate of hospital admissions, and despite the increase in number of studies, methodological limitations remain. For the scoping review, only half (51.8%) of the teams had a care pathway to manage crises and the primary need for referral was behavioral or psychological factors. Conclusion Evidence in the literature for the effectiveness of crisis teams for older adults with dementia remains limited. Being mainly cohort designs can make it difficult to evaluate the effectiveness of the intervention. In practice, it appears that the pathway for care managing crisis for people with dementia varies widely across services in England. There was a wide range of names given to the provision of teams managing crisis for people with dementia, which may reflect the differences in the setup and procedures of the service. To provide evidence on crisis intervention teams, a comprehensive protocol is required to deliver a standardized care pathway and measurable intervention as part of a large-scale evaluation of effectiveness. PMID:29042760

Indonesian heath care and the economic crisis: is managed care the needed reform?

PubMed

Hotchkiss, D R; Jacobalis, S

1999-03-01

The ramifications of the current economic crisis are being felt throughout Asia, but problems are particularly acute in Indonesia; in the midst of high inflation and unemployment the government is considering expanding managed care reform. In this paper, we discuss the impact of the recent economic crisis on the health sector in Indonesia, and analyze the potential for implementing effective reform following the managed care model. The health sector is discussed, highlighting pre-existing problems in the health care supply environment. The determinants of the economic crisis are summarized, and the broad impacts of the crisis to date on the health sector are assessed. Next the prospects for success of current managed-care reform proposals are examined in some detail: viability of expanded managed care reform measures are assessed in light of the continuing crisis and its likely impacts on the consumers and suppliers of health care. Analysis of the potential impact of the continuing crisis focuses on key participants in health care reform: households, the government, and private health care providers. In conclusion the potential viability of managed care appears poor, given the current economic, political, and institutional conditions and likely future impacts, and suggest some alternative reform measures.

Modeling Adversaries in Counterterrorism Decisions Using Prospect Theory.

PubMed

Merrick, Jason R W; Leclerc, Philip

2016-04-01

Counterterrorism decisions have been an intense area of research in recent years. Both decision analysis and game theory have been used to model such decisions, and more recently approaches have been developed that combine the techniques of the two disciplines. However, each of these approaches assumes that the attacker is maximizing its utility. Experimental research shows that human beings do not make decisions by maximizing expected utility without aid, but instead deviate in specific ways such as loss aversion or likelihood insensitivity. In this article, we modify existing methods for counterterrorism decisions. We keep expected utility as the defender's paradigm to seek for the rational decision, but we use prospect theory to solve for the attacker's decision to descriptively model the attacker's loss aversion and likelihood insensitivity. We study the effects of this approach in a critical decision, whether to screen containers entering the United States for radioactive materials. We find that the defender's optimal decision is sensitive to the attacker's levels of loss aversion and likelihood insensitivity, meaning that understanding such descriptive decision effects is important in making such decisions. © 2014 Society for Risk Analysis.

Exploring the Strategic Role of Human Resource Development in Organizational Crisis Management

ERIC Educational Resources Information Center

Wang, Jia; Hutchins, Holly M.; Garavan, Thomas N.

2009-01-01

Crisis management has been a largely overlooked territory in human resource development (HRD) despite the increasingly recognized impact of organizational crises on the individual and organizational performance. This article explores the strategic role of HRD in the context of organizational crisis management using Garavan's strategic HRD model as…

An official American Thoracic Society workshop report: assessment and palliative management of dyspnea crisis.

PubMed

Mularski, Richard A; Reinke, Lynn F; Carrieri-Kohlman, Virginia; Fischer, Mark D; Campbell, Margaret L; Rocker, Graeme; Schneidman, Ann; Jacobs, Susan S; Arnold, Robert; Benditt, Joshua O; Booth, Sara; Byock, Ira; Chan, Garrett K; Curtis, J Randall; Donesky, Doranne; Hansen-Flaschen, John; Heffner, John; Klein, Russell; Limberg, Trina M; Manning, Harold L; Morrison, R Sean; Ries, Andrew L; Schmidt, Gregory A; Selecky, Paul A; Truog, Robert D; Wang, Angela C C; White, Douglas B

2013-10-01

In 2009, the American Thoracic Society (ATS) funded an assembly project, Palliative Management of Dyspnea Crisis, to focus on identification, management, and optimal resource utilization for effective palliation of acute episodes of dyspnea. We conducted a comprehensive search of the medical literature and evaluated available evidence from systematic evidence-based reviews (SEBRs) using a modified AMSTAR approach and then summarized the palliative management knowledge base for participants to use in discourse at a 2009 ATS workshop. We used an informal consensus process to develop a working definition of this novel entity and established an Ad Hoc Committee on Palliative Management of Dyspnea Crisis to further develop an official ATS document on the topic. The Ad Hoc Committee members defined dyspnea crisis as "sustained and severe resting breathing discomfort that occurs in patients with advanced, often life-limiting illness and overwhelms the patient and caregivers' ability to achieve symptom relief." Dyspnea crisis can occur suddenly and is characteristically without a reversible etiology. The workshop participants focused on dyspnea crisis management for patients in whom the goals of care are focused on palliation and for whom endotracheal intubation and mechanical ventilation are not consistent with articulated preferences. However, approaches to dyspnea crisis may also be appropriate for patients electing life-sustaining treatment. The Ad Hoc Committee developed a Workshop Report concerning assessment of dyspnea crisis; ethical and professional considerations; efficient utilization, communication, and care coordination; clinical management of dyspnea crisis; development of patient education and provider aid products; and enhancing implementation with audit and quality improvement.

Nuclear Arms Control, Nonproliferation, and Counterterrorism: Impacts on Public Health

PubMed Central

Pregenzer, Arian

2014-01-01

Reducing the risks of nuclear war, limiting the spread of nuclear weapons, and reducing global nuclear weapons stockpiles are key national and international security goals. They are pursued through a variety of international arms control, nonproliferation, and counterterrorism treaties and agreements. These legally binding and political commitments, together with the institutional infrastructure that supports them, work to establish global norms of behavior and have limited the spread of weapons of mass destruction. Beyond the primary security objectives, reducing the likelihood of the use of nuclear weapons, preventing environmental releases of radioactive material, increasing the availability of safe and secure nuclear technology for peaceful purposes, and providing scientific data relevant to predicting and managing the consequences of natural or human-caused disasters worldwide provide significant benefits to global public health. PMID:24524501

The Nurse Leader Role in Crisis Management.

PubMed

Edmonson, Cole; Sumagaysay, Dio; Cueman, Marie; Chappell, Stacey

2016-09-01

Leaders from the American Organization of Nurse Executives describe the dynamic state of today's healthcare system related to crisis management. Adaptive leadership, driven by strong values and morality, can guide leaders and organizations through the most difficult times.

Crisis Management Demonstration and Development Facility (CM/DDF)

DTIC Science & Technology

1980-12-01

summaries were input to the DDF in real time over leased communication lines. Thus, EWAMS had an up-to-date database on which to operate. Users were...ready access to the historical record of recent U.S. crisis operations for DOD per- sonnel and to prescribe actions in real - time . The user searched the...personnel showed increasing interest in, and demand for, crisis management tools. Based on the state-of-the-art at the time , it was expected that

American Electrical: Managing an Environmental Crisis.

ERIC Educational Resources Information Center

O'Rourke, James S., IV

1998-01-01

Presents a case study for use in business communication classes to help students understand and learn both the context and the strategies for communication with business and management. Deals with an electrical company that finds itself with an environmental crisis on its hands. Includes five assignments as well as five samples. (SR)

Hyperglycemic crisis.

PubMed

Van Ness-Otunnu, Ronald; Hack, Jason B

2013-11-01

Hyperglycemic crisis is a metabolic emergency associated with uncontrolled diabetes mellitus that may result in significant morbidity or death. Acute interventions are required to manage hypovolemia, acidemia, hyperglycemia, electrolyte abnormalities, and precipitating causes. Despite advances in the prevention and management of diabetes, its prevalence and associated health care costs continue to increase worldwide. Hyperglycemic crisis typically requires critical care management and hospitalization and contributes to global health expenditures. Diagnostic and resolution criteria and management strategies for diabetic ketoacidosis and hyperosmolar hyperglycemic crisis are provided. A discussion of prevalence, mortality, pathophysiology, risk factors, clinical presentation, differential diagnosis, evaluation, and management considerations for hyperglycemic crisis are included. Emergency physicians confront the most severe sequelae of uncontrolled diabetes and provide crucial, life-saving management. With ongoing efforts from diabetes societies to incorporate the latest clinical research to refine treatment guidelines, management and outcomes of hyperglycemic crisis in the emergency department continue to improve. We provide an overview of the evaluation and treatment of hyperglycemic crisis and offer a concise, targeted management algorithm to aid the practicing emergency physician. Copyright © 2013 Elsevier Inc. All rights reserved.

Asking the Right Questions: A Framework for Assessing Counterterrorism Actions

DTIC Science & Technology

2016-11-21

hope to em - power policy makers to ask the right questions about countering terrorism and practitioners to answer them. Notes 1. The history of...10576100590950156. 8. Ibid., 308. 9. Michele L. Malvesti, “ Bombing bin Laden: Assessing the Effectiveness of Air Strikes as a Counter-Terrorism Strategy

Managing a Crisis with Social Media

ERIC Educational Resources Information Center

Bender, T. Gregory

2012-01-01

Thanks to the proliferation of handheld devices and social media such as Facebook and Twitter, people can share information instantly and succinctly. The December 8, 2011, shooting on the Virginia Tech campus underscores how important it is for information to go out quickly but accurately to help school administrators effectively manage a crisis.…

Crisis Management: Research Summaries

ERIC Educational Resources Information Center

Brock, Stephen E., Ed.; Dorman, Sally; Anderson, Luke; McNair, Daniel

2013-01-01

This article presents summaries of three studies relevant to school crisis response. The first report, "A Framework for International Crisis Intervention" (Sally Dorman), is a review of how existing crisis intervention models (including the NASP PREPaRE model) have been adapted for international use. The second article, "Responding…

SISNeT/EGNOS as a tool in Crisis Management

NASA Astrophysics Data System (ADS)

Trómiński, Paweł; Fellner, Andrzej; Sulkowski, Jarosław; Zadrä G, Paweł

2010-05-01

Crisis management can be studied on many aspects of our modern societies. Many of public services are involved in dealing with it more often. The paper covers fire-brigade operation. The case was examined in Polish cities Chełm and Warszawa. Fire brigade deals daily with many emergency situations such as fires, floods, earthquakes, accidents occurring during transportation of hazardous materials or traffic accidents. Every mentioned situation can result in injuries and even loss of lives. It means that all possible means have to be used for the most efficient dealing with an unpredictable event that occurred - the best technologies should be used on every stage of crisis management to minimize negative consequences. In this case SISNeT/EGNOS data implemented and used for dealing with crisis is considered. The fundamental purpose of the task is to develop and test monitoring platform based on GNSS and data from SISNeT/EGNOS corrections, which fulfils following conditions: accuracy, reliability and continuity of service at a level required by a highly demanding user (fire service unit). The project identifies benefits and potential of SISNeT/EGNOS system especially for user like public forces who have to assess, understand, and cope with a serious situations. The Crisis Management part of SISNeT Application project is aimed at an experimental augmentation of the positioning and monitoring system used by fire-brigade units with EGNOS/SISNeT corrections: defining the enhanced system, implementing and testing it in real operational conditions.

Fool-proofing design and crisis management for customized intelligent physical fitness and healthcare system.

PubMed

Huang, Chung-Chi; Huang, Chung-Lin; Liu, Hsiao-Man

2015-01-01

In recent years, it is quite important to develop a customized system which can enhance physical fitness and health for people. And the system reliability is more important. In the paper, a fool-proofing design and crisis management for customized physical fitness and healthcare system is proposed. It is designed to prevent the failure of the various mechanisms of customized physical fitness and healthcare system, including records, surveillance, assessments, predictions, diagnosis, prescription, and scheduling. It is separated into (1) fool-proofing design module (2) crisis management module. The fool-proofing indexes are set to prevent the failure of the various mechanisms. The states of the various mechanisms are managed by the auto-checked fool-proofing indexes. If mistakes prevention was fail, we have to execute the crisis management for stopping harmful results. The crisis management will find the error level and response the solution by using fuzzy method. By the experiments, we can find the advantages of the fool-proofing design and crisis management for customized physical fitness and healthcare system. And it is effective to prevent the failure of the various mechanisms of intelligent customized physical fitness and healthcare system.

Crisis planning to manage risks posed by animal rights extremists.

PubMed

Bailey, Matthew R; Rich, Barbara A; Bennett, B Taylor

2010-01-01

Among the multitude of crises that US research institutions may face are those caused by animal rights activists. While most activists opposed to animal research use peaceful and lawful means of expressing their opinions, some extremists resort to illegal methods. Arson, break-ins, and theft with significant property damage at US animal research facilities began in the 1980s. The most troubling trend to develop in the past decade is the targeting of individuals associated with animal research, whether directly or indirectly, and the use of violent scare tactics to intimidate researchers and their families. The National Association for Biomedical Research has a 30-year history of monitoring the animal rights movement and assisting member institutions with crisis situations. In this article we discuss attacks on researchers at their homes, cyber crimes, exploitation of new media formats, infiltration of research facilities, and the targeting of external research stakeholders and business partners. We describe the need for a well-conceived crisis management plan and strong leadership to mitigate crisis situations. Institutions with well-informed leaders and crisis management teams ready to take timely action are best equipped to protect staff, laboratory animals, and research programs. They act on early warnings, provide support for targeted staff, seek legal remedies, thoughtfully control access to research facilities, and identify and enlist new research supporters. We underscore the importance of up-to-date crisis planning so that institutions are not only aware of ongoing risks posed by animal rights extremists but also better prepared to take preemptive action and able to manage those risks successfully.

Nuclear Arms Control, Nonproliferation, and Counterterrorism: Impacts on Public Health

DOE PAGES

Dreicer, Mona; Pregenzer, Arian

2014-04-01

Reducing the risks of nuclear war, limiting the spread of nuclear weapons and reducing global nuclear weapons stockpiles are key national and international security goals. They are pursued through a variety of international arms control, nonproliferation and counter-terrorism treaties and agreements. These legally binding and political commitments, together with the institutional infrastructure that supports them, work to establish global norms of behavior and have limited the spread of weapons of mass destruction. Beyond the primary security objectives, reducing the likelihood of the use of nuclear weapons, preventing environmental releases of radioactive material, increasing the availability of safe and secure nuclearmore » technology for peaceful purposes, and providing scientific data relevant to predicting and managing the consequences of natural or human-caused disasters world-wide provide significant benefits to global public health.« less

Food Safety Crisis Management-A Comparison between Germany and the Netherlands.

PubMed

van Asselt, E D; van der Fels-Klerx, H J; Breuer, O; Helsloot, I

2017-02-01

In order to prevent food safety incidents from becoming a crisis, a good crisis management structure is essential. The aim of the current study was to compare and evaluate the national food incident response plans of 2 neighboring EU Member States: Germany and the Netherlands. This revealed that the structure of these plans is comparable, starting with initial alerting, assessment of the problem, upscaling, an execution phase and finally an evaluation of the crisis management. However, the German communication structure is more complex than the Dutch one and cross-border communication between both countries is currently limited. In general, the presence of national response plans does not guarantee a good and swift response to a food safety incident as this is often hampered by difficulties in tracing the source of the problem as well as difficulties in communication between organizations involved in crisis management. A timely detection can be improved through the development of fast screening and detecting systems and through combining various data sources using computer software systems. Mutual cooperation and communication can be improved through joint exercises or projects. This will help to streamline communication toward consumers and trade partners. Such communication should be transparent relaying not only the facts but also the uncertainties in a crisis in order to gain consumer trust and safeguard international trade. © 2017 Institute of Food Technologists®.

School Crisis Management Manual: Guidelines for Administrators.

ERIC Educational Resources Information Center

Smith, Judie

A disturbing escalation in campus emergencies compels school districts to draft effective crisis-management action plans. Effective plans can be devised that relieve burdens on principals and other school personnel, by diminishing chaos and panic, disseminating accurate information, attending to emotional strain on staff and students, and…

A Comparison of Perceived Crisis Training Management and Optimum Training Management Techniques in the Army

DTIC Science & Technology

1980-08-27

Ambiguity and Time Management relating to crisis management are key issues for consideration in the development of this investigation. These concepts are...themselves to be optimum-management-oriented. The study indicates the possibility of continuing problems in the areas of time management contributing to

Perioperative pharmacological management of pulmonary hypertensive crisis during congenital heart surgery.

PubMed

Brunner, Nathan; de Jesus Perez, Vinicio A; Richter, Alice; Haddad, François; Denault, André; Rojas, Vanessa; Yuan, Ke; Orcholski, Mark; Liao, Xiaobo

2014-03-01

Pulmonary hypertensive crisis is an important cause of morbidity and mortality in patients with pulmonary arterial hypertension secondary to congenital heart disease (PAH-CHD) who require cardiac surgery. At present, prevention and management of perioperative pulmonary hypertensive crisis is aimed at optimizing cardiopulmonary interactions by targeting prostacyclin, endothelin, and nitric oxide signaling pathways within the pulmonary circulation with various pharmacological agents. This review is aimed at familiarizing the practitioner with the current pharmacological treatment for dealing with perioperative pulmonary hypertensive crisis in PAH-CHD patients. Given the life-threatening complications associated with pulmonary hypertensive crisis, proper perioperative planning can help anticipate cardiopulmonary complications and optimize surgical outcomes in this patient population.

Coordinating management disciplines to build operational resilience in response to a major crisis situation.

PubMed

Drachal, Marcin

2017-01-01

Using case studies of the Ebola outbreak in Western Africa in 2014, and the terrorist attacks in Paris and Brussels in 2015 and 2016 respectively, this paper demonstrates how various resilience-related corporate functions contributed to effective crisis response. This paper describes the logical order of actions taken in each of the cases, and how the organisation prioritised its assets and coordinated activities to ensure the response was adequate, efficient and timely. The article demonstrates how business continuity, physical security, threat management, security intelligence and incident management worked together to support the organisation's crisis management structures in complex crisis situations.

A crisis management quality improvement initiative in a children's psychiatric hospital: design, implementation, and outcome.

PubMed

Paccione-Dyszlewski, Margaret R; Conelea, Christine A; Heisler, Walter C; Vilardi, Jodie C; Sachs, Henry T

2012-07-01

Behavioral crisis management, including the use of seclusion and restraint, is the most high risk process in the psychiatric care of children and adolescents. The authors describe hospital-wide programmatic changes implemented at a children's psychiatric hospital that aimed to improve the quality of crisis management services. Pre/post quantitative and qualitative data suggest reduced restraint and seclusion use, reduced patient and staff injury related to crisis management, and increased patient satisfaction during the post-program period. Factors deemed beneficial in program implementation are discussed.

Perioperative pharmacological management of pulmonary hypertensive crisis during congenital heart surgery

PubMed Central

2014-01-01

Abstract Pulmonary hypertensive crisis is an important cause of morbidity and mortality in patients with pulmonary arterial hypertension secondary to congenital heart disease (PAH-CHD) who require cardiac surgery. At present, prevention and management of perioperative pulmonary hypertensive crisis is aimed at optimizing cardiopulmonary interactions by targeting prostacyclin, endothelin, and nitric oxide signaling pathways within the pulmonary circulation with various pharmacological agents. This review is aimed at familiarizing the practitioner with the current pharmacological treatment for dealing with perioperative pulmonary hypertensive crisis in PAH-CHD patients. Given the life-threatening complications associated with pulmonary hypertensive crisis, proper perioperative planning can help anticipate cardiopulmonary complications and optimize surgical outcomes in this patient population. PMID:25006417

Enhanced Systemic Understanding of the Information Environment in Complex Crisis Management - Analytical Concept, Version 1.0

DTIC Science & Technology

2010-10-22

4. TITLE AND SUBTITLE Enhanced Systemic Understanding of the Information Environment in Complex Crisis Management Analytical Concept, Version 1.0...Email: schmidtb@iabg.de UNCLASSIFIED FOR PUBLIC RELEASE – Enhanced Systemic Understanding of the Information Environment in Complex Crisis ...multinational crisis management and the security sector about the significance and characteristics of the information environment. The framework is

Designing Mixed Reality Mobile Games for Crisis Management Training

ERIC Educational Resources Information Center

Di Loreto, Ines; Mora, Simone; Divitini, Monica

2013-01-01

Games for crisis management offer an interesting complement to traditional training. Experiments on their usage show that games can be promising tools able to address some of the limitations of traditional training. Also our first assessment with a board game for panic management shows that this particular kind of game could be useful for soft…

Producing 'internal suspect bodies': divisive effects of UK counter-terrorism measures on Muslim communities in Leeds and Bradford.

PubMed

Abbas, Madeline-Sophie

2018-04-06

Research on UK government counter-terrorism measures has claimed that Muslims are treated as a 'suspect community'. However, there is limited research exploring the divisive effects that membership of a 'suspect community' has on relations within Muslim communities. Drawing from interviews with British Muslims living in Leeds or Bradford, I address this gap by explicating how co-option of Muslim community members to counter extremism fractures relations within Muslim communities. I reveal how community members internalize fears of state targeting which precipitates internal disciplinary measures. I contribute the category of 'internal suspect body' which is materialized through two intersecting conditions within preventative counter-terrorism: the suspected extremist for Muslims to look out for and suspected informer who might report fellow Muslims. I argue that the suspect community operates through a network of relations by which terrors of counter-terrorism are reproduced within Muslim communities with divisive effects. © London School of Economics and Political Science 2018.

The Ongoing War Between the United States National Counter-Terrorism Structure and Militant Islamists: Is the Next 9/11 Preventable

DTIC Science & Technology

2008-05-22

security organizations. At lower levels of the Counter-Terrorism structure, fusion centers exist within nearly all fifty states. This is a completely new...all Americans who do not convert to Islam. He elaborated how Muslims believe that rabbis and monks altered the Torah and Bible and that only the ...Forces (JTTF), and fusion artment of Homeland Security, the National Counterterrorism Center, and changes to the organization of the FBI and Congress

Securitisation, Counterterrorism and the Silencing of Dissent: The Educational Implications of "Prevent"

ERIC Educational Resources Information Center

O'Donnell, Aislinn

2016-01-01

This paper outlines some of the implications of counterterrorist legislation, including Prevent, for the pedagogical relationship and for educational institutions. The concept of "radicalisation", central to the Prevent Strategy, is one that is contested in the field of counterterrorism, yet educators are now expected to identify and…

Crisis management and disaster planning: some recent lessons.

PubMed

1989-11-01

Two recent disasters--Hurricane Hugo and the San Francisco-Oakland area earthquake--put a number of hospitals (and their disaster plans) to the text this fall. In future issues, we will present details on how hospitals faced those emergencies. The need for crisis management and disaster planning, however, is not limited to natural disasters like hurricanes, earthquakes, tornadoes, or floods. Man-made disasters, both internal and external, can occur virtually at any time. These include accidents, terrorists bombs, fires, explosions, and toxic chemical spills. In this report, we will present the key elements of a crisis management plan, as well as some expert pointers on what to include in a disaster plan. We will give you details on how two hospitals fared when a major air crash occurred in their community. We will tell you some of the things they would do differently, and we will also describe how an interagency disaster planning committee responded.

Digging Deeper: Crisis Management in the Coal Industry

ERIC Educational Resources Information Center

Miller, Barbara M.; Horsley, J. Suzanne

2009-01-01

This study explores crisis management/communication practices within the coal industry through the lens of high reliability organization (HRO) concepts and sensemaking theory. In-depth interviews with industry executives and an analysis of an emergency procedures manual were used to provide an exploratory examination of the status of crisis…

Access to opioids: a global pain management crisis.

PubMed

Buitrago, Rosa

2013-03-01

The lack of availability of opioids in many countries has created a pain management crisis. Because the Single Convention on Narcotic Drugs requires governments to report annual opioid statistics, there is a need for methods to calculate individual nations' opioid needs. Ways to address this need are discussed.

Making patient safety the focus: crisis resource management in the undergraduate curriculum.

PubMed

Flanagan, Brendan; Nestel, Debra; Joseph, Michele

2004-01-01

This paper examines the role of high fidelity simulation and crisis resource management in bridging the gap between theory and practice. Patient safety is fundamental to healthcare professional practice and is a common goal for healthcare providers. It provides a focus to motivate practitioners. Patient safety issues are not a priority in undergraduate curricula. Raising the profile at this level is crucial to improving the safety and quality of healthcare delivery. This paper explores the role of simulation in providing a realistic, safe environment for participants with different levels of experience to manage evolving crises in the context of their work environment. The Southern Health Simulation and Skills Centre uses a patient safety focus in delivering a specialised educational programme adapted from aviation to healthcare. The programme, crisis resource management, enables participants to consolidate knowledge, attitudes and skills to achieve a deeper understanding of how their performance impacts on patient safety and the quality of healthcare provided. Self-reported written evaluation data was collected from participants of three different courses at Southern Health. Participants consistently report that these courses offer unique learning experiences that address aspects of workplace learning in ways that have not previously been possible. A video-assisted reflective process powerfully reinforces learning. Crisis resource management courses demonstrate the value of simulation in bridging the gap between 'knowing' and 'doing' and keeping the focus on patient safety. Recommendations are made for ways in which the core elements of crisis resource management philosophy can influence the conceptualization of a new medical curriculum.

U.S.-China Counterterrorism Cooperation: Issues for U.S. Policy

DTIC Science & Technology

2008-10-29

Resolution 1368 (to combat terrorism). On September 20, Beijing said that it offered “unconditional support” in fighting terrorism. On September 20-21...bilateral relationship pursued by President Bush since late 2001. In the short-term, U.S. security policy toward Beijing sought counterterrorism...attacks), and its image as a responsible world power helped explain China’s supportive stance. However, Beijing also worried about U.S. military action

U.S.-China Counterterrorism Cooperation: Issues for U.S. Policy

DTIC Science & Technology

2009-05-07

the others for Resolution 1368 (to combat terrorism). On September 20, Beijing said that it offered “unconditional support” in fighting terrorism...Bush since late 2001. In the short-term, U.S. security policy toward Beijing sought counterterrorism cooperation, shifting from issues about weapons...supportive stance. However, Beijing also worried about U.S. military action near China, U.S.-led alliances, Japan’s active role in the war on terrorism

U.S.-China Counterterrorism Cooperation: Issues for U.S. Policy

DTIC Science & Technology

2010-07-08

2005 and 2006 raised U.S. concerns, despite the SCO’s claim to be a counterterrorism group. In addition to Mongolia, the countries of India , Pakistan ... Pakistan to counter terrorists and the Taliban increased after the attack in Mumbai, India , in November 2008. Pakistan’s Interior Minister confirmed...in February 2009 that some of plotters were in Pakistan . The CIA reportedly brokered intelligence-sharing between India and Pakistan .130 Also in

A Location Based Communication Proposal for Disaster Crisis Management

NASA Astrophysics Data System (ADS)

Gülnerman, A. G.; Goksel, C.; Tezer, A.

2014-12-01

The most vital applications within urban applications under the title of Geographical Information system applications are Disaster applications. Especially, In Turkey the most occured disaster type Earthquakes impacts are hard to retain in urban due to greatness of area, data and effected resident or victim. Currently, communications between victims and institutions congested and collapsed, after disaster that results emergency service delay and so secondary death and desperation. To avoid these types of life loss, the communication should be established between public and institutions. Geographical Information System Technology is seen capable of data management techniques and communication tool. In this study, Life Saving Kiosk Modal Proposal designed as a communication tool based on GIS, after disaster, takes locational emegency demands, meets emergency demands over notification maps which is created by those demands,increase public solidarity by visualizing close emergency demanded area surrounded another one and gathers emergency service demanded institutions notifications and aims to increasethe capability of management. This design prosals' leading role is public. Increase in capability depends on public major contribution to disaster management by required communication infrastructure establishment. The aim is to propound public power instead of public despiration. Apart from general view of disaster crisis management approaches, Life Saving Kiosk Modal Proposal indicates preparedness and response phases within the disaster cycle and solve crisis management with the organization of design in preparedness phase, use in response phase. This resolution modal flow diagram is builded between public, communication tool (kiosk) amd response force. The software is included in communication tools whose functions, interface designs and user algorithms are provided considering the public participation. In this study, disaster crisis management with public

Crisis management can leave residual effects.

PubMed

Margolis, G L; DeMuro, P R

1991-10-01

A healthcare organization that once suffered from poor financial performance may fail to correct recovery methods that can cause lingering legal and accounting problems. A crisis management style is prone to creating problems with an organization's debt structure, Medicare and Medicaid payment, tax issues, labor relations, licensing and accreditation, compliance with fraud and abuse rules, and accounting for charity care. After stabilizing a worrisome financial situation, a healthcare organization should conduct an internal audit to ensure that its legal and accounting practices remain above board.

Risk Management of the English Universities after the 2008 Financial Crisis

ERIC Educational Resources Information Center

Yokoyama, Keiko

2018-01-01

The objective of the paper is to identify whether the global financial crisis in 2008 re-shaped risk management in the English universities in order to avoid future financial turbulence and manage risk in uncertain and insecure environments. The paper examined changes in the risk management mechanism of the English university system between 2008…

Counter-terrorism threat prediction architecture

NASA Astrophysics Data System (ADS)

Lehman, Lynn A.; Krause, Lee S.

2004-09-01

This paper will evaluate the feasibility of constructing a system to support intelligence analysts engaged in counter-terrorism. It will discuss the use of emerging techniques to evaluate a large-scale threat data repository (or Infosphere) and comparing analyst developed models to identify and discover potential threat-related activity with a uncertainty metric used to evaluate the threat. This system will also employ the use of psychological (or intent) modeling to incorporate combatant (i.e. terrorist) beliefs and intent. The paper will explore the feasibility of constructing a hetero-hierarchical (a hierarchy of more than one kind or type characterized by loose connection/feedback among elements of the hierarchy) agent based framework or "family of agents" to support "evidence retrieval" defined as combing, or searching the threat data repository and returning information with an uncertainty metric. The counter-terrorism threat prediction architecture will be guided by a series of models, constructed to represent threat operational objectives, potential targets, or terrorist objectives. The approach would compare model representations against information retrieved by the agent family to isolate or identify patterns that match within reasonable measures of proximity. The central areas of discussion will be the construction of an agent framework to search the available threat related information repository, evaluation of results against models that will represent the cultural foundations, mindset, sociology and emotional drive of typical threat combatants (i.e. the mind and objectives of a terrorist), and the development of evaluation techniques to compare result sets with the models representing threat behavior and threat targets. The applicability of concepts surrounding Modeling Field Theory (MFT) will be discussed as the basis of this research into development of proximity measures between the models and result sets and to provide feedback in support of model

Principal Experiences with Crisis Management Professional Development, Collaboration, and Implementation of the National Incident Management System Phases of Emergency Management

ERIC Educational Resources Information Center

Naradko, Anthony M.

2017-01-01

The purpose of this qualitative single-subject case study was to identify the elements critical to crisis management professional development for school principals; the factors influencing the implementation of the National Incident Management System Phases of Emergency Management (2010) for principals; and the necessary elements for fostering…

Crisis Management

ERIC Educational Resources Information Center

Brock, Stephen E., Ed.

2011-01-01

This paper presents summaries of four articles relevant to school crisis response. The first article, "Peritraumatic Dissociation Predicts Posttraumatic Stress in Youth Following Accidents" summarized by Jim Matthews, suggests that peritraumatic dissociation is a powerful predictor of PTSD symptoms among youth who have been in a car…

The Role of Pulsed Power in International Security and Counterterrorism

DTIC Science & Technology

2013-06-01

penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. 1. REPORT DATE JUN 2003...2. REPORT TYPE N/A 3. DATES COVERED - 4. TITLE AND SUBTITLE The Role Of Pulsed Power In International Security And Counterterrorism 5a...In spite of the international sanctions, the Third Reich enjoyed the second-largest industrial base on earth . In a number of technical disciplines

The fiscal crisis in the health sector: Patterns of cutback management across Europe.

PubMed

Ongaro, Edoardo; Ferré, Francesca; Fattore, Giovanni

2015-07-01

The article investigates trends in health sector cutback management strategies occurred during the ongoing financial and fiscal crisis across Europe. A European-wide survey to top public healthcare managers was conducted in ten different countries to understand their perception about public sector policy reactions to the financial and economic crisis; answers from 760 respondents from the healthcare sector (30.7% response rate) were analyzed. A multinomial logistic regression was used to assess the characteristics of respondents, countries' institutional healthcare models and the trend in public health resources availability during the crisis associated to the decision to introduce unselective cuts, targeted cuts or efficiency savings measures. Differentiated responses to the fiscal crisis that buffeted public finances were reported both across and within countries. Organizational position of respondents is significant in explaining the perceived cutback management approach introduced, where decentralized positions detect a higher use of linear cuts compared to their colleagues working in central level organizations. Compared to Bismark-like systems Beveridge-like ones favour the introduction of targeted cuts. Postponing the implementation of new programmes and containing expenses through instruments like pay freezes are some of the most popular responses adopted, while outright staff layoffs or reduction of frontline services have been more selectively employed. To cope with the effects of the fiscal crisis healthcare systems are undergoing important changes, possibly also affecting the scope of universal coverage. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Crisis Management in the Schools: New Aspects of Professionalism.

ERIC Educational Resources Information Center

Shrestha, Bijaya K.

1990-01-01

Effective crisis management as a function of the chief school administrator's role is examined. A new professionalism and recognition of districts and schools as complex organizations facilitate administrators' ability to handle this enlarged responsibility. Chapter 1 identifies forms of school crises and offers explanations, drawing upon…

Review of crisis resource management (CRM) principles in the setting of intraoperative malignant hyperthermia.

PubMed

Isaak, Robert Scott; Stiegler, Marjorie Podraza

2016-04-01

The practice of medicine is characterized by routine and typical cases whose management usually goes according to plan. However, the occasional case does arise which involves rare catastrophic emergencies, such as intraoperative malignant hyperthermia (MH), which require a comprehensive, coordinated, and resource-intensive treatment plan. Physicians are expected to provide expert quality care for routine, typical cases, but is it reasonable to expect the same standard of expertise and comprehensive management when the emergency involves a rare entity? Although physicians would like to say yes to this question, the reality is that no physician will ever amass the amount of experience in patient care needed to truly qualify as an expert in the management of a rare emergency entity, such as MH. However, physicians can become expert in the global process of managing emergencies by using the principles of crisis resource management (CRM). In this article, we review the key concepts of CRM, using a real life example of a team who utilized CRM principles to successfully manage an intraoperative MH crisis, despite there being no one on the team who had ever previously encountered a true MH crisis.

Using a Functional Simulation of Crisis Management to Test the C2 Agility Model Parameters on Key Performance Variables

DTIC Science & Technology

2013-06-01

1 18th ICCRTS Using a Functional Simulation of Crisis Management to Test the C2 Agility Model Parameters on Key Performance Variables...AND SUBTITLE Using a Functional Simulation of Crisis Management to Test the C2 Agility Model Parameters on Key Performance Variables 5a. CONTRACT...command in crisis management. C2 Agility Model Agility can be conceptualized at a number of different levels; for instance at the team

How Prepared Are America's Colleges and Universities for Major Crises? Assessing the State of Crisis Management

ERIC Educational Resources Information Center

Mitroff, Ian I.; Diamond, Michael A.; Alpaslan, Murat C.

2006-01-01

This article outlines a set of recommendations to college and university leaders and governing bodies on how to develop crisis-management systems to ensure that their institutions are as well prepared as possible for a wide range of crises. These recommendations are based, in part, on crisis-management programs developed for various business…

Cyclone Tracy and the Darwin Educators: A Case in Crisis Management.

ERIC Educational Resources Information Center

Beare, Hedley

The story of successful crisis management teaches some lessons applicable not only to surmounting crises but to everyday management decisions as well. On Christmas eve, 1974, a cyclone demolished 90 percent of the city of Darwin in Australia's Northern Territory. As thousands gathered in neighborhood schools, a team of educational administrators…

Adrenal crisis in treated Addison's disease: a predictable but under-managed event.

PubMed

White, Katherine; Arlt, Wiebke

2010-01-01

Adrenal crisis is a life-threatening event that occurs regularly in Addison's patients receiving standard replacement therapy. Patient reports suggest that it is an underestimated and under-managed event. To assess the frequency of adrenal crisis in diagnosed patients and to understand the factors contributing to the risks of adrenal crisis. We conducted a postal survey of Addison's patients in four countries, UK (n=485), Canada (n=148), Australia (n=123) and New Zealand (n=85) in 2003, asking about patients' experiences of adrenal crisis and their demographic characteristics. In 2006, a shorter follow-up survey was conducted in the UK (n=261). The frequency and causes of adrenal crisis were compared across both surveys. Demographic data from the 2003 survey were analysed to establish the main variables associated with an elevated risk of crisis. Around 8% of diagnosed cases can be expected to need hospital treatment for adrenal crisis annually. Exposure to gastric infection is the single most important factor predicting the likelihood of adrenal crisis. Concomitant diabetes and/or asthma increase the frequency of adrenal crises reported by patients. The endocrinologist has a responsibility to ensure that Addison's patients have adequate access to life-saving emergency injection materials and repeated, practical training sessions in how to use them, while the general practitioner plays a vital role as in arranging prompt emergency admissions.

U.S. Counterterrorism in Sub-Saharan Africa: Understanding Costs, Cultures, and Conflicts

DTIC Science & Technology

2008-09-01

counterterrorism in SSA. Vast and diverse, SSA is divided subregionally into East, West, and Southern Africa so as to highlight the different ...divided into East, West, and Southern Africa subregions so as to highlight the different geographies, histories, threats, and perceptions. Section...subregional approach. It divides SSA into East, West, and Southern Africa to highlight the different geogra- phies, histories, threats, and perceptions

Phaeochromocytoma [corrected] crisis.

PubMed

Whitelaw, B C; Prague, J K; Mustafa, O G; Schulte, K-M; Hopkins, P A; Gilbert, J A; McGregor, A M; Aylwin, S J B

2014-01-01

Phaeochromocytoma [corrected] crisis is an endocrine emergency associated with significant mortality. There is little published guidance on the management of phaeochromocytoma [corrected] crisis. This clinical practice update summarizes the relevant published literature, including a detailed review of cases published in the past 5 years, and a proposed classification system. We review the recommended management of phaeochromocytoma [corrected] crisis including the use of alpha-blockade, which is strongly associated with survival of a crisis. Mechanical circulatory supportive therapy (including intra-aortic balloon pump or extra-corporeal membrane oxygenation) is strongly recommended for patients with sustained hypotension. Surgical intervention should be deferred until medical stabilization is achieved. © 2013 John Wiley & Sons Ltd.

[The legal issue of the present occupational physician system in crisis management of health damage].

PubMed

Yuki, Tomoshi; Hakozaki, Yukiya; Yoshinaga, Takeo; Koizumi, Akio

2004-09-01

In present day Japan, when a crisis like the Bhopal accident occurs, due to defects in the current of industrial health law, effective crisis management cannot be taken to minimize health damage in both workers and residents. The current law characterizes industrial health as a part of the welfare service provided by employers for employees. Nevertheless, the company should be liable for all failure and damage including health impairment as a primary party. Moreover, in an emergency crisis, unlike the case of reparations, it is not accepted to argue whether the company should take absolute liability or not. Accordingly, in such cases, we consider it more appropriate to apply the "Polluter Pays Principle" and the principle of "Liability without Fault" to the company's responsibility. By these rules, the company should mobilize their own professionals, who are experts of managing crises, such as occupational physicians and/or industrial health professionals to minimize health damages among citizens in general. The company should take such a social responsibility in a crisis when it is the primary responsible party to the crisis.

The interactions of Canadian ethics consultants with health care managers and governing boards during times of crisis.

PubMed

Kaposy, Chris; Maddalena, Victor; Brunger, Fern; Pullman, Daryl; Singleton, Richard

2017-01-01

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. This study investigates the nature and degree of involvement of Canadian ethics consultants in such situations. This qualitative study used semi-structured interviews with Canadian ethics consultants to investigate the nature of their interactions with upper-level managers and governing board members in health care organizations, particularly in times of organizational crisis. We used a purposive sampling technique to identify and recruit ethics consultants throughout Canada. We found variability in the interactions between ethics consultants and upper-level managers and governing boards. Some ethics consultants we interviewed did not participate in managing organizational crisis situations. Most ethics consultants reported that they had assisted in the management of some crises and that their participation was usually initiated by managers. Some ethics consultants reported the ability to bring issues to the attention of upper-level managers and indirectly to their governing boards. The interactions between managers and ethics consultants were characterized by varying degrees of collegiality. Ethics consultants reported participating in or chairing working groups, participating in incident management teams, and developing decision-making frameworks. Canadian ethics consultants tend to believe that they have valuable skills to offer in the management of organizational crisis situations. Most of the ethics consultants

Mandating doctors to attend counter-terrorism workshops is medically unethical.

PubMed

Summerfield, Derek

2016-04-01

This is a brief exploration of the ethical issues raised for psychiatrists, and for universities, schools and wider society, by the demand that they attend mandatory training as part of the UK government's Prevent counter-terrorism strategy. The silence on this matter to date on the part of the General Medical Council, medical Royal Colleges, and the British Medical Association is a failure of ethical leadership. There is also a civil liberties issue, reminiscent of the McCarthyism of 1950s USA. We should refuse to attend.

The Post-9/11 European Union Counterterrorism Response: Legal-Institutional Framework

DTIC Science & Technology

2012-12-01

www.diw.de/documents/publikationen/73/diw_01.c.386651. de /diw_econsec0055.pdf. 23 EUROPOL, TE-SAT 2012 EU Terrorism Situation and Trend Report (The...europoltsat.pdf. 11 should be taken with a certain caution because some of positive outcomes are not known in public. De Goede concludes “due...www.diw.de/documents/publikationen/73/diw_01.c.94888. de /diw_econsec0002.pdf; Bures, EU Counterterrorism Policy, 31-58. 12 Eurobarometer28 as the

Managing crisis: the role of primary care for people with serious mental illness.

PubMed

Lester, Helen; Tritter, Jonathan Q; Sorohan, Helen

2004-01-01

More than 30% of patients with serious mental illness in the United Kingdom now receive all their health care solely from primary care. This study explored the process of managing acute mental health crises from the dual perspective of patients and primary care health professionals. Eighteen focus groups involving 45 patients, 39 general practitioners, and eight practice nurses were held between May and November 2002 in six Primary Care Trusts across the British West Midlands. The topic guide explored perceptions of gold standard care, current issues and critical incidents in receiving/providing care, and ideas on improving services. Themes relevant to the management of acute crisis included issues of process, such as access, advocacy, communication, continuity, and coordination of care; the development of more structured care that might reduce the need for crisis responses; and issues raised by the development of a more structured approach to care. Access to services is a complicated yet crucial feature of managing care in a crisis, with patients identifying barriers at the level of primary care and health professionals at the interface with secondary care. The development of more structured systems as a solution may generate its own ethical and pragmatic challenges.

Crisis-management and the Security in the Internet

NASA Astrophysics Data System (ADS)

Harada, Izumi

This paper discusses about the crisis-management and the security in the Internet. The crime that not is so far occurs during widespread to the society of the Internet, and a big social trouble. Moreover, the problem of a new security such as a cyber war and cyber terrorism appeared, too. It is necessary to recognize such a situation, and to do both correspondences corresponding to the environmental transformation by government and the people.

Expanding Possibilities through Metaphor: Breaking Biases to Improve Crisis Management

ERIC Educational Resources Information Center

Cirka, Carol C.; Corrigall, Elizabeth A.

2010-01-01

In this article, we demonstrate that an exercise using metaphors to overcome cognitive biases helped students to proactively imagine and prepare for an expanded set of potential crises. The exercise complements traditional textbook approaches to crisis management and incorporates creativity skill building in a realistic context. Learning outcomes…

The Roman Empire - The Third Century Crisis and Crisis Management

DTIC Science & Technology

2012-04-04

December 2010. Hekster, Olivier, Gerda De Kleijn, and Danielle Slootjes. "Introduction." Impact of Empire. 7, (2006, June 1): 3-10. Koselleck...Crisis of the Third Century. Edited by Olivier Hekster, Gerda De Kleijn, and Danielle Slootjes. Vol. 7, Impact of EMpire. Boston: Brill Academic, 2012...1. Protagoras and John Nicols, Mapping the Crisis of the Third Century, ed. Olivier Hekster, Gerda De Kleijn, and Danielle Slootjes

Considering Time-Dependency of Social Vulnerability in Crisis Modeling and Management

NASA Astrophysics Data System (ADS)

Aubrecht, C.; Steinnocher, K.; Freire, S.; Loibl, W.; Peters-Anders, J.; Ungar, J.

2012-04-01

Crisis and disaster management is much more than the immediate first-response actions following an incident. In many projects the main focus has been on the phase starting at the point when an unwanted event happens and lasting until the activities return to normal routines (i.e., ad hoc reaction rather than proactive mitigation). There has been less emphasis on the other phases of the disaster management cycle such as prevention, preparedness, recovery and reconstruction, even though those phases have a strong influence on the general status of a society and its citizens. Especially the potential of a crisis to escalate into a large-scale disaster is heavily dependent on the overall level of preparedness as well as on the planning of mitigation and response actions and their timely execution. There is a need for improved decision-making support that enables modeling of different crisis scenarios and their impacts according to chosen prevention and response actions. Vulnerability describing the status of a society with respect to an imposed hazard or potential impact is considered a strongly multidisciplinary concept. A central objective of vulnerability assessment is to provide indications where and how people - and more specifically, what kind of people - might be affected by a certain impact. Results should provide decision- and policy-makers with supporting information to target response and mitigation actions adequately. For assessment of the social dimension of vulnerability, population exposure mapping is usually considered the starting point. Integration of social structure and varying aspects of resilience further differentiate situation-specific vulnerability patterns on a local scale. In a disaster risk management context, assessment of human vulnerability has generally been lagging behind hazard analysis efforts. Accurately estimating population exposure is a key component of catastrophe loss modeling, one element of effective integrated risk analysis

Children's moral experiences of crisis management in a child mental health setting.

PubMed

Montreuil, Marjorie; Thibeault, Catherine; McHarg, Linda; Carnevale, Franco A

2018-02-15

The experiences of children related to conflict and crisis management in child mental health settings, especially those aged 12 and below, have been rarely studied. This study examined the moral experiences of children related to conflict and crisis management and the related use of restraint and seclusion in a child mental health setting. A 5-month focused ethnography using a participatory hermeneutic framework was conducted in a day hospital programme for children with severe disruptive disorders within a mental health institute. Children considered restraints and seclusion could help them feel safe in certain instances, for example if another child was being aggressive towards them or in exceptional cases to prevent self-injury. However, their own experiences of being restrained were predominantly negative, especially if not knowing the reason for their use, which they then found unfair. Some of the children emphasized the punitive nature of the use of restraints and seclusion, and most children disagreed with these practices when used as a punishment. Children's perspectives also highlighted the limits of the use of a uniform de-escalation approach by the staff to manage crises. Children considered discussing with the staff and developing a relationship with them as more helpful in case of a crisis then the use of a de-escalation approach or coercive strategies. © 2018 Australian College of Mental Health Nurses Inc.

Managing a Crisis

ERIC Educational Resources Information Center

Pierce, Dennis

2016-01-01

Planning ahead, practicing your response for various scenarios, being open and honest, showing empathy and respect for other peoples' perspectives and assuring stakeholders that you have the situation covered are the foundations of communicating successfully during a crisis, experts say. This article provides strategies for Community College…

Perceptions of Crisis Management in a K-12 School District

ERIC Educational Resources Information Center

Tucker, Joy

2012-01-01

This multiple-case qualitative study was conducted to examine the perceptions of community members, students, and staff regarding school crisis management following a 2006 tornado and 2010 bus accident in a small rural school district in Missouri. Online surveys were collected from 66 participants, and 10 follow-up interviews were completed with…

Using Emotional Intelligence in Training Crisis Managers: The Pandora Approach

ERIC Educational Resources Information Center

Mackinnon, Lachian; Bacon, Liz; Cortellessa, Gabriella; Cesta, Amedeo

2013-01-01

Multi-agency crisis management represents one of the most complex of real-world situations, requiring rapid negotiation and decision-making under extreme pressure. However, the training offered to strategic planners, called Gold Commanders, does not place them under any such pressure. It takes the form of paper-based, table-top exercises, or…

Before Crisis Hits: Building a Strategic Crisis Plan.

ERIC Educational Resources Information Center

Smith, Larry L.; Millar, Dan P.

This guide offers suggestions to college administrators for dealing with a variety of emergency or crisis situations that could affect a community college's effectiveness. The authors used the Institute for Crisis Management's (ICM) four types of crises in higher education as the framework for the guide. The four types of crises are: (1) sudden;…

Management of the mass casualty from the 2001 Jos crisis.

PubMed

Ozoilo, K N; Kidmas, A T; Nwadiaro, H C; Iya, D; Onche, I I; Misauno, M A; Sule, A Z; Yiltok, S J; Uba, A F; Ramyil, V M; Dakum, N K; Ugwu, B T

2014-01-01

We report our experience in the hospital management of mass casualty following the Jos civil crisis of 2001. A retrospective analysis of the records of patients managed in the Jos civil crisis of September 2001, in Plateau State, Nigeria. Information extracted included demographic data of patients, mechanisms of injury, nature and site of injury, treatment modalities and outcome of care. A total of 463 crisis victims presented over a 5 day period. Out of these, the records of 389 (84.0%) were available and analyzed. There were 348 (89.5%) males and 41 females (10.5%) aged between 3 weeks and 70 years, with a median age of 26 years. Most common mechanisms of injury were gunshot in 176 patients (45.2%) and blunt injuries from clubs and sticks in 140 patients (36.0%). Debridement with or without suturing was the most common surgical procedure, performed in 128 patients (33%) followed by exploratory laparotomy in 27 (6.9%) patients. Complications were documented in 55 patients (14.1%) and there were 16 hospital deaths (4.1% mortality). Challenges included exhaustion of supplies, poor communication and security threats both within the hospital and outside. Most patients reaching the hospital alive had injuries that did not require lifesaving interventions. Institutional preparedness plan would enable the hospital to have an organized approach to care, with better chances of success. More effective means of containing crises should be employed to reduce the attendant casualty rate.

Crisis in environmental management of the Soviet Union

NASA Astrophysics Data System (ADS)

Khabibullov, Marat

1991-11-01

The prevailing system of environmental management strongly depends on the economic and political structures of a country and is influenced by the current condition of them. Environmental degradation in the Soviet Union has been caused mainly by the political and economic misconceptions listed in this article. With the transformation of its state order to the model of Western democracies, the Soviet Union is experiencing a deep economic crisis of restructuring, reflected in a parallel crisis in its system of environmental management, which is manifest in the form of rapid transformation. This is characterized by the contradiction of the state’s old administrative institutions, which still exist, with the efforts to use market mechanisms of environmental control. Such methods include various fees and payments for the use of natural resources or for pollution and creation of specialized regional funds and banks to finance environmental programs. All these occur in the context of the strengthening of regional sovereignty, the introduction of self-accounting for economic units, the adoption of comprehensive legal enactments, and the setting up of an efficient administrative system of their enforcement. Public activism, as one of the principal actors in this structure, also has undergone quick maturation. Nevertheless the future development of the new Soviet system of environmental control remains uncertain because of the present unpredictability of the overall situation in the short run.

Principal Leadership and School Culture with a School-Wide Implementation of Professional Crisis Management: A Redemptive v. Punitive Model

ERIC Educational Resources Information Center

Adams, Mark Thomas

2013-01-01

This qualitative study investigated the nature of the relationship between principal leadership and school culture within a school-wide implementation of Professional Crisis Management (PCM). PCM is a comprehensive and fully integrated system designed to manage crisis situations effectively, safely, and with dignity. While designed primarily to…

Do technical skills correlate with non-technical skills in crisis resource management: a simulation study.

PubMed

Riem, N; Boet, S; Bould, M D; Tavares, W; Naik, V N

2012-11-01

Both technical skills (TS) and non-technical skills (NTS) are key to ensuring patient safety in acute care practice and effective crisis management. These skills are often taught and assessed separately. We hypothesized that TS and NTS are not independent of each other, and we aimed to evaluate the relationship between TS and NTS during a simulated intraoperative crisis scenario. This study was a retrospective analysis of performances from a previously published work. After institutional ethics approval, 50 anaesthesiology residents managed a simulated crisis scenario of an intraoperative cardiac arrest secondary to a malignant arrhythmia. We used a modified Delphi approach to design a TS checklist, specific for the management of a malignant arrhythmia requiring defibrillation. All scenarios were recorded. Each performance was analysed by four independent experts. For each performance, two experts independently rated the technical performance using the TS checklist, and two other experts independently rated NTS using the Anaesthetists' Non-Technical Skills score. TS and NTS were significantly correlated to each other (r=0.45, P<0.05). During a simulated 5 min resuscitation requiring crisis resource management, our results indicate that TS and NTS are related to one another. This research provides the basis for future studies evaluating the nature of this relationship, the influence of NTS training on the performance of TS, and to determine whether NTS are generic and transferrable between crises that require different TS.

Counter-Terrorism Contributions from the National Labs

NASA Astrophysics Data System (ADS)

Davis, Jay

2002-04-01

The DOD and NNSA laboratories have significant technical capabilities that can contribute to counter-terrorism and homeland security. Maximizing those contributions, however, requires that laboratory staff engage the doctrinal and operational issues of these problems as well. The broader interagency community needs support in these components of the problem as much as in the technical components. The speaker's experiences as director of the DoD Defense Threat Reduction Agency, established in 1998 to address DoD's role in defense against weapons of mass destruction in all venues, have given him a somewhat unique perspective on this problem. Examples of issues identified in scenario play at Cabinet level in the last Admistration will be given to illustrate the breadth of this problem, as will the speaker's assessment of the grand challenges in deterring use of WMD against the Homeland.

EUROPE IN CRISIS

DTIC Science & Technology

2017-04-06

the only international organization that can manage the Syrian refugee security crisis causing problems for the EU from root to branch because NATO is...AIR WAR COLLEGE AIR UNIVERSITY EUROPE IN CRISIS By Peter Halseth, Civilian, Defense Logistics Agency A Research Report Submitted...Syrian refugee crisis and providing intelligence assistance to member countries in the European Union (EU) of foreign fighters returning from the

Crisis Management: How to Handle a Salmonella Outbreak at Camp.

ERIC Educational Resources Information Center

Becker, William A.; Popkin, Rodger

1992-01-01

Details events of six days during Salmonella outbreak at camp in North Carolina. Explains how camp handled 280 sick campers and staff, well campers, news media, and parents. Based on an epidemiologic survey of food eaten, it was suspected that the culprit of the outbreak was a meat item. Offers suggestions for crisis management in the camp…

A strategy for management of intraoperative Addisonian crisis during coronary artery bypass grafting.

PubMed

D'Silva, Celma; Watson, Dale; Ngaage, Dumbor

2012-04-01

Patients with Addison's disease undergoing cardiac surgery are at risk of developing a crisis. There is no consensus on the preoperative and intraoperative management of this group of patients undergoing cardiac surgery so the recommendations for non-cardiac patients are often used. The consensus statement from the international task force of the American College of Critical Care medicine recommends 100 mg of intravenous hydrocortisone for patients with adrenal insufficiency in septic shock, but in patients undergoing surgery, especially with extracorporeal circulation, the dosage may even be higher. We report our management of a patient with well-controlled adrenal insufficiency for 30 years who developed intraoperative Addisonian crisis despite the recommended preoperative corticosteroid supplementation. The importance of adequate corticosteroid supplementation for cardiac surgery patients, adapting the surgical strategy to allow for optimal management of potential complications and close monitoring with heightened awareness are discussed.

Hypertensive crisis in children.

PubMed

Chandar, Jayanthi; Zilleruelo, Gastón

2012-05-01

Hypertensive crisis is rare in children and is usually secondary to an underlying disease. There is strong evidence that the renin-angiotensin system plays an important role in the genesis of hypertensive crisis. An important principle in the management of children with hypertensive crisis is to determine if severe hypertension is chronic, acute, or acute-on-chronic. When it is associated with signs of end-organ damage such as encephalopathy, congestive cardiac failure or renal failure, there is an emergent need to lower blood pressures to 25-30% of the original value and then accomplish a gradual reduction in blood pressure. Precipitous drops in blood pressure can result in impairment of perfusion of vital organs. Medications commonly used to treat hypertensive crisis in children are nicardipine, labetalol and sodium nitroprusside. In this review, we discuss the pathophysiology, differential diagnosis and recent developments in management of hypertensive crisis in children.

Oil terrorism-militancy link: Mediating role of moral disengagement in emergency and crisis management.

PubMed

Mafimisebi, Oluwasoye Patrick; Thorne, Sara

2015-01-01

The controversial issues of terrorism and militancy have generated contemporary interests and different interpretations have emerged on how to combat and manage these dangerous events. This study widens understanding of moral disengagement mechanism application in the perpetuation of inhumanities within the context of oil terrorist and militant behaviors. The research findings and model are explicit on how people form moral evaluations of agents who are forced to make morally relevant decisions over times in context of crisis situations. Quite crucially, understanding the context of terrorism and militancy provides policymakers, emergency and crisis managers better analysis and response to such events. The research fundamental purpose was to investigate the mediating role of moral disengagement on delinquency of oil terrorism and militancy; and considered implications for emergency and crisis management practices. The study found that situational-induced crises such as oil terrorism and militancy were sufficient to account for an individual's misdeeds and unethical or inhumane decisions made under frustration and agitation may be perceived as less indicative of one's fundamental character. Findings suggest that more repugnant delinquencies could have been committed in the name of justice than in the name of injustice, avenues for future research. In context, the result of the moral disengagement scale shows that morality of delinquency (oil terrorism and militancy) is accomplished by cognitively redefining the morality of such acts. The main finding is that people in resistance movements are rational actors making rational choices. The authors argue that theorists, policymakers, and practitioners must give meaningful attention to understanding the multidimensional nature of emergency, crisis and disaster management for better strength of synthesis between theory and practice. The research is concluded by thorough examination of the implication and limitations for

U.S. Counterterrorism Landscape: An Examination of Policy and Strategy Using a Conceptual Approach

DTIC Science & Technology

2015-06-12

deterrence, destroy) may yield a different agency lead to implement CT strategy depending on the terrorist organization. The current struggle against...marshal and present evidence in overseas attack, while the FBI and the Justice Department would pursue traditional law enforcement methods to conduct...also fighting for the future of CIA/DOD integrated counterterrorism warfare around the globe. While we will make mistakes as we chart new territory

Effective information management and assurance for a modern organisation during a crisis.

PubMed

MacLeod, Andrew

2015-01-01

During a crisis, organisations face a major unpredictable event with potentially negative consequences. Effective information management and assurance can assist the organisation in making sure that they have the correct information in a secure format to make decisions to recover their operations. The main elements of effective information management and assurance are confidentiality, integrity and availability, combined with non-repudiation. Should an element of effective information management or assurance be removed it can have a detrimental effect on the other elements and render the information management and assurance practices of the organisation ineffectual.

When Crisis Strikes.

ERIC Educational Resources Information Center

Caudle, Melissa

1994-01-01

School crises may be categorized as emergency situations, human-made crises, natural events, medical emergencies, and mechanical crises. Central to any successful crisis-management plan are onsite and district-level crisis response teams. Plans should specify staff responsibilities; provide for communication codes, devices, and procedures;…

K-12 School Leaders and School Crisis: An Exploration of Principals' School Crisis Competencies and Preparedness

ERIC Educational Resources Information Center

McCarty, Sean P.

2012-01-01

On any given day, principals could find themselves faced with a situation that could define their roles as crisis leaders. This dissertation research offers an exploratory study in the field of crisis response and educational leadership. From experts in the field of crisis response, the author compiled a list of crisis management competencies…

Interagency Communication and Collaboration on School Crisis Response Planning and Management

ERIC Educational Resources Information Center

Skavdahl, Britta M.

2010-01-01

Purpose. The purpose of this study was to determine what research-based and federally recommended practices in the area of school crisis response planning and management were being implemented in K-8 school districts in Northern California, as well as the degree with which the recommended practices were being implemented. Finally, the study…

European Union’s Military Crisis Management: Challenges and Perspectives

DTIC Science & Technology

2012-06-08

respond quickly and decisively, but “the curious alchemy of German leadership, Italian support for it, British limitation of it, [and] French ambition...EUROPEAN UNION’S MILITARY CRISIS MANAGEMENT: CHALLENGES AND PERSPECTIVES A thesis presented to the Faculty of the U.S. Army...Command and General Staff College in partial fulfillment of the requirements for the degree MASTER OF MILITARY ART AND SCIENCE General Studies

Hypertensive Crisis, Burden, Management, and Outcome at a Tertiary Care Center in Karachi

PubMed Central

Almas, Aysha; Ghouse, Ayaz; Iftikhar, Ahmed Raza; Khursheed, Munawwar

2014-01-01

Objectives. Hypertension, if uncontrolled, can lead to hypertensive crisis. We aim to determine the prevalence of hypertensive crisis, its management, and outcome in patients presenting to a tertiary care center in Karachi. Methods. This was a cross-sectional study conducted at the Aga Khan University, Karachi, Pakistan. Adult inpatients (>18 yrs) presenting to the ER who were known hypertensive and had uncontrolled hypertension were included. Results. Out of 1336 patients, 28.6% (387) had uncontrolled hypertension. The prevalence of hypertensive crisis among uncontrolled hypertensive was 56.3% (218). Per oral calcium channel blocker; 35.4% (137) and intravenous nitrate; 22.7% (88) were the most commonly administered medication in the ER. The mean (SD) drop in SBP in patients with hypertensive crisis on intravenous treatment was 53.1 (29) mm Hg and on per oral treatment was 43 (27) mm Hg. The maximum mean (SD) drop in blood pressure was seen by intravenous sodium nitroprusside; 80 (51) mm Hg in SBP. Acute renal failure was the most common complication with a prevalence of 11.5% (24). Conclusion. The prevalence of hypertensive crisis is high. Per oral calcium channel blocker and intravenous nitrate are the most commonly administered medications in our setup. PMID:26464857

Hypertensive Crisis, Burden, Management, and Outcome at a Tertiary Care Center in Karachi.

PubMed

Almas, Aysha; Ghouse, Ayaz; Iftikhar, Ahmed Raza; Khursheed, Munawwar

2014-01-01

Objectives. Hypertension, if uncontrolled, can lead to hypertensive crisis. We aim to determine the prevalence of hypertensive crisis, its management, and outcome in patients presenting to a tertiary care center in Karachi. Methods. This was a cross-sectional study conducted at the Aga Khan University, Karachi, Pakistan. Adult inpatients (>18 yrs) presenting to the ER who were known hypertensive and had uncontrolled hypertension were included. Results. Out of 1336 patients, 28.6% (387) had uncontrolled hypertension. The prevalence of hypertensive crisis among uncontrolled hypertensive was 56.3% (218). Per oral calcium channel blocker; 35.4% (137) and intravenous nitrate; 22.7% (88) were the most commonly administered medication in the ER. The mean (SD) drop in SBP in patients with hypertensive crisis on intravenous treatment was 53.1 (29) mm Hg and on per oral treatment was 43 (27) mm Hg. The maximum mean (SD) drop in blood pressure was seen by intravenous sodium nitroprusside; 80 (51) mm Hg in SBP. Acute renal failure was the most common complication with a prevalence of 11.5% (24). Conclusion. The prevalence of hypertensive crisis is high. Per oral calcium channel blocker and intravenous nitrate are the most commonly administered medications in our setup.

[Total quality management in times of crisis. The case of Argentina].

PubMed

Larroca, Norberto

2003-01-01

Healthcare organizations were faced with so great a challenge following the financial slump that they were forced to 'sharpen their wits' in order to survive. Integrated Quality Management (in Spanish GIC), proved the ideal instrument. GIC has four foundational elements, the application of which allow for successful management of crisis situations. They are as follows: TRAINING of human resources EVALUATION of healthcare institutions SELF-EVALUATION by institutions QUALITY ACCREDITATION of institutions All our organizations have the appropriate tools to carry out these activities which form the basis of our project: CAES (Argentinean Chamber of Healthcare Institutions) -training-, CIDCAM (Inter-institutional Committee for Quality Development in Medical Care) -evaluation and self-evaluation-, CENAS (Specialist Centre for the Standardization and Accreditation in Health Care)-accreditation-. In times of crisis, we play an active part, that is, instead of withdrawing our efforts, we do our best to achieve the best and most adequate objective in order to meet the needs of the population through Integrated Quality Management. Eventually, when the results are examined, medical care that meets the best quality standards is found to be, after all, the most economical (that is best results, better satisfaction of healthcare users and providers as well as less mistakes).

Crisis Management Plans in Higher Education: Commonalities, Attributes, and Perceived Effectiveness

ERIC Educational Resources Information Center

Lott, Mary Keane

2012-01-01

Crisis has remained as prevalent in our lives today as it ever has been, especially in this post-9/11 era. People handle all types of crises, whether personally, professionally or socially. Arguably, people's worldviews after the tragedies of September 11, 2001 have never been the same, including the way they manage and respond to crises. This…

The use of emergency manuals in perioperative crisis management: a cautious approach.

PubMed

Szabo, Ashley; August, David A; Klainer, Suzanne; Miller, Andrew D; Kaye, Alan D; Raemer, Daniel B; Urman, Richard D

2015-01-01

When an unexpected perioperative crisis arises, simulation studies have suggested that the use of an emergency manual (EM) may offset the large cognitive load involved in crisis management, facilitating the efficient performance of key steps in treatment. However, little is known about how well EMs will translate into actual practice and what is required to use them optimally. While EMs are a promising tool in the management of perioperative critical events, more research is needed to define best practices and their limitations. In the interim, cautious use of these cognitive aids is recommended, especially when the diagnosis is not straightforward, falls "in between" sections of the EM, or falls outside of the EM itself. Further research should focus on the efficacy of EMs as measured by the percentage of critical steps correctly performed by their users in scenarios that do not closely mirror one of the listed EM scenarios from the beginning or as the situation evolves.

Myasthenic crisis patients who require intensive care unit management.

PubMed

Sakaguchi, Hideya; Yamashita, Satoshi; Hirano, Teruyuki; Nakajima, Makoto; Kimura, En; Maeda, Yasushi; Uchino, Makoto

2012-09-01

The purpose of this report was to investigate predictive factors that necessitate intensive care in myasthenic crisis (MC). We retrospectively reviewed MC patients at our institution and compared ICU and ward management groups. Higher MG-ADL scale scores, non-ocular initial symptoms, infection-triggered findings, and higher MGFA classification were observed more frequently in the ICU group. In patients with these prognostic factors, better outcomes may be obtained with early institution of intensive care. Copyright © 2012 Wiley Periodicals, Inc.

Role of strategic human resource management in crisis management in Australian greenfield hospital sites: a crisis management theory perspective.

PubMed

Kendrick, Madeleine Iris; Bartram, Timothy; Cavanagh, Jillian; Burgess, John

2017-11-20

Objective This study examined strategic human resource management (SHRM) activities in two case hospitals relative to their approach to greenfield site success. Methods A comparative case study analysis approach was used, with documents sourced from public, open-access sites. The theoretical framework of crisis management theory's (CMT) proactive management and open communication channels was used to examine the documents, which were annual reports addressing both hospitals' first year of performance, union publications and transcripts of relevant parliamentary inquiries. Results The hospital that effectively used CMT in its first 12 months was demonstratively more 'successful' than the hospital that reported to not have effectively used CMT. 'Success' in this project was articulated as the hospital's ability to consolidate operations, without ongoing negative media attention, after 12 months. Conclusion This study provided an identification of how the use of CMT in a hospital's greenfield stage can increase the hospital's chances of 'success'. What is known about the topic? Journal and media articles illustrated a gap in greenfield human resource management (HRM) regarding successful consolidation, especially the healthcare context. Although manufacturing firms are addressed in academic literature in a greenfield context, there is a lack of knowledge concerning successful greenfield HRM in a healthcare context. What does this paper add? This study is among the first to identify the role of CMT in successful greenfield site establishment by identifying its presence in management activities. What are the implications for practitioners? The findings of this study suggest a potential link between the implementation of CMT and greenfield site success. This could allow future greenfield healthcare sites to operate with less cost and risk. The lack of stakeholder participation in the present study limits the applicability of its findings. However, archival document

A Behavioral Framework for Managing Massive Airline Flight Disruptions through Crisis Management, Organization Development, and Organization Learning

NASA Astrophysics Data System (ADS)

Larsen, Tulinda Deegan

In this study the researcher provides a behavioral framework for managing massive airline flight disruptions (MAFD) in the United States. Under conditions of MAFD, multiple flights are disrupted throughout the airline's route network, customer service is negatively affected, additional costs are created for airlines, and governments intervene. This study is different from other studies relating to MAFD that have focused on the operational, technical, economic, financial, and customer service impacts. The researcher argues that airlines could improve the management of events that led to MAFD by applying the principles of crisis management where the entire organization is mobilized, rather than one department, adapting organization development (OD) interventions to implement change and organization learning (OL) processes to create culture of innovation, resulting in sustainable improvement in customer service, cost reductions, and mitigation of government intervention. At the intersection of crisis management, OD, and OL, the researcher has developed a new conceptual framework that enhances the resiliency of individuals and organizations in responding to unexpected-yet-recurring crises (e.g., MAFD) that impact operations. The researcher has adapted and augmented Lalonde's framework for managing crises through OD interventions by including OL processes. The OD interventions, coupled with OL, provide a framework for airline leaders to manage more effectively events that result in MAFD with the goal of improving passenger satisfaction, reducing costs, and preventing further government intervention. Further research is warranted to apply this conceptual framework to unexpected-yet-recurring crises that affect operations in other industries.

When a Crisis Hits, Will Your School Be Ready?

ERIC Educational Resources Information Center

Decker, Robert H.

This guidebook describes the components involved in proactively developing a comprehensive crisis-management plan. Chapter 1 explains the philosophical underpinnings of a crisis-management plan and discusses the importance of vision and staff development. Chapter 2 answers the questions: Why do we need a crisis-management plan? Who needs to be…

Crisis Communication in the Area of Risk Management: The CriCoRM Project.

PubMed

Scarcella, Carmelo; Antonelli, Laura; Orizio, Grazia; Rossmann, Costanze; Ziegler, Lena; Meyer, Lisa; Garcia-Jimenez, Leonarda; Losada, Jose Carlos; Correia, Joao; Soares, Joana; Covolo, Loredana; Lirangi, Enrico; Gelatti, Umberto

2013-09-02

During the last H1N1 pandemic has emerged the importance of crisis communication as an essential part of health crisis management. The Project aims specifically to improve the understanding of crisis communication dynamics and effective tools and to allow public health institutions to communicate better with the public during health emergencies. THE PROJECT WILL PERFORM DIFFERENT ACTIVITIES: i) state of the art review; ii) identification of key stakeholders; iii) communicational analysis performed using data collected on stakeholder communication activities and their outcomes considering the lessons learnt from the analysis of the reasons for differing public reactions during pandemics; iv) improvement of the existing guidelines; v) development of Web 2.0 tools as web-platform and feed service and implementation of impact assessment algorithms; vi) organization of exercises and training on this issues. In the context of health security policies at an EU level, the project aims to find a common and innovative approach to health crisis communication that was displayed by differing reactions to the H1N1 pandemic policies. The focus on new social media tools aims to enhance the role of e-health, and the project aims to use these tools in the specific field of health institutions and citizens. The development of Web 2.0 tools for health crisis communication will allow an effective two-way exchange of information between public health institutions and citizens. An effective communication strategy will increase population compliance with public health recommendations. Significance for public healthThe specific aim of the project is to develop a European strategy approach on how to communicate with the population and with different stakeholders groups involved in the crisis management process, based on an analysis of the communication process during the H1N1 pandemic (content analysis of press releases, press coverage and forum discussions) and on interviews with key

Towards integrated crisis support of regional emergency networks.

PubMed

Caro, D H

1999-01-01

Emergency and crisis management pose multidimensional information systems challenges for communities across North America. In the quest to reduce mortality and morbidity risks and to increase the level of crisis preparedness, regional emergency management networks have evolved. Integrated Crisis Support Systems (ICSS) are enabling information technologies that assist emergency managers by enhancing the ability to strategically manage and control these regional emergency networks efficiently and effectively. This article underscores the ICCS development, control and leadership issues and their promising implications for regional emergency management networks.

VHR satellite imagery for humanitarian crisis management: a case study

NASA Astrophysics Data System (ADS)

Bitelli, Gabriele; Eleias, Magdalena; Franci, Francesca; Mandanici, Emanuele

2017-09-01

During the last years, remote sensing data along with GIS have been largely employed for supporting emergency management activities. In this context, the use of satellite images and derived map products has become more common also in the different phases of humanitarian crisis response. In this work very high resolution satellite imagery was processed to assess the evolution of Za'atari Refugee Camp, built in Jordan in 2012 by the UN Refugee Agency to host Syrian refugees. Multispectral satellite scenes of the Za'atari area were processed by means of object-based classifications. The main aim of the present work is the development of a semiautomated procedure for multi-temporal camp monitoring with particular reference to the dwellings detection. Whilst in the emergency mapping domain automation of feature extraction is widely investigated, in the field of humanitarian missions the information is often extracted by means of photointerpretation of the satellite data. This approach requires time for the interpretation; moreover, it is not reliable enough in complex situations, where features of interest are often small, heterogeneous and inconsistent. Therefore, the present paper discusses a methodology to obtain information for assisting humanitarian crisis management, using a semi-automatic classification approach applied to satellite imagery.

Social Science for Counterterrorism: Putting the Pieces Together

DTIC Science & Technology

2009-01-01

Term Communications In countering terrorism or insurgency, short-term communications efforts—such as crisis response or rapid message adaptation in...of time. Within the literature on crisis communications is a generally agreed- on list of preparatory actions an organization should take, including...writing a crisis response plan, assigning crisis spokespersons and teams, training staff for crises, identifying communications risks and vulner

A Study of Crisis Management Based on Stakeholders Analysis Model

NASA Astrophysics Data System (ADS)

Qingchun, Yue

2017-11-01

From the view of stakeholder theory, not only the enterprises should provide services to shareholders, but also take care of the demands of stakeholders. Stakeholders for the enterprise crisis are the organizations and individuals, which cause crisis, respond to the crisis and affected by the enterprise crisis. In this paper, first of all, to comb the development of stakeholder theory systematically; secondly, with the help of the enterprise crisis stakeholder analysis model, analyze the concept of stakeholders for the enterprise crisis and membership, and with the example of Shuanghui Group for further analysis; finally, we put forward relevant proposals for the enterprise crisis from the view of stakeholders.

Experience in the management of the mass casualty from the January 2010 Jos Crisis.

PubMed

Ozoilo, K N; Amupitan, I; Peter, S D; Ojo, E O; Ismaila, B O; Ode, M; Adoga, A A; Adoga, A S

2016-01-01

On the 17 of January 2010, a sectarian crisis broke out in Jos the capital of Plateau state, Nigeria. It created a mass casualty situation in the Jos University Teaching Hospital. We present the result of the hospital management of that mass casualty incident. To share our experience in the management of the mass casualty situation arising from the sectarian crisis of Jos in January 2010. We retrospectively reviewed the hospital records of patients who were treated in our hospital with injuries sustained in the Jos crisis of January 2010. A total of 168 patients presented over a four day period. There were 108 males (64.3%) and 60 females (35.7%). The mean age was 26 ± 16 years. Injury was caused by gunshots in 68 patients (40.5%), machete in 56 (33.3%), falls in 22 (13.1%) and burning in 21 (13.1%). The body parts injured were the upper limbs in 61(36.3%) patients, lower limbs 44 (26.2%) and scalp 43 (25.6%). Majority, 125 (74.4%) did not require formal operative care. Fourteen (8.3%) patients had complications out of which 10 (6.0%) were related to infections. There were 5 (3.1%) hospital mortalities and the mean duration of hospital stay was 4.2 days. The hospital operations returned to routine 24 hours after the last patient was brought in. As a result of changes made to our protocol, management proceeded smoothly and there was no stoppage of the hospital response at any point. This civil crisis involved mostly young males. Injuries were mainly lacerations from machete and gunshot injuries. Majority of the victims did not require formal surgical operations beyond initial care. Maintaining continuity in the positions of the Incident commander and the mass casualty commander ensure a smooth disaster response with fewer challenges.

Crisis resource management training for an anaesthesia faculty: a new approach to continuing education.

PubMed

Blum, Richard H; Raemer, Daniel B; Carroll, John S; Sunder, Neelakantan; Felstein, David M; Cooper, Jeffrey B

2004-01-01

Human error and system failures continue to play a substantial role in adverse outcomes in health care. Anaesthesia crisis resource management addresses many patient safety issues by teaching behavioural skills for critical events but it has not been systematically utilized to teach experienced faculty. An anaesthesia crisis resource management course was created for the faculty of our medical school's anaesthesia teaching programmes. The course objectives were to understand and improve participants' proficiency in crisis resource management (CRM) skills and to learn skills for debriefing residents after critical events. Through surveys, measurement objectives assessed acceptance, utility and need for recurrent training immediately post-course. These were measured again approximately 1 year later along with self-perceived changes in the management of difficult or critical events. The highly rated course was well received in terms of overall course quality, realism, debriefings and didactic presentation. Course usefulness, CRM principles, debriefing skills and communication were highly rated immediately post-course and 1 year later. Approximately half of the faculty staff reported a difficult or critical event following the course; of nine self-reported CRM performance criteria surveyed all claimed improvement in their CRM non-technical skills. A unique and highly rated anaesthesia faculty course was created; participation made the faculty staff eligible for malpractice premium reductions. Self-reported CRM behaviours in participants' most significant difficult or critical events indicated an improvement in performance. These data provide indirect evidence supporting the contention that this type of training should be more widely promoted, although more definitive measures of improved outcomes are needed.

Campus Crisis Response at Viberg College

ERIC Educational Resources Information Center

Eaker, Rachel; Viars, Jamie

2014-01-01

This fictional case study examines crisis response in higher education settings. Information about current crisis response procedures, plans, and trends was gathered from informational interviews, current crisis management literature, and multiple college and university websites. The information was synthesized into a fictional case study using…

Social media in disaster risk reduction and crisis management.

PubMed

Alexander, David E

2014-09-01

This paper reviews the actual and potential use of social media in emergency, disaster and crisis situations. This is a field that has generated intense interest. It is characterised by a burgeoning but small and very recent literature. In the emergencies field, social media (blogs, messaging, sites such as Facebook, wikis and so on) are used in seven different ways: listening to public debate, monitoring situations, extending emergency response and management, crowd-sourcing and collaborative development, creating social cohesion, furthering causes (including charitable donation) and enhancing research. Appreciation of the positive side of social media is balanced by their potential for negative developments, such as disseminating rumours, undermining authority and promoting terrorist acts. This leads to an examination of the ethics of social media usage in crisis situations. Despite some clearly identifiable risks, for example regarding the violation of privacy, it appears that public consensus on ethics will tend to override unscrupulous attempts to subvert the media. Moreover, social media are a robust means of exposing corruption and malpractice. In synthesis, the widespread adoption and use of social media by members of the public throughout the world heralds a new age in which it is imperative that emergency managers adapt their working practices to the challenge and potential of this development. At the same time, they must heed the ethical warnings and ensure that social media are not abused or misused when crises and emergencies occur.

Health and rescue services management system during a crisis event

PubMed Central

Nicolaidou, Iolie; Hadjichristofi, George; Kyprianou, Stelios; Christou, Synesios; Constantinou, Riana

2016-01-01

Τhe performance of rescuers and personnel handling major emergencies or crisis events can be significantly improved through continuous training and through technology support. The work done in order to create a system has been discussed which can support both resources and victims during a crisis or major emergency event. More specifically, the system supports real-time management of firefighter teams, rescue teams, health services, and victims during a major disaster. It can be deployed in an ad hoc manner in the disaster area, as a stand-alone infrastructure (using its own telecommunications and power). It mainly consists of a control station, which is installed in the area command centre, the firefighters units, the rescuers units, the ambulance vehicles units, and the telemedicine units that can be used in order to support victim handling at the casualties clearing station. The system has been tested and improved through continuous communication with experts and through professional exercises; the results and conclusions are presented. PMID:27733928

Discussing Terrorism: A Pupil-Inspired Guide to UK Counter-Terrorism Policy Implementation in Religious Education Classrooms in England

ERIC Educational Resources Information Center

Quartermaine, Angela

2016-01-01

My research into pupils' perceptions of terrorism and current UK counter-terrorism policy highlights the need for more detailed and accurate discussions about the implementation of the educational aims, in particular those laid out by the Prevent Strategy. Religious education (RE) in England is affected by these aims, specifically the challenging…

Sciatic (Popliteal Fossa) Catheter for Pediatric Pain Management of Sickle Cell Crisis: A Case Report.

PubMed

Weber, Garret; Liao, Sherry; Burns, Micah Alexander

2017-11-15

Sickle cell crisis, or vaso-occlusive crisis (VOC), is a major cause of hospitalizations for adults and children with sickle cell disease, and is associated with increased morbidity and mortality. Despite prompt pharmacological treatment and multimodal pain management, acute pain during a VOC is often not adequately controlled in the pediatric population. We placed a continuous popliteal sciatic nerve block under ultrasound guidance in a pediatric patient for localized refractory pain during a VOC, resulting in improved pain control with preserved sensorimotor function.

Panel 2.18: logistics, information technology (IT), and telecommunications in crisis management.

PubMed

De Silva, Terrence; Chikersal, Jyotsna; Snoad, Nigel; Woodworth, Brent; Ghaly, Cherif; Catterall, Martin

2005-01-01

This is a summary of the presentations and discussion of Panel 2.18, Logistics, Information Technology, and Telecommunications in Crisis Management of the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization (WHO) in Phuket, Thailand, 04-06 May 2005. The topics discussed included issues related to logistics, information technology (IT), and crisis communication pertaining to the responses to the damage created by the Tsunami. It is presented in the following major sections: (1) issues; (2) lessons learned; (3) what was done well; (4) what could have been done better; and (5) conclusions and recommendations. Each major section is presented in four sub-sections: (1) needs assessments; (2) coordination; (3) filling the gaps; and (4) capacity building.

Crisis Communication in the Area of Risk Management: The CriCoRM Project

PubMed Central

Scarcella, Carmelo; Antonelli, Laura; Orizio, Grazia; Rossmann, Costanze; Ziegler, Lena; Meyer, Lisa; Garcia-Jimenez, Leonarda; Losada, Jose Carlos; Correia, Joao; Soares, Joana; Covolo, Loredana; Lirangi, Enrico; Gelatti, Umberto

2013-01-01

Background During the last H1N1 pandemic has emerged the importance of crisis communication as an essential part of health crisis management. The Project aims specifically to improve the understanding of crisis communication dynamics and effective tools and to allow public health institutions to communicate better with the public during health emergencies. Design and methods The Project will perform different activities: i) state of the art review; ii) identification of key stakeholders; iii) communicational analysis performed using data collected on stakeholder communication activities and their outcomes considering the lessons learnt from the analysis of the reasons for differing public reactions during pandemics; iv) improvement of the existing guidelines; v) development of Web 2.0 tools as web-platform and feed service and implementation of impact assessment algorithms; vi) organization of exercises and training on this issues. Expected impact of the study for public health In the context of health security policies at an EU level, the project aims to find a common and innovative approach to health crisis communication that was displayed by differing reactions to the H1N1 pandemic policies. The focus on new social media tools aims to enhance the role of e-health, and the project aims to use these tools in the specific field of health institutions and citizens. The development of Web 2.0 tools for health crisis communication will allow an effective two-way exchange of information between public health institutions and citizens. An effective communication strategy will increase population compliance with public health recommendations. Significance for public health The specific aim of the project is to develop a European strategy approach on how to communicate with the population and with different stakeholders groups involved in the crisis management process, based on an analysis of the communication process during the H1N1 pandemic (content analysis of press

Crisis crowdsourcing framework: designing strategic configurations of crowdsourcing for the emergency management domain

USGS Publications Warehouse

Liu, Sophia B.

2014-01-01

Crowdsourcing is not a new practice but it is a concept that has gained significant attention during recent disasters. Drawing from previous work in the crisis informatics, disaster sociology, and computer-supported cooperative work (CSCW) literature, the paper first explains recent conceptualizations of crowdsourcing and how crowdsourcing is a way of leveraging disaster convergence. The CSCW concept of “articulation work” is introduced as an interpretive frame for extracting the salient dimensions of “crisis crowdsourcing.” Then, a series of vignettes are presented to illustrate the evolution of crisis crowdsourcing that spontaneously emerged after the 2010 Haiti earthquake and evolved to more established forms of public engagement during crises. The best practices extracted from the vignettes clarified the efforts to formalize crisis crowdsourcing through the development of innovative interfaces designed to support the articulation work needed to facilitate spontaneous volunteer efforts. Extracting these best practices led to the development of a conceptual framework that unpacks the key dimensions of crisis crowdsourcing. The Crisis Crowdsourcing Framework is a systematic, problem-driven approach to determining the why, who, what, when, where, and how aspects of a crowdsourcing system. The framework also draws attention to the social, technological, organizational, and policy (STOP) interfaces that need to be designed to manage the articulation work involved with reducing the complexity of coordinating across these key dimensions. An example of how to apply the framework to design a crowdsourcing system is offered with with a discussion on the implications for applying this framework as well as the limitations of this framework. Innovation is occurring at the social, technological, organizational, and policy interfaces enabling crowdsourcing to be operationalized and integrated into official products and services.

Mapping the Strategic Thinking of Public Relations Managers in a Crisis Situation: An Illustrative Example Using Conjoint Analysis.

ERIC Educational Resources Information Center

Bronn, Peggy Simcic; Olson, Erik L.

1999-01-01

Illustrates the operationalization of the conjoint analysis multivariate technique for the study of the public relations function within strategic decision making in a crisis situation. Finds that what the theory describes as the strategic way of handling a crisis is also the way each of the managers who were evaluated would prefer to conduct…

Helping Crisis Managers Protect Reputational Assets: Initial Tests of the Situational Crisis Communication Theory.

ERIC Educational Resources Information Center

Coombs, W. Timothy; Holladay, Sherry J.

2002-01-01

Explains a comprehensive, prescriptive, situational approach for responding to crises and protecting organizational reputation: the situational crisis communication theory (SCCT). Notes undergraduate students read two crisis case studies from a set of 13 cases and responded to questions following the case. Validates a key assumption in SCCT and…

The effectiveness of crisis resource management and team debriefing in resuscitation education of nursing students: A randomised controlled trial.

PubMed

Coppens, Imgard; Verhaeghe, Sofie; Van Hecke, Ann; Beeckman, Dimitri

2018-01-01

The aim of this study was to investigate (i) whether integrating a course on crisis resource management principles and team debriefings in simulation training, increases self-efficacy, team efficacy and technical skills of nursing students in resuscitation settings and (ii) which phases contribute the most to these outcomes. Crisis resource management principles have been introduced in health care to optimise teamwork. Simulation training offers patient safe training opportunities. There is evidence that simulation training increases self-efficacy and team efficacy but the contribution of the different phases like crisis resource management principles, simulation training and debriefing on self-efficacy, team efficacy and technical skills is not clear. Randomised controlled trial in a convenience sample (n = 116) in Belgium. Data were collected between February 2015-April 2015. Participants in the intervention group (n = 60) completed a course on crisis resource management principles, followed by a simulation training session, a team debriefing and a second simulation training session. Participants in the control group (n = 56) only completed two simulation training sessions. The outcomes self-efficacy, team efficacy and technical skills were assessed after each simulation training. An ancillary analysis of the learning effect was conducted. The intervention group increased on self-efficacy (2.13%, p = .02) and team efficacy (9.92%, p < .001); the control group only increased significantly on team efficacy (4.5%, p = .001). The intervention group scored significantly higher on team efficacy (8.49%, p < .001) compared to the control group. Combining crisis resource management principles and team debriefings in simulation training increases self-efficacy and team efficacy. The debriefing phase contributes the most to these effects. By partnering with healthcare settings, it becomes possible to offer interdisciplinary simulation training that can

When a Crisis Strikes.

ERIC Educational Resources Information Center

Keebler, Barbara A.

1989-01-01

Urges Catholic educators to develop a crisis communication plan to ensure that all communication with the press and public is handled promptly and thoroughly by a designated spokesperson. Describes workshops which simulate real-life challenges as a means of testing crisis management plans. Offers guidelines for the development of a crisis…

Management of myasthenic crisis in a child.

PubMed

Rybojad, Beata; Lesiuk, Witold; Fijałkowska, Anna; Rybojad, Paweł; Sawicki, Marek; Lesiuk, Leszek

2013-01-01

Myasthenia gravis is an autoimmune disorder of peripheral nervous system, leading to fluctuating muscle weakness. It is caused by circulating antibodies that block acetylcholine nicotinic postsynaptic receptors at the postsynaptic neuromuscular junction. Myasthenic crisis is a life-threatening complication, which is defined as weakness from acquired myasthenia gravis. In this paper we described a 15-year-old boy who was admitted to the Paediatric Intensive Care Unit due to myasthenic crisis. He had suffered not only from myasthenia gravis but also hypothyroidism, cerebral palsy and epilepsy. The patient required mechanical ventilation and was successfully treated with both plasmapheresis and intravenous immunoglobulins. He recovered from the crisis and then thymectomy was performed. Perioperative period and anaesthesia passed uncomplicated. Discharged home from the hospital after 2.5 month-treatment, for the last 4 years, he has only come on scheduled outpatient medical appointments. This case reveals that myasthenic crisis, albeit rare, may occur in male adolescents. In such cases multidisciplinary care followed by surgery becomes a procedure of choice. Concomitant medical problems, if well controlled, do not affect the results of outcome of the underlying disease.

Assessment of the Temperament, Motivation, and Capability of a School System District for Emergency Management/Crisis Performance

ERIC Educational Resources Information Center

Hoff, Larry A.

2009-01-01

This study was a cross-sectional study of leadership and staff of a public school system in Georgia concerning their temperament type, emergency management motivation and emergency management knowledge in relation to Emergency Management/Crisis performance (ERCM). The study consisted of an inclusive questionnaire that contains questions on four…

To Issue of Mathematical Management Methods Applied for Investment-Building Complex under Conditions of Economic Crisis

NASA Astrophysics Data System (ADS)

Novikova, V.; Nikolaeva, O.

2017-11-01

In the article the authors consider a cognitive management method of the investment-building complex in the crisis conditions. The factors influencing the choice of an investment strategy are studied, the basic lines of the activity in the field of crisis-management from a position of mathematical modelling are defined. The general approach to decision-making on investment in real assets on the basis of the discrete systems based on the optimum control theory is offered. With the use of a discrete maximum principle the task in view of the decision is found. The numerical algorithm to define the optimum control is formulated by investments. Analytical decisions for the case of constant profitability of the basic means are obtained.

The social process of escalation: a promising focus for crisis management research

PubMed Central

2012-01-01

Background This study identifies a promising, new focus for the crisis management research in the health care domain. After reviewing the literature on health care crisis management, there seems to be a knowledge-gap regarding organisational change and adaption, especially when health care situations goes from normal, to non-normal, to pathological and further into a state of emergency or crisis. Discussion Based on studies of escalating situations in obstetric care it is suggested that two theoretical perspectives (contingency theory and the idea of failure as a result of incomplete interaction) tend to simplify the issue of escalation rather than attend to its complexities (including the various power relations among the stakeholders involved). However studying the process of escalation as inherently complex and social allows us to see the definition of a situation as normal or non-normal as an exercise of power in itself, rather than representing a putatively correct response to a particular emergency. Implications The concept of escalation, when treated this way, can help us further the analysis of clinical and institutional acts and competence. It can also turn our attention to some important elements in a class of social phenomenon, crises and emergencies, that so far have not received the attention they deserve. Focusing on organisational choreography, that interplay of potential factors such as power, professional identity, organisational accountability, and experience, is not only a promising focus for future naturalistic research but also for developing more pragmatic strategies that can enhance organisational coordination and response in complex events. PMID:22704075

Assessing Counter-Terrorism field training with multiple behavioral measures.

PubMed

Spiker, V Alan; Johnston, Joan H

2013-09-01

Development of behavioral pattern recognition and analysis skills is an essential element of Counter-Terrorism training, particularly in the field. Three classes of behavioral measures were collected in an assessment of skill acquisition during a US Joint Forces Command-sponsored course consisting of Combat Tracking and Combat Profiling segments. Measures included situational judgment tests, structured behavioral observation checklists, and qualitative assessments of the emergence of specific knowledge-skills-attitudes over the course of the training. The paper describes statistical evidence across the three types of measures that indicate that behavioral pattern recognition and analysis skills were successfully acquired by most students (a mix of Army and civilian law enforcement personnel) during the field training exercises. Implications for broader training of these critical skills are also discussed. Copyright © 2012 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Thyrotoxic crisis presenting with jaundice.

PubMed

Wickramasinghe, R D S S; Luke, W A N V; Sebastiampillai, B S; Gunathilake, M P M L; Premaratna, R

2016-06-23

Thyrotoxic crisis is a medical emergency requiring early diagnosis and urgent management, which can be challenging due to its diverse clinical presentations. While common presentations include fever, sweating, palpitations, tremors and confusion, presence of jaundice is rare. We report a 35-year-old male who presented with jaundice due to cholestasis along with other features of thyrotoxic crisis due to Graves' disease. He had a good clinical recovery with resolution of cholestasis following treatment for thyrotoxic crisis. Jaundice can be a rare manifestation of thyrotoxic crisis, and should be considered in the differential diagnosis when other clinical features of thyrotoxic crisis are present. However secondary causes of jaundice should be looked into and excluded.

When a Crisis Occurs: A Trustee's Perspective.

ERIC Educational Resources Information Center

Kenney, Phyllis Gutierrez

1997-01-01

Argues that, although crises are unavoidable, they can be planned for and that there should be a crisis management model for each situation. Discusses components of an effective crisis management plan, including clear lines of governance, trust, and communication between boards and the president and effective communication with the media and…

Crisis management during anaesthesia: hypotension.

PubMed

Morris, R W; Watterson, L M; Westhorpe, R N; Webb, R K

2005-06-01

two thirds of these. It was further estimated that completion of this followed by the specific sub-algorithm for hypotension would have led to earlier recognition of the problem and/or better management in 6% of cases compared with actual management reported. Pattern recognition in most cases enables anaesthetists to determine the cause and manage hypotension. However, an algorithm based approach is likely to improve the management of a small proportion of atypical but potentially life threatening cases. While an algorithm based approach will facilitate crisis management, the frequency of co-existing abnormalities in other vital signs means that all cases of hypotension cannot be dealt with using a single algorithm. Diagnosis, in particular, may potentially be assisted by cross referencing to the specific sub-algorithms for these.

Management of chronic myeloid leukemia in blast crisis.

PubMed

Saußele, S; Silver, Richard T

2015-04-01

Due to the high efficacy of BCR-ABL tyrosine kinase inhibition (TKI) in chronic phase (CP) chronic myeloid leukemia (CML), the frequency of blast crisis (BC) is greatly reduced compared to the pre-TKI era. However, TKI treatment of BC has only marginally improved the number of favorable responses, including remissions, which for the most part have only been transitory. Occasionally, they provide a therapeutic window to perform an allogeneic stem cell transplantation (allo-SCT). The challenge remains to improve management of BC with the limited options available. We review and summarize articles pertaining to the treatment of BC CML published after 2002. Additionally, we will discuss whether there is a need for a new definition of BC and/or treatment failure.

ACT for Leadership: Using Acceptance and Commitment Training to Develop Crisis-Resilient Change Managers

ERIC Educational Resources Information Center

Moran, Daniel J.; Consulting, Pickslyde

2010-01-01

The evidence-based executive coaching movement suggests translating empirical research into practical methods to help leaders develop a repertoire of crisis resiliency and value-directed change management skills. Acceptance and Commitment Therapy (ACT) is an evidence-based modern cognitive-behavior therapy approach that has been and applied to…

Effect of sleep deprivation after a night shift duty on simulated crisis management by residents in anaesthesia. A randomised crossover study.

PubMed

Arzalier-Daret, Ségolène; Buléon, Clément; Bocca, Marie-Laure; Denise, Pierre; Gérard, Jean-Louis; Hanouz, Jean-Luc

2018-04-01

Sleep deprivation has been associated with an increased incidence of medical errors and can jeopardise patients' safety during medical crisis management. The aim of the study was to assess the effect of sleep deprivation on the management of simulated anaesthesia crisis by residents in anaesthesiology. A randomised, comparative, monocentric crossover study involving 48 residents in anaesthesia was performed on a high fidelity patient simulator. Each resident was evaluated in a sleep-deprived state (deprived group, after a night shift duty) and control state (control group, after a night of sleep). Performance was assessed through points obtained during crisis scenario 1 (oesophageal intubation followed by anaphylactic shock) and scenario 2 (anaesthesia-related bronchospasm followed by ventricular tachycardia). Sleep periods were recorded by actigraphy. Two independent observers assessed the performances. The primary endpoint of the study was the score obtained for each scenario. Resident's crisis management performance is associated with sleep deprivation (scenario 1: control=39 [33-42] points vs. deprived=26 [19-40] points, P=0.02; scenario 2: control=21 [17-24] vs. deprived=14 [12-19], P=0.01). The main errors observed were: error in drug administration and dose, delay in identification of hypotension, and missing communication with the surgical team about situation. The present study showed that sleep deprivation is associated with impairment of performance to manage crisis situations by residents in anaesthesia. Copyright © 2017 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

Consumer experience of formal crisis-response services and preferred methods of crisis intervention.

PubMed

Boscarato, Kara; Lee, Stuart; Kroschel, Jon; Hollander, Yitzchak; Brennan, Alice; Warren, Narelle

2014-08-01

The manner in which people with mental illness are supported in a crisis is crucial to their recovery. The current study explored mental health consumers' experiences with formal crisis services (i.e. police and crisis assessment and treatment (CAT) teams), preferred crisis supports, and opinions of four collaborative interagency response models. Eleven consumers completed one-on-one, semistructured interviews. The results revealed that the perceived quality of previous formal crisis interventions varied greatly. Most participants preferred family members or friends to intervene. However, where a formal response was required, general practitioners and mental health case managers were preferred; no participant wanted a police response, and only one indicated a preference for CAT team assistance. Most participants welcomed collaborative crisis interventions. Of four collaborative interagency response models currently being trialled internationally, participants most strongly supported the Ride-Along Model, which enables a police officer and a mental health clinician to jointly respond to distressed consumers in the community. The findings highlight the potential for an interagency response model to deliver a crisis response aligned with consumers' preferences. © 2014 Australian College of Mental Health Nurses Inc.

Military Force and Culture Change: Systems, Narratives, and the Social Transmission of Behavior in Counter-Terrorism Strategy

DTIC Science & Technology

2006-03-01

prospects of acting upon culture with force. In particular, this thesis explores the narrative and storytelling dimensions of culture, offering a theory...narrative and storytelling dimensions of culture, offering a theory of story that can be used to drive innovative counter-terrorism strategies and... storytelling ), and limn the prospects for using military force to shape that piece. This charter is, of course, far too broad to constitute a thesis-length

Using Role-Play to Enhance Foodborne Illness Crisis Management Capacity in the Produce Industry

ERIC Educational Resources Information Center

Kreske, Audrey; Ducharme, Diane; Gunter, Chris; Phister, Trevor

2013-01-01

Foodborne illness outbreaks have measurable public health effects and often lead to negative produce industry impacts. Reducing loss following a crisis event requires a management plan, although many fresh produce industry members don't have one. Evidence-based workshops using a role-play simulated outbreak were delivered to impact crisis…

Developing Clinical Competency in Crisis Event Management: An Integrated Simulation Problem-Based Learning Activity

ERIC Educational Resources Information Center

Liaw, S. Y.; Chen, F. G.; Klainin, P.; Brammer, J.; O'Brien, A.; Samarasekera, D. D.

2010-01-01

This study aimed to evaluate the integration of a simulation based learning activity on nursing students' clinical crisis management performance in a problem-based learning (PBL) curriculum. It was hypothesized that the clinical performance of first year nursing students who participated in a simulated learning activity during the PBL session…

Emergency medicine resident crisis resource management ability: a simulation-based longitudinal study

PubMed Central

Clarke, Samuel; Horeczko, Timothy; Carlisle, Matthew; Barton, Joseph D.; Ng, Vivienne; Al-Somali, Sameerah; Bair, Aaron E.

2014-01-01

Background Simulation has been identified as a means of assessing resident physicians’ mastery of technical skills, but there is a lack of evidence for its utility in longitudinal assessments of residents’ non-technical clinical abilities. We evaluated the growth of crisis resource management (CRM) skills in the simulation setting using a validated tool, the Ottawa Crisis Resource Management Global Rating Scale (Ottawa GRS). We hypothesized that the Ottawa GRS would reflect progressive growth of CRM ability throughout residency. Methods Forty-five emergency medicine residents were tracked with annual simulation assessments between 2006 and 2011. We used mixed-methods repeated-measures regression analyses to evaluate elements of the Ottawa GRS by level of training to predict performance growth throughout a 3-year residency. Results Ottawa GRS scores increased over time, and the domains of leadership, problem solving, and resource utilization, in particular, were predictive of overall performance. There was a significant gain in all Ottawa GRS components between postgraduate years 1 and 2, but no significant difference in GRS performance between years 2 and 3. Conclusions In summary, CRM skills are progressive abilities, and simulation is a useful modality for tracking their development. Modification of this tool may be needed to assess advanced learners’ gains in performance. PMID:25499769

Crisis DSM Generation To Support Refugee Camp Management

NASA Astrophysics Data System (ADS)

Gstaiger, Veronika; d'Angelo, Pablo; Schneiderhan, Tobais; Krauss, Thomas

2013-12-01

The extraction of high resolution surface information from satellite data has become an important area of research. One of the numerous fields of application is disaster management. Detailed information about the affected terrain is not only needed for analyses during the emergency relief phase, but also for reconstruction and prevention activities. In this paper the authors present the generation of a Digital Surface Model (DSM) based on three very high resolution optical satellite images. The DSM was produced to supplement a flood mapping activity in Jordan and serves as example for the implementation of scientific results during an emergency request. The flood affected the Zaatari refugee camp in Jordan and was mapped by the Center for Satellite Based Crisis Information (ZKI) at the German Aerospace Center (DLR) in January 2013 under emergency mapping conditions.

The Research of the Crisis Pre-Warning Management System under the Particularity of Nationalities Universities and Colleges

ERIC Educational Resources Information Center

Wang, Hui

2009-01-01

The nationalities universities and colleges set up the crisis pre-warning management system, not only related to the management of our nationalities universities and colleges and their growth, but also related to the country's national unity plan in some way. However, because of minority students in the particularity of the national cultural…

Using Crisis Simulations in Public Relations Education

ERIC Educational Resources Information Center

Veil, Shari R.

2010-01-01

Objectives: Students will demonstrate research, decision making, team building, and public speaking skills, while applying issues management and crisis communication concepts in a realistic setting. Courses: Introduction to Public Relations, Public Relations Cases, Crisis Communication.

An Assessment of Perceptions of United States Army Provost Marshals Pertaining to Counterterrorism Policy and Programs on Army Installations.

DTIC Science & Technology

1981-01-01

incidents of terrorism directed against Army installations; the availability and adequacy of intelligence concerning local terrorist activities; the degree of...current counterterrorism intelli- gence is available and adequate. A further conclusion is that many survey respondents expect acts of terrorism to...responsihility arr not ade- quately protected. INDEX WORDS: Terrorism , Military, Defense, Army, Counterterrorir:.n DEDICATION To Beverly, my wife and best

'HTA for Crisis': sharing experiences during the 7th EBHC Symposium.

PubMed

Wladysiuk, Magdalena; Tabor, Anna; Godman, Brian

2013-02-01

The Central and Eastern European Society of Technology Assessment in Health Care was founded in Krakow, Poland in 2003. On October 8th and 9th, the 7th symposium took place titled 'HTA for Crisis'. This meeting was attended by over 250 decision makers, evidence-based specialists, healthcare managers, commercial company personnel and experts. The symposium was principally divided into four main themes: insurance in times of crisis; importance of pricing of health services in times of crisis; managing welfare benefits in times of crisis and Health Technology Assessment in crisis-laden countries. The symposium finished by debating potential ways forward for healthcare systems in times of crisis.

The Halcyon Days Are over. Or Are They? Implications of the Global Financial Crisis for Managers' Careers

ERIC Educational Resources Information Center

Marchant, Teresa

2009-01-01

This paper discusses the implications for managers' careers of the global financial crisis. It draws on empirical research during the last period of major job cuts. Evidence comes from a mail survey of over 1000 career histories of Australian managers, with a response rate of 44%. Changes to career satisfaction, job satisfaction, job security,…

Don't panic--prepare: towards crisis-aware models of emergency department operations.

PubMed

Ceglowski, Red; Churilov, Leonid; Wasserheil, Jeff

2005-12-01

The existing models of Emergency Department (ED) operations that are based on the "flow-shop" management logic do not provide adequate decision support in dealing with the ED overcrowding crises. A conceptually different crisis-aware approach to ED modelling and operational decision support is introduced in this paper. It is based on Perrow's theory of "normal accidents" and calls for recognizing the inevitable nature of ED overcrowding crises within current health system setup. Managing the crisis before it happens--a standard approach in crisis management area--should become an integral part of ED operations management. The potential implications of adopting such a crisis-aware perspective for health services research and ED management are outlined.

Governing during an Institutional Crisis: 10 Fundamental Principles

ERIC Educational Resources Information Center

White, Lawrence

2012-01-01

In today's world, managing a campus crisis poses special challenges for an institution's governing board, which may operate some distance removed from the immediate events giving rise to the crisis. In its most challenging form, a campus crisis--a shooting, a natural disaster, a fraternity hazing death, the arrest of a prominent campus…

44 CFR 206.171 - Crisis counseling assistance and training.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Crisis counseling assistance... Assistance § 206.171 Crisis counseling assistance and training. (a) Purpose. This section establishes the policy, standards, and procedures for implementing section 416 of the Act, Crisis Counseling Assistance...

44 CFR 206.171 - Crisis counseling assistance and training.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Crisis counseling assistance... Assistance § 206.171 Crisis counseling assistance and training. (a) Purpose. This section establishes the policy, standards, and procedures for implementing section 416 of the Act, Crisis Counseling Assistance...

44 CFR 206.171 - Crisis counseling assistance and training.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false Crisis counseling assistance... Assistance § 206.171 Crisis counseling assistance and training. (a) Purpose. This section establishes the policy, standards, and procedures for implementing section 416 of the Act, Crisis Counseling Assistance...

44 CFR 206.171 - Crisis counseling assistance and training.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Crisis counseling assistance... Assistance § 206.171 Crisis counseling assistance and training. (a) Purpose. This section establishes the policy, standards, and procedures for implementing section 416 of the Act, Crisis Counseling Assistance...

The Status of Crisis Management at NASPA Member Institutions

ERIC Educational Resources Information Center

Catullo, Linda A.; Walker, David A.; Floyd, Deborah L.

2009-01-01

This study assessed the level of crisis preparedness in higher education from the perspective of chief student affairs administrators at residential universities post-September 11, 2001 to pre-Virginia Tech shootings in April 2007. Crisis preparedness was determined by compiling and comparing data results derived from an instrument implemented in…

Modelling and simulating a crisis management system: an organisational perspective

NASA Astrophysics Data System (ADS)

Chaawa, Mohamed; Thabet, Inès; Hanachi, Chihab; Ben Said, Lamjed

2017-04-01

Crises are complex situations due to the dynamism of the environment, its unpredictability and the complexity of the interactions among several different and autonomous involved organisations. In such a context, establishing an organisational view as well as structuring organisations' communications and their functioning is a crucial requirement. In this article, we propose a multi-agent organisational model (OM) to abstract, simulate and analyse a crisis management system (CMS). The objective is to evaluate the CMS from an organisational view, to assess its strength as well as its weakness and to provide deciders with some recommendations for a more flexible and reactive CMS. The proposed OM is illustrated through a real case study: a snowstorm in a Tunisian region. More precisely, we made the following contribution: firstly, we provide an environmental model that identifies the concepts involved in the crisis. Then, we define a role model that copes with the involved actors. In addition, we specify the organisational structure and the interaction model that rule communications and structure actors' functioning. Those models, built following the GAIA methodology, abstract the CMS from an organisational perspective. Finally, we implemented a customisable multi-agent simulator based on the Janus platform to analyse, through several performed simulations, the organisational model.

Use of CLYC spectrometer in counter-terrorism applications

NASA Astrophysics Data System (ADS)

Ing, H.; Smith, M. B.; Koslowsky, M. R.; Andrews, H. R.

2015-05-01

A new scintillator crystal, now known as CLYC (Cs2LiYCl6:Ce), has been under development for over 15 years (1). It was primarily of interest for radiation detection applications because of its good energy resolution for gamma rays (< 4% for 662 keV gamma rays) and its capability for detection of thermal neutrons. The pulse shapes of the signals from the two radiations are different, which allow them to be separated electronically, permitting simultaneous detection of gamma rays and neutrons. The crystal is now commercially available. Early investigations of the neutron response by the current authors (2) revealed that CLYC also responds to fast neutrons. In fact, the good energy resolution of the response under monoenergetic neutron irradiations showed that CLYC was an excellent high-energy neutron spectrometer. This discovery has great impact on the field of neutron spectroscopy, which has numerous, although often specialized, applications. This presentation focuses on applications in counter-terrorism scenarios where neutrons may be involved. The relative importance of the fast neutron response of CLYC, compared to the thermal and gamma-ray response, will be discussed for these scenarios.

Characteristics and management of the 2006-2008 volcanic crisis at the Ubinas volcano (Peru)

NASA Astrophysics Data System (ADS)

Rivera, Marco; Thouret, Jean-Claude; Mariño, Jersy; Berolatti, Rossemary; Fuentes, José

2010-12-01

Ubinas volcano is located 75 km East of Arequipa and ca. 5000 people are living within 12 km from the summit. This composite cone is considered the most active volcano in southern Peru owing to its 24 low to moderate magnitude (VEI 1-3) eruptions in the past 500 years. The onset of the most recent eruptive episode occurred on 27 March 2006, following 8 months of heightened fumarolic activity. Vulcanian explosions occurred between 14 April 2006 and September 2007, at a time ejecting blocks up to 40 cm in diameter to distances of 2 km. Ash columns commonly rose to 3.5 km above the caldera rim and dispersed fine ash and aerosols to distances of 80 km between April 2006 and April 2007. Until April 2007, the total volume of ash was estimated at 0.004 km 3, suggesting that the volume of fresh magma was small. Ash fallout has affected residents, livestock, water supplies, and crop cultivation within an area of ca. 100 km 2 around the volcano. Continuous degassing and intermittent mild vulcanian explosions lasted until the end of 2008. Shortly after the initial explosions on mid April 2006 that spread ash fallout within 7 km of the volcano, an integrated Scientific Committee including three Peruvian institutes affiliated to the Regional Committee of Civil Defense for Moquegua, aided by members of the international cooperation, worked together to: i) elaborate and publish volcanic hazard maps; ii) inform and educate the population; and iii) advise regional authorities in regard to the management of the volcanic crisis and the preparation of contingency plans. Although the 2006-2008 volcanic crisis has been moderate, its management has been a difficult task even though less than 5000 people now live around the Ubinas volcano. However, the successful management has provided experience and skills to the scientific community. This volcanic crisis was not the first one that Peru has experienced but the 2006-2008 experience is the first long-lasting crisis that the Peruvian civil

Resilient Communication: A New Crisis Communication Strategy for Homeland Security

DTIC Science & Technology

2012-03-01

communication theory. Author, Timothy Coombs , in Ongoing Crisis Communication , discusses the need for a crisis management 10 plan to prepare for potential... COMMUNICATION : A NEW CRISIS COMMUNICATION STRATEGY FOR HOMELAND SECURITY by Sharon L. Watson March 2012 Thesis Advisor: Christopher Bellavita...REPORT TYPE AND DATES COVERED Master’s Thesis 4. TITLE AND SUBTITLE Resilient Communication : A New Crisis Communication

Breaking through the crisis in marine conservation and management: insights from the philosophies of Ed Ricketts.

PubMed

Sagarin, Raphael D; Crowder, Larry B

2009-02-01

Over the last decade, 2 major U.S. commissions on ocean policy and a wide range of independent sources have argued that ocean ecosystems are in a period of crisis and that current policies are inadequate to prevent further ecological damage. These sources have advocated ecosystem-based management as an approach to address conservation issues in the oceans, but managers remain uncertain as to how to implement ecosystem-based approaches in the real world. We argue that the philosophies of Edward F. Ricketts, a mid-20th-century marine ecologist, offer a framework and clear guidance for taking an ecosystem approach to marine conservation. Ricketts' philosophies, which were grounded in basic observations of natural history, espoused building a holistic picture of the natural world, including the influence of humans, through repeated observation. This approach, when applied to conservation, grounds management in what is observable in nature, encourages early action in the face of uncertainty, and supports an adaptive approach to management as new information becomes available. Ricketts' philosophy of "breaking through," which focuses on getting beyond crisis and conflict through honest debate of different parties' needs (rather than forcing compromise of differing positions), emphasizes the social dimension of natural resource management. New observational technologies, long-term ecological data sets, and especially advances in the social sciences made available since Ricketts' time greatly enhance the utility of Ricketts' philosophy of marine conservation.

Managing a Crisis for School Security

ERIC Educational Resources Information Center

Badzmierowski, William F.

2011-01-01

In recent years, campus tragedies across the country have prompted leaders of education institutions to redouble their crisis planning efforts. Too often, however, these emergency plans focus almost exclusively on facilities, hardware and systems without sufficient consideration for the people they potentially affect. People, not equipment, will…

[Teaching non-technical skills for critical incidents: Crisis resource management training for medical students].

PubMed

Krüger, A; Gillmann, B; Hardt, C; Döring, R; Beckers, S K; Rossaint, R

2009-06-01

Physicians have to demonstrate non-technical skills, such as communication and team leading skills, while coping with critical incidents. These skills are not taught during medical education. A crisis resource management (CRM) training was established for 4th to 6th year medical students using a full-scale simulator mannikin (Emergency Care Simulator, ECS, METI). The learning objectives of the course were defined according to the key points of Gaba's CRM concept. The training consisted of theoretical and practical parts (3 simulation scenarios with debriefing). Students' self-assessment before and after the training provided the data for evaluation of the training outcome. A total of 65 students took part in the training. The course was well received in terms of overall course quality, debriefings and didactic presentation, the mean overall mark being 1.4 (1: best, 6: worst). After the course students felt significantly more confident when facing incidents in clinical practice. The main learning objectives were achieved. The effectiveness of applying the widely used ECS full-scale simulator in interdisciplinary teaching has been demonstrated. The training exposes students to crisis resource management issues and motivates them to develop non-technical skills.

[Crisis management during obstetric surgery].

PubMed

Okutomi, Toshiyuki

2009-05-01

Obstetric crisis includes hemorrhagic shock, embolisms and difficult airway. Life will be rapidly threatened with disseminated intravascular coagulation, multiple organ failure or systemic inflammatory response syndrome in these crises. In the face of the crisis, repeated evaluation of parturients and differential diagnosis are necessary along with fetal heart monitoring. For evaluation of bleeding, one should notice that the visual estimation of vaginal bleeding does not reflect the extent of intravascular volume deficit. Treatments for hemorrhagic shock include fluid replacement, blood transfusion as well as fresh frozen plasma, platelet, anticoagulants, anti-thrombin III, and protease inhibitors. When bleeding is still uncontrollable, arterial embolization or hysterectomy will be considered. Embolic disorders are another cause of maternal mortality. The signs and symptoms are all similar (dyspnea, cyanosis and sudden cardiovascular collapse). Strategies against the embolism will be basically symptomatic therapy. The physiological change with pregnancy results in the need of careful pre-anesthetic airway evaluation for parturients. A difficult or failed intubation drill is also extremely important. Recently, laryngeal mask airway has been successfully used in these parturients. During resuscitation of a pregnant woman, left uterine displacement is essential. For a patient who has not responded after 4 to 5 minutes of ACLS, immediate cesarean delivery should be considered.

Crisis Revisited: An Analysis of Strategies Used by Tylenol in the Second Tampering Episode.

ERIC Educational Resources Information Center

Benson, James A.

1988-01-01

Illustrates how Johnson & Johnson's crisis communication management adhered to many of the recommended guidelines for managing contingency planning, for mobilizing a crisis communication effort, and for post-crisis communication. Reveals the advantageous use of flexible, proactive, and corollary communication strategies. (MS)

Crisis communication. Lessons from 9/11.

PubMed

Argenti, Paul

2002-12-01

The sheer enormity of last year's terrorist attacks on the World Trade Center and the Pentagon gave new meaning to the term "crisis management." Suddenly, companies near Ground Zero, as well as those more than a thousand miles away, needed a plan. Because the disasters disrupted established channels not only between businesses and customers but between businesses and employees, internal crisis-communications strategies that could be quickly implemented became a key responsibility of top management. Without these strategies, employees' trauma and confusion might have immobilized their firms and set their customers adrift. In this article, executives from a range of industries talk about how their companies, including Morgan Stanley, Oppenheimer Funds, American Airlines, Verizon, the New York Times, Dell, and Starbucks, went about restoring operations and morale. From his interviews with these individuals, author and management professor Paul Argenti was able to distill a number of lessons, each of which, he says, may "serve as guideposts for any company facing a crisis that undermines its employees' composure, confidence, or concentration." His advice to senior executives includes: Maintain high levels of visibility, so that employees are certain of top management's command of the situation and concern; establish contingency communication channels and work sites; strive to keep employees focused on the business itself, because a sense of usefulness enhances morale and good morale enhances usefulness; and ensure that employees have absorbed the firm's values, which will guide them as they cope with the unpredictable. The most forward-thinking leaders realize that managing a crisis-communications program requires the same dedication and resources they give to other dimensions of their business. More important, they realize that their employees always come first.

Accelerating and Braking in Times of Economic Crisis: Organisational Learning in a Top Management Team

ERIC Educational Resources Information Center

Wallo, Andreas; Kock, Henrik; Nilsson, Peter

2012-01-01

Purpose: The purpose of this article is to present the results of a study of an industrial company's top management team (TMT) that fought to survive an economic crisis. Specifically, the article seeks to focus on describing the TMT's composition, group processes, and work during a period of high external pressure; analysing the TMT's work in…

Developing the Political Citizen: How Teachers Are Navigating the Statutory Demands of the Counter-Terrorism and Security Act 205 and the Prevent Duty

ERIC Educational Resources Information Center

Bryan, Hazel

2017-01-01

The "Revised Prevent Duty Guidance for England and Wales" presents statutory guidance under section 29 of the Counter-Terrorism and Security Act 2015. This guidance states that "Schools should be safe spaces in which children and young people can understand and discuss sensitive topics, including terrorism and the extremist ideas…

Crisis Management in a Primary School

ERIC Educational Resources Information Center

Barclay, Colette

2004-01-01

Dunblane Primary School, Scotland, and Columbine High School, USA. Two headline tragedies that have led to trauma for their pupils and staff. Trauma that could be devastating because of the psychological impact and the practical requirements a crisis brings. Children's social and personal development can be negatively affected, their academic…

Crisis GIS: Preparing for the Next Volcanic Crisis in the United States

NASA Astrophysics Data System (ADS)

Ramsey, D. W.; Robinson, J. E.; Schilling, S. P.; Schaefer, J. R.; Kimberly, P.; Trusdell, F. A.; Guffanti, M. C.; Mayberry, G. C.; Cameron, C. E.; Smith, J. G.; McIntire, J. A.; Snedigar, S.; Ewert, J. W.

2004-12-01

Geographic Information Systems (GIS) specialists from the Volcano Hazards Program (VHP) of the U.S. Geological Survey (USGS), including personnel at Menlo Park, California, the Cascades Volcano Observatory in Vancouver, Washington, the Alaska Volcano Observatory in Anchorage and Fairbanks, Alaska, the Hawaiian Volcano Observatory in Hawaii National Park, Hawaii, and the Smithsonian Institution Global Volcanism Program in Washington, DC, are developing a GIS response plan in the event of a volcano crisis. This plan, referred to as "Crisis GIS", outlines how VHP can ensure rapid, reliable delivery of spatial and ancillary information for data analysis and visualization at any required location during a volcanic crisis or event within the United States. An effective Crisis GIS needs the capacity to store multiple, large datasets, including: base layer data, elevation data, geologic maps, hazard assessment maps, satellite data, and aerial photography for volcanoes around the U.S. It must be readily accessible by VHP GIS specialists stationed around the Nation. Such a GIS should also support installations of monitoring instruments and telemetry equipment that relay monitoring signals, and provision of updates to public officials, the media, and the public during a crisis. GIS technology has proven to be an invaluable tool for crisis response. Recently, GIS was applied as part of the response efforts to two large-scale crises: the terrorist attacks of September 11, 2001, and the Southern California wildfires of Fall 2003. In each case, GIS was used to organize large quantities of spatial data and to produce electronic and paper maps that illustrated hazards, supported decision making, and communicated developing situations to responsible emergency-management authorities and to the populace affected (Kant, 2002, and Pratt, 2003). VHP GIS specialists are currently testing the software and hardware employed in recent major crisis response efforts and are learning to adapt

Hypertensive crisis: an update on clinical approach and management.

PubMed

Ipek, Emrah; Oktay, Ahmet Afşin; Krim, Selim R

2017-07-01

Here, we review current concepts on hypertensive crisis (HTN-C) with a focus on epidemiology, causes, pathophysiology and prognosis. We also offer a practical approach to the management of HTN-C. HTN-C is characterized by a severe and abrupt increase in blood pressure (BP) with impending or progressive acute end-organ damage (EOD). HTN-C can be divided into hypertensive emergency (HTN-E) and hypertensive urgency (HTN-U) based on the presence or absence of acute EOD, respectively. Recent retrospective studies have demonstrated that emergency department (ED) referrals from an outpatient clinic or rapid BP-lowering strategies in the ED do not lead to improved outcomes in patients with HTN-U. HTN-C can be a de-novo manifestation or a complication of essential or secondary HTN. The presence of acute EOD is a major poor prognostic indicator in HTN-C. The main objectives of the management of HTN-C are distinction of HTN-E from HTN-U and appropriate risk stratification, prevention or regression of acute EOD due to severely elevated BP, prevention of recurrence of HTN-C with an effective long-term management plan and avoidance of rapid lowering of BP except in some special circumstances. The majority of patients with asymptomatic HTN-U can be safely managed in the outpatient setting without exposing them to the risks of aggressive BP lowering. However, patients with HTN-E require hospitalization, prompt treatment and close monitoring.

Recent Developments in the Classification, Evaluation, Pathophysiology, and Management of Scleroderma Renal Crisis.

PubMed

Ghossein, Cybele; Varga, John; Fenves, Andrew Z

2016-01-01

Scleroderma renal crisis (SRC) is an uncommon complication of systemic sclerosis. Despite the advent of angiotensin-converting inhibitor therapy, SRC remains a life-threatening complication. Recent studies have contributed to a better understanding of SRC, but much remains unknown regarding its pathophysiology, risk factors, and optimal management. Genetic studies provide evidence that immune dysregulation might be a contributing factor, providing hope that further research in this direction might illuminate pathogenesis and provide novel predictors for this complication.

Pheochromocytoma crisis is not a surgical emergency.

PubMed

Scholten, Anouk; Cisco, Robin M; Vriens, Menno R; Cohen, Jenny K; Mitmaker, Elliot J; Liu, Chienying; Tyrrell, J Blake; Shen, Wen T; Duh, Quan-Yang

2013-02-01

Pheochromocytoma crisis is a feared and potentially lethal complication of pheochromocytoma. We sought to determine the best treatment strategy for pheochromocytoma crisis patients and hypothesized that emergency resection is not indicated. Retrospective cohort study (1993-2011); literature review (1944-2011). Tertiary referral center. There were 137 pheochromocytoma patients from our center and 97 pheochromocytoma crisis patients who underwent adrenalectomy from the literature. Medical management of pheochromocytoma crisis; adrenalectomy. Perioperative complications, conversion, and mortality. In our database, 25 patients (18%) presented with crisis. After medical stabilization and α-blockade, 15 patients were discharged and readmitted for elective surgery and 10 patients were operated on urgently during the same hospitalization. None underwent emergency surgery. Postoperatively, patients who underwent elective surgery had shorter hospital stays (1.7 vs 5.7 d, P = 0.001) and fewer postoperative complications (1 of 15 [7%] vs 5 of 10 [50%], P = 0.045) and were less often admitted to the intensive care unit (1 of 15 [7%] vs 5 of 10 [50%], P = 0.045) in comparison with urgently operated patients. There was no mortality. Review of the literature (n = 97) showed that crisis patients who underwent elective or urgent surgery vs emergency surgery had less intraoperative (13 of 31 [42%] vs 20 of 25 [80%], P < 0.001) and postoperative complications (15 of 45 [33%] vs 15 of 21 [71%], P = 0.047) and a lower mortality (0 of 64 vs 6 of 33 [18%], P = 0.002). Management of patients presenting with pheochromocytoma crisis should include initial stabilization of the acute crisis followed by sufficient α-blockade before surgery. Emergency resection of pheochromocytoma is associated with high surgical morbidity and mortality.

Managing the 1920s' Chilean educational crisis: A historical view combined with machine learning.

PubMed

Rengifo, Francisca; Ruz, Gonzalo A; Mascareño, Aldo

2018-01-01

In the first decades of the 20th century, political actors diagnosed the incubation of a crisis in the Chilean schooling process. Low rates of enrollment, literacy, and attendance, inefficiency in the use of resources, poverty, and a reduced number of schools were the main factors explaining the crisis. As a response, the Law on Compulsory Primary Education, considering mandatory for children between 6 and 14 years old to attend any school for at least four years, was passed in 1920. Using data from Censuses of the Republic of Chile from 1920 and 1930, reports of the Ministry of Justice, the Ministry of Education, and the Statistical Yearbooks between 1895 and 1930, we apply machine learning techniques (clustering and decision trees) to assess the impact of this law on the Chilean schooling process between 1920 and 1930. We conclude that the law had a positive impact on the schooling indicators in this period. Even though it did not overcome the differences between urban and rural zones, it brought about a general improvement of the schooling process and a more efficient use of resources and infrastructure in both big urban centers and small-urban and rural zones, thereby managing the so-called crisis of the Republic.

[THE GLOBAL AND ECONOMIC CRISIS. AND HEALTH MANAGEMENT].

PubMed

del Rey Calero, Juan

2014-01-01

The Global and economic crisis and Health Management The Health care process discussed are 4 steps: assessment, planing, intervention and evaluation. The identify association between social factors linked to social vulnerability (socio economic status, unemployed, poverty) and objective health relate quality of life. The poverty rate is 24.2%, unemployed 26.26%, youth unemployed 56.13%.ratio worker/retired 2.29. Debts 100% GDP The health inequality influence on health related quality of life. The Health System efficiency index. according Bloomber rate (2,013) Spain is 5 degrees in the world, points 68.3 on 100, for the life expectancy 82.3 years, the personal cost of health care 2,271€. Health care 10% GDP (public 7%,private 3%), SS protected population 92.4%, retired person cost 9.2% GDP, p. capita GDP 23,737€. Cost of Care: Hospital/specialist 54%, P. Care 15%, Pharmaceutical 19.8%, P. Health 3.1%.

Hypercalcemic crisis: a clinical review.

PubMed

Ahmad, Shazia; Kuraganti, Gayatri; Steenkamp, Devin

2015-03-01

Hypercalcemia is a common metabolic perturbation. However, hypercalcemic crisis is an unusual endocrine emergency, with little clinical scientific data to support therapeutic strategy. We review the relevant scientific English literature on the topic and review current management strategies after conducting a PubMed, MEDLINE, and Google Scholar search for articles published between 1930 and June 2014 using specific keywords: "hypercalcemic crisis," "hyperparathyroid crisis," "parathyroid storm," "severe primary hyperparathyroidism," "acute hyperparathyroidism," and "severe hypercalcemia" for articles pertaining to the diagnosis, epidemiology, clinical presentation, and treatment strategies. Despite extensive clinical experience, large and well-designed clinical studies to direct appropriate clinical care are lacking. Nonetheless, morbidity and mortality rates have substantially decreased since early series reported almost universal fatality. Improved outcomes can be attributed to modern diagnostic capabilities, leading to earlier diagnosis, along with the recognition that primary hyperparathyroidism is the most common etiology for hypercalcemic crisis. Hypercalcemic crisis is an unusual endocrine emergency that portends excellent outcomes if rapid diagnosis, medical treatment, and definitive surgical treatment are expedited. Copyright © 2015 Elsevier Inc. All rights reserved.

Validation of a Self-Efficacy Instrument and Its Relationship to Performance of Crisis Resource Management Skills

ERIC Educational Resources Information Center

Plant, Jennifer L.; van Schaik, Sandrijn M.; Sliwka, Diane C.; Boscardin, Christy K.; O'Sullivan, Patricia S.

2011-01-01

Self-efficacy is thought to be important for resuscitation proficiency in that it influences the development of and access to the associated medical knowledge, procedural skills and crisis resource management (CRM) skills. Since performance assessment of CRM skills is challenging, self-efficacy is often used as a measure of competence in this…

A drinking water crisis in Lake Taihu, China: linkage to climatic variability and lake management.

PubMed

Qin, Boqiang; Zhu, Guangwei; Gao, Guang; Zhang, Yunlin; Li, Wei; Paerl, Hans W; Carmichael, Wayne W

2010-01-01

In late May, 2007, a drinking water crisis took place in Wuxi, Jiangsu Province, China, following a massive bloom of the toxin producing cyanobacteria Microcystis spp. in Lake Taihu, China's third largest freshwater lake. Taihu was the city's sole water supply, leaving approximately two million people without drinking water for at least a week. This cyanobacterial bloom event began two months earlier than previously documented for Microcystis blooms in Taihu. This was attributed to an unusually warm spring. The prevailing wind direction during this period caused the bloom to accumulate at the shoreline near the intake of the water plant. Water was diverted from the nearby Yangtze River in an effort to flush the lake of the bloom. However, this management action was counterproductive, because it produced a current which transported the bloom into the intake, exacerbating the drinking water contamination problem. The severity of this microcystin toxin containing bloom and the ensuing drinking water crisis were attributable to excessive nutrient enrichment; however, a multi-annual warming trend extended the bloom period and amplified its severity, and this was made worse by unanticipated negative impacts of water management. Long-term management must therefore consider both the human and climatic factors controlling these blooms and their impacts on water supply in this and other large lakes threatened by accelerating eutrophication.

Integrating Learning, Leadership, and Crisis in Management Education: Lessons from Army Officers in Iraq and Afghanistan

ERIC Educational Resources Information Center

Kayes, D. Christopher; Allen, Nate; Self, Nate

2013-01-01

This article presents a model and case study used to teach crisis leadership as a management education topic. The materials emerge from studies of U.S. Army leaders (company commanders and platoon leaders) working in Iraq and Afghanistan. The authors explain how examples and cases from military combat provide tools to teach about crisis…

Anesthetic management of hypertensive crisis in a three-year-old patient with undiagnosed severe renal artery stenosis: a case report.

PubMed

Park, Sang-Hee; Lee, Yoon-Sook; Min, Too Jae; Kim, Woon Young; Kim, Jae Hwan; Park, Young Cheol

2014-10-01

Pediatric hypertensive crisis is a potentially life threatening medical emergency, usually secondary to an underlying disease. Hypertension commonly occurs during general anesthesia, and is usually promptly and appropriately treated by anesthesiologists. However in children with severe, unexplained, or refractory hypertension, it has the potential to cause morbidity and even mortality in susceptible patients. We report an anesthetic management of an unexpected hypertensive crisis that developed during general anesthesia in a three-year-old girl with undiagnosed severe left renal artery stenosis.

Anesthetic management of hypertensive crisis in a three-year-old patient with undiagnosed severe renal artery stenosis: a case report

PubMed Central

Park, Sang-hee; Min, Too Jae; Kim, Woon Young; Kim, Jae Hwan; Park, Young Cheol

2014-01-01

Pediatric hypertensive crisis is a potentially life threatening medical emergency, usually secondary to an underlying disease. Hypertension commonly occurs during general anesthesia, and is usually promptly and appropriately treated by anesthesiologists. However in children with severe, unexplained, or refractory hypertension, it has the potential to cause morbidity and even mortality in susceptible patients. We report an anesthetic management of an unexpected hypertensive crisis that developed during general anesthesia in a three-year-old girl with undiagnosed severe left renal artery stenosis. PMID:25368787

Combating Transnational Terrorism in the East African Region: The Role of the African Union Mission in Somalia

DTIC Science & Technology

2017-06-01

four main groups : prevention; disruption; prosecution; and coordination and information sharing. Under prevention, counterterrorism forces are... group has transformed into small active units capable of conducting assassinations, kidnapping, planting improvised explosive devices, and attacking...remaining challenges and highlights 1 International Crisis Group , “Working to Prevent Conflict Worldwide

Intricacies in Drought Management Policy, Crisis Response and Preparedness: Linking the Interface

NASA Astrophysics Data System (ADS)

Prakash, P.; Harter, T.

2016-12-01

Drought per se is often misrepresented as mere water scarcity issue overlooking the complexities associated with it. In many parts of the world, the drought management policy prescriptions are often driven by crisis management rather than preventive approach. As a result, the economic, social and environmental impact of droughts continues to increase even to this day. To overcome this calamity, nations should encourage coordinated effort at both national and regional scale. An integrated approach on open data sharing, technical advancement in monitoring and robust early warning system to deliver timely information to decision makers, drought projection through high performance mathematical model and effective impact assessment procedure, implementing proactive risk management measures and preparedness with effective emergency response programs plans, will certainly increase the likelihood of drought coping capabilities. The present study focuses on knowledge augmentation for better policy framework and action for all countries that suffer from droughts. A comprehensive database at the global scale has been compiled giving information on existing drought management policies/practices and the major challenges faced by major drought distressed countries. Plausible solution is suggested towards integrating the water management policy, response and preparedness, that has been garnered through the lessons from success/failure stories of nations with effective drought management policies

Emergency and crisis management: critical incident stress management for first responders and business organisations.

PubMed

Guenthner, Daniel H

2012-01-01

A literature review was performed on critical incident stress after September 11th, 2001 (9/11), and Hurricanes Katrina and Rita, which focused on the need to implement a holistic critical incident stress management programme for first responders and business organisations. Critical incident stress management is required to handle acute stress and other distress in the face of natural or man-made disasters, including terrorist attacks. A holistic approach to community resilience through a well-planned and implemented critical incident stress management programme has been shown in the literature to promote self-help and self-efficacy of individuals and organisations. The interventions and programme elements defined clearly show how a number of different intervention and prevention strategies will promote business and community resilience and also self-efficacy in a culturally-diverse community and organisation. Implementing a critical incident stress management programme within a responding business organisation is critical because of the fact that first responders are the most susceptible every day to exposure to critical incidents that will affect their mental health; and business employees will suffer some of the same maladies as first responders in the event of a disaster or crisis. Utilising the framework provided, a holistic critical incident stress management programme can be implemented to help reduce the effects of burnout, absenteeism, acute stress, post-traumatic stress, substance use and traumatic stress, and to work to promote community resilience and toughen individuals against the effects of stress. Taking care of the needs of the employees of a business organisation, and of those of first responders, is clearly required.

5 CFR 550.409 - Evacuation payments during a pandemic health crisis.

Code of Federal Regulations, 2010 CFR

2010-01-01

... health crisis. 550.409 Section 550.409 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL... during a pandemic health crisis. (a) An agency may order one or more employees to evacuate from their... the employee) during a pandemic health crisis without regard to whether the agency and the employee...

Model testing on the crisis interventions and actions to prevent medical disputes: a Taiwanese nursing perspective.

PubMed

Tzeng, Huey-Ming

2006-05-01

This study investigated the contributions of comprehensiveness and necessity scales on crisis interventions and actions toward nursing practice-related medical disputes in Taiwanese hospitals and institutions' demographic characteristics, to overall satisfaction toward nursing-related crisis management policies and interventions and overall satisfaction toward their institution's crisis management system. In a health-care environment that is focused on cost containment, for overworked nurses and understaffed medical wards, patients still expect nurses to provide high quality, compassionate care. Patients usually regard nurses as the principal link between the technical and interpersonal aspects of their care. However, current hospital systems tend to require patients to be self-reliant in managing their own care. Patient mistrust of medical care providers might have contributed to the current medical error/dispute crisis. In this cross-sectional study, the subjects were nursing directors of Taiwanese hospitals (197 valid subjects). The author developed the questionnaire used in this study. The ordinal logistic regression analyses demonstrated that being a public hospital managed by the government, being a hospital operated by a corporate body, the more comprehensive the technical/structural aspect and the assessment aspect and the more needed the psychological aspect, contribute to higher general satisfaction levels toward nursing-related crisis management. The more comprehensive the strategic aspect and having more acute beds, contributes to higher satisfaction levels with their institution's overall crisis management activities. These findings inferred a possible change in a hospital's resource allocation or power structure when dealing with issues of patient care quality, including nursing practice-related crisis management policies, interventions and actions. RELEVANT TO CLINICAL PRACTICE: A good crisis management system may help to keep a crisis from worsening

Transfer of learning and patient outcome in simulated crisis resource management: a systematic review.

PubMed

Boet, Sylvain; Bould, M Dylan; Fung, Lillia; Qosa, Haytham; Perrier, Laure; Tavares, Walter; Reeves, Scott; Tricco, Andrea C

2014-06-01

Simulation-based learning is increasingly used by healthcare professionals as a safe method to learn and practice non-technical skills, such as communication and leadership, required for effective crisis resource management (CRM). This systematic review was conducted to gain a better understanding of the impact of simulation-based CRM teaching on transfer of learning to the workplace and subsequent changes in patient outcomes. Studies on CRM, crisis management, crew resource management, teamwork, and simulation published up to September 2012 were searched in MEDLINE(®), EMBASE™, CINAHL, Cochrane Central Register of Controlled Trials, and ERIC. All studies that used simulation-based CRM teaching with outcomes measured at Kirkpatrick Level 3 (transfer of learning to the workplace) or 4 (patient outcome) were included. Studies measuring only learners' reactions or simple learning (Kirkpatrick Level 1 or 2, respectively) were excluded. Two authors independently reviewed all identified titles and abstracts for eligibility. Nine articles were identified as meeting the inclusion criteria. Four studies measured transfer of simulation-based CRM learning into the clinical setting (Kirkpatrick Level 3). In three of these studies, simulation-enhanced CRM training was found significantly more effective than no intervention or didactic teaching. Five studies measured patient outcomes (Kirkpatrick Level 4). Only one of these studies found that simulation-based CRM training made a clearly significant impact on patient mortality. Based on a small number of studies, this systematic review found that CRM skills learned at the simulation centre are transferred to clinical settings, and the acquired CRM skills may translate to improved patient outcomes, including a decrease in mortality.

Impact of crisis resource management simulation-based training for interprofessional and interdisciplinary teams: A systematic review.

PubMed

Fung, Lillia; Boet, Sylvain; Bould, M Dylan; Qosa, Haytham; Perrier, Laure; Tricco, Andrea; Tavares, Walter; Reeves, Scott

2015-01-01

Crisis resource management (CRM) abilities are important for different healthcare providers to effectively manage critical clinical events. This study aims to review the effectiveness of simulation-based CRM training for interprofessional and interdisciplinary teams compared to other instructional methods (e.g., didactics). Interprofessional teams are composed of several professions (e.g., nurse, physician, midwife) while interdisciplinary teams are composed of several disciplines from the same profession (e.g., cardiologist, anaesthesiologist, orthopaedist). Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and ERIC were searched using terms related to CRM, crisis management, crew resource management, teamwork, and simulation. Trials comparing simulation-based CRM team training versus any other methods of education were included. The educational interventions involved interprofessional or interdisciplinary healthcare teams. The initial search identified 7456 publications; 12 studies were included. Simulation-based CRM team training was associated with significant improvements in CRM skill acquisition in all but two studies when compared to didactic case-based CRM training or simulation without CRM training. Of the 12 included studies, one showed significant improvements in team behaviours in the workplace, while two studies demonstrated sustained reductions in adverse patient outcomes after a single simulation-based CRM team intervention. In conclusion, CRM simulation-based training for interprofessional and interdisciplinary teams show promise in teaching CRM in the simulator when compared to didactic case-based CRM education or simulation without CRM teaching. More research, however, is required to demonstrate transfer of learning to workplaces and potential impact on patient outcomes.

Financial Crisis Management in Higher Education: Responses by 20 Private Colleges and Universities to the 2007-2009 Financial Crisis

ERIC Educational Resources Information Center

Dorantes, Andrew R.; Low, Justin R.

2016-01-01

As a result of the Great Recession, higher education in the United States suffered from the most significant financial crisis since the Great Depression (Breneman 2008; Zumeta 2010). This crisis affected all institutions of higher education since it challenged three major revenue sources: net tuition income, endowment income, and gift income…

Modeling the Car Crash Crisis Management System Using HiLA

NASA Astrophysics Data System (ADS)

Hölzl, Matthias; Knapp, Alexander; Zhang, Gefei

An aspect-oriented modeling approach to the Car Crash Crisis Management System (CCCMS) using the High-Level Aspect (HiLA) language is described. HiLA is a language for expressing aspects for UML static structures and UML state machines. In particular, HiLA supports both a static graph transformational and a dynamic approach of applying aspects. Furthermore, it facilitates methodologically turning use case descriptions into state machines: for each main success scenario, a base state machine is developed; all extensions to this main success scenario are covered by aspects. Overall, the static structure of the CCCMS is modeled in 43 classes, the main success scenarios in 13 base machines, the use case extensions in 47 static and 31 dynamic aspects, most of which are instantiations of simple aspect templates.

Emotional First Aid: Crisis Development and Systems of Intervention.

ERIC Educational Resources Information Center

Rosenbluh, Edward S.; And Others

This instructional manual takes a developmental approach toward understanding the psychological, social and behavioral dynamics of human crisis. The manual describes the behavior patterns characterizing various psychological and physical crises, and provides background information and methods of crisis intervention with which to manage each. In…

Nursing in Crisis

ERIC Educational Resources Information Center

Fulcher, Roxanne

2007-01-01

Both the nation's health-care and nursing education systems are in crisis. While the care provided by registered nurses (RNs) is essential to patients' recovery from acute illness and to the effective management of their chronic conditions, the United States is experiencing a nursing shortage that is anticipated to increase as baby boomers age and…

Intraoperative crisis resource management during a non-intubated video-assisted thoracoscopic surgery

PubMed Central

Gálvez, Carlos; Rivera-Cogollos, María Jesus; Galiana-Ivars, María; Bolufer, Sergio; Martínez-Adsuar, Francisco

2015-01-01

The management of surgical and medical intraoperative emergencies are included in the group of high acuity (high potential severity of an event and the patient impact) and low opportunity (the frequency in which the team is required to manage the event). This combination places the patient into a situation where medical errors could happen more frequently. Although medical error are ubiquitous and inevitable we should try to establish the necessary knowledge, skills and attitudes needed for effective team performance and to guide the development of a critical event. This strategy would probably reduce the incidence of error and improve decision-making. The way to apply it comes from the application of the management of critical events in the airline industry. Its use in a surgical environment is through the crisis resource management (CRM) principles. The CRM tries to develop all the non-technical skills necessary in a critical situation, but not only that, also includes all the tools needed to prevent them. The purpose of this special issue is to appraise and summarize the design, implementation, and efficacy of simulation-based CRM training programs for a specific surgery such as the non-intubated video-assisted thoracoscopic surgery. PMID:26046052

School Crisis Teams within an Incident Command System

ERIC Educational Resources Information Center

Nickerson, Amanda B.; Brock, Stephen E.; Reeves, Melissa A.

2006-01-01

Despite the increasing attention given to the need for schools to be prepared to respond in a variety of crisis situations, there is a lack of information about how to coordinate with multiple agencies following a crisis. This article describes the U. S. Department of Homeland Security's (2004) National Incident Management System and its Incident…

What Are the Attributes and Duties of the School Crisis Intervention Team?

ERIC Educational Resources Information Center

Gullatt, David E.; Long, Douglas

1996-01-01

Physical measures such as weapons checks and metal detectors are inadequate to forestall school violence. The key to managing crises is a trained, broad-based crisis-intervention team and a crisis-management plan. Team responsibilities include developing an intervention plan, coordinating with community services, educating and training staff, and…

Leadership in crisis situations: merging the interdisciplinary silos.

PubMed

Paquin, Hugo; Bank, Ilana; Young, Meredith; Nguyen, Lily H P; Fisher, Rachel; Nugus, Peter

2018-02-05

Purpose Complex clinical situations, involving multiple medical specialists, create potential for tension or lack of clarity over leadership roles and may result in miscommunication, errors and poor patient outcomes. Even though copresence has been shown to overcome some differences among team members, the coordination literature provides little guidance on the relationship between coordination and leadership in highly specialized health settings. The purpose of this paper is to determine how different specialties involved in critical medical situations perceive the role of a leader and its contribution to effective crisis management, to better define leadership and improve interdisciplinary leadership and education. Design/methodology/approach A qualitative study was conducted featuring purposively sampled, semi-structured interviews with 27 physicians, from three different specialties involved in crisis resource management in pediatric centers across Canada: Pediatric Emergency Medicine, Otolaryngology and Anesthesia. A total of three researchers independently organized participant responses into categories. The categories were further refined into conceptual themes through iterative negotiation among the researchers. Findings Relatively "structured" (predictable) cases were amenable to concrete distributed leadership - the performance by micro-teams of specialized tasks with relative independence from each other. In contrast, relatively "unstructured" (unpredictable) cases required higher-level coordinative leadership - the overall management of the context and allocations of priorities by a designated individual. Originality/value Crisis medicine relies on designated leadership over highly differentiated personnel and unpredictable events. This challenges the notion of organic coordination and upholds the validity of a concept of leadership for crisis medicine that is not reducible to simple coordination. The intersection of predictability of cases with types

Learning crisis resource management: Practicing versus an observational role in simulation training - a randomized controlled trial.

PubMed

Lai, Anita; Haligua, Alexis; Dylan Bould, M; Everett, Tobias; Gale, Mark; Pigford, Ashlee-Ann; Boet, Sylvain

2016-08-01

Simulation training has been shown to be an effective way to teach crisis resource management (CRM) skills. Deliberate practice theory states that learners need to actively practice so that learning is effective. However, many residency programs have limited opportunities for learners to be "active" participants in simulation exercises. This study compares the effectiveness of learning CRM skills when being an active participant versus being an observer participant in simulation followed by a debriefing. Participants were randomized to two groups: active or observer. Active participants managed a simulated crisis scenario (pre-test) while paired observer participants viewed the scenario via video transmission. Then, a trained instructor debriefed participants on CRM principles. On the same day, each participant individually managed another simulated crisis scenario (post-test) and completed a post-test questionnaire. Two independent, blinded raters evaluated all videos using the Ottawa Global Rating Scale (GRS). Thirty-nine residents were included in the analysis. Normally distributed data were analyzed using paired and unpaired t-tests. Inter-rater reliability was 0.64. Active participants significantly improved from pre-test to post-test (P=0.015). There was no significant difference between the post-test performance of active participants compared to observer participants (P=0.12). We found that learning CRM principles was not superior when learners were active participants compared to being observers followed by debriefing. These findings challenge the deliberate practice theory claiming that learning requires active practice. Assigning residents as observers in simulation training and involving them in debriefing is still beneficial. Copyright © 2016 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

Crisis, What Crisis?

ERIC Educational Resources Information Center

Jones, Ken

2010-01-01

Responding to the recent work of Andrew Gamble, the article discusses the extent to which the British situation can be described in terms of crisis. It suggests that an essential element of crisis is that of political and social contestation, and explores the terms on which contestation is taking shape in and around British education.

Communicating Geographical Risks in Crisis Management: The Need for Research.

PubMed

French, Simon; Argyris, Nikolaos; Haywood, Stephanie M; Hort, Matthew C; Smith, Jim Q

2017-10-23

In any crisis, there is a great deal of uncertainty, often geographical uncertainty or, more precisely, spatiotemporal uncertainty. Examples include the spread of contamination from an industrial accident, drifting volcanic ash, and the path of a hurricane. Estimating spatiotemporal probabilities is usually a difficult task, but that is not our primary concern. Rather, we ask how analysts can communicate spatiotemporal uncertainty to those handling the crisis. We comment on the somewhat limited literature on the representation of spatial uncertainty on maps. We note that many cognitive issues arise and that the potential for confusion is high. We note that in the early stages of handling a crisis, the uncertainties involved may be deep, i.e., difficult or impossible to quantify in the time available. In such circumstance, we suggest the idea of presenting multiple scenarios. © 2017 Society for Risk Analysis.

Simulating Terrorism: Credible Commitment, Costly Signaling, and Strategic Behavior

ERIC Educational Resources Information Center

Siegel, David A.; Young, Joseph K.

2009-01-01

We present two simulations designed to convey the strategic nature of terrorism and counterterrorism. The first is a simulated hostage crisis, designed primarily to illustrate the concepts of credible commitment and costly signaling. The second explores high-level decision making of both a terrorist group and the state, and is designed to…

Preparing for a Crisis.

ERIC Educational Resources Information Center

Perea, Rosalie D.; Morrison, Shirley

1997-01-01

To handle unforeseen crises, Albuquerque Public Schools established a critical-incident response team with a simple, understandable chain of command. The group aims to ensure maximum safety and people' well-being, develop a districtwide crisis-response-management plan, coordinate necessary training, and collaborate with community agencies…

Does warm-up using mental practice improve crisis resource management performance? A simulation study.

PubMed

Hayter, M A; Bould, M D; Afsari, M; Riem, N; Chiu, M; Boet, S

2013-02-01

Mental practice (MP) is defined as the 'symbolic rehearsal of a physical activity in the absence of any gross-muscular movements' and has been used in sport and music to enhance performance. In healthcare, MP has been demonstrated to improve technical skill performance of surgical residents. However, its effect on crisis resource management (CRM) skills has yet to be determined. We aimed to investigate the effect of warm-up with MP on CRM skill performance during a simulated crisis scenario. Following ethics board approval, 40 anaesthesia residents were randomized. The intervention group performed 20 min of MP of a script based on CRM principles. The control group received a 20 min didactic teaching session on an unrelated topic. Each subject then managed a simulated cardiac arrest. Two CRM experts rated the video recordings of each performance using the previously validated Ottawa GRS. The time to start chest compressions, administer epinephrine, and give blood was recorded. There was no significant difference between the intervention and control groups: total Ottawa GRS score was 24.50 (18.63-28.88 [6.50-34.50]) (median (inter-quartile range [range]) vs 20.50 (13.00-29.13 [6.50-34.50]) (P=0.53); the time to start chest compressions 146.0 s (138.0-231.0 [115.0-323.0]) vs 162.5 s (138.0-231.0 [100.0-460.0]) (P=0.27), the time to epinephrine administration 163.0 s (151.0-187.0 [111.0-337.0]) vs 187.0 s (164.0-244.0 [115.0-310.0]) (P=0.09), and the time to blood administration 220.5 s (130.8-309.0 [92.0-485.0]) vs 252.5 (174.5-398.8 [65.0-527.0]) (P=0.48). Unlike technical skills, warm-up with MP does not seem to improve CRM skills in simulated crisis scenarios.

Leadership in a (permanent) crisis.

PubMed

Heifetz, Ronald; Grashow, Alexander; Linsky, Marty

2009-01-01

The current economic crisis is not just another rough spell. Today's mix of urgency, high stakes, and uncertainty will continue even after the recession ends. The immediate crisis--which we will get through with policy makers' expert technical adjustments--sets the stage for a sustained, or even permanent, crisis, a relentless series of challenges no one has encountered before. Instead of hunkering down and relying on their familiar expertise to deal with the sustained crisis, people in positions of authority--whether they are CEOs or managers heading up a company initiative--must practice what the authors call adaptive leadership. They must, of course, tackle the underlying causes of the crisis, but they must also simultaneously make the changes that will allow their organizations to thrive in turbulent environments. Adaptive leadership is an improvisational and experimental art, requiring some new practices. Like Julie Gilbert, who overcame internal resistance to reorient Best Buy toward female purchasers, adaptive leaders get things done to meet today's challenges and then modify those things to thrive in tomorrow's world. They also embrace disequilibrium, using turbulence as an opportunity to build crucial new capacities, as Paul Levy did to rescue Beth Israel Deaconess Medical Center from a profound financial crisis. Finally, adaptive leaders, such as Egon Zehnder, the founder of an executive search firm, draw out the leadership skills that reside deep in the organization, recognizing the interdependence of all employees and mobilizing everyone to generate solutions.

GIS Based System for Post-Earthquake Crisis Managment Using Cellular Network

NASA Astrophysics Data System (ADS)

Raeesi, M.; Sadeghi-Niaraki, A.

2013-09-01

Earthquakes are among the most destructive natural disasters. Earthquakes happen mainly near the edges of tectonic plates, but they may happen just about anywhere. Earthquakes cannot be predicted. Quick response after disasters, like earthquake, decreases loss of life and costs. Massive earthquakes often cause structures to collapse, trapping victims under dense rubble for long periods of time. After the earthquake and destroyed some areas, several teams are sent to find the location of the destroyed areas. The search and rescue phase usually is maintained for many days. Time reduction for surviving people is very important. A Geographical Information System (GIS) can be used for decreasing response time and management in critical situations. Position estimation in short period of time time is important. This paper proposes a GIS based system for post-earthquake disaster management solution. This system relies on several mobile positioning methods such as cell-ID and TA method, signal strength method, angel of arrival method, time of arrival method and time difference of arrival method. For quick positioning, the system can be helped by any person who has a mobile device. After positioning and specifying the critical points, the points are sent to a central site for managing the procedure of quick response for helping. This solution establishes a quick way to manage the post-earthquake crisis.

Calibrating Fundamental British Values: How Head Teachers Are Approaching Appraisal in the Light of the Teachers' Standards 2012, Prevent and the Counter-Terrorism and Security Act, 2015

ERIC Educational Resources Information Center

Revell, Lynn; Bryan, Hazel

2016-01-01

In requiring that teachers should "not undermine fundamental British values (FBV)," a phrase originally articulated in the Home Office counter-terrorism document, Prevent, the Teachers' Standards has brought into focus the nature of teacher professionalism. Teachers in England are now required to promote FBV within and outside school,…

Effective Crisis Management at the Smaller Campus.

ERIC Educational Resources Information Center

DeWitt, Robert C.

Pennsylvania State University Beaver Campus developed crisis guidelines and a formal working relationship with a local community mental health center in order to be able to deal with on-campus crises and their followup. The guidelines provide each employee with a single, easy-to-follow document that outlines the decision making process to be…

Mapping a Crisis, One Text Message at a Time

ERIC Educational Resources Information Center

Bauduy, Jennifer

2010-01-01

An interactive mapping project is revolutionizing the way crises are reported and managed, and is spotlighting the value of citizen journalism. The project, called Ushahidi, which means testimony in Swahili, uses crowdsourcing (gathering information from a large number of people) to map crisis information. This crisis mapping tool has since been…

Learning Crisis Unit through Post-Crisis: Characteristics and Mechanisms

ERIC Educational Resources Information Center

Chebbi, Hela; Pündrich, Aline Pereira

2015-01-01

Purpose: This paper aims to identify the characteristics that a crisis unit should have to achieve effective learning after crisis. Literature has identified many relations between learning organizations and crisis; yet, there is a dearth of research on specific studies about crisis units and their post-crisis learning features. Thus, this paper…

Reviewing the definition of crisis in dementia care

PubMed Central

2013-01-01

Background Crisis is a term frequently used in dementia care lacking a standardized definition. This article systematically reviews existing definitions of crisis in dementia care literature to create a standardized definition that can be utilized for research, policy and clinical practice. Methods We systematically searched for articles containing definitions of crisis in the context of dementia care. We created an operational framework of crisis based on retrieved definitions. Recommendations to address crisis situations were reviewed and classified according to care settings. Results Abstracts and titles of 1,113 articles, screened from PubMed and EMBASE, were narrowed down to 27 articles. After review, crisis in dementia was defined as a process where a stressor causes an imbalance requiring an immediate decision to be made which leads to a desired outcome and therefore a resolution of the crisis. If the crisis is not resolved, the cycle continues. Recommendations for resolving crisis involving persons with dementia and their caregivers include awareness therapy after diagnosis and increased contact with general practitioners, case manager consultations, caregiver support and education. Furthermore, nursing home staff should be attuned to the environmental, physical and psychological needs of persons with dementia. Conclusions This is the first article to review the definition of crisis in the context of dementia care. A review of the literature indicated that the definition of a crisis is idiosyncratic. Therefore, it is difficult to prevent or plan for all crises. We used an operational framework to compile types of crisis stressors and recommendations from the crisis literature based on three different perspectives; the person with the dementia, the caregiver and the healthcare providers. PMID:23374634

Reviewing the definition of crisis in dementia care.

PubMed

MacNeil Vroomen, Janet; Bosmans, Judith E; van Hout, Hein P J; de Rooij, Sophia E

2013-02-01

Crisis is a term frequently used in dementia care lacking a standardized definition. This article systematically reviews existing definitions of crisis in dementia care literature to create a standardized definition that can be utilized for research, policy and clinical practice. We systematically searched for articles containing definitions of crisis in the context of dementia care. We created an operational framework of crisis based on retrieved definitions. Recommendations to address crisis situations were reviewed and classified according to care settings. Abstracts and titles of 1,113 articles, screened from PubMed and EMBASE, were narrowed down to 27 articles. After review, crisis in dementia was defined as a process where a stressor causes an imbalance requiring an immediate decision to be made which leads to a desired outcome and therefore a resolution of the crisis. If the crisis is not resolved, the cycle continues. Recommendations for resolving crisis involving persons with dementia and their caregivers include awareness therapy after diagnosis and increased contact with general practitioners, case manager consultations, caregiver support and education. Furthermore, nursing home staff should be attuned to the environmental, physical and psychological needs of persons with dementia. This is the first article to review the definition of crisis in the context of dementia care. A review of the literature indicated that the definition of a crisis is idiosyncratic. Therefore, it is difficult to prevent or plan for all crises. We used an operational framework to compile types of crisis stressors and recommendations from the crisis literature based on three different perspectives; the person with the dementia, the caregiver and the healthcare providers.

Higher Educational Policy, Interest Politics and Crisis Management: Facets and Aspects of the Greek Case within the EHEA

ERIC Educational Resources Information Center

Papadakis, Nikos E.; Tsakanika, Theofano; Kyridis, Argyris

2012-01-01

With this paper we approach the new policy making paradigm for Europe's higher education policy, set with the Bologna Process, given emphasis to the legitimacy deficit of this political venture and the necessity of a crisis management over the implementation phase within national frames. The implementation of the Bologna's policies, using Greece…

The Crisis of Methamphetamine and Its Management: Preparation, Participation, and Prevention

ERIC Educational Resources Information Center

Cunniff, Judith; Cunniff, Daniel T.; Kay, Kenneth D.

2008-01-01

There is a drug crisis in the United States that is growing at an alarming rate. Its participants work in our businesses, government agencies, and schools. California leads the nation in drug use and until recently, Fresno County was the leader in methamphetamine production. This drug crisis is having a paralyzing effect causing loss of income,…

Mission Command: Retooling the Leadership Paradigm for Homeland Security Crisis Response?

DTIC Science & Technology

2015-03-01

security crisis management. While, there is some literature regarding the efforts by the USFS and the federal wildland firefighting community towards...psychologically stressful and potentially overwhelming. The need to communicate and cooperate with other agencies in a crisis places added...environment where formal hierarchies and tightly controlled plans may become irrelevant in a crisis . Grant and De Waard examined the communication

Evolving School-Crisis Management since 9/11

ERIC Educational Resources Information Center

Brickman, Heather K.; Jones, Stephanie E.; Groom, Sara E.

2004-01-01

The word "terrorism" has become commonplace in the headlines, workplaces, and homes since September 11, 2001. In the past, school crisis plans commonly addressed how to evacuate in the event of a gas leak or fire. Today, schools must be prepared to address biological, chemical, and radiological attacks, as well as car bombings, suicide attacks,…

Crisis-Management Plans Are Untested, Survey Says

ERIC Educational Resources Information Center

June, Audrey Williams

2007-01-01

Newly released survey results reveal that many colleges are focusing more than ever on preparing for a crisis since the massacre at Virginia Tech, but that they may not be well equipped to handle one. The online survey was conducted by SimpsonScarborough, a consulting firm that focuses on colleges and universities. It invited 546 people who are…

Development and Reliability of the Comprehensive Crisis Plan Checklist

ERIC Educational Resources Information Center

Aspiranti, Kathleen B.; Pelchar, Taylor K.; McCLeary, Daniel F.; Bain, Sherry K.; Foster, Lisa N.

2011-01-01

It is of vital importance that children are educated in a safe environment. Every school needs to have a well-developed crisis management document containing plans for prevention, intervention, and postvention. We developed the Comprehensive Crisis Plan Checklist (CCPC) to serve as a valuable tool that can be used to assist practitioners with…

Deficient crisis-probing practices and taken-for-granted assumptions in health organisations.

PubMed

Canyon, Deon V; Adhikari, Ashmita; Cordery, Thomas; Giguère-Simmonds, Philippe; Huang, Jessica; Nguyen, Helen; Watson, Michael; Yang, Daniel

2011-04-18

The practice of crisis-probing in proactive organisations involves meticulous and sustained investigation into operational processes and management structures for potential weaknesses and flaws before they become difficult to resolve. In health organisations, crisis probing is a necessary part of preparing to manage emerging health threats. This study examined the degree of pre-emptive probing in health organisations and the type of crisis training provided to determine whether or not they are prepared in this area. This evidence-based study draws on cross-sectional responses provided by executives from chiropractic, physiotherapy, and podiatry practices; dental and medical clinics; pharmacies; aged care facilities; and hospitals. The data show a marked lack of mandatory probing and a generalised failure to reward crisis reporting. Crisis prevention training is poor in all organisations except hospitals and aged care facilities where it occurs at an adequate frequency. However this training focuses primarily on natural disasters, fails to address most other crisis types, is mostly reactive and not designed to probe for and uncover key taken-for-granted assumptions. Crisis-probing in health organisations is inadequate, and improvements in this area may well translate into measurable improvements in preparedness and response outcomes.

Deficient crisis-probing practices and taken-for-granted assumptions in health organisations

PubMed Central

Canyon, Deon V.; Adhikari, Ashmita; Cordery, Thomas; Giguère-Simmonds, Philippe; Huang, Jessica; Nguyen, Helen; Watson, Michael; Yang, Daniel

2011-01-01

The practice of crisis-probing in proactive organisations involves meticulous and sustained investigation into operational processes and management structures for potential weaknesses and flaws before they become difficult to resolve. In health organisations, crisis probing is a necessary part of preparing to manage emerging health threats. This study examined the degree of pre-emptive probing in health organisations and the type of crisis training provided to determine whether or not they are prepared in this area. This evidence-based study draws on cross-sectional responses provided by executives from chiropractic, physiotherapy, and podiatry practices; dental and medical clinics; pharmacies; aged care facilities; and hospitals. The data show a marked lack of mandatory probing and a generalised failure to reward crisis reporting. Crisis prevention training is poor in all organisations except hospitals and aged care facilities where it occurs at an adequate frequency. However this training focuses primarily on natural disasters, fails to address most other crisis types, is mostly reactive and not designed to probe for and uncover key taken-for-granted assumptions. Crisis-probing in health organisations is inadequate, and improvements in this area may well translate into measurable improvements in preparedness and response outcomes. PMID:24149030

Challenges of the management of mass casualty: lessons learned from the Jos crisis of 2001.

PubMed

Ozoilo, Kenneth N; Pam, Ishaya C; Yiltok, Simon J; Ramyil, Alice V; Nwadiaro, Hyacinth C

2013-10-28

Jos has witnessed a series of civil crises which have generated mass casualties that the Jos University Teaching Hospital has had to respond to from time to time. We review the challenges that we encountered in the management of the victims of the 2001 crisis. We reviewed the findings of our debriefing sessions following the sectarian crisis of September 2001 and identified the challenges and obstacles experienced during these periods. Communication was a major challenge, both within and outside the hospital. In the field, there was poor field triage and no prehospital care. Transportation and evacuation was hazardous, for both injured patients and medical personnel. This was worsened by the imposition of a curfew on the city and its environs. In the hospital, supplies such as fluids, emergency drugs, sterile dressings and instruments, splints, and other consumables, blood and food were soon exhausted. Record keeping was erratic. Staff began to show signs of physical and mental exhaustion as well as features of anxiety and stress. Tensions rose between different religious groups in the hospital and an attempt was made by rioters to attack the hospital. Patients suffered poor subsequent care following resuscitation and/or surgery and there was neglect of patients on admission prior to the crisis as well as non trauma medical emergencies. Mass casualties from disasters that disrupt organized societal mechanisms for days can pose significant challenges to the best of institutional disaster response plans. In the situation that we experienced, our disaster plan was impractical initially because it failed to factor in such a prolongation of both crisis and response. We recommend that institutional disaster response plans should incorporate provisions for the challenges we have enumerated and factor in peculiarities that would emanate from the need for a prolonged response.

Challenges of the management of mass casualty: lessons learned from the Jos crisis of 2001

PubMed Central

2013-01-01

Background Jos has witnessed a series of civil crises which have generated mass casualties that the Jos University Teaching Hospital has had to respond to from time to time. We review the challenges that we encountered in the management of the victims of the 2001 crisis. Methodology We reviewed the findings of our debriefing sessions following the sectarian crisis of September 2001 and identified the challenges and obstacles experienced during these periods. Results Communication was a major challenge, both within and outside the hospital. In the field, there was poor field triage and no prehospital care. Transportation and evacuation was hazardous, for both injured patients and medical personnel. This was worsened by the imposition of a curfew on the city and its environs. In the hospital, supplies such as fluids, emergency drugs, sterile dressings and instruments, splints, and other consumables, blood and food were soon exhausted. Record keeping was erratic. Staff began to show signs of physical and mental exhaustion as well as features of anxiety and stress. Tensions rose between different religious groups in the hospital and an attempt was made by rioters to attack the hospital. Patients suffered poor subsequent care following resuscitation and/or surgery and there was neglect of patients on admission prior to the crisis as well as non trauma medical emergencies. Conclusion Mass casualties from disasters that disrupt organized societal mechanisms for days can pose significant challenges to the best of institutional disaster response plans. In the situation that we experienced, our disaster plan was impractical initially because it failed to factor in such a prolongation of both crisis and response. We recommend that institutional disaster response plans should incorporate provisions for the challenges we have enumerated and factor in peculiarities that would emanate from the need for a prolonged response. PMID:24164778

Error Detection-Based Model to Assess Educational Outcomes in Crisis Resource Management Training: A Pilot Study.

PubMed

Bouhabel, Sarah; Kay-Rivest, Emily; Nhan, Carol; Bank, Ilana; Nugus, Peter; Fisher, Rachel; Nguyen, Lily Hp

2017-06-01

Otolaryngology-head and neck surgery (OTL-HNS) residents face a variety of difficult, high-stress situations, which may occur early in their training. Since these events occur infrequently, simulation-based learning has become an important part of residents' training and is already well established in fields such as anesthesia and emergency medicine. In the domain of OTL-HNS, it is gradually gaining in popularity. Crisis Resource Management (CRM), a program adapted from the aviation industry, aims to improve outcomes of crisis situations by attempting to mitigate human errors. Some examples of CRM principles include cultivating situational awareness; promoting proper use of available resources; and improving rapid decision making, particularly in high-acuity, low-frequency clinical situations. Our pilot project sought to integrate CRM principles into an airway simulation course for OTL-HNS residents, but most important, it evaluated whether learning objectives were met, through use of a novel error identification model.

Thyrotoxic and pheochromocytoma multisystem crisis: a case report.

PubMed

Suzuki, Kodai; Miyake, Takahito; Okada, Hideshi; Yamaji, Fuminori; Kitagawa, Yuichiro; Fukuta, Tetsuya; Yasuda, Ryu; Tanaka, Yoshihito; Okamoto, Haruka; Nachi, Sho; Doi, Tomoaki; Yoshida, Takahiro; Kumada, Keisuke; Yoshida, Shozo; Ushikoshi, Hiroaki; Toyoda, Izumi; Ogura, Shinji

2017-06-23

Thyrotoxic crisis and pheochromocytoma multisystem crisis are rare, life-threatening, emergency endocrine diseases with various clinical manifestations. Here we report a case of a patient who simultaneously developed thyrotoxic crisis and pheochromocytoma multisystem crisis and required intensive cardiovascular management. A 60-year-old Asian man experienced nausea and vomiting, and subsequently developed dyspnea and cold sweats while farming. His serum free thyroxine, free triiodothyronine, and thyrotropin receptor antibody levels were elevated at 2.9 ng/dL, 7.2 pg/dL, and 4.7 IU/L, respectively. Serum thyrotropin levels were suppressed at less than 0.01 μIU/mL. Thyroid echography demonstrated no thyroid swelling (23 × 43 mm). A whole body computed tomography was performed for systemic evaluation. This revealed exophthalmos and a mass of size 57 × 64 mm in the anterior pararenal space. Based on these findings, we made an initial diagnosis of thyrotoxic crisis secondary to exacerbation of Grave's hyperthyroidism. Treatment was begun with an iodine agent at a dose of 36 mg/day, thiamazole at a dose of 30 mg/day, and hydrocortisone at a dose of 300 mg daily for 3 consecutive days. To control tachycardia, continuous intravenously administered propranolol and diltiazem infusions were given. At the same time, small doses of doxazosin and carvedilol were used for both alpha and beta adrenergic blockade. On hospital day 5, his blood pressure and serum catecholamine concentrations (adrenalin 42,365 pg/mL, dopamine 6409 pg/mL, noradrenalin 72,212 pg/mL) were still high despite higher beta blocker and calcium channel blocker doses. These findings contributed to the diagnosis of pheochromocytoma multisystem crisis with simultaneous thyrotoxic crisis. We increased the doses of doxazosin and carvedilol, which stabilized his hemodynamic status. On hospital day 16, metaiodobenzylguanidine scintigraphy showed high accumulation in the right adrenal gland tumor

Crisis Begets Change: Hurricane Recovery at Gulf Coast Institutions

ERIC Educational Resources Information Center

Shaw, Mahauganee Dawn

2012-01-01

Despite a growing body of literature on campus crisis management and the breadth of research on organizational change, little is known about organizational changes prompted by campus crisis. The purpose of this study is to examine the changes made to the operational profiles of Gulf Coast institutions during the process of recovering from major…

Crisis Team Management in a Scarce Resource Setting: Angkor Hospital for Children in Siem Reap, Cambodia.

PubMed

Henker, Richard Alynn; Henker, Hiroko; Eng, Hor; O'Donnell, John; Jirativanont, Tachawan

2017-01-01

A crisis team management (CTM) simulation course was developed by volunteers from Health Volunteers Overseas for physicians and nurses at Angkor Hospital for Children (AHC) in Siem Reap, Cambodia. The framework for the course was adapted from crisis resource management (1, 2), crisis team training (3), and TeamSTEPPs© models (4). The CTM course focused on teaching physicians and nurses on the development of team performance knowledge, skills, and attitudes. Challenges to providing this course at AHC included availability of simulation equipment, cultural differences in learning, and language barriers. The purpose of this project was to evaluate the impact of a CTM simulation course at AHC on attitudes and perceptions of participants on concepts related to team performance. Each of the CTM courses consisted of three lectures, including team performance concepts, communication, and debriefing followed by rotation through four simulation scenarios. The evaluation instrument used to evaluate the AHC CTM course was developed for Cambodian staff at AHC based on TeamSTEPPs© instruments evaluating attitude and perceptions of team performance (5). CTM team performance concepts included in lectures, debriefing sessions, and the evaluation instrument were: team structure, leadership, situation monitoring, mutual support, and communication. The Wilcoxon signed-rank test was used to analyze pre- and post-test paired data from participants in the course. Of the 54 participants completing the three CTM courses at AHC, 27 were nurses, 6 were anesthetists, and 21 were physicians. Attitude and perception scores were found to significantly improve ( p  < 0.05) for team structure, leadership, situation monitoring, and communication. Team performance areas that improved the most were: discussion of team performance, communication, and exchange of information. Teaching of non-technical skills can be effective in a setting with scarce resources in a Southeastern Asian country.

Cognitive Aids for Role Definition (CARD) to improve interprofessional team crisis resource management: An exploratory study.

PubMed

Renna, Tania Di; Crooks, Simone; Pigford, Ashlee-Ann; Clarkin, Chantalle; Fraser, Amy B; Bunting, Alexandra C; Bould, M Dylan; Boet, Sylvain

2016-09-01

This study aimed to assess the perceived value of the Cognitive Aids for Role Definition (CARD) protocol for simulated intraoperative cardiac arrests. Sixteen interprofessional operating room teams completed three consecutive simulated intraoperative cardiac arrest scenarios: current standard, no CARD; CARD, no CARD teaching; and CARD, didactic teaching. Each team participated in a focus group interview immediately following the third scenario; data were transcribed verbatim and qualitatively analysed. After 6 months, participants formed eight new teams randomised to two groups (CARD or no CARD) and completed a retention intraoperative cardiac arrest simulation scenario. All simulation sessions were video recorded and expert raters assessed team performance. Qualitative analysis of the 16 focus group interviews revealed 3 thematic dimensions: role definition in crisis management; logistical issues; and the "real life" applicability of CARD. Members of the interprofessional team perceived CARD very positively. Exploratory quantitative analysis found no significant differences in team performance with or without CARD (p > 0.05). In conclusion, qualitative data suggest that the CARD protocol clarifies roles and team coordination during interprofessional crisis management and has the potential to improve the team performance. The concept of a self-organising team with defined roles is promising for patient safety.

Outcome of Extended Thymectomy in Myasthenia Crisis Patient.

PubMed

Aftabuddin, M; Bhandari, S

2016-07-01

Myasthenic crisis is a life-threatening condition. We studied the demographic, frequency, causes and clinical presentation of isolated Myasthenic crisis, steps of treatment and to review our experience of extended thymectomy on patients with at least one episode myasthenic crisis. A prospective and retrospective study was conducted on patients with at least one episode of myasthenic crisis, from March 2010 to September 2014, at the Department of Cardiac Surgery, BSMMU, Dhaka, Bangladesh who were referred for thymectomy. Eighteen patients (13.6% of the total 132 patients with myasthenia gravis were admitted with single to multiple episodes of myasthenic crisis, median crisis was 2.5 episodes. Mean age of the patient was 35.5 (18-72) years with male predominance. All eighteen patients had undergone extended thymectomy after completion of 5 cycle plasmapheresis, of which 2 had experienced postoperative respiratory crisis, required invasive ventilator support for median 14 days. One patient required invasive ventilator support after third post operative day. Six patients had thymoma and 12 had thymic hyperplasia. Three patients needed Intravenous immunoglobin. Nine patients needed post operative anti acetylcholinesterase inhibitor after median 2.5 post days. Post thymectomy remission and decreases the frequency of myasthenic crisis was seen in follow up and post operative medication requirement reduced significantly as compared to the preoperative requirement. This report highlights that the patients who had extended thymectomy after episodes of myasthenia crisis are benefitted even in the histhopathology report does not confirmed thymoma. After thymectomy, there was remission of myasthenic crisis. Patients with myasthenic crisis should have judicious drug adjustments under supervision and should be treated aggressively during impending myasthenic crisis. With modern management of myasthenia gravis, early surgery with myasthenic crisis is safe with good long

From crowd modeling to safety problems. Comment on "Human behaviours in evacuation crowd dynamics: From modelling to "big data" toward crisis management" by Nicola Bellomo et al.

NASA Astrophysics Data System (ADS)

Elaiw, Ahmed

2016-09-01

Paper [3] presents a survey and a critical analysis on models of crowd dynamics derived to support crisis management related to safety problems. This is an important topic which can have an important impact on the wellbeing of our society. We are very interested in this topic as we operate in a country, Saudi Arabia, where huge crowds can be present and that stress conditions can be occasionally induced by non predictable events. In these situations the problem of crisis management is of fundamental importance.

Are you ready? Crisis leadership in a hyper-VUCA environment.

PubMed

Alkhaldi, Khaldoon H; Austin, Meredith L; Cura, Boris A; Dantzler, Darrell; Holland, Leslie; Maples, David L; Quarrelles, Jamie C; Weinkle, Robert K; Marcus, Leonard J

2017-01-01

The current hyper-volatile, -uncertain, -complex, and -ambiguous (VUCA) threat environment demands a more cohesive support structure for crisis leaders who may be faced with crises of increasing magnitude and frequency and, in some instances, multiple crisis events simultaneously. The project team investigates the perceptions of crisis leaders regarding establishing a crisis leader advisor position for crisis leaders to benefit from their experience while prosecuting crisis response activities. The team linked hyper-VUCA crises, crisis response frameworks, meta-leadership, crisis leader attributes, and advisor attributes. The overall goal of the project is to increase the ability of the crisis leaders to more effectively and efficiently navigate crisis events resulting in more efficient and effective response and recovery. Three research questions were developed to assess the following: thoughts of integrating a crisis leader advisor position; development of a crisis leader advisor certification program; and attributes of crisis leader advisors. A qualitative research methodology using a phenomenological approach was employed. Forty-one participants were purposefully selected and administered a short, online survey consisting of 11 questions. Data were analyzed using percentage analysis, weighted sums, and inductive thematic analysis. The project team found an overwhelming support for the crisis leader advisor position and the crisis leader advisor certification program. Additionally, experience and trustworthiness ranked among the top sought after attributes of a crisis leader advisor. The team recommendations included (1) implement a crisis leaders advisor guide/framework; (2) create a formal crisis leader advisor position in national incident management system; (3) implement a crisis leader advisor certification framework; (4) benchmark established advisor programs; and (5) implement a framework to match leaders and advisors.

Are you ready? Crisis leadership in a hyper-VUCA environment.

PubMed

Alkhaldi, Khaldoon H; Austin, Meredith L; Cura, Boris A; Dantzler, Darrell; Holland, Leslie; Maples, David L; Quarrelles, Jamie C; Weinkle, Robert K; Marcus, Leonard J

The current hyper-volatile, -uncertain, -complex, and -ambiguous (VUCA) threat environment demands a more cohesive support structure for crisis leaders who may be faced with crises of increasing magnitude and frequency and, in some instances, multiple crisis events simultaneously. The project team investigates the perceptions of crisis leaders regarding establishing a crisis leader advisor position for crisis leaders to benefit from their experience while prosecuting crisis response activities. The team linked hyper-VUCA crises, crisis response frameworks, meta-leadership, crisis leader attributes, and advisor attributes. The overall goal of the project is to increase the ability of the crisis leaders to more effectively and efficiently navigate crisis events resulting in more efficient and effective response and recovery. Three research questions were developed to assess the following: thoughts of integrating a crisis leader advisor position; development of a crisis leader advisor certification program; and attributes of crisis leader advisors. A qualitative research methodology using a phenomenological approach was employed. Forty-one participants were purposefully selected and administered a short, on-line survey consisting of 11 questions. Data were analyzed using percentage analysis, weighted sums, and inductive thematic analysis. The project team found an overwhelming support for the crisis leader advisor position and the crisis leader advisor certification program. Additionally, experience and trustworthiness ranked among the top sought after attributes of a crisis leader advisor. The team recommendations included (1) implement a crisis leaders advisor guide/framework; (2) create a formal crisis leader advisor position in national incident management system; (3) implement a crisis leader advisor certification framework; (4) benchmark established advisor programs; and (5) implement a framework to match leaders and advisors.

Are you ready? Crisis leadership in a hyper-VUCA environment.

PubMed

Alkhaldi, Khaldoon H; Austin, Meredith L; Cura, Boris A; Dantzler, Darrell; Holland, Leslie; Maples, David L; Quarrelles, Jamie C; Weinkle, Robert K; Marcus, Leonard J

The current hyper-volatile, -uncertain, -complex, and -ambiguous (VUCA) threat environment demands a more cohesive support structure for crisis leaders who may be faced with crises of increasing magnitude and frequency and, in some instances, multiple crisis events simultaneously. The project team investigates the perceptions of crisis leaders regarding establishing a crisis leader advisor position for crisis leaders to benefit from their experience while prosecuting crisis response activities. The team linked hyper-VUCA crises, crisis response frameworks, meta-leadership, crisis leader attributes, and advisor attributes. The overall goal of the project is to increase the ability of the crisis leaders to more effectively and efficiently navigate crisis events resulting in more efficient and effective response and recovery. Three research questions were developed to assess the following: thoughts of integrating a crisis leader advisor position; development of a crisis leader advisor certification program; and attributes of crisis leader advisors. A qualitative research methodology using a phenomenological approach was employed. Forty-one participants were purposefully selected and administered a short, on-line survey consisting of 11 questions. Data were analyzed using percentage analysis,weighted sums, and inductive thematic analysis. The project team found an overwhelming support for the crisis leader advisor position and the crisis leader advisor certification program. Additionally, experience and trustworthiness ranked among the top sought after attributes of a crisis leader advisor. The team recommendations included (1) implement a crisis leaders advisor guide/framework; (2) create a formal crisis leader advisor position in national incident management system; (3) implement a crisis leader advisor certification framework; (4) benchmark established advisor programs; and (5) implement a framework to match leaders and advisors.

College Football and Public Crisis: Appropriate Actions and Justifications after the Kennedy Assassination.

ERIC Educational Resources Information Center

Brown, Robert S.

This paper contends that domestic response to John F. Kennedy's assassination took two basic forms in the United States: active crisis management and retreat. According to the paper, while government, churches, and the media engaged in active crisis management, businesses and schools closed, and the public retreated to mourn rather than to…

[Management of vascular crisis of free flaps after reconstruction of head and neck defects caused by tumor resection].

PubMed

Ni, Song; Zhu, Yiming; Li, Dezhi; Liu, Jie; An, Changming; Zhang, Bin; Liu, Shaoyan

2015-11-01

To discuss the management of vascular crisis of free flaps after reconstruction of head and neck defects caused by tumor resection. A total of 259 cases of free flap reconstruction performed in the Cancer Hospital of Chinese Academy of Medical Sciences from 2010 to 2013 were retrospectively analyzed, including 89 cases of anterolateral thigh flaps, 48 cases of radial forearm flaps, 46 free fibula flaps, 5 cases of inferior epigastric artery perforator flaps, 5 cases of free latissimus dorsi flaps, one case of lateral arm flap, and one case of medial femoral flap. The surveillance frequency of free flaps was q1h on post-operative day (POD) 1, q2h on POD 2 and 3, and q4h after POD 3. Vascular crises were reviewed for analysis. The incidence rate of vascular crisis was 8.1% (21/259), with 15 males and 6 females. The average age was 54.8 years old (17-68), and the average time of vascular crisis was 100.8 h post-operation (3-432). There were 7 cases of free jejunum flaps and 14 dermal free flaps. Seven of these 21 cases with vascular crisis were rescued by surgery. The success rate of salvage surgery within 72 hours from the primary operation was 54.5% (6/11), significantly higher than that of salvage surgery performed later than 72 hours from primary operation (10.0%, 1/10, P=0.043). There were 14 cases of flap necrosis, two of which died of local infection. Early detection of vascular crisis can effectively improve the success rate of salvage, so as to avoid the serious consequences caused by free flap necrosis.

Human behaviours in evacuation crowd dynamics: From modelling to "big data" toward crisis management

NASA Astrophysics Data System (ADS)

Bellomo, N.; Clarke, D.; Gibelli, L.; Townsend, P.; Vreugdenhil, B. J.

2016-09-01

This paper proposes an essay concerning the understanding of human behaviours and crisis management of crowds in extreme situations, such as evacuation through complex venues. The first part focuses on the understanding of the main features of the crowd viewed as a living, hence complex system. The main concepts are subsequently addressed, in the second part, to a critical analysis of mathematical models suitable to capture them, as far as it is possible. Then, the third part focuses on the use, toward safety problems, of a model derived by the methods of the mathematical kinetic theory and theoretical tools of evolutionary game theory. It is shown how this model can depict critical situations and how these can be managed with the aim of minimizing the risk of catastrophic events.

Crisis and emergency risk communication as an integrative model.

PubMed

Reynolds, Barbara; W Seeger, Matthew

2005-01-01

This article describes a model of communication known as crisis and emergency risk communication (CERC). The model is outlined as a merger of many traditional notions of health and risk communication with work in crisis and disaster communication. The specific kinds of communication activities that should be called for at various stages of disaster or crisis development are outlined. Although crises are by definition uncertain, equivocal, and often chaotic situations, the CERC model is presented as a tool health communicators can use to help manage these complex events.

Animal disease outbreak control: the use of crisis management tools.

PubMed

Kroschewski, K; Kramer, M; Micklich, A; Staubach, C; Carmanns, R; Conraths, F J

2006-04-01

In this era of globalisation the effective control of animal disease outbreaks requires powerful crisis management tools. In the 1990s software packages for different sectors of the government and agricultural industry began to be developed. In 2004, as a special application for tracking the movement of animals and animal products, the European Union developed the Trade Control and Expert System (TRACES) on the basis of its predecessor, the ANImal MOvement (ANIMO) project. The nationwide use of the ANIMO system by the veterinary authorities in Germany marked the beginning of the development in 1993 of a computerised national animal disease reporting system--the TierSeuchenNachrichten (TSN)--using the ANIMO hardware and software components. In addition to TRACES and TSN the third pillar for the management of animal disease outbreaks and crises in Germany is the national cattle and swine database--called Herkunftssicherungs- und Informationssystem für Tiere. A high degree of standardisation is necessary when integrating the different solutions at all levels of government and with the private sector. In this paper, the authors describe the use of these tools on the basis of their experience and in relation to what we can do now and what we should opt for in the future.

Educational program in crisis management for cardiac surgery teams including high realism simulation.

PubMed

Stevens, Louis-Mathieu; Cooper, Jeffrey B; Raemer, Daniel B; Schneider, Robert C; Frankel, Allan S; Berry, William R; Agnihotri, Arvind K

2012-07-01

Cardiac surgery demands effective teamwork for safe, high-quality care. The objective of this pilot study was to develop a comprehensive program to sharpen performance of experienced cardiac surgical teams in acute crisis management. We developed and implemented an educational program for cardiac surgery based on high realism acute crisis simulation scenarios and interactive whole-unit workshop. The impact of these interventions was assessed with postintervention questionnaires, preintervention and 6-month postintervention surveys, and structured interviews. The realism of the acute crisis simulation scenarios gradually improved; most participants rated both the simulation and whole-unit workshop as very good or excellent. Repeat simulation training was recommended every 6 to 12 months by 82% of the participants. Participants of the interactive workshop identified 2 areas of highest priority: encouraging speaking up about critical information and interprofessional information sharing. They also stressed the importance of briefings, early communication of surgical plan, knowing members of the team, and continued simulation for practice. The pre/post survey response rates were 70% (55/79) and 66% (52/79), respectively. The concept of working as a team improved between surveys (P = .028), with a trend for improvement in gaining common understanding of the plan before a procedure (P = .075) and appropriate resolution of disagreements (P = .092). Interviewees reported that the training had a positive effect on their personal behaviors and patient care, including speaking up more readily and communicating more clearly. Comprehensive team training using simulation and a whole-unit interactive workshop can be successfully deployed for experienced cardiac surgery teams with demonstrable benefits in participant's perception of team performance. Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Economic crisis and nursing in Spain.

PubMed

Zabalegui, Adelaida; Cabrera, Esther

2010-07-01

The purpose of the present study is to describe the economic context in Spain and its impact on the health care sector and in nursing schools. The global economic crisis is affecting nursing in Spain. This study analyses and compares indicators related to health care and nursing schools among European countries. Some new strategies to cope with the challenges arising from the health care crisis are suggested. Health care costs are increasing as a result of the ageing of the Spanish population, immigration, chronicity of health problems and new medical technology. Nursing education has changed in 2010 from a 3-year diploma programme to a 4-year University degree in Nursing. This change requires new resources involving staff, facilities and equipment, all of which are lacking because of the economic crisis in Spain. The worldwide economic crisis has affected Spain more than it has other European Union (EU) countries. This global crisis has an impact on the health care sector as well on nursing schools. It is essential for nursing management to develop creative approaches to maintain cost effective patient care. New programmes and technology must be carefully evaluated in terms of cost effectiveness before being implemented. All health care professionals should be well informed and have a solid understanding of this situation.

A tap water turbidity crisis in Tel Aviv, Israel, due to technical failure: toxicological and risk management issues.

PubMed

Winston, Gary; Lerman, Shlomo; Goldberger, Shalom; Collins, Malcolm; Leventhal, Alex

2003-06-01

Herein, we report on the actual events linked to an ammonia spillage into the main waterline of the Tel-Aviv metropolitan area and its surrounding municipalities. Based upon a large magnitude increase of unknown origin in the turbidity and ammonia levels of the main drinking water supply, area residents were warned of possible serious contamination and advised to refrain from drinking tap water until further notice. Turbidity was later linked only to CaCO3, which was precipitated from the water due to the rise in pH caused by the excessive ammonia levels. The source of the ammonia (a malfunction of the measurement buoy in the ammonia tank) was not identified until several days after the warning was issued. The toxicological implications of the turbidity and ammonia elevations are considered and reconciled with the management strategies that followed. Of consequence to the management of this crisis was the approach of Ministry of Health officials to regard the ammonia, from the onset, as an indicator of several possible sources of origin rather than as a contaminant. Decision-making policies were hampered by ineffective communication between the national water supplier and government health officials. An outcome of this crisis was a heightened awareness of the potential of a water crisis occurring during peace time and not only in association with terrorist activities, to which Israeli citizens are highly sensitized. Finally, the present paper may serve to guide municipal environmental and health officials more appropriately in the event of similar drinking water crises in Israel or elsewhere.

Help, Resources and Information: National Opioids Crisis

MedlinePlus

... HHS 5-POINT STRATEGY TO COMBAT THE OPIOIDS CRISIS BETTER ADDICTION PREVENTION, TREATMENT, AND RECOVERY SERVICES BETTER DATA BETTER PAIN MANAGEMENT BETTER TARGETING OF OVERDOSE REVERSING DRUGS BETTER RESEARCH ...

Choosing the Right Words: The Development of Guidelines for the Selection of the "Appropriate" Crisis-Response Strategies.

ERIC Educational Resources Information Center

Coombs, W. Timothy

1995-01-01

States that although crisis management has evolved rapidly in the past decade, the symbolic aspect of crisis management has been ignored. Indicates little research has been done to examine the effects of crisis-response strategies to see how they shape public opinion. Presents a list of guidelines for appropriate use of a given strategy (based on…

Deciding to institutionalize: caregiving crisis, intergenerational communication, and uncertainty management for elders and their children in Shanghai.

PubMed

Chen, Lin

2015-01-01

This phenomenological study integrated crisis theory, social identity theory, and uncertainty management theory to conceptualize the decision-making process around institutionalization among nursing home residents and their children in Shanghai. I conducted face-to-face, semistructured interviews with 12 dyads of matched elders and their children (N = 24). The findings suggest that caregiving crises triggered intergenerational communication about caregiving alternatives and new arrangements, although each generation had different stances and motivations. Children finalized the decision by helping their parents to manage the uncertainties pertaining to institutionalization. This study sheds light on caregiving decision-making dynamics for the increasing aging population across cultures.

The Uses of Crisis: Taking the Tide at the Flood. ASHE Annual Meeting 1981 Paper.

ERIC Educational Resources Information Center

Kerchner, Charles T.; Schuster, Jack H.

The management strategy of calling attention to problems and labeling them as crises is discussed as a method of coping with prolonged periods of shrinking resources. Part I, "Entering the Realm of Crisis," discusses the importance of defining a crisis, the crisis as an organizational good, and when to declare a crisis. Two types of…

Education and training initiatives for crisis management in the European Union: a web-based analysis of available programs.

PubMed

Ingrassia, Pier Luigi; Foletti, Marco; Djalali, Ahmadreza; Scarone, Piercarlo; Ragazzoni, Luca; Corte, Francesco Della; Kaptan, Kubilay; Lupescu, Olivera; Arculeo, Chris; von Arnim, Gotz; Friedl, Tom; Ashkenazi, Michael; Heselmann, Deike; Hreckovski, Boris; Khorram-Manesh, Amir; Khorrram-Manesh, Amir; Komadina, Radko; Lechner, Kostanze; Patru, Cristina; Burkle, Frederick M; Fisher, Philipp

2014-04-01

Education and training are key elements of disaster management. Despite national and international educational programs in disaster management, there is no standardized curriculum available to guide the European Union (EU) member states. European- based Disaster Training Curriculum (DITAC), a multiple university-based project financially supported by the EU, is charged with developing a holistic and highly-structured curriculum and courses for responders and crisis managers at a strategic and tactical level. The purpose of this study is to qualitatively assess the prevailing preferences and characteristics of disaster management educational and training initiatives (ETIs) at a postgraduate level that currently exist in the EU countries. An Internet-based qualitative search was conducted in 2012 to identify and analyze the current training programs in disaster management. The course characteristics were evaluated for curriculum, teaching methods, modality of delivery, target groups, and funding. The literature search identified 140 ETIs, the majority (78%) located in United Kingdom, France, and Germany. Master level degrees were the primary certificates granted to graduates. Face-to-face education was the most common teaching method (84%). Approximately 80% of the training initiatives offered multi- and cross-disciplinary disaster management content. A competency-based approach to curriculum content was present in 61% of the programs. Emergency responders at the tactical level were the main target group. Almost all programs were self-funded. Although ETIs currently exist, they are not broadly available in all 27 EU countries. Also, the curricula do not cover all key elements of disaster management in a standardized and competency-based structure. This study has identified the need to develop a standardized competency-based educational and training program for all European countries that will ensure the practice and policies that meet both the standards of care and

Use of crisis management interventions among suicidal patients: Results of a randomized controlled trial.

PubMed

Bryan, Craig J; May, Alexis M; Rozek, David C; Williams, Sean R; Clemans, Tracy A; Mintz, Jim; Leeson, Bruce; Burch, T Scott

2018-05-10

Previous research supports the efficacy of the crisis response plan (CRP) for the reduction of suicidal behaviors as compared to treatment as usual (TAU). Patient perspectives and use of the CRP, and their relationship to later suicidal thoughts, remain unknown. A secondary analysis of a randomized clinical trial comparing a standard CRP (S-CRP), a CRP enhanced with reasons for living (E-CRP), and TAU in a sample of 97 active-duty U.S. Army personnel was conducted. Participants were asked about their use, perceptions, and recall of each intervention. Generalized estimating equations were used to test the conditional effects of intervention use, perceptions, and recall on severity of suicide ideation during follow-up. Across all treatment groups, over 80% of participants retained their written CRP up to 6 months later, but less than 25% had the written plan in their physical possession at the time of each assessment. Participants in S-CRP and E-CRP were more likely to recall self-management strategies and sources of social support. Participants in TAU were more likely to recall use of professional healthcare services and crisis management services. All three interventions were rated as highly useful. More frequent use of the E-CRP and recall of its components were associated with significantly reduced suicide ideation as compared to TAU. Both CRPs have high acceptability ratings. The effect of both CRPs on reduced suicide ideation is associated with patient recall of components. More frequent use of the E-CRP is associated with larger reductions in suicide ideation. © 2018 Wiley Periodicals, Inc.

Simulated Trauma and Resuscitation Team Training course-evolution of a multidisciplinary trauma crisis resource management simulation course.

PubMed

Gillman, Lawrence M; Brindley, Peter; Paton-Gay, John Damian; Engels, Paul T; Park, Jason; Vergis, Ashley; Widder, Sandy

2016-07-01

We previously reported on a pilot trauma multidisciplinary crisis resource course titled S.T.A.R.T.T. (Simulated Trauma and Resuscitative Team Training). Here, we study the course's evolution. Satisfaction was evaluated by postcourse survey. Trauma teams were evaluated using the Ottawa global rating scale and an Advanced Trauma Life Support primary survey checklist. Eleven "trauma teams," consisting of physicians, nurses, and respiratory therapists, each completed 4 crisis simulations over 3 courses. Satisfaction remained high among participants with overall mean satisfaction being 4.39 on a 5-point Likert scale. As participants progressed through scenarios, improvements in global rating scale scores were seen between the 1st and 4th (29.8 vs 36.1 of 42, P = .022), 2nd and 3rd (28.2 vs 34.6, P = .017), and 2nd and 4th (28.2 vs 36.1, P = .003) scenarios. There were no differences in Advanced Trauma Life Support checklist with mean scores for each scenario ranging 11.3 to 13.2 of 17. The evolved Simulated Trauma and Resuscitative Team Training curriculum has maintained high participant satisfaction and is associated with improvement in team crisis resource management skills over the duration of the course. Copyright © 2015 Elsevier Inc. All rights reserved.

Provincial Reconstruction Teams in Afghanistan: An Innovative Instrument of International Crisis Management Being Put to the Test

DTIC Science & Technology

2008-01-01

the official policy or position of the George C. Marshall European Center for Security Studies, the U.S. Department of Defense, the German Ministry... The Framework Conditions for the Deployment of PRTs 1.1 New Challenges in Crisis Management 1.2 Positioning of PRTs within International Operations...Afghanistan have led to a surge in civilian activities provided by the armed forces and have caused an increased debate on the legitimacy , principles

The Impact of Creativity Management in Fighting the Educational Crisis in Secondary Schools in Palestine from the Viewpoint of Headmasters

ERIC Educational Resources Information Center

Alawawdeh, Sabreen

2016-01-01

The study aims to identify the impact of creativity management in fighting the educational crisis in secondary schools in Palestine from the viewpoint of headmasters, researcher worked to follow the descriptive analytical method and also resorted to statistical methods, has developed a questionnaire included several paragraphs about the school…

Using medical simulation to teach crisis resource management and decision-making skills to otolaryngology housestaff.

PubMed

Volk, Mark S; Ward, Jessica; Irias, Noel; Navedo, Andres; Pollart, Jennifer; Weinstock, Peter H

2011-07-01

Develop a course to use in situ high-fidelity medical simulation (HFS) in an actual operating room (OR) to (1) teach teamwork and crisis resource management (CRM) skills simultaneously to otolaryngology and anesthesia trainees and OR nurses and (2) provide decision-making experience to ear, nose, and throat residents and OR teams in simulated high-risk, low-frequency airway emergencies. A simulation-based, in situ CRM course was developed to teach airway management and CRM in the OR. Upon completion of each course, the participants were surveyed using questions with (1-5) scale answers. The simulated clinical scenarios took place in the intensive care unit and OR at Children's Hospital Boston. The participants consisted of pediatric otolaryngology fellows, otolaryngology residents, anesthesiology residents, fellows, and certified registered nurse anesthetists as well as OR nurses. Fifty-nine individuals participated in 9 simulation-based courses given between October 2008 and May 2010. The team members participated together in 3 simulated medical crises that centered on airway and anesthesia issues. Each simulated crisis was followed by a structured debriefing session conducted by trained debriefers. Embedded within the course were didactics on CRM principles. The participants' responses on the survey included General Course Organization, Realism, Debriefing, and Relevance to Future Practice. Ninety percent of the responses were favorable or very favorable. Using a newly developed, in situ HFS-based course, clinical decision-making skills and teamwork can be effectively taught concurrently to members of an OR team.

Science-Driven Approach to Disaster Risk and Crisis Management

NASA Astrophysics Data System (ADS)

Ismail-Zadeh, A.

2014-12-01

Disasters due to natural extreme events continue to grow in number and intensity. Disaster risk and crisis management requires long-term planning, and to undertake that planning, a science-driven approach is needed to understand and assess disaster risks and to help in impact assessment and in recovery processes after a disaster. Science is used in assessments and rapid modeling of the disaster impact, in forecasting triggered hazards and risk (e.g., a tsunami or a landslide after a large earthquake), in contacts with and medical treatment of the affected population, and in some other actions. At the stage of response to disaster, science helps to analyze routinely the disaster happened (e.g., the physical processes led to this extreme event; hidden vulnerabilities; etc.) At the stage of recovery, natural scientists improve the existing regional hazard assessments; engineers try to use new science to produce new materials and technologies to make safer houses and infrastructure. At the stage of disaster risk mitigation new scientific methods and approaches are being developed to study natural extreme events; vulnerability of society is periodically investigated, and the measures for increasing the resilience of society to extremes are developed; existing disaster management regulations are improved. At the stage of preparedness, integrated research on disaster risks should be developed to understand the roots of potential disasters. Enhanced forecasting and early warning systems are to be developed reducing predictive uncertainties, and comprehensive disaster risk assessment is to be undertaken at local, regional, national and global levels. Science education should be improved by introducing trans-disciplinary approach to disaster risks. Science can help society by improving awareness about extreme events, enhancing risk communication with policy makers, media and society, and assisting disaster risk management authorities in organization of local and regional

Preliminary evaluation of a "formulation-driven cognitive behavioral guided self-help (fCBT-GSH)" for crisis and transitional case management clients.

PubMed

Naeem, Farooq; Johal, Rupinder K; Mckenna, Claire; Calancie, Olivia; Munshi, Tariq; Hassan, Tariq; Nasar, Amina; Ayub, Muhammad

2017-01-01

Cognitive behavioral therapy (CBT) is found to be effective for common mental disorders and has been delivered in self-help and guided self-help formats. Crisis and transitional case management (TCM) services play a vital role in managing clients in acute mental health crises. It is, therefore, an appropriate setting to try CBT in guided self-help format. This was a preliminary evaluation of a formulation-driven cognitive behavioral guided self-help. Thirty-six (36) consenting participants with a diagnosis of nonpsychotic illness, attending crisis and the TCM services in Kingston, Canada, were recruited in this study. They were randomly assigned to the guided self-help plus treatment as usual (TAU) (treatment group) or to TAU alone (control group). The intervention was delivered over 8-12 weeks. Assessments were completed at baseline and 3 months after baseline. The primary outcome was a reduction in general psychopathology, and this was done using Clinical Outcomes in Routine Evaluation - Outcome Measure. The secondary outcomes included a reduction in depression, measured using the Hospital Anxiety and Depression Scale, and reduction in disability, measured using the World Health Organization Disability Assessment Schedule 2.0. Participants in the treatment group showed statistically significant improvement in overall psychopathology ( P <0.005), anxiety and depression ( P <0.005), and disability ( P <0.005) at the end of the trial compared with TAU group. A formulation-driven cognitive behavioral guided self-help was feasible for the crisis and TCM clients and can be effective in improving mental health, when compared with TAU. This is the first report of a trial of guided self-help for clients attending crisis and TCM services.

Crisis communications moves to front burner.

PubMed

1995-01-01

Crisis communications, or crisis management, moved to the front burner on a national basis following the Tylenol poisonings in the early '80s. It's a fact of life (or death) that day after day, incident after incident, hospital after hospital has to deal with internal problems that become external issues. Balancing disclosure and the media's relentless quest for every available detail with the legal implications involved can test the public relations skills of even the most experienced practitioner. So how do you learn how to handle a crisis situation? There are books available on the topic, there are experts in the field and then there are those who have "been there, done that" and have agreed to share the experiences. Enter Greg McGarry, public relations director at Albany Medical Center in Albany, N.Y. If any hospital PR director has had to deal with a more challenging series of tragic and unusual circumstances in a brutally short timeframe, we have yet to hear about it. As a result of his forthrightness and candidness, backed by a supportive and understanding senior management team, news articles were fair, balanced and included the hospital's position. Even critical editorials included words of praise.

Utilizing Social Networks in Times of Crisis: Understanding, Exploring and Analyzing Critical Incident Management at Institutions of Higher Education

ERIC Educational Resources Information Center

Asselin, Martha Jo

2012-01-01

With the rising number of major crises on college campuses today (Security on Campus Inc., 2009), institutions of higher education can benefit from understanding of how social networks may be used in times of emergency. What is currently known about the usage of social networks is not integral to the current practices of crisis management that are…

Responding to the Medical Malpractice Insurance Crisis: A National Risk Management Information System

PubMed Central

Wess, Bernard P.; Jacobson, Gary

1987-01-01

In the process of forming a new medical malpractice reinsurance company, the authors analyzed thousands of medical malpractice cases, settlements, and verdicts. The evidence of those analyses indicated that the medical malpractice crisis is (1)emerging nation- and world-wide, (2)exacerbated by but not primarily a result of “predatory” legal action, (3)statistically determined by a small percentage of physicians and procedures, (4)overburdened with data but poor on information, (5)subject to classic forms of quality control and automation. The management information system developed to address this problem features a tiered data base architecture to accommodate medical, administrative, procedural, statistical, and actuarial analyses necessary to predict claims from untoward events, not merely to report them.

Crisis management and recovery from the damage to the laboratory animal production facility due to the Great East Japan Earthquake.

PubMed

Ikeda, Takuya

2012-01-01

Charles River Laboratories Japan produces laboratory animals, mainly mice and rats. In its history, we have experienced many crises such as mass food poisoning of staff and contamination of animals. However, we overcame these crises, accomplishing our corporate missions to secure steady supply of healthy animals. Under such circumstances, in 2008, we faced an unprecedented crisis involving a novel influenza possibly becoming pandemic. Therefore, we prepared a Crisis Management Plan (CMP) and Business Continuity Plan (BCP) to avoid the worst case scenario. Fortunately, the novel influenza did not develop into a pandemic and no major problems occurred in production of our laboratory animals. In March 2011, our Tsukuba Breeding Center was struck by the Great East Japan Earthquake. Many cages fell from racks, and consequently, 14,000 mice and rats were euthanized. Moreover, this animal production facility experienced not only blackouts and water outage but also various maintenance problems. After triage of the animals, almost half of the animals kept were eventually lost. However, we recovered and resumed shipment of animals two weeks after the disaster by utilizing the CMP and BCP we initially created as a countermeasure against novel influenza. After two months, our production volume returned to normal except for two strains. I sincerely hope this review, which highlights our experience and related issues, will be a useful resource in regard to crisis management for people who are engaged in laboratory animal care and use.

Environmental, Disaster and Crisis Management Strategies: Interdisciplinarity and Synergy in Postgraduate Studies

NASA Astrophysics Data System (ADS)

Lekkas, Efthymis; Andreadakis, Emmanouil; Nomikou, Paraskevi; Antoniou, Varvara; Kapourani, Eleni; Papaspyropoulos, Konstantinos

2017-04-01

Environmental issues, disasters and crises have been showing an increasing complexity and interconnections in every level and aspect, thus requiring a holistic approach from simple problem solving to emergency management. Recent challenges include geographical and affected population escalation, complex or cascading disasters and interconnection of regional conflicts to transboundary social, political and environmental impact. One of the issues concerning the traditional management is competition or even antagonism between organizations, services and disciplines, from science to operations. In this context, a postgraduate program answering to these issues was designed in Greece, applying multidisciplinarity, crossdisciplinarity and interdisiplinarity, from teaching staff and tutors, to students, objects and fields of knowledge and research. The program offers a curriculum of lessons and disciplines integrating science, humanities, legislation, institutions and operations. Geosciences carry an inherent interdisciplinarity culture and a long tradition in the research of environment and disasters, along with their familiarity with the complexity of such issues. That is why the program "Environmental, Disaster and Crisis Management Strategies" was organized by the Department of Geology and Geoenvironment of the National and Kapodistrian University of Athens, but involves social scientists, emergency operators, medical scientists etc. The program aims at the diffusion of basic principles and tools of all related disciplines and develops a common ground and a communication language with the least barriers, and the building of trust and understanding between all parties involved. The curriculum is designed so that professionals of all disciplines and industries are able to attend without interrupting their other activities, while pursuing their personal scientific and professional educational goals and interests through selection of lessons and thesis subject. As a result

Multiple scales modelling approaches to social interaction in crowd dynamics and crisis management. Comment on "Human behaviours in evacuation crowd dynamics: From modelling to "big data" toward crisis management" by Nicola Bellomo et al.

NASA Astrophysics Data System (ADS)

Trucu, Dumitru

2016-09-01

In this comprehensive review concerning the modelling of human behaviours in crowd dynamics [3], the authors explore a wide range of mathematical approaches spanning over multiple scales that are suitable to describe emerging crowd behaviours in extreme situations. Focused on deciphering the key aspects leading to emerging crowd patterns evolutions in challenging times such as those requiring an evacuation on a complex venue, the authors address this complex dynamics at both microscale (individual level), mesoscale (probability distributions of interacting individuals), and macroscale (population level), ultimately aiming to gain valuable understanding and knowledge that would inform decision making in managing crisis situations.

The Efficacy of Crisis Intervention Training for Educators: A Preliminary Study from the United States

ERIC Educational Resources Information Center

Forthun, Larry F.; McCombie, Jeffrey W.

2011-01-01

Professional development in crisis intervention skills can help address the growing needs of schools to train faculty to respond to students in acute crisis. Unlike traditional methods of classroom management, crisis intervention training teaches specific strategies to de-escalate conflict while at the same time addressing the underlying…

Guide of Hypertensive Crisis Pharmacotherapy.

PubMed

Wani-Parekh, Priyanka; Blanco-Garcia, Carlos; Mendez, Melissa; Mukherjee, Debabrata

2017-01-01

Cardiovascular diseases (CVD) are the number one cause of death globally compared to any other cause. CVD accounts for approximately 17.3 million deaths per year and are rising. Hypertension is the leading risk factor for cardiovascular diseases. Approximately, 80 million people suffer from hypertension in the U.S. While, majority of these individuals are on antihypertensive medications only 54% of individuals with hypertension are optimally controlled. Heart failure and stroke are some of the devastating complications of uncontrolled hypertension. Hypertensive crisis can be classified as either an urgency or emergency; difference between the two is the presence of end organ damage, which is noted in hypertensive emergency. Hypertensive crisis is usually treated by parenteral antihypertensive medications. The main drug classes of drugs for treatment are nitrates, calcium channel blockers, dopamine-1 agonists, adrenergic-blocking agents etc. In this review, we discuss approach to management of hypertensive crisis and each drug class with its physiology and complications. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Assessment of health-care waste management in a humanitarian crisis: A case study of the Gaza Strip.

PubMed

Caniato, Marco; Tudor, Terry Louis; Vaccari, Mentore

2016-12-01

Health-care waste management requires technical, financial and human resources, and it is a challenge for low- and middle income countries, while it is often neglected in protracted crisis or emergency situations. Indeed, when health, safety, security or wellbeing of a community is threatened, solid waste management usually receives limited attention. Using the Gaza Strip as the case study region, this manuscript reports on health-care waste management within the context of a humanitarian crisis. The study employed a range of methods including content analyses of policies and legislation, audits of waste arisings, field visits, stakeholder interviews and evaluation of treatment systems. The study estimated a production from clinics and hospitals of 683kg/day of hazardous waste in the Gaza Strip, while the total health-care waste production was 3357 kg/day. A number of challenges was identified including lack of clear definitions and regulations, limited accurate data on which to base decisions and strategies and poor coordination amongst key stakeholders. Hazardous and non-hazardous waste was partially segregated and treatment facilities hardly used, and 75% of the hazardous waste was left untreated. Recommendations for mitigating these challenges posed to patients, staff and the community in general are suggested. The outputs are particularly useful to support decision makers, and re-organize the system according to reliable data and sound assumptions. The methodology can be replicated in other humanitarian settings, also to other waste flows, and other sectors of environmental sanitation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Occupational Practitioner's Role in the Management of a Crisis: Lessons Learned from the Paris November 2015 Terrorist Attack.

PubMed

Descatha, Alexis; Huynh Tuong, Alice; Coninx, Pierre; Baer, Michel; Loeb, Thomas; Despréaux, Thomas

2016-01-01

In massive catastrophic events, occupational health practitioners are more and more frequently involved in the management of such situations. We aim to describe the multiple aspects of the role that occupational health practitioners might play, by focusing on the recent example of the Paris terrorist attack of November 2015. During and after the Paris attack, occupational practitioners, in collaboration with emergency and security professionals, were involved in psychological care, assembling information, follow-up, return-to-work, and improving in-company safety plans. Based on this experience and other industrial disasters, we distinguish three phases: the critical phase, the post-critical phase, and the anticipation phase. In the critical phase, the occupational practitioner cares for patients before the emergency professionals take charge, initiates the psychological management, and may also play an organizational role for company health aspects. In the post-critical phase, he or she would be involved in monitoring those affected by the events and participate in preventing, to the extent possible, posttraumatic stress disorder, helping victims in the return-to-work process, and improving procedures and organizing drills. In addition to their usual work of primary prevention, occupational practitioners should endeavor to improve preparedness in the anticipation phase, by taking part in contingency planning, training in first aid, and defining immediately applicable protocols. In conclusion, recent events have highlighted the essential role of occupational health services in anticipation of a crisis, management during the crisis, and follow-up.

Cardiovascular Hypertensive Crisis: Recent Evidence and Review of the Literature

PubMed Central

Varounis, Christos; Katsi, Vasiliki; Nihoyannopoulos, Petros; Lekakis, John; Tousoulis, Dimitris

2017-01-01

Despite the high prevalence of hypertension (HTN), only a small proportion of the hypertensive patients will ultimately develop hypertensive crisis. In fact, some patients with hypertensive crisis do not report a history of HTN or previous use of antihypertensive medication. The majority of the patients with hypertensive crisis often report non-specific symptoms, whereas heart-related symptoms (dyspnea, chest pain, arrhythmias, and syncope) are less common. Hypertensive crises can be divided into hypertensive emergencies or hypertensive urgencies according to the presence or absence of acute target organ damage, respectively. This differentiation is an extremely useful classification in clinical practice since a different management is needed, which in turn has a significant effect on the morbidity and mortality of these patients. Therefore, it is very crucial for the physician in the emergency department to identify the hypertensive emergencies and to manage them through blood pressure lowering medications in order to avoid further target organ damage or deterioration. The aim of this narrative review is to summarize the recent evidence in an effort to improve the awareness, recognition, risk stratification, and treatment of hypertensive crisis in patients referred to the emergency department. PMID:28119918

Cardiovascular Hypertensive Crisis: Recent Evidence and Review of the Literature.

PubMed

Varounis, Christos; Katsi, Vasiliki; Nihoyannopoulos, Petros; Lekakis, John; Tousoulis, Dimitris

2016-01-01

Despite the high prevalence of hypertension (HTN), only a small proportion of the hypertensive patients will ultimately develop hypertensive crisis. In fact, some patients with hypertensive crisis do not report a history of HTN or previous use of antihypertensive medication. The majority of the patients with hypertensive crisis often report non-specific symptoms, whereas heart-related symptoms (dyspnea, chest pain, arrhythmias, and syncope) are less common. Hypertensive crises can be divided into hypertensive emergencies or hypertensive urgencies according to the presence or absence of acute target organ damage, respectively. This differentiation is an extremely useful classification in clinical practice since a different management is needed, which in turn has a significant effect on the morbidity and mortality of these patients. Therefore, it is very crucial for the physician in the emergency department to identify the hypertensive emergencies and to manage them through blood pressure lowering medications in order to avoid further target organ damage or deterioration. The aim of this narrative review is to summarize the recent evidence in an effort to improve the awareness, recognition, risk stratification, and treatment of hypertensive crisis in patients referred to the emergency department.

[Hi-Fi simulation: Teaching crisis resource management to surgery residents].

PubMed

Georgescu, Mihai; Tanoubi, Issam; Drolet, Pierre; Robitaille, Arnaud; Perron, Roger; Patenaude, Jean Victor

2015-02-01

High-fidelity (HiFi) simulation has shown its effectiveness for teaching crisis resource management (CRM) principles, and our institutional experience in this area is mainly with anesthesiology residents. We recently added to our postgraduate curriculum a new CRM course designed to cater to the specific needs of surgical residents. This short communication describes the experience of the University of Montreal Simulation Centre (Centre d'Apprentissage des Attitudes et Habiletés Cliniques CAAHC) regarding HiFi simulationbased CRM and communication skills teaching for surgical residents. Thirty residents agreed to participate in a simulation course with pre-established scenarios and educational CRM objectives on a voluntary basis. When surveyed immediately after the activity, all residents agreed that the educational objectives were well defined (80% "strongly agree" and 20% "agree"). The survey also showed that the course was well accepted by all participants (96% "strongly agree" and 4% "agree"). Further trials with randomized groups and more reliable assessment tools are needed to validate our results. Still, integrating HiFi simulation based CRM learning in the surgical residency curriculum seems like an interesting step.

Installed Base Registration of Decentralised Solar Panels with Applications in Crisis Management

NASA Astrophysics Data System (ADS)

Aarsen, R.; Janssen, M.; Ramkisoen, M.; Biljecki, F.; Quak, W.; Verbree, E.

2015-08-01

In case of a calamity in the Netherlands - e.g. a dike breach - parts of the nationwide electric network can fall out. In these occasions it would be useful if decentralised energy sources of the Smart Grid would contribute to balance out the fluctuations of the energy network. Decentralised energy sources include: solar energy, wind energy, combined heat and power, and biogas. In this manner, parts of the built environment - e.g. hospitals - that are in need of a continuous power flow, could be secured of this power. When a calamity happens, information about the Smart Grid is necessary to control the crisis and to ensure a shared view on the energy networks for both the crisis managers and network operators. The current situation of publishing, storing and sharing data of solar energy has been shown a lack of reliability about the current number, physical location, and capacity of installed decentralised photovoltaic (PV) panels in the Netherlands. This study focuses on decentralised solar energy in the form of electricity via PV panels in the Netherlands and addresses this challenge by proposing a new, reliable and up-to-date database. The study reveals the requirements for a registration of the installed base of PV panels in the Netherlands. This new database should serve as a replenishment for the current national voluntary registration, called Production Installation Register of Energy Data Services Netherland (EDSN-PIR), of installed decentralised PV panel installations in the Smart Grid, and provide important information in case of a calamity.

Crisis as opportunity: international health work during the economic depression.

PubMed

Borowy, Iris

2008-01-01

The economic depression of the 1930s represented the most important economic and social crisis of its time. Surprisingly, its effect on health did not show in available morbidity and mortality rates. In 1932, the League of Nations Health Organisation embarked on a six-point program addressing statistical methods of measuring the effect and its influence on mental health and nutrition and establishing ways to safeguard public health through more efficient health systems. Some of these studies resulted in considerations of general relevance beyond crisis management. Unexpectedly, the crisis offered an opportunity to reconsider key concepts of individual and public health.

Preventing Terrorism in the Long Term: The Disutility of Racial Profiling in Preventing Crime and the Counterproductive Nature of Ethnic and Religious Profiling in Counterterrorism Policing

DTIC Science & Technology

2009-12-01

enforcement officers, many of whom are now or have been active participants in CT-operations, use in identifying suspicious behavior and building...provide benefits that are greater than the costs of using profiling as part of an overall counterterrorism strategy. 2 A. IMPORTANCE: TAKING SIDES ON...that the benefits of ethnic and religious profiling are trumped by the social costs and consequences of its use . More specifically, the ethnic and

ESRD in the geriatric population: the crisis of managed care and the opportunity of disease management.

PubMed

Steinman, Theodore I

2002-01-01

The geriatric population with end-stage renal disease (ESRD) is placed at risk with regards to the quality and extent of medical coverage because of the rapidly changing financial environment. Managed care organizations (MCOs) are generally for-profit companies that must focus on the bottom line. While the verbal commitment to quality care is voiced, the financial pressures on MCOs have led to a decrease in coverage of many services and outright denial for some necessary treatments. While denying services, the MCOs have also reduced payments to providers for services rendered. The coverage crisis is compounded by health maintenance organizations (HMOs) quitting Medicare because the reimbursement from the Health Care Financing Administration (HCFA) is less than their costs. Because of the above issues which can potentially impact on the quality of care delivered to the ESRD geriatric population, a new approach to disease management has created the opportunity to improve total patient care to a level not yet achieved in the United States. Disease management encompasses integrated care across all disciplines. Every component of care can be tracked by a dedicated information system. Improvement in outcomes has far exceeded the U.S. Renal Data System (USRDS) benchmark performance measurements with a disease management model approach. The key to success is the health service coordinator (HSC), a senior nurse with many years of ESRD experience. This individual coordinates care across all disciplines and expedites necessary referrals. With rapid attention to patient needs there has been a significant reduction in hospital admissions, hospital length of stay, and emergency room visits. Patient care will steadily improve as the disease management system matures as a consequence of understanding the patients total physical and psychosocial needs.

Hypertensive crisis during pregnancy and postpartum period.

PubMed

Too, Gloria T; Hill, James B

2013-08-01

Hypertension affects 10% of pregnancies, many with underlying chronic hypertension, and approximately 1-2% will undergo a hypertensive crisis at some point during their lives. Hypertensive crisis includes hypertensive urgency and emergency; the American College of Obstetricians and Gynecologists describes a hypertensive emergency in pregnancy as persistent (lasting 15 min or more), acute-onset, severe hypertension, defined as systolic BP greater than 160 mmHg or diastolic BP >110 mmHg in the setting of pre-eclampsia or eclampsia. Pregnancy may be complicated by hypertensive crisis, with lower blood pressure threshold for end-organ damage than non-pregnant patients. Maternal assessment should include a thorough history. Fetal assessment should include heart rate tracing, ultrasound for growth and amniotic assessment, and Doppler evaluation if growth restriction is suspected. Initial management of hypertensive emergency (systolic BP >160 mmHg or diastolic BP >110 mmHg in the setting of pre-eclampsia or eclampsia) generally includes the rapid reduction of blood pressure through the use of intravenous antihypertensive medications, with goal systolic blood pressure between 140 mmHg and 150 mmHg and diastolic pressure between 90 mmHg and 100 mmHg. First-line intravenous drugs include labetalol and hydralazine, but other agents may be used, including esmolol, nicardipine, nifedipine, and, as a last resort, sodium nitroprusside. Among patients with hypertensive urgency, slower blood pressure reduction can be provided with oral agents. The objective of this article is to review the current understanding, diagnosis, and management of hypertensive crisis during pregnancy and the postpartum period. Copyright © 2013 Elsevier Inc. All rights reserved.

Telephone Crisis Support Workers' Psychological Distress and Impairment.

PubMed

Kitchingman, Taneile A; Wilson, Coralie J; Caputi, Peter; Wilson, Ian; Woodward, Alan

2018-01-01

In order to respond to crises with appropriate intervention, crisis workers are required to manage their own needs as well as the needs of those they respond to. A systematic review of the literature was conducted to examine whether telephone crisis support workers experience elevated symptoms of psychological distress and are impaired by elevated symptoms. Studies were identified in April 2015 by searching three databases, conducting a gray literature search, and forward and backward citation chaining. Of 113 identified studies, seven were included in the review. Results suggest that that telephone crisis support workers experience symptoms of vicarious traumatization, stress, burnout, and psychiatric disorders, and that they may not respond optimally to callers when experiencing elevated symptoms of distress. However, definitive conclusions cannot be drawn due to the paucity and methodological limitations of available data. While the most comprehensive search strategy possible was adopted, resource constraints meant that conference abstracts were not searched and authors were not contacted for additional unpublished information. There is an urgent need to identify the impact of telephone crisis support workers' role on their well-being, the determinants of worker well-being in the telephone crisis support context, and the extent to which well-being impacts their performance and caller outcomes. This will help inform strategies to optimize telephone crisis support workers' well-being and their delivery of support to callers.

The influence of the environmental management system on the environmental impact of seaport companies during an economic crisis: Lithuanian case study.

PubMed

Anne, Olga; Burskyte, Vilma; Stasiskiene, Zaneta; Balciunas, Arunas

2015-01-01

Freight handling in EU ports fell by more than 12 % during the global economic crisis in 2008-2009 after almost a decade of continuous growth. The decrease of freight handling in the Klaipeda seaport, the only port in Lithuania, was 6.7 % and happened due to the dominant outward movement of goods (mainly oil products). The Klaipeda seaport, due to its peculiarity, is the only ice-free port in the northern part of Baltic Sea. The present study explores the environmental impact of Klaipeda seaport activities from 2001 to 2011. Moreover, it compares the environmental effectiveness of environmental protection strategies used in the four biggest companies that, in fact, cover about 88 % of total activities (except general cargo) of the seaport. The first group of targeted companies used an environmental protection strategy to implement an ISO 14001-based environmental management system, and the second group selected to follow environmental management practices without certification. The paper analyses the development of the companies' activities in regard to the change of environmental effectiveness. The paper evaluates the pressure of the economic crisis on the companies' activities and its influence on environmental decisions, with particular interest in the ability of different environmental protection systems to resist and handle the expected performance. The study identified a significant decrease in companies' activities during the crisis period. However, the economic activities and environmental effectiveness demonstrated similar short-term tendencies in regard to the environmental strategy selection but differed in long-term perspective.

The usefulness of information and communication technologies in crisis response.

PubMed

Paul, Sharoda A; Reddy, Madhu; Abraham, Joanna; DeFlitch, Christopher; Deflitch, Christopher J

2008-11-06

Information and communication technologies (ICTs) play a vital role in coordinating crisis response between pre-hospital services and emergency departments of hospitals. In spite of the advances in these technologies, there remain a variety of challenges to their usage during a crisis. To identify these challenges, we conducted focus group interviews with emergency department (ED) and emergency medical services (EMS) personnel. We found that ED and EMS personnel have widely varying perceptions about the usefulness and ease-of-use of information tools and communication tools used in crisis management. We discuss the importance of bringing together communication and information tools into integrated networks of ICTs for effective crisis response. We also highlight design features of ICTs which can support seamless and effective communication and coordination between ED and EMS teams.

The Usefulness of Information and Communication Technologies in Crisis Response

PubMed Central

Paul, Sharoda A.; Reddy, Madhu; Abraham, Joanna; DeFlitch, Christopher

2008-01-01

Information and communication technologies (ICTs) play a vital role in coordinating crisis response between pre-hospital services and emergency departments of hospitals. In spite of the advances in these technologies, there remain a variety of challenges to their usage during a crisis. To identify these challenges, we conducted focus group interviews with emergency department (ED) and emergency medical services (EMS) personnel. We found that ED and EMS personnel have widely varying perceptions about the usefulness and ease-of-use of information tools and communication tools used in crisis management. We discuss the importance of bringing together communication and information tools into integrated networks of ICTs for effective crisis response. We also highlight design features of ICTs which can support seamless and effective communication and coordination between ED and EMS teams. PMID:18998898

Qualitative Investigation of the Wellness Recovery Action Plan in a UK NHS Crisis Care Setting.

PubMed

Ashman, Michael; Halliday, Vanessa; Cunnane, Joseph G

2017-07-01

Crisis theory suggests that in addition to presenting a threat to mental well-being, crises are also opportunities where successful interventions can lead to successful outcomes. UK mental health crisis teams aim to reduce hospital admission by treating people at home and by building resilience and supporting learning from crisis, yet data on repeat crisis episodes suggest this could be improved. This qualitative study sought to explore the Wellness Recovery Action Plan (WRAP) as a means of supporting resilience-building and maximising the opportunity potential of crisis. The following themes emerged: The meaning of crisis; Engaging with the WRAP process; WRAP and self-management; and Changes and transformations. This research suggests that WRAP has potential in supporting recovery from crisis, revealing insights into the nature of crisis which can inform the further development of crisis services.

Improvement of Emergency Management Mechanism of Public Health Crisis in Rural China: A Review Article.

PubMed

Hu, Jiaxiang; Chen, Chao; Kuai, Tingting

2018-02-01

With the rapid development of social economy in China, various public health emergencies frequently occur. Such emergencies cause a serious threat to human health and public safety, especially in rural China. Owing to flaws in emergency management mechanism and policy, the government is not capable to effectively deal with public health emergencies. Therefore, this study aimed to discuss the path to improve the emergency management mechanism for public health emergency in rural China. This study was conducted in 2017 to detect the emergency management mechanism of public health crisis (EMMPHC) in Rural China. Data were collected using the following keywords: Rural China, public health emergency, emergency management mechanism, organization mechanism, operation mechanism in the databases of PubMed, Scopus, Web of Science, and CNKI. EMMPHC in rural China can be enhanced from the following three aspects. First, a permanent institution for rural emergency management with public health management function is established. Second, the entire process of emergency management mechanism, including the stages of pre-disaster, disaster, and post-disaster, is improved. Finally, investment in rural public health is increased, and an adequate reserve system for emergency resources is formed. The new path of EMMPHC in rural China can effectively help the local government accomplish the dispatch capability in public health emergency, and it has important research significance for the protection of public health and social stability of residents in rural China.

Does the age of acute care physicians impact their (1) crisis management performance and (2) learning after simulation-based education? A protocol for a multicentre prospective cohort study in Toronto and Ottawa, Canada.

PubMed

Alam, Fahad; LeBlanc, Vicki R; Baxter, Alan; Tarshis, Jordan; Piquette, Dominique; Gu, Yuqi; Filipkowska, Caroline; Krywenky, Ashley; Kester-Greene, Nicole; Cardinal, Pierre; Au, Shelly; Lam, Sandy; Boet, Sylvain; Clinical Trials Group, Perioperative Anesthesia

2018-04-21

The proportion of older acute care physicians (ACPs) has been steadily increasing. Ageing is associated with physiological changes and prospective research investigating how such age-related physiological changes affect clinical performance, including crisis resource management (CRM) skills, is lacking. There is a gap in the literature on whether physician's age influences baseline CRM performance and also learning from simulation. We aim to investigate whether ageing is associated with baseline CRM skills of ACPs (emergency, critical care and anaesthesia) using simulated crisis scenarios and to assess whether ageing influences learning from simulation-based education. This is a prospective cohort multicentre study recruiting ACPs from the Universities of Toronto and Ottawa, Canada. Each participant will manage an advanced cardiovascular life support crisis-simulated scenario (pretest) and then be debriefed on their CRM skills. They will then manage another simulated crisis scenario (immediate post-test). Three months after, participants will return to manage a third simulated crisis scenario (retention post-test). The relationship between biological age and chronological age will be assessed by measuring the participants CRM skills and their ability to learn from high-fidelity simulation. This protocol was approved by Sunnybrook Health Sciences Centre Research Ethics Board (REB Number 140-2015) and the Ottawa Health Science Network Research Ethics Board (#20150173-01H). The results will be disseminated in a peer-reviewed journal and at scientific meetings. NCT02683447; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Crowd dynamics and safety. Reply to comments on "Human behaviours in evacuation crowd dynamics: From modelling to "big data" toward crisis management"

NASA Astrophysics Data System (ADS)

Bellomo, N.; Clarke, D.; Gibelli, L.; Townsend, P.; Vreugdenhil, B. J.

2016-09-01

The survey [13] presents an overview and critical analysis of the existing literature on the modeling of crowd dynamics related to crisis management toward the search of safety conditions. Out of this general review some rationale on research perspectives have been brought to the attention of the reader.

Employing crisis postcards with case management in Kaohsiung, Taiwan: 6-month outcomes of a randomised controlled trial for suicide attempters.

PubMed

Chen, Wei-Jen; Ho, Chi-Kung; Shyu, Shi-Sen; Chen, Cheng-Chung; Lin, Guei-Ging; Chou, Li-Shiu; Fang, Yun-Ju; Yeh, Pin-Yang; Chung, Tieh-Chi; Chou, Frank Huang-Chih

2013-07-17

Suicide attempts constitute a serious clinical problem and have important implications for healthcare resources. The aim of the present study was to evaluate the effectiveness of case management using crisis postcards over a 6-month follow-up period. A randomised controlled trial was conducted in Kaohsiung, Taiwan. Prevention of further suicide attempts was compared between two groups with and without the postcard intervention. The intervention group consisted of 373 participants (139 males, 234 females; age: 39.8 ± 14.0 yrs.). The control group consisted of 388 participants (113 males, 275 females; age: 40.0 ± 16.0 yrs.). A survival analysis was used to test the effectiveness of the crisis postcard intervention for the prevention of suicide reattempts. Per-protocol and intention-to-treat analyses were conducted. The intention-to-treat analysis indicated that the crisis postcard had no effect (hazard ratio = 0.84; 95% CI = 0.56 - 1.29), whereas the per-protocol analysis showed a strong benefit for the crisis postcard (hazard ratio = 0.39; 95% CI = 0.21 - 0.72). Although the results of the present study indicated that the postcard intervention did not reduce subsequent suicide behaviour, our study provides an alteration to the postcard intervention. Further studies need to be conducted to clarify whether this type of intervention can reduce subsequent suicidal behaviour, with a particular focus on reducing the rate of loss to follow-up.

Managing Communication during a School Crisis: A Case Study

ERIC Educational Resources Information Center

Gentilucci, James L.

2007-01-01

Crisis communication training of school principals is problematic because it overemphasizes media relations and underemphasizes the critical importance of immediate and personal communication with students, staff, and parents--those most affected by school crises. A case study involving the death of a student in a small rural school explains why…

[Human factors and crisis resource management: improving patient safety].

PubMed

Rall, M; Oberfrank, S

2013-10-01

A continuing high number of patients suffer harm from medical treatment. In 60-70% of the cases the sources of harm can be attributed to the field of human factors (HFs) and teamwork; nevertheless, those topics are still neither part of medical education nor of basic and advanced training even though it has been known for many years and it has meanwhile also been demonstrated for surgical specialties that training in human factors and teamwork considerably reduces surgical mortality.Besides the medical field, the concept of crisis resource management (CRM) has already proven its worth in many other industries by improving teamwork and reducing errors in the domain of human factors. One of the best ways to learn about CRM and HFs is realistic simulation team training with well-trained instructors in CRM and HF. The educational concept of the HOTT (hand over team training) courses for trauma room training offered by the DGU integrates these elements based on the current state of science. It is time to establish such training for all medical teams in emergency medicine and operative care. Accompanying safety measures, such as the development of a positive culture of safety in every department and the use of effective critical incident reporting systems (CIRs) should be pursued.

Timelines in the management of adrenal crisis - targets, limits and reality.

PubMed

Hahner, Stefanie; Hemmelmann, Nina; Quinkler, Marcus; Beuschlein, Felix; Spinnler, Christina; Allolio, Bruno

2015-04-01

To evaluate current management timelines in adrenal crisis (AC) and to establish time targets and time limits for emergency treatment. Patients from a prospective study who had reported an AC (n = 46) were contacted and asked about management of their AC. A survey among 24 European endocrinologists collected expert recommendations concerning time targets and time limits for contact-arrival time of emergency health professionals and presentation of emergency card-glucocorticoid (GC) injection time. Median time targets and time limits regarded by experts as adequate for contact-arrival time were 45 and 90 min, respectively, and for card-injection time 15 and 30 min, respectively. Thirty-seven of 46 patients could be interviewed. All patients were equipped with an emergency card but only 23 (62%) with an emergency kit. Seven patients (19%) were trained in GC self-injection. The median time interval between contacting a health professional and arrival was 20 min (range 2-2880 min); ≤45 min: n = 32 (86%), <90 min: n = 34 (92%). The median time interval between arrival and administration of GC was 30 min (range 2-2400 min); ≤15 min: n = 17 (46%), ≤30 min: n = 20 (54%). While the time between contacting health professionals and their arrival was within the limits set by experts, initiation of GC administration was delayed in 46% of patients. Thus, improved management of AC needs to focus on shortening the presentation of card-injection time. Given the current reality in the management of AC, promotion of self-injection of GC (s.c. or i.m.) is warranted. © 2014 John Wiley & Sons Ltd.

How Long Is a Minute? The Importance of a Measured Plan of Response to Crisis Situations

ERIC Educational Resources Information Center

Bickel, Perry S.

2010-01-01

Physical interventions for special education students in crisis remains a controversial concept. The first minute of a crisis situation represents the most crucial time to prevent injury or the exacerbation of injury. Although preventing violence and escalation of negative emotions is the first step in crisis management, school staff also must be…

Coasts in Crisis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hinrichsen, D.

1996-11-01

Coastal areas are staggering under an onslaught of human activity. We are presently in the process of destroying 70 percent of the world`s 600,000 square kilometers of coral reefs, an ecosystem containing some 200,000 different species and rivaling tropical rain forests in biodiversity. A combination of pollution, habitat destruction, and gross overfishing has led to the collapse of major fisheries and paved the way for malnutrition and disease in regions where people fish for subsistence. Globally, little is being done to manage the crisis of our coasts. Management strategies, if they exist at all, often deal with economic development alongmore » a wafer-thin strip of coastal land. Resource degradation is ignored, and watershed management is mostly rhetoric. Although some 55 countries have drawn up coastal management plans, only a handful have been properly implemented. Coasts must be managed in an integrated manner that takes into account the full range of human activities. Initiating this process is costly, time-consuming, and difficult. Yet we have more than three decades of accumulated experience to draw on.« less

Crisis Intervention with Older Persons: State of the Art and Clinical Applications.

ERIC Educational Resources Information Center

Duffy, Michael

A basic tenet of this paper is that the concept of crisis and crisis management has developed as a central issue within the fields of community psychiatry, psychology, and mental health, but that little systematic attention has been devoted to a particular subgroup at risk, i.e., older persons. Both theoretical background and clinical implications…

Crisis management of fire in the OR.

PubMed

Seifert, Patricia C; Peterson, Erik; Graham, Karen

2015-02-01

Fire in the OR is a life-threatening emergency that demands prompt, coordinated, and effective interventions. Specific applications of fire protocols and guidelines for perioperative nurses and their interprofessional colleagues may take several approaches. The perioperative nurse’s role is one that can frequently prevent or ameliorate the damaging thermal effects of a fire. For example, to some degree, the nurse can control all three components of the fire triangle: the ignition sources used during surgery (eg, fiberoptic lights, ESU devices), the oxidizers (eg, room air, supplemental oxygen administered during procedures under straight local anesthesia), and the fuel sources (eg, alcohol-based prep solutions). Although all members of the surgical team play an important role, the ability of and the opportunity for the nurse to minimize the risks of fire are important patient safety attributes of the nurse. Team training, rehearsing appropriate actions, and reacting effectively are essential to preparing health care providers to respond in emergent situations and be able to deliver optimal care. In most jurisdictions, any fired--regardless of size--must be reported to the local fire department. Personnel, managers, and administrators should be prepared also for the possibility of participating in postcrisis evaluations by the fire marshal, The Joint Commission, the Occupational Safety and Health Administration, Centers for Medicare & Medicaid Services, and possibly other fire safety-related organizations. Additionally, supplemental information related to investigating a fire is available through the ECRI Institute.28 The ECRI Institute serves as a third-party investigator and can facilitate root-cause analyses, identify whether the crisis ought to be reported and to whom, and assist in restoring clinical operations.

The European air traffic management response to volcanic ash crises: towards institutionalised aviation crisis management.

PubMed

Dopagne, Jacques

2011-06-01

A cloud of ash drifting from the erupting Eyjafjallajökull volcano in Iceland in April and May 2010 covered Europe and created an unprecedented situation. It resulted in an almost complete lockdown of European airspace in the period from 15th to 21st April, 2010: more than 100,000 flights were cancelled, 10 million people were affected and over US$1.8bn was lost by airlines globally. This paper presents the air traffic management (ATM) view of the situation. Through an analysis of the evolution of the events in the affected region, the paper will provide more details on ATM planning, reaction and follow-up actions. Furthermore, the influence of this event on the identification of further improvements needed to advance volcanic procedures internationally will be discussed. Actions undertaken since the end of the event - the establishment of the European Aviation Crisis Coordination Cell, running of the International Civil Aviation Organization VOLCEX 11/01 volcanic ash exercise and European response to the Grimsvötn eruption in May 2011 - will be discussed at the end of the paper.

Beyond police crisis intervention: moving "upstream" to manage cases and places of behavioral health vulnerability.

PubMed

Wood, Jennifer D; Beierschmitt, Laura

2014-01-01

Law enforcement officers continue to serve on the front lines as mental health interventionists, and as such have been subject to a wave of "first generation" reform designed to enhance their crisis response capabilities. Yet, this focus on crisis intervention has not answered recent calls to move "upstream" and bolster early intervention in the name of long-term recovery. This paper reports on findings from an action research project in Philadelphia aimed at exploring opportunities for enhanced upstream engagement. Study methods include spatial analyses of police mental health transportations from an eight year period (2004-2011) and qualitative data from twenty-three "framing conversations" with partners and other stakeholders, seven focus groups with police and outreach workers, five key informant interviews as well as document reviews of the service delivery system in Philadelphia. Recommendations include the need to move beyond a focus on what police can do to a wider conception of city agencies and business stakeholders who can influence vulnerable people and vulnerable spaces of the city. We argue for the need to develop shared principles and rules of engagement that clarify roles and stipulate how best to enlist city resources in a range of circumstances. Since issues of mental health, substance use and disorder are so tightly coupled, we stress the importance of establishing a data-driven approach to crime and disorder reduction in areas of the city we term "hotspots of vulnerability". In line with a recovery philosophy, such an approach should reduce opportunities for anti-social behavior among the "dually labeled" in ways consistent with "procedural justice". Furthermore, crime and disorder data flowing from police and security to behavioral health analysts could contribute to a more focused case management of "repeat utilizers" across the two systems. Our central argument is that a twin emphasis on "case management" and "place management" may provide

Occupational Practitioner’s Role in the Management of a Crisis: Lessons Learned from the Paris November 2015 Terrorist Attack

PubMed Central

Descatha, Alexis; Huynh Tuong, Alice; Coninx, Pierre; Baer, Michel; Loeb, Thomas; Despréaux, Thomas

2016-01-01

In massive catastrophic events, occupational health practitioners are more and more frequently involved in the management of such situations. We aim to describe the multiple aspects of the role that occupational health practitioners might play, by focusing on the recent example of the Paris terrorist attack of November 2015. During and after the Paris attack, occupational practitioners, in collaboration with emergency and security professionals, were involved in psychological care, assembling information, follow-up, return-to-work, and improving in-company safety plans. Based on this experience and other industrial disasters, we distinguish three phases: the critical phase, the post-critical phase, and the anticipation phase. In the critical phase, the occupational practitioner cares for patients before the emergency professionals take charge, initiates the psychological management, and may also play an organizational role for company health aspects. In the post-critical phase, he or she would be involved in monitoring those affected by the events and participate in preventing, to the extent possible, posttraumatic stress disorder, helping victims in the return-to-work process, and improving procedures and organizing drills. In addition to their usual work of primary prevention, occupational practitioners should endeavor to improve preparedness in the anticipation phase, by taking part in contingency planning, training in first aid, and defining immediately applicable protocols. In conclusion, recent events have highlighted the essential role of occupational health services in anticipation of a crisis, management during the crisis, and follow-up. PMID:27703965

Crisis Management.

ERIC Educational Resources Information Center

Hore, Terry

1978-01-01

Problems of "steady state" institutions and techniques of management that have implications for Monash University, Australia are considered. The term "steady state" is used to indicate a lack of additional funds being injected into the system to promote growth and/or development. A trend toward public accountability in higher…

Implications of Organizational Planning for Crisis Relocation.

DTIC Science & Technology

1982-12-01

AD-A 23 956 IMPLICATIONS OF ORGANIZATIDNAL PLANNING FOR CRISIS RELOCATION(U) NORTH CAROLINA DEPT OF CRIME CONTROL AND PUBLIC SAFETY RALEIG.. M A...policies of the Federal Emergency Management Agency. Division of Emergency Management North Carolina Department of Crime Control and Public Safety...North Carolina Department of Crime Control and Work Unit 0 4412 1 Public Safety, 116 W.Jones St. ,Raleigh, NC 27611 II. CONTROLLING OFFICE NAME AND

Trust, confidence, and the 2008 global financial crisis.

PubMed

Earle, Timothy C

2009-06-01

The 2008 global financial crisis has been compared to a "once-in-a-century credit tsunami," a disaster in which the loss of trust and confidence played key precipitating roles and the recovery from which will require the restoration of these crucial factors. Drawing on the analogy between the financial crisis and environmental and technological hazards, recent research on the role of trust and confidence in the latter is used to provide a perspective on the former. Whereas "trust" and "confidence" are used interchangeably and without explicit definition in most discussions of the financial crisis, this perspective uses the TCC model of cooperation to clearly distinguish between the two and to demonstrate how this distinction can lead to an improved understanding of the crisis. The roles of trust and confidence-both in precipitation and in possible recovery-are discussed for each of the three major sets of actors in the crisis, the regulators, the banks, and the public. The roles of trust and confidence in the larger context of risk management are also examined; trust being associated with political approaches, confidence with technical. Finally, the various stances that government can take with regard to trust-such as supportive or skeptical-are considered. Overall, it is argued that a clear understanding of trust and confidence and a close examination of the specific, concrete circumstances of a crisis-revealing when either trust or confidence is appropriate-can lead to useful insights for both recovery and prevention of future occurrences.

Does the Economic Crisis Have an Influence on the Higher Education Dropout Rate?

ERIC Educational Resources Information Center

Leão Fernandes, Graça; Chagas Lopes, Margarida

2016-01-01

This research aims to identify the effects of the economic crisis on higher education (HE) dropout rates at Lisbon School of Economics and Management (ISEG)--Universidade de Lisboa, after having controlled for individual characteristics, family background, High School and HE trajectories. Our main hypothesis is that the economic crisis induces…

Improvement of Emergency Management Mechanism of Public Health Crisis in Rural China: A Review Article

PubMed Central

HU, Jiaxiang; CHEN, Chao; KUAI, Tingting

2018-01-01

Background: With the rapid development of social economy in China, various public health emergencies frequently occur. Such emergencies cause a serious threat to human health and public safety, especially in rural China. Owing to flaws in emergency management mechanism and policy, the government is not capable to effectively deal with public health emergencies. Therefore, this study aimed to discuss the path to improve the emergency management mechanism for public health emergency in rural China. Methods: This study was conducted in 2017 to detect the emergency management mechanism of public health crisis (EMMPHC) in Rural China. Data were collected using the following keywords: Rural China, public health emergency, emergency management mechanism, organization mechanism, operation mechanism in the databases of PubMed, Scopus, Web of Science, and CNKI. Results: EMMPHC in rural China can be enhanced from the following three aspects. First, a permanent institution for rural emergency management with public health management function is established. Second, the entire process of emergency management mechanism, including the stages of pre-disaster, disaster, and post-disaster, is improved. Finally, investment in rural public health is increased, and an adequate reserve system for emergency resources is formed. Conclusion: The new path of EMMPHC in rural China can effectively help the local government accomplish the dispatch capability in public health emergency, and it has important research significance for the protection of public health and social stability of residents in rural China. PMID:29445625

Crisis water management and ibis breeding at Narran Lakes in arid Australia.

PubMed

Brandis, K J; Kingsford, R T; Ren, S; Ramp, D

2011-09-01

Narran Lakes is a Ramsar site recognised for its importance for colonial waterbird breeding, which only occurs after large highly variable flooding events. In 2008, 74,095 pairs of ibis bred for the first time in seven years, establishing two contiguous colonies, a month apart. Most (97%) of the colony consisted of the straw-necked ibis (Threskiornis spinicollis) with the remainder consisting of glossy ibis (2%, Plegadis falcinellus) and Australian white ibis (1%, T. molucca). Following cessation of river flows, water levels fell rapidly in the colony site, resulting in a crisis management decision by governments to purchase and deliver water (10,423 Ml) to avert mass desertion of the colonies. There were significant differences in the reproductive success of each colony. In colony 1 60% of eggs hatched and 94% of chicks fledged, while in colony 2 40% of eggs hatched with only 17% of chicks fledging. Statistical analyses found that water depth was a significant variable in determining reproductive success. Rapid falls in water level during the chick stage in colony 2 resulted in decreased chick and overall offspring success. The results of this study identify the impact of upstream water resource development on colonial waterbird breeding and have implications for water management policies.

Combating Terrorism: Issues in Managing Counterterrorist Programs

DTIC Science & Technology

2000-04-06

major effort to develop a national strategy, to date the strategy does not include a clear desired outcome to be achieved. Resources to combat...Federal exercises, in contrast to earlier years, are now practicing crisis and consequence management simultaneously and including state and local...categories—crisis management and consequence management. Crisis management includes efforts to stop a terrorist attack, arrest terrorists, and gather

The management of acute parathyroid crisis secondary to parathyroid carcinoma: a case report.

PubMed

Rock, Kathy; Fattah, Nariman; O'Malley, Diarmuid; McDermott, Enda

2010-01-29

Hypercalcaemic hyperparathyroid crisis is a rare but life-threatening complication of primary hyperparathyroidism. Parathyroid carcinoma is a rare malignancy with an incidence of 0.5% to 4% of all reported cases of primary hyperparathyroidism. We report the case of a 60-year-old Caucasian man with hypercalcaemic hyperparathyroid crisis associated with parathyroid carcinoma. He presented with a classic hypercalcaemic syndrome and his serum calcium and parathyroid hormone levels were at 4.65 mmol/L and 1743 ng/L, respectively. He initially presented with a two-week history of weakness and lethargy and a one-week history of vomiting, polyuria and polydipsia. An emergency left thyroid lobectomy and left lower parathyroidectomy were performed. There was a prompt decrease in his parathyroid hormone level immediately after surgery. Histology revealed that our patient had a 4-cm parathyroid carcinoma. In patients with parathyroid carcinoma, the optimal surgical treatment is en bloc resection with ipsilateral thyroid lobectomy and removal of any enlarged or abnormal lymph nodes. Surgery is the only curative treatment. In our patient, prompt surgical intervention proved successful. At six months the patient is well with no evidence of disease recurrence. This case highlights the importance of considering a hyperparathyroid storm in the context of a parathyroid carcinoma. Parathyroid carcinoma is a rare entity and our knowledge is mainly derived from case reports and retrospective studies. This case report increases awareness of this serious and life-threatening complication. This report also illustrates how prompt and appropriate management provides the best outcome for the patient.

Outcomes from two forms of training for first-responder competency in cholinergic crisis management.

PubMed

Andreatta, Pamela; Klotz, Jessica J; Madsen, James M; Hurst, Charles G; Talbot, Thomas B

2015-04-01

Military and civilian first responders must be able to recognize and effectively manage mass disaster casualties. Clinical management of injuries resulting from nerve agents provides different challenges for first responders than those of conventional weapons. We evaluated the impact of a mixed-methods training program on competency acquisition in cholinergic crisis clinical management using multimedia with either live animal or patient actor examples, and hands-on practice using SimMan3G mannequin simulators. A purposively selected sample of 204 civilian and military first responders who had not previously completed nerve agent training were assessed pre- and post-training for knowledge, performance, self-efficacy, and affective state. We conducted analysis of variance with repeated measures; statistical significance p < 0.05. Both groups had significant performance improvement across all assessment dimensions: knowledge > 20%, performance > 50%, self-efficacy > 34%, and affective state > 15%. There were no significant differences between the live animal and patient actor groups. These findings could aid in the specification of training for first-responder personnel in military and civilian service. Although less comprehensive than U.S. Army Medical Research Institute of Chemical Defense courses, the training outcomes associated with this easily distributed program demonstrate its value in increasing the competency of first responders in recognizing and managing a mass casualty cholinergic event. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Ecological advice for the global fisher crisis.

PubMed

Roberts, C M

1997-01-01

Fisheries science was the precursor of population ecology and continues to contribute important theoretical advances. Despite this, fishery scientists have a poor record for applying their insights to real-world fisheries management. Is there a gulf between theory and application or does the high variability inherent in fish populations and complexity of multispecies fisheries demand a different approach to management? Perhaps the solution to the world fisheries crisis is obvious after all?

How do people with long-term mental health problems negotiate relationships with network members at times of crisis?

PubMed

Walker, Sandra; Kennedy, Anne; Vassilev, Ivaylo; Rogers, Anne

2018-02-01

Social network processes impact on the genesis and management of mental health problems. There is currently less understanding of the way people negotiate networked relationships in times of crisis compared to how they manage at other times. This paper explores the patterns and nature of personal network involvement at times of crises and how these may differ from day-to-day networks of recovery and maintenance. Semi-structured interviews with 25 participants with a diagnosis of long-term mental health (MH) problems drawn from recovery settings in the south of England. Interviews centred on personal network mapping of members and resources providing support. The mapping interviews explored the work of network members and changes in times of crisis. Interviews were recorded, transcribed and analysed using a framework analysis. Three key themes were identified: the fluidity of network relationality between crisis and recovery; isolation as a means of crises management; leaning towards peer support. Personal network input retreated at times of crisis often as result of "ejection" from the network by participants who used self-isolation as a personal management strategy in an attempt to deal with crises. Peer support is considered useful during a crisis, whilst the role of services was viewed with some ambiguity. Social networks membership, and type and depth of involvement, is subject to change between times of crisis and everyday support. This has implications for managing mental health in terms of engaging with network support differently in times of crises versus recovery and everyday living. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Crisis Resources for Emergency Workers (CREW II): results of a pilot study and simulation-based crisis resource management course for emergency medicine residents.

PubMed

Hicks, Christopher M; Kiss, Alex; Bandiera, Glen W; Denny, Christopher J

2012-11-01

Emergency department resuscitation requires the coordinated efforts of an interdisciplinary team. Aviation-based crisis resource management (CRM) training can improve safety and performance during complex events. We describe the development, piloting, and multilevel evaluation of "Crisis Resources for Emergency Workers" (CREW), a simulation-based CRM curriculum for emergency medicine (EM) residents. Curriculum development was informed by an a priori needs assessment survey. We constructed a 1-day course using simulated resuscitation scenarios paired with focused debriefing sessions. Attitudinal shifts regarding team behaviours were assessed using the Human Factors Attitude Survey (HFAS). A subset of 10 residents participated in standardized pre- and postcourse simulated resuscitation scenarios to quantify the effect of CREW training on our primary outcome of CRM performance. Pre/post scenarios were videotaped and scored by two blinded reviewers using a validated behavioural rating scale, the Ottawa CRM Global Rating Scale (GRS). Postcourse survey responses were highly favourable, with the majority of participants reporting that CREW training can reduce errors and improve patient safety. There was a nonsignificant trend toward improved team-based attitudes as assessed by the HFAS (p  =  0.210). Postcourse performance demonstrated a similar trend toward improved scores in all categories on the Ottawa GRS (p  =  0.16). EM residents find simulation-based CRM instruction to be useful, effective, and highly relevant to their practice. Trends toward improved performance and attitudes may have arisen because our study was underpowered to detect a difference. Future efforts should focus on interdisciplinary training and recruiting a larger sample size.

An evaluation of crisis hotline outcomes. Part 1: Nonsuicidal crisis callers.

PubMed

Kalafat, John; Gould, Madelyn S; Munfakh, Jimmie Lou Harris; Kleinman, Marjorie

2007-06-01

The effectiveness of telephone crisis services/hotlines, examining proximal outcomes as measured by changes in callers' crisis state from the beginning to the end of their calls to eight centers in the U.S. and intermediate outcomes within 3 weeks of their calls, was evaluated. Between March 2003 and July 2004, 1,617 crisis callers were assessed during their calls and 801 (49.5%) participated in the followup assessment. Significant decreases in callers' crisis states and hopelessness were found during the course of the telephone session, with continuing decreases in crisis states and hopelessness in the following weeks. A majority of callers were provided with referrals and/or plans of actions for their concerns and approximately one third of those provided with mental health referrals had followed up with the referral by the time of the follow-up assessment. While crisis service staff coded these callers as nonsuicidal, at follow-up nearly 12% of them reported having suicidal thoughts either during or since their call to the center. The need to conduct suicide risk assessments with crisis callers and to identify strategies to improve referral follow-up is highlighted.

Crisis communication: an inequalities perspective on the 2010 Boston water crisis.

PubMed

Galarce, Ezequiel M; Viswanath, K

2012-12-01

Although the field of crisis risk communication has generated substantial research, the interaction between social determinants, communication processes, and behavioral compliance has been less well studied. With the goal of better understanding these interactions, this report examines how social determinants influenced communications and behavioral compliance during the 2010 Boston, Massachusetts, water crisis. An online survey was conducted to assess Boston residents' knowledge, beliefs, attitudes, mass and interpersonal communication, and preventive behaviors on emergency preparedness topics dealing with the water crisis. Of a total sample of 726 respondents, approximately one-third (n = 267) reported having been affected by the water crisis. Only data from affected participants were analyzed. Following an order to boil water, 87.5% of respondents refrained from drinking unboiled tap water. These behaviors and other cognitive and attitudinal factors, however, were not uniform across population subgroups. All communication and behavioral compliance variables varied across sociodemographic factors. Crisis communication, in conjunction with other public health preparedness fields, is central to reducing the negative impact of sudden hazards. Emergency scenarios such as the Boston water crisis serve as unique opportunities to understand how effectively crisis messages are conveyed to and received by different segments of the population.

AANA Journal course: update for nurse anesthetists--ERR WATCH: anesthesia crisis resource management from the nurse anesthetist's perspective.

PubMed

Fletcher, J L

1998-12-01

Anesthesia crisis resource management (ACRM) was developed by David Gaba, MD, and colleagues at Stanford University in the early 1990s. Derived from cockpit resource management of the aviation industry, ACRM addresses the issues of human performance and patient safety in anesthesia. Due to the inherent complexity of our dynamic work environment, we are frequently faced with situations that could escalate into critical incidents. ACRM explains the role of personal and environmental factors that can contribute to the evolution of critical incidents and provides the practitioner with some behavioral and intellectual guidelines to manage the risks more effectively. ERR WATCH is an acronym I developed to interpret the principles of ACRM from the nurse anesthetist's perspective. It provides a quick review of the major principles of ACRM, which are Environment, Resources, Reevaluation, Workload, Attention, Teamwork, Communication, and Help. Used together with good clinical management, these principles may provide an edge in solving complex problems and improving performance.

Management of hypercalcaemic crisis in adults: Current role of renal replacement therapy.

PubMed

Bentata, Yassamine; El Maghraoui, H; Benabdelhak, M; Haddiya, I

2018-06-01

Neoplasms and hematologic diseases are the predominant etiologies of hypercalcemic crisis in adults and the immediate treatment is mainly medical and symptomatic. The use of renal replacement therapy (RRT) is often necessary to correct the hypercalcemia, uremia and electrolyte disturbances related to Acute Kidney Injury (AKI). The aim of this work was to determine the etiologies and the place of RRT in treating patients with hypercalcaemic crisis. We conducted a retrospective study for 36months at the Nephrology Unit, University Hospital, Oujda, eastern of Morocco. We included all adult patients diagnosed with hypercalcemic crisis that was defined as corrected total serum calcium of >3.5mmol/l. 12 patients were collected. All patients were female and 5 patients were elderly (≥65years). Three patients had a serum calcium value of >4mmol/l and the highest calcium value was 5.8mmol/l. Electrocardiographic abnormalities were observed in 8 cases. AKI was observed in 8 cases. Three patients had chronic kidney disease on hemodialysis. Neoplasm was noted in 9 cases. All patients received venous rehydration, glucocorticoids and biphosphonates. The use of RRT with low calcium dialysate was performed in 11 cases. Three patients died during the first 24h of hospitalization. RRT must play its full role as first line treatment of hypercalcemia crisis. Improvements in hemodialysis techniques and the use of low calcium or calcium-free dialysates currently allows this therapeutic measure to be prescribed safely, and the benefit-risk balance is positive for the great benefit provided by dialysis. Copyright © 2018 Elsevier Inc. All rights reserved.

Geographic Information System Technology Leveraged for Crisis Planning, Emergency, Response, and Disaster Management

NASA Astrophysics Data System (ADS)

Ross, A.; Little, M. M.

2013-12-01

NASA's Atmospheric Science Data Center (ASDC) is piloting the use of Geographic Information System (GIS) technology that can be leveraged for crisis planning, emergency response, and disaster management/awareness. Many different organizations currently use GIS tools and geospatial data during a disaster event. ASDC datasets have not been fully utilized by this community in the past due to incompatible data formats that ASDC holdings are archived in. Through the successful implementation of this pilot effort and continued collaboration with the larger Homeland Defense and Department of Defense emergency management community through the Homeland Infrastructure Foundation-Level Data Working Group (HIFLD WG), our data will be easily accessible to those using GIS and increase the ability to plan, respond, manage, and provide awareness during disasters. The HIFLD WG Partnership has expanded to include more than 5,900 mission partners representing the 14 executive departments, 98 agencies, 50 states (and 3 territories), and more than 700 private sector organizations to directly enhance the federal, state, and local government's ability to support domestic infrastructure data gathering, sharing and protection, visualization, and spatial knowledge management.The HIFLD WG Executive Membership is lead by representatives from the Department of Defense (DoD) Office of the Assistant Secretary of Defense for Homeland Defense and Americas' Security Affairs - OASD (HD&ASA); the Department of Homeland Security (DHS), National Protection and Programs Directorate's Office of Infrastructure Protection (NPPD IP); the National Geospatial-Intelligence Agency (NGA) Integrated Working Group - Readiness, Response and Recovery (IWG-R3); the Department of Interior (DOI) United States Geological Survey (USGS) National Geospatial Program (NGP), and DHS Federal Emergency Management Agency (FEMA).

Hypertensive crisis-induced electrocardiographic changes: a case series.

PubMed

Farha, Khalid Abou; van Vliet, André; van Marle, Sjoerd; Vrijlandt, Patrick; Westenbrink, Daan

2009-08-20

Myocardial injury is one of the most notorious complications of a hypertensive crisis. Key electrocardiograph signs used to detect cardiac injury such as ST segment changes and cardiac arrhythmias usually indicate acute ongoing end-organ damage. Lack of early signs to predict end-organ damage might lead to a delay in the initiation of therapy and selection of the incorrect therapeutic strategy. We describe five cases of tall, hyper acute symmetrical T-waves alone or accompanied by other electrocardiograph abnormalities in five healthy participants: three women aged 52, 60 and 62-years and two men aged 49 and 66-years, during a tyramine-monoamine oxidase-inhibitor interaction, phase I clinical trial. T-wave changes appeared early during the course of the hypertensive crisis and were attributed to subendocardial ischemia. The changes were transient and reverted to baseline in parallel with a fall in blood pressure. Recognition of tall symmetrical T-waves in early phases of hypertensive crisis heralds commencement of myocardial damage. This calls for prompt medical intervention to avoid an impending irreversible myocardial injury. It is our belief that these findings will add new insight into the management of hypertensive crisis and will open avenues of further investigation.

Adaptability in Crisis Management: The Role of Organizational Structure

DTIC Science & Technology

2013-06-01

individuals to make optimal decisions under constraints of high risk, uncertainty, high workload, and time pressure (see, e.g., Brehmer, 2007 ). There is...et al., 2003; Hallam & Stammers , 1981). For instance, Hallam and Stammers (1981) showed that the impact of variations in task complexity on team...each team member. FIRESCOPE, a commonly used crisis intervention plan developed in California (Office of Emergency Services, 2007 ) is a good

Family and Staff Perspectives on Service Use for Individuals with Intellectual Disabilities in Crisis

ERIC Educational Resources Information Center

McMorris, Carly A.; Weiss, Jonathan A.; Cappelletti, Gabriella; Lunsky, Yona

2013-01-01

Carers of individuals with an intellectual disability are often responsible for managing their children's psychiatric crises when they arise. The purpose of this study was to examine the experiences of families using crisis and short-term transitional supports from the perspectives of families and of crisis and transitional support staff. Three…

Hyperparathyroid crisis presenting with hyperemesis gravidarum.

PubMed

Yilmaz, Banu Aktaş; Altay, Mustafa; Değertekin, Ceyla Konca; Çimen, Ali Riza; Iyidir, Özlem Turhan; Biri, Aydan; Yüksel, Osman; Törüner, Füsun Baloş; Arslan, Metin

2014-10-01

Primary hyperparathyroidism during pregnancy is a rare condition, and the diagnosis may be confounded by pregnancy related conditions. Since the appropriate management reduces the maternal and fetal complications; differential diagnosis becomes quite crucial. Clinical course of a patient with hyperparathyroid crisis will be discussed with the review of the literature. A 22-year- old, (gravida 2, para 1) woman was presented with hyperparathyroid crisis at the 11th weeks' gestation. She was hospitalized twice due to hyperemesis gravidarum. When she was admitted to the hospital for the third time due to increased vomiting and weight-loss, serum biochemistry panel was performed and it revealed severe hypercalcemia that serum Ca was 17.59 mg/dl, and she was referred to our hospital as parathyroid crisis. Maternal hypercalcemia was resolved after urgent parathyroidectomy. She was diagnosed as preeclampsia at the 30 weeks' gestation and delivered a male infant weighing 1,090 g at 33 weeks' gestation with APGAR scores 6 at 1 min, and 7 at min 5, without evidence of neonatal hypocalcemia or tetany. Urgent parathyroidectomy is the definite treatment in symptomatic patients with hyperparathyroidism during pregnancy. Resolving maternal hypercalcemia prevents neonatal tetany and hypocalcemia. Hyperemesis may lead to hypercalcemic crisis in patients with hyperparathyroidism, so serum Ca level should be checked in patients with hyperemesis gravidarum especially who detoriate rapidly. Although they share some common pathogenetic mechanisms, there is not enough evidence for attributing preeclampsia to primary hyperparathyroidism.

Use of a clinical pathway to improve the acute management of vaso-occlusive crisis pain in pediatric sickle cell disease.

PubMed

Ender, Katherine L; Krajewski, Jennifer A; Babineau, John; Tresgallo, Mary; Schechter, William; Saroyan, John M; Kharbanda, Anupam

2014-04-01

The most common, debilitating morbidity of sickle cell disease (SCD) is vaso-occlusive crisis (VOC) pain. Although guidelines exist for its management, they are generally not well-followed, and research in other pediatric diseases has shown that clinical pathways improve care. The purpose of our study was to determine whether a clinical pathway improves the acute management of sickle cell vaso-occlusive crisis (VOC) pain in the pediatric emergency department (PED). Pain management practices were prospectively investigated before and after the initiation of a clinical pathway in the PED of an urban, tertiary care center with 50,000 ED visits per year and approximately 200 active sickle cell patients. The pathway included instructions for triage, monitoring, medication administration, and timing of assessments and interventions. Data were eligible from 35 pre-pathway and 33 post-pathway visits. Primary outcome was time interval to administration of first analgesic medication. Statistical analysis was by Student's t-test, using natural-log-transformed data for outcomes with skewed distribution curves. Time interval to first analgesic improved from 74 to 42 minutes (P = 0.012) and to first opioid from 94 to 46 minutes (P = 0.013). The percentage of patients who received ketorolac increased from 57% to 82% (P = 0.03). Decrease in time interval to subsequent pain score assessment was not statistically significant (110 to 72 minutes (P = 0.07)), and change in pain score was not different (P = 0.25). The use of a clinical pathway for sickle cell VOC in the PED can improve important aspects of pain management and merits further investigation and implementation. © 2013 Wiley Periodicals, Inc.

Middle-Range Farmers Persisting Through the Agricultural Crisis.

ERIC Educational Resources Information Center

Salamon, Sonya; Davis-Brown, Karen

1986-01-01

Ethnographic study of north-central Illinois agricultural county compares entrepreneurial and yeoman farm families and concludes that management strategies reflecting goals and values of these types of families affect susceptibility to financial crisis. Yeoman financial conservatism, family cooperation, modest farm goals, and behavior correlated…

An Evaluation of Crisis Hotline Outcomes. Part 1: Nonsuicidal Crisis Callers

ERIC Educational Resources Information Center

Kalafat, John; Gould, Madelyn S.; Munfakh, Jimmie Lou Harris; Kleinman, Marjorie

2007-01-01

The effectiveness of telephone crisis services/hotlines, examining proximal outcomes as measured by changes in callers' crisis state from the beginning to the end of their calls to eight centers in the U.S. and intermediate outcomes within 3 weeks of their calls, was evaluated. Between March 2003 and July 2004, 1,617 crisis callers were assessed…

Hemolytic crisis

MedlinePlus

Hemolytic crisis occurs when large numbers of red blood cells are destroyed over a short time. The loss of ... During a hemolytic crisis, the body cannot make enough red blood cells to replace those that are destroyed. This causes acute and often ...

Double whammy- acute splenic sequestration crisis in patient with aplastic crisis due to acute parvovirus infection.

PubMed

Minhas, Parminder S; K Virdi, Jaspreet; Patel, Rajeshkumar

2017-07-01

Splenic dysfunction is a major feature of sickle cell disease (SCD) and can manifest as acute splenic sequestration crisis (ASSC), which is the earliest life-threatening complication seen in patients with SCD. Aplastic crisis is another potentially deadly complication of sickle cell disease that develops when erythrocyte production temporarily drops. Infection with parvovirus B-19 frequently causes aplastic crises. These two complications are known to be mutually exclusive due to their classic presentation signs and symptoms but there have been few cases where a patient can have concomitant presentation of both phenomena, which can result in a fatal outcome. These few cases force us to rethink the etiology and subsequent management guidelines of these complications. We present to you a case of an unfortunate 23-year-old female who had both complications occurring at the same time, resulting in death.

Exupéry - a mobile fast response system for managing a volcanic crisis

NASA Astrophysics Data System (ADS)

Hort, M. K.

2009-12-01

Despite ever increasing efforts to monitor historically active volcanoes many of those are still very poorly or unmonitored, even in highly populated areas. In case of volcanic unrest or even a volcanic crisis evaluating the situation is therefore often very difficult due to the little information that is available for that specific volcano. Over the past decades several different programs have supported volcanic crisis management efforts in third world countries from sending experts all the way to improving or even installing new networks around the volcano. One of the main problems especially when quickly upgrading networks during a crisis is that each system usually comes with its own acquisition and processing system which makes it very difficult to manage the observational network and provide an interdisciplinary interpretation of the data with respect to the activity status of the volcano. Here we present a newly developed volcano fast response system which overcomes several of these shortcomings. The core of the system is a novel database (SEISHUB) that allows for the collection of data of various kinds, i.e. simple time series data like seismic data, gas measurements, GPS measurements, as well as satellite data (SO2 flux, thermal anomaly, ground deformation). Part of the collected data may also come from an already existing network. Data from new field instruments are transmitted through a wireless network that has been specifically designed for the volcano fast response system. One of the main difficulties with such a multidisciplinary data set is an easy access to the data. This is provided through a common Web based GIS interface which allows various datalayers being simultaneously accessed through a Web Browser. The underlying software is designed in such a way that it only uses open source software, so it can be easily installed on other systems not having to deal with purchasing proprietary software. Aside from this the system provides tools to

[MATCHE: Management Approach to Teaching Consumer and Homemaking Education.] Consumer Approach Strand: Human Development. Module I-E-4: Individuals and Families in Crisis.

ERIC Educational Resources Information Center

California State Univ., Fresno. Dept. of Home Economics.

This competency-based preservice home economics teacher education module on individuals and families in crisis is the fourth in a set of five modules on consumer education related to human development. (This set is part of a larger series of sixty-seven modules on the Management Approach to Teaching Consumer and Homemaking Education [MATCHE]--see…

Averting a pandemic health crisis in Europe by 2020: what physicians need to know regarding cholesterol management.

PubMed

Catapano, Alberico L; Pedersen, Terje R; de Backer, Guy

2007-04-01

Cardiovascular disease (CVD) represents a major cause of premature death, disability, and escalating healthcare costs throughout Europe. According to a recent report by the Stockholm Network (an independent European 'think tank'), major political, economic, social, and medical changes are urgently needed with respect to cholesterol management to help prevent CVD. To identify key cholesterol management issues that practitioners should consider to help prevent an impending European health crisis, our collective experience of policies and practices relating to CVD and cholesterol management in our respective countries was consolidated and used to develop this commentary. Physicians and healthcare workers are uniquely positioned to make immediate and meaningful improvements in preventing and treating CVD if they recognize and address a handful of key clinical issues pertaining to cholesterol management. These issues include utilizing newer combination therapies and realizing the limitations of statins, improving compliance with cholesterol-lowering therapies, promoting a healthy lifestyle and diet, making treatment decisions based on patients' total CVD risk, fostering communication between primary and secondary providers, and soliciting governmental funding to implement disease management programmes. By promptly and effectively addressing these cholesterol management issues, physicians and other healthcare professionals have an unprecedented opportunity to help reduce CVD in Europe to lessen the personal, social, and economic impact of this devastating disease.

Top Management Team Crisis Communication after Claims of Sexual Harassment

ERIC Educational Resources Information Center

Bull Schaefer, Rebecca A.; Crosswhite, Alicia M.

2018-01-01

Both sexual harassment and managerial crisis communication are important topics in undergraduate, graduate, and executive programs. This article describes a group role-play exercise that engages students in the process of responding to a public claim of workplace sexual harassment and requires small groups to share their reactions within a press…

Debriefing decreases mental workload in surgical crisis: A randomized controlled trial.

PubMed

Boet, Sylvain; Sharma, Bharat; Pigford, Ashlee-Ann; Hladkowicz, Emily; Rittenhouse, Neil; Grantcharov, Teodor

2017-05-01

Mental workload is the amount of mental effort involved in performing a particular task. Crisis situations may increase mental workload, which can subsequently negatively impact operative performance and patient safety. This study aims to measure the impact of learning through debriefing and a systematic approach to crisis on trainees' mental workload in a simulated surgical crisis. Twenty junior surgical residents participated in a high-fidelity, simulated, postoperative crisis in a surgical ward environment (pretest). Participants were randomized to either an instructor-led debriefing, including performance feedback (intervention; n = 10) or no debriefing (control; n = 10). Subjects then immediately managed a second simulated crisis (post-test). Mental workload was assessed in real time during the scenarios using a previously validated, wireless, vibrotactile device. Mental workload was represented by subject response times to the vibrations, which were recorded and analyzed using the Mann-Whitney U test. Participants in the debriefing arm had a significantly reduced median response time in milliseconds (post-test minus pretest -695, quartile range -2,136 to -297) compared to participants in the control arm (42, -1,191 to 763), (between-arm difference P = .049). Debriefing after simulated surgical crisis situations may improve performance by decreasing trainee's mental workload during a subsequent simulated surgical crisis. Copyright © 2016 Elsevier Inc. All rights reserved.

The synergy of the refugee crisis and the financial crisis in Greece: Impact on mental health.

PubMed

Anagnostopoulos, Dimitris C; Giannakopoulos, George; Christodoulou, Nikos G

2017-06-01

The current global financial crisis that started in 2008 resulted in a significant decline in global trade, slowing/reversing economic growth worldwide, and a dramatic increase in public sector debt. At the same time, the global migrant/refugee crisis has reached extreme rates, with millions of people being forced to abandon their homes and communities because of war, political violence or related threats. There is a broad consensus about the deleterious consequences of these crises on psychological well-being, depression, anxiety disorders, insomnia, alcohol abuse and suicidal behavior. Although the separate consequences of economic recession and immigration are extensively discussed in previous research, we know very little about the processes through which the intersection of economic crisis and migrant crisis contributes to the vulnerabilities of natives and migrants during these crises. Of particular concern is the status of children, adolescents and their families, who constitute one of the most vulnerable groups in society. To discuss the contexts that economic and migrant crises shape and suggest possible effects of this intersection on mental health risks, especially among children, adolescents and their families, through reflecting on the recent experience in Greece. Review of the literature and critical analysis of the effects of the confluent crises. The interactive effects of these two crises need further exploration. Novel and diverse models of psychological understanding need to be developed in order to manage the effects of the confluent crises. The role of mental health professionals is crucial in this respect, offering culturally flexible, accommodating and empathetic approaches, allowing healing and acceptance in the face of adversity.

78 FR 9711 - Agency Information Collection Activities; Submission for OMB Review; Comment Request: Crisis...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-11

... Request: Crisis Counseling Assistance and Training Program AGENCY: Federal Emergency Management Agency, DHS. ACTION: Notice. SUMMARY: The Federal Emergency Management Agency (FEMA) will submit the... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID: FEMA-2012-0031...

Stabilisation and humanitarian access in a collapsed state: the Somali case.

PubMed

Menkhaus, Ken

2010-10-01

Somalia today is the site of three major threats: the world's worst humanitarian crisis; the longest-running instance of complete state collapse; and a robust jihadist movement with links to Al-Qa'ida. External state-building, counter-terrorism and humanitarian policies responding to these threats have worked at cross-purposes. State-building efforts that insist humanitarian relief be channelled through the nascent state in order to build its legitimacy and capacity undermine humanitarian neutrality when the state is a party to a civil war. Counter-terrorism policies that seek to ensure that no aid benefits terrorist groups have the net effect of criminalising relief operations in countries where poor security precludes effective accountability. This paper argues that tensions between stabilisation and humanitarian goals in contemporary Somalia reflect a long history of politicisation of humanitarian operations in the country. © 2010 The Author(s). Journal compilation © Overseas Development Institute, 2010.

Collective learning dynamics in behavioral crowds. Comment on "Human behaviours in evacuation crowd dynamics: From modeling to "big data" toward crisis management" by Nicola Bellomo et al.

NASA Astrophysics Data System (ADS)

Burini, D.

2016-09-01

A recent literature on crowd dynamics [9,10] has enlightened that the management of crisis situations needs models able to depict social behaviors and, in particular, the spread of emotional feelings such as stress by panic situation.

Sickle Cell Crisis (For Teens)

MedlinePlus

... Safe Videos for Educators Search English Español Sickle Cell Crisis (Pain Crisis) KidsHealth / For Teens / Sickle Cell ... drepanocíticas (Crisis de dolor) What Is a Sickle Cell Crisis? Sickle cell disease changes the shape of ...

Modeling of Economy Considering Crisis

NASA Astrophysics Data System (ADS)

Petrov, Lev F.

2009-09-01

We discuss main modeling's problems of economy dynamic processes and the reason forecast's absence of economic crisis. We present a structure of complexity level of system and models and discuss expected results concerning crisis phenomena. We formulate the basic perspective directions of the mathematical modeling of economy, including possibility of the analysis of the pre crisis, crisis and post crisis phenomena in economic systems.

Waiting for a Crisis: Case Studies of Crisis Leaders in Higher Education

ERIC Educational Resources Information Center

Muffet-Willett, Stacy L.

2010-01-01

This study examines the system of crisis leadership in higher education. Using case study methods, five crisis leadership participants were interviewed to develop a deep understanding of how they perceive their university crisis leadership system. Two participants were from a private institution, and three were from a public institution. Higher…

Virtual Golden Foods Corporation: Generic Skills in a Virtual Crisis Environment (A Pilot Study)

ERIC Educational Resources Information Center

Godat, Meredith

2007-01-01

Workplace learning in a crisis-rich environment is often difficult if not impossible to integrate into programs so that students are able to experience and apply crisis management practices and principles. This study presents the results of a pilot project that examined the effective use of a virtual reality (VR) environment as a tool to teach…

Hypertensive crisis-induced electrocardiographic changes: a case series

PubMed Central

2009-01-01

Introduction Myocardial injury is one of the most notorious complications of a hypertensive crisis. Key electrocardiograph signs used to detect cardiac injury such as ST segment changes and cardiac arrhythmias usually indicate acute ongoing end-organ damage. Lack of early signs to predict end-organ damage might lead to a delay in the initiation of therapy and selection of the incorrect therapeutic strategy. Case presentation We describe five cases of tall, hyper acute symmetrical T-waves alone or accompanied by other electrocardiograph abnormalities in five healthy participants: three women aged 52, 60 and 62-years and two men aged 49 and 66-years, during a tyramine-monoamine oxidase-inhibitor interaction, phase I clinical trial. T-wave changes appeared early during the course of the hypertensive crisis and were attributed to subendocardial ischemia. The changes were transient and reverted to baseline in parallel with a fall in blood pressure. Conclusion Recognition of tall symmetrical T-waves in early phases of hypertensive crisis heralds commencement of myocardial damage. This calls for prompt medical intervention to avoid an impending irreversible myocardial injury. It is our belief that these findings will add new insight into the management of hypertensive crisis and will open avenues of further investigation. PMID:19918270

Catecholamine crisis during induction of general anesthesia : A case report.

PubMed

Sonntagbauer, M; Koch, A; Strouhal, U; Zacharowski, K; Weber, C F

2018-03-01

Catecholamine crises associated with pheochromocytoma may cause life-threatening cardiovascular conditions. We report the case of a 75-year-old male who developed a hypertensive crisis during induction of general anesthesia for elective resection of a cervical neuroma due to an undiagnosed pheochromocytoma. Hemodynamic instability occurred immediately after the injection of fentanyl, propofol and rocuronium, prior to laryngoscopy and in the absence of any manipulation of the abdomen. In this case report, we present the management of this incident and discuss the underlying pathophysiology triggering a catecholamine crisis.

Rapidly absorbed orodispersible tablet containing molecularly dispersed felodipine for management of hypertensive crisis: development, optimization and in vitro/in vivo studies.

PubMed

Basalious, Emad B; El-Sebaie, Wessam; El-Gazayerly, Omaima

2013-01-01

A liquisolid orodispersible tablet of felodipine, a BCS Class II drug, was developed to improve drug dissolution and absorption through the buccal mucosa for management of hypertensive crisis. A 24 full-factorial design was applied to optimize felodipine liquisolid systems (FLSs) having acceptable flow properties and possessing enhanced drug dissolution rates. Four formulation variables; The liquid type, X1 (PG or PEG), drug concentration, X2 (10% and 20%), type of coat, X3 (Aerosil® and Aeroperl®) and excipients ratio, X4 (10 and 20) were included in the design. The systems were assessed for dissolution and flow properties. Following optimization, the formulation components (X1, X2, X3 and X4) were PEG, 10%, Aerosil® and 20, respectively. The optimized FLS was compressed into felodipine liquisolid orodispersible tablet using Prosolv® as carrier material (FLODT-2). The in vitro and in vivo disintegration times of FLODT-2 were 9 and 7 s, respectively. The in vivo pharmacokinetic study using human volunteers showed a significant increase in dissolution and absorption rates of the formulation of FLODT-2 compared to soft gelatin capsules filled with felodipine solution in PEG under the same conditions. Our results proposed that the optimized FLODT formulation could be promising to manage hypertensive crisis.

Crisis leadership in an acute clinical setting: christchurch hospital, new zealand ICU experience following the february 2011 earthquake.

PubMed

Zhuravsky, Lev

2015-04-01

On Tuesday, February 22, 2011, a 6.3 magnitude earthquake struck Christchurch, New Zealand. This qualitative study explored the intensive care units (ICUs) staff experiences and adopted leadership approaches to manage a large-scale crisis resulting from the city-wide disaster. To date, there have been a very small number of research publications to provide a comprehensive overview of crisis leadership from the perspective of multi-level interactions among staff members in the acute clinical environment during the process of the crisis management. The research was qualitative in nature. Participants were recruited into the study through purposive sampling. A semi-structured, audio-taped, personal interview method was chosen as a single data collection method for this study. This study employed thematic analysis. Formal team leadership refers to the actions undertaken by a team leader to ensure the needs and goals of the team are met. Three core, formal, crisis-leadership themes were identified: decision making, ability to remain calm, and effective communication. Informal leaders are those individuals who exert significant influence over other members in the group to which they belong, although no formal authority has been assigned to them. Four core, informal, crisis-leadership themes were identified: motivation to lead, autonomy, emotional leadership, and crisis as opportunity. Shared leadership is a dynamic process among individuals in groups for which the objective is to lead one another to the achievement of group or organizational goals. Two core, shared-leadership themes were identified: shared leadership within formal medical and nursing leadership groups, and shared leadership between formal and informal leaders in the ICU. The capabilities of formal leaders all contributed to the overall management of a crisis. Informal leaders are a very cohesive group of motivated people who can make a substantial contribution and improve overall team performance in a

Locked down and out: Crisis at Central High

ERIC Educational Resources Information Center

Barron Ausbrooks, Carrie Y.

2010-01-01

This case study is designed for preservice school administrators enrolled in principalship and school law courses in educational administration. It describes an incident in which a school's crisis management and communication protocol were challenged. One day, through a series of unanticipated events, an assistant principal is engulfed in a test…

"It's overwhelming... everything seems to be too much:" A theory of crisis for individuals with severe persistent mental illness.

PubMed

Ball, Jeffrey S; Links, Paul S; Strike, Carol; Boydell, Katherine M

2005-01-01

Crisis in individuals with severe persistent mental illness (SPMI) is a poorly understood phenomenon for which traditional crisis models do not apply. In this study we explored the crisis experience using in-depth interviews conducted with individuals with severe persistent mental illness from two community support programs. A grounded theory of the crisis experience was developed and the results illustrate that underlying vulnerability sets the stage for crisis occurrence which involves feeling overwhelmed and lacking control and manifests as agitation/anger/aggression, being low, feeling anxious, or euphoria. Immediate responses to crises involve getting help or managing alone and numerous factors contribute to crisis resolution and prevention.

77 FR 61772 - Agency Information Collection Activities: Proposed Collection; Comment Request, Crisis Counseling...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-11

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2012-0031; OMB No. 1660-0085] Agency Information Collection Activities: Proposed Collection; Comment Request, Crisis Counseling Assistance and Training Program AGENCY: Federal Emergency Management Agency, DHS. ACTION: Notice...

Simulation-Based Laparoscopic Surgery Crisis Resource Management Training-Predicting Technical and Nontechnical Skills.

PubMed

Goldenberg, Mitchell G; Fok, Kai H; Ordon, Michael; Pace, Kenneth T; Lee, Jason Y

2017-12-19

To develop a unique simulation-based assessment using a laparoscopic inferior vena cava (IVC) injury scenario that allows for the safe assessment of urology resident's technical and nontechnical skills, and investigate the effect of personality traits performance in a surgical crisis. Urology residents from our institution were recruited to participate in a simulation-based training laparoscopic nephrectomy exercise. Residents completed demographic and multidimensional personality questionnaires and were instructed to play the role of staff urologist. A vasovagal response to pneumoperitoneum and an IVC injury event were scripted into the scenario. Technical and nontechnical skills were assessed by expert laparoscopic surgeons using validated tools (task checklist, GOALS, and NOTSS). Ten junior and five senior urology residents participated. Five residents were unable to complete the exercise safely. Senior residents outperformed juniors on technical (checklist score 15.1 vs 9.9, p < 0.01, GOALS score 18.0 vs 13.3, p < 0.01) and nontechnical performance (NOTSS score 13.8 vs 10.1, p = 0.03). Technical performance scores correlated with NOTSS scores (p < 0.01) and pass/fail rating correlated with technical performance (p < 0.01 for both checklist and GOALS), NOTSS score (p = 0.02), and blood loss (p < 0.01). Only the conscientiousness dimension of the big five inventory correlated with technical score (p = 0.03) and pass/fail rating (p = 0.04). Resident level of training and laparoscopic experience correlated with technical performance during a simulation-based laparoscopic IVC injury crisis management scenario, as well as multiple domains of nontechnical performance. Personality traits of our surgical residents are similar and did not predict technical skill. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Quantitative evaluation of hand cranking a roller pump in a crisis management drill.

PubMed

Tomizawa, Yasuko; Tokumine, Asako; Ninomiya, Shinji; Momose, Naoki; Matayoshi, Toru

2008-01-01

The heart-lung machines for open-heart surgery have improved over the past 50 years; they rarely break down and are almost always equipped with backup batteries. The hand-cranking procedure only becomes necessary when a pump breaks down during perfusion or after the batteries have run out. In this study, the performance of hand cranking a roller pump was quantitatively assessed by an objective method using the ECCSIM-Lite educational simulator system. A roller pump connected to an extracorporeal circuit with an oxygenator and with gravity venous drainage was used. A flow sensor unit consisting of electromagnetic sensors was used to measure arterial and venous flow rates, and a built-in pressure sensor was used to measure the water level in the reservoir. A preliminary study of continuous cranking by a team of six people was conducted as a surprise drill. This system was then used at a perfusion seminar. At the seminar, 1-min hand-cranking drills were conducted by volunteers according to a prepared scenario. The data were calculated on site and trend graphs of individual performances were given to the participants as a handout. Preliminary studies showed that each person's performance was different. Results from 1-min drills showed that good performance was not related to the number of clinical cases experienced, years of practice, or experience in hand cranking. Hand cranking to maintain the target flow rate could be achieved without practice; however, manipulating the venous return clamp requires practice. While the necessity of performing hand cranking during perfusion due to pump failure is rare, we believe that it is beneficial for perfusionists and patients to include hand-cranking practice in periodic extracorporeal circulation crisis management drills because a drill allows perfusionists to mentally rehearse the procedures should such a crisis occur.

Testing a Model of Functional Impairment in Telephone Crisis Support Workers.

PubMed

Kitchingman, Taneile A; Wilson, Coralie J; Caputi, Peter; Wilson, Ian; Woodward, Alan

2017-11-01

It is well known that helping professionals experience functional impairment related to elevated symptoms of psychological distress as a result of frequent empathic engagement with distressed others. Whether telephone crisis support workers are impacted in a similar way is not currently reported in the literature. The purpose of this study was to test a hypothesized model of factors contributing to functional impairment in telephone crisis support workers. A national sample of 210 telephone crisis support workers completed an online survey including measures of emotion regulation, symptoms of general psychological distress and suicidal ideation, intentions to seek help for symptoms, and functional impairment. Structural equation modeling was used to test the fit of the data to the hypothesized model. Goodness-of-fit indices were adequate and supported the interactive effects of emotion regulation, general psychological distress, suicidal ideation, and intentions to seek help for ideation on functional impairment. These results warrant the deliberate management of telephone crisis support workers' impairment through service selection, training, supervision, and professional development strategies. Future research replicating and extending this model will further inform the modification and/or development of strategies to optimize telephone crisis support workers' well-being and delivery of support to callers.

Husserl's Crisis as a crisis of psychology.

PubMed

Feest, Uljana

2012-06-01

This paper places Husserl's mature work, The Crisis of the European Sciences, in the context of his engagement with--and critique of--experimental psychology at the time. I begin by showing (a) that Husserl accorded psychology a crucial role in his philosophy, i.e., that of providing a scientific analysis of subjectivity, and (b) that he viewed contemporary psychology--due to its naturalism--as having failed to pursue this goal in the appropriate manner. I then provide an analysis of Husserl's views about naturalism and scientific philosophy. Some central themes of the Crisis are traced back to Husserl's earlier work and to his relationship with his teacher, Franz Brentano, with whom he disagreed about the status of "inner perception" as the proper scientific method for a phenomenological analysis. The paper then shows that Husserl was well aware of at least one publication about the crisis of psychology (Bühler's 1927 book), and it teases out some aspects of the complicated relationship between Husserl and members of the Würzburg School of thought psychology: The latter had drawn on Husserl's writings, but Husserl felt that they had misunderstood his central thesis. I conclude by placing Husserl's work in the wider context of scientific, cultural, and political crisis-discourses at the time. Copyright © 2011 Elsevier Ltd. All rights reserved.

Crisis Communication Plans: Poor Predictors of Excellent Crisis Public Relations.

ERIC Educational Resources Information Center

Marra, Francis J.

1998-01-01

Argues that newly developed theory in crisis public relations suggests a shift is necessary in the way practitioners view crises. Notes that the new paradigm defines excellent crisis public relations very differently from the literature of the past 20 years. (RS)

For Whom the Bell Tolls: Imagining Accidents and the Development of Crisis Simulation in Organizations

ERIC Educational Resources Information Center

Smith, Denis

2004-01-01

This article explores how organizations can prepare for crisis events by training crisis management teams (CMTs) using real-time, simulated crises. The article focuses on the impact of such training on the performance of CMTs and the manner in which such training can improve the capability of the organization to deal with adverse events. The…

Intracerebral Bleeding and Massive Pericardial Effusion as Presenting Symptoms of Myxedema Crisis

PubMed Central

Rimpau, C.; Nickel, C. H.; Baier, P.

2017-01-01

The endocrinological emergency of a fully blown myxedema crisis can present as a multicolored clinical picture. This can obscure the underlying pathology and easily lead to mistakes in clinical diagnosis, work-up, and treatment. We present a case of an unconscious 39-year-old patient with a medical history of weakness, lethargy, and findings of hyponatremia, intracerebral bleeding, and massive pericardial effusion. Finally, myxedema crisis was diagnosed as underlying cause. Replacement therapy of thyroid hormone and conservative management of the intracerebral bleeding resulted in patient's survival without significant neurological impairment. However, diagnostic pericardiocentesis resulted in life-threatening pericardial tamponade. It is of tremendous importance to diagnose myxoedema crisis early to avoid adverse health outcomes. PMID:28255471

[Crisis management in pediatric anesthesia].

PubMed

Takeuchi, Mamoru; Otsuka, Yoji; Taga, Naoyuki; Sato, Yuki; Iwai, Hidetaka; Okada, Osamu

2009-05-01

We describe the risk management of pediatric anesthesia. The most important risk management of pediatric anesthesia is airway and temperature management. Neonates and infants easily become hypoxic due to their insufficient functional residual capacity. Therefore airway management is most important not only during induction of anesthesia but also during maintenance of anesthesia and extubation. The management of patients' temperature, including control of room temperature should be taken into consideration. In addition, careful attention should be paid not to introduce air bubbles in any lines, especially in patients with congenital heart diseases.

[Attempted suicide during the financial crisis in Athens].

PubMed

Stavrianakos, K; Kontaxakis, V; Moussas, G; Paplos, K; Papaslanis, T; Havaki-Kontaxaki, B; Papadimitriou, Gn

2014-01-01

) and 95 in 2011, during the financial crisis (mean age 41.0 years, women 65%). There is an increase of suicide attempts by 35.71%. There were no statistically significant differences between the two periods regarding the gender and age of attempters. There was a statistically significant increase of unemployed (p=0.004), as well as of married/widowed/divorced (p=0.02) suicide attempters during the crisis. There was not statistically significant difference in the severity of suicide attempts before and during the economic crisis or the severity of psychopathology of the attempters. The financial crisis is probably associated with upward trend in attempted suicide of the Athens population. Most affected are those who are unemployed, married, widowed, divorced. Suicide prevention programs are essential for the accurate and timely identification and the immediate and effective management of this special high risk group of attempters during the financial crisis.

The Uses of Crisis: Taking the Tide at the Flood.

ERIC Educational Resources Information Center

Kerchner, Charles T.; Schuster, Jack H.

1982-01-01

Crises can, under certain conditions, be transformed into instruments of organizational good. Undergoing crisis in an organization--calling attention to problems and labeling them as crises--may be a preferable management strategy to coping with prolonged periods of shrinking resources. (MLW)

Intelligence Activities Relating to Iraq Conducted by the Policy Counterterrorism Evaluation Group and the Office of Special Plans within the Office of the Under Secretary of Defense for Policy, together with Additional and Minority Views

DTIC Science & Technology

2008-06-01

The new issue areas included any intelligence activities relating to Iraq conducted by the Policy Counterterrorism Evaluation Group and the Office of...Special Plans within the Office of the Under Secretary of Defense for Policy. The Committee pursued this issue area in 2004, but subsequently the Committee’s attention was placed on other aspects of the terms of reference.

Modified crisis intervention for personality disorder.

PubMed

Rudnick, A

1998-01-01

This study proposes that the goal of crisis intervention for persons with personality disorders should be to return them to their pre-crisis level of functioning, even though this is maladaptive. This is contrasted with standard crisis intervention, which aims to return normal or neurotic persons to their pre-crisis normal or neurotic functioning, usually by means of few and short-term therapeutic encounters. The modification proposed costs more time and resources in persons with personality disorders in crisis and fits the intervention to the personality type. This is illustrated by the case of Eve, a patient in crisis, whose pre-crisis functioning was maladaptive because of a dependent personality disorder. The goal of (modified) crisis intervention in this case was to return the patient to her dependent lifestyle, by means of pharmacotherapy combined with intensive supportive psychotherapy during 3-4 months of partial (day) hospitalization. The special nature of crisis in personality disorders is discussed.

Practical Guide for Emergency Crime Prevention and Penal System Alternatives in Crisis Relocation Planning.

DTIC Science & Technology

1982-09-01

93117____________ 11. CONTROLLING OFFICE NAMIE AND ADDRESS 12. REPORT DATE Federal Emergency Management Agency 21 September 1982 13. NUMBER OF...relocation is the controlled , orderly evacuation of a community that is a possible target for attack by a foreign power. The concept of crisis...SI s Relocation? Crisis relocation is the controlled , orderly evacuation of a comunity which is considered a possible target for foreign attack

Randomised controlled trial of the clinical and cost-effectiveness of a peer-delivered self-management intervention to prevent relapse in crisis resolution team users: study protocol

PubMed Central

Mason, Oliver; Osborn, David; Henderson, Claire; Marston, Louise; Ambler, Gareth; Pilling, Stephen; Morant, Nicola; Gray, Richard; Weaver, Tim; Nolan, Fiona; Lloyd-Evans, Brynmor

2017-01-01

Introduction Crisis resolution teams (CRTs) provide assessment and intensive home treatment in a crisis, aiming to offer an alternative for people who would otherwise require a psychiatric inpatient admission. They are available in most areas in England. Despite some evidence for their clinical and cost-effectiveness, recurrent concerns are expressed regarding discontinuity with other services and lack of focus on preventing future relapse and readmission to acute care. Currently evidence on how to prevent readmissions to acute care is limited. Self-management interventions, involving supporting service users in recognising and managing signs of their own illness and in actively planning their recovery, have some supporting evidence, but have not been tested as a means of preventing readmission to acute care in people leaving community crisis care. We thus proposed the current study to test the effectiveness of such an intervention. We selected peer support workers as the preferred staff to deliver such an intervention, as they are well-placed to model and encourage active and autonomous recovery from mental health problems. Methods and analysis The CORE (CRT Optimisation and Relapse Prevention) self-management trial compares the effectiveness of a peer-provided self-management intervention for people leaving CRT care, with treatment as usual supplemented by a booklet on self-management. The planned sample is 440 participants, including 40 participants in an internal pilot. The primary outcome measure is whether participants are readmitted to acute care over 1 year of follow-up following entry to the trial. Secondary outcomes include self-rated recovery at 4 and at 18 months following trial entry, measured using the Questionnaire on the Process of Recovery. Analysis will follow an intention to treatment principle. Random effects logistic regression modelling with adjustment for clustering by peer support worker will be used to test the primary hypothesis. Ethics

The First 120 Minutes: A Guide to Crisis Management in Education.

ERIC Educational Resources Information Center

Dodds, Dick; Swiniarski, Donna

The first 2 hours following a crisis can determine the public's lasting perception of an educational system or organization. Following the assumption that crises are inevitable, school administrators must be prepared to communicate quickly and accurately to avoid being judged unfairly. This book offers strategies to public-sector educators who are…

The future of the welfare state: crisis myths and crisis realities.

PubMed

Castles, Francis G

2002-01-01

Accounts of the future of the welfare state are often presented in crisis terms. Some commentators identify globalization as a force that has already led to a major retreat by the state and is likely to lead to further downsizing of the public sector. Others see the future burden of an aging population as creating huge public expenditure pressures that can be countered only by increased parsimony in most areas of spending. Although both crisis scenarios contain elements of truth, analysis of recent public expenditure trends shows that both are substantially exaggerated as general representations of likely developments over the next two or three decades. However, unnoticed by most commentators, a real, longer-term crisis is beginning to make itself felt. This crisis arises, in part, from the demographic impact of a cultural transformation in the labor market, in progress for several decades. Extreme scenarios of possible consequences over the next 50 to 100 years include population implosion, mass migration, increasingly dangerous eruptions of right-wing populism, and, possibly, territorial conflict between developed and underdeveloped nations. This is not a crisis of the welfare state but rather a crisis for which the welfare state may be an essential part of the answer. The only way Western societies can lessen the future impact of the ongoing cultural transformation of the labor market is through the redesign of welfare state institutions to confront these new challenges.

Crisis-counselor perceptions of job training, stress, and satisfaction during disaster recovery.

PubMed

Bellamy, Nikki D; Wang, Min Qi; McGee, Lori A; Liu, Julie S; Robinson, Maryann E

2018-05-03

The United States Crisis Counseling Assistance and Training Program (CCP; authorized by the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 1974/2013) aims to provide disaster-recovery support to communities following natural or human-caused disasters through outreach. Job satisfaction among the crisis counselors the CCP employs may affect the delivery of outreach services to survivors and their communities. The present study was conducted to gain insight into CCP crisis counselors' experiences with job training and work-related stress as predictors of job satisfaction. Data was collected from 47 CCP service-provider agencies, including 532 completed service-provider feedback surveys to examine the usefulness of the CCP training they had received, the support and supervision provided by program management, the workload and its duration, resources provided, and the stress experienced. Quantitative and qualitative data were examined, and a multiple linear regression was calculated to predict job satisfaction based on training usefulness, job stress, gender, age, race, full- or part-time status, highest level of education achieved, and supervisory position. The overall regression equation was significant, F(8, 341) = 8.428, p < .000. The regression coefficients indicated that the higher the job training was rated as useful (p < .001), the lower the job stress (p < .01), and the older the age of the respondents (p < .05), the greater the level of job satisfaction. Findings suggest that proper training and management of stress among crisis counselors are necessary for influencing levels of staff job satisfaction. Where self-care and stress management were not adequately emphasized, more stress was reported. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

[Hypertensive crisis in kidney patients].

PubMed

Scrivano, Jacopo; Giuliani, Anna; Pettorini, Laura; Punzo, Giorgio; Mene', Paolo; Pirozzi, Nicola

2011-01-01

The classification and management of hypertensive crisis have been recently reviewed in the context of both European and American guidelines. The key points for proper blood pressure control in severe arterial hypertension are: 1 - Distinction between urgent intervention and emergencies 2 - Choice of the best drug(s) 3 - Choice of the correct route of administration. In patients with renal disease, beside the common causes of hypertension/ hypertensive crises, kidney-specific causes should be taken into account such as renal parenchymal hypertension, renovascular hypertension, sclerodermic crises, and preeclampsia.

Out of the healthcare crisis.

PubMed

Siriwardena, A Niroshan

2011-01-01

W Edwards Deming's Out of the Crisis, was first published almost three decades ago.(1) It was a bestseller and remains a classic text written by one of the foremost quality improvement experts of the 20th century. It is a book which certainly warrants re-examination in light of today's challenges for health care. This discussion paper reviews what Deming can teach us about causes of failure in management, including health care, what can be done to remedy them and how to avert problems in future.

Economic crisis and challenges for the Greek healthcare system: the emergent role of nursing management.

PubMed

Notara, Venetia; Koupidis, Sotirios A; Vaga, Elissavet; Grammatikopoulos, Ilias A

2010-07-01

Despite several reform efforts, the Greek health care system still faces problems related to misdistribution of trained health staff and finance between geographical areas. The objectives of the present study were to describe the current situation of the delivery of the healthcare service in Greece, to explore the basic implications of the economic crisis from a nursing management perspective and to examine future practices opening a debate in policy developments. The principal finding of this study was the serious shortage of trained nurses, the imbalances in nursing personnel, an excess of doctors and the complete absence of a Primary Healthcare System in civil areas provided by general doctors. It is important that health care policy makers become aware and seriously consider rearranging the Health Care System to become more effective and efficient for the population (client). Special attention should be paid to strengthening areas such as primary health care, public health and health promotion in the direction of minimizing the demand of hospital services. Any implementation of major health care reforms should consider seriously the role of the nursing management which formulates the substantial link between the health services and the patient.

JSA guideline for the management of malignant hyperthermia crisis 2016.

PubMed

2017-04-01

Malignant hyperthermia (MH) can be fatal if the crisis is not appropriately treated. It is an inherited disease usually triggered by the administration of volatile inhalational anesthetics and/or succinylcholine, a muscle relaxant. In a patient with suspected MH, the mechanism of calcium release from storage in the sarcoplasmic reticulum in the skeletal muscle is abnormally accelerated. Unexplained hypercarbia representing >55 mmHg of end-tidal carbon dioxide, tachycardia, and muscle rigidity (including masseter muscle rigidity) are early signs of the initiation of MH, because the metabolism is accelerated. The body temperature can rise by >0.5 °C/15 min and may reach ≥40 °C. Respiratory and metabolic acidosis, arrhythmia, cola-colored urine, increased levels of serum potassium, and tented T-waves on electrocardiogram are common and can lead to cardiac arrest. MH should be treated by discontinuation of the triggering agents, administration of intravenous dantrolene (initially 1 mg/kg), and reduction of the body temperature. Early diagnosis and sufficient dantrolene with body temperature reduction are essential to relieve the patient's MH crisis. This guideline in Japanese translation has been posted on the website: http://www.anesth.or.jp/guide/pdf/guideline_akuseikounetsu.pdf .

Chaos and Crisis: Propositions for a General Theory of Crisis Communication.

ERIC Educational Resources Information Center

Seeger, Matthew W.

2002-01-01

Presents key concepts of chaos theory (CT) as a general framework for describing organizational crisis and crisis communication. Discusses principles of predictability, sensitive dependence on initial conditions, bifurcation as system breakdown, emergent self-organization, and fractals and strange attractors as principles of organization. Explores…

Socio economic crisis and mortality. Epidemiological testimony of the financial collapse of Argentina.

PubMed

Gurfinkel, Enrique P; Bozovich, Gerardo E; Dabbous, Omar; Mautner, Branco; Anderson, Frederick

2005-12-13

Natural disasters, war, and terrorist attacks, have been linked to cardiac mortality. We sought to investigate whether a major financial crisis may impact on the medical management and outcomes of acute coronary syndromes. We analyzed the Argentine cohort of the international multicenter Global Registry of Acute Coronary Events (GRACE). The primary objective was to estimate if there was an association between the financial crisis period (April 1999 to December 2002) and in- hospital cardiovascular mortality, with the post-crisis period (January 2003 to September 2004) as the referent. Each period was defined according to the evolution of the Gross Domestic Product. We investigated the demographic characteristics, diagnostic and therapeutic procedures, morbidity and mortality. We analyzed data from 3220 patients, 2246 (69.8%) patients in the crisis period and 974 (30.2%) in the post-crisis frame. The distribution of demographic and clinical baseline characteristics were not significantly different between both periods. During the crisis period the incidence of in-hospital myocardial infarction was higher (6.9% Vs 2.9%; p value < 0.0001), as well as congestive heart failure (16% Vs 11%; p value < 0.0001). Time to intervention with angioplasty was longer during the crisis, especially among public sites (median 190 min Vs 27 min). The incidence proportion of mortality during hospitalization was 6.2% Vs 5.1% after crisis. The crude OR for mortality was 1.2 (95% C.I. 0.87, 1.7). The odds for mortality were higher among private institutions {1.9 (95% C.I. 0.9, 3.8)} than for public centers {1.2 (95% C.I. 0.83, 1.79)}. We did not observe a significant interaction between type of hospital and crisis. Our findings suggest that the financial crisis may have had a negative impact on cardiovascular mortality during hospitalization, and higher incidence of medical complications.

Socio economic crisis and mortality. Epidemiological testimony of the financial collapse of Argentina

PubMed Central

Gurfinkel, Enrique P; Bozovich, Gerardo E; Dabbous, Omar; Mautner, Branco; Anderson, Frederick

2005-01-01

Background Natural disasters, war, and terrorist attacks, have been linked to cardiac mortality. We sought to investigate whether a major financial crisis may impact on the medical management and outcomes of acute coronary syndromes. Methods We analyzed the Argentine cohort of the international multicenter Global Registry of Acute Coronary Events (GRACE). The primary objective was to estimate if there was an association between the financial crisis period (April 1999 to December 2002) and in- hospital cardiovascular mortality, with the post-crisis period (January 2003 to September 2004) as the referent. Each period was defined according to the evolution of the Gross Domestic Product. We investigated the demographic characteristics, diagnostic and therapeutic procedures, morbidity and mortality. Results We analyzed data from 3220 patients, 2246 (69.8%) patients in the crisis period and 974 (30.2%) in the post-crisis frame. The distribution of demographic and clinical baseline characteristics were not significantly different between both periods. During the crisis period the incidence of in-hospital myocardial infarction was higher (6.9% Vs 2.9%; p value < 0.0001), as well as congestive heart failure (16% Vs 11%; p value < 0.0001). Time to intervention with angioplasty was longer during the crisis, especially among public sites (median 190 min Vs 27 min). The incidence proportion of mortality during hospitalization was 6.2% Vs 5.1% after crisis. The crude OR for mortality was 1.2 (95% C.I. 0.87, 1.7). The odds for mortality were higher among private institutions {1.9 (95% C.I. 0.9, 3.8)} than for public centers {1.2 (95% C.I. 0.83, 1.79)}. We did not observe a significant interaction between type of hospital and crisis. Conclusion Our findings suggest that the financial crisis may have had a negative impact on cardiovascular mortality during hospitalization, and higher incidence of medical complications. PMID:16351728

Care management of the agitation or aggressiveness crisis in patients with TBI. Systematic review of the literature and practice recommendations.

PubMed

Luauté, Jacques; Plantier, David; Wiart, Laurent; Tell, Laurence

2016-02-01

The agitation crisis in the awakening phase after traumatic brain injury (TBI) is one of the most difficult behavioral disorders to alleviate. Current treatment options are heterogeneous and may involve excessive sedation. Practice guidelines are required by professionals in charge of TBI patients. Few reviews were published but those are old and based on expert opinions. The purpose of this work is to propose evidence-based guidelines to treat the agitation crisis. The elaboration of these guidelines followed the procedure validated by the French health authority for good practice recommendations, close to the Prisma statement. Guidelines were elaborated on the basis of a systematic and critical review of the literature. Twenty-eight articles concerning 376 patients were analyzed. Recommendations are: when faced with an agitation crisis, the management strategy implies to search for an underlying factor that should be treated such as pain, acute sepsis, and drug adverse effect (expert opinion). Physical restraints should be discarded when possible (expert opinion). Neuroleptic agent with a marketing authorization can be used in order to obtain a quick sedation so as to protect the patient from himself, closed ones or the healthcare team but the duration should be as short as possible (expert opinion). The efficacy of beta-blockers and antiepileptics with mood regulation effects like carbamazepine and valproate yield the most compelling evidence and should be preferably used when a background regimen is envisioned (grade B for beta-blocker and C for antiepileptics). Neuroleptics, antidepressants, benzodiazepines, buspirone may be prescribed but are considered second-line treatments (expert opinion). This study provides a strategy for treating the agitation crisis based on scientific data and expert opinion. The level of evidence remains low and published data are often old. New studies are essential to validate results from previous studies and test new drugs and

Principles to enable leaders to navigate the harsh realities of crisis and risk communication.

PubMed

Reynolds, Barbara J

2010-07-01

Leadership during a crisis that involves the physical safety and emotional or financial wellbeing of those being led offers an intense environment that may not allow for on-the-job training. One of the challenges faced by crisis leaders is to communicate effectively the courses of action needed to allow for a reduction of harm to individuals and the ultimate restoration of the group, organisation or community. The six principles of crisis and emergency risk communication (CERC) give leaders tools to navigate the harsh realities of speaking to employees, media, partners and stakeholders during an intense crisis. CERC also helps leaders to avoid the five most common communication mistakes during crises. Much of the harmful individual and group behaviour predicted in a profound crisis can be mitigated with effective crisis and emergency risk communication. A leader must anticipate what mental stresses followers will be experiencing and apply appropriate communication strategies to attempt to manage these stresses among staff or the public and preserve or repair the organisation's reputation. In an emergency, the right message at the right time is a 'resource multiplier' - it helps leaders to get their job done.

Telephone Crisis Support Workers' Intentions to Use Recommended Skills While Experiencing Functional Impairment.

PubMed

Kitchingman, Taneile A; Wilson, Coralie J; Woodward, Alan; Caputi, Peter; Wilson, Ian

2018-05-01

Empathic engagement with distressed others can lead to elevated symptoms of psychological distress and functional impairment, which preclude helping professionals' delivery of optimal patient care. Whether telephone crisis support workers are impacted in a similar way is not currently reported in the literature. This study examined the relationship between functional impairment and intentions to use recommended support skills in a representative national sample of 210 telephone crisis support workers. Participants completed an online survey including measures of functional impairment and intentions to use recommended telephone crisis support skills with callers reporting suicidal ideation, symptoms of depression, and anxiety. As a group, participants who experienced greater functional impairment during the past month reported significantly lower intentions to use recommended support skills with callers than those who reported lower functional impairment. Future research is needed to clarify the extent to which results generalize to telephone crisis support workers from other organizations. Results warrant further research to (a) identify determinants of telephone crisis support workers' functional impairment, and (b) for the deliberate management of telephone crisis support workers' functional impairment through developing and/or modifying existing service strategies to optimize workers' psychological well-being and delivery of support to callers.

Geography's Image Crisis.

ERIC Educational Resources Information Center

Hudson, John C.

1984-01-01

If geography faces a crisis today, it is an inner crisis that has come from listening to those who advocate aggrandizement rather than accomplishment. Geographers should devote no more time than necessary to the business of selling themselves and, instead, produce the kind of scholarship that commands attention. (RM)

Addressing challenges of clinical trials in acute pain: The Pain Management of Vaso-occlusive Crisis in Children and Young Adults with Sickle Cell Disease Study.

PubMed

Nottage, Kerri A; Hankins, Jane S; Faughnan, Lane G; James, Dustin M; Richardson, Julie; Christensen, Robbin; Kang, Guolian; Smeltzer, Matthew; Cancio, Maria I; Wang, Winfred C; Anghelescu, Doralina L

2016-08-01

Neuropathic pain is a known component of vaso-occlusive pain in sickle cell disease; however, drugs targeting neuropathic pain have not been studied in this population. Trials of acute pain are complicated by the need to obtain consent, to randomize participants expeditiously while optimally treating pain. We describe the challenges in designing and implementing the Pain Management of Vaso-occlusive Crisis in Children and Young Adults with Sickle Cell Disease Study (NCT01954927), a phase II, randomized, double-blind, placebo-controlled trial to determine the effect of gabapentin for vaso-occlusive crisis. In the Pain Management of Vaso-occlusive Crisis in Children and Young Adults with Sickle Cell Disease Study, we aim to assess the analgesic effect of gabapentin during vaso-occlusive crisis. Difficulties we identified included avoiding delay of notification of study staff of potential participants which we resolved by automated notification. Concern for rapid randomization and drug dispensation was addressed through careful planning with an investigational pharmacy and a single liquid formulation. We considered obtaining consent during well-visits to avoid the time constraints with acute presentations, but the large number of patients and limited duration that consent is valid made this impractical. In all, 79% of caregivers/children approached have agreed to participate. The trial is currently active, and enrollment is at 45.8% of that targeted (76 of 166) and expected to continue for two more years. Maintaining staff availability after-hours remains problematic, with 8% of screened patients missed for lack of available staff. Lessons learned in designing a trial to expedite procedures in the acute pain setting include (1) building study evaluations upon a standard-of-care backbone; (2) implementing a simple study design to facilitate consent and data capture; (3) assuring ample, well-trained study staff; and (4) utilizing technology to automate procedures

The health crisis in Argentina.

PubMed

Escudero, José Carlos

2003-01-01

The health crisis in Argentina is part of the larger crisis that has resulted from a collapse in the country's economic and political systems. After a brief review of the country's history over the last century, from international success story to economic failure, the author explains the health crisis in particular and the social crisis in general in terms of failed neoliberal policies imposed on Argentina by the United States and International Monetary Fund through the mediation of the country's political class.

Management of the acute painful crisis in sickle cell disease- a re-evaluation of the use of opioids in adult patients.

PubMed

Telfer, Paul; Bahal, Nawal; Lo, Alice; Challands, Joanne

2014-07-01

Management of the acute painful crisis (APC) of sickle cell disease (SCD) remains unsatisfactory despite advances in the understanding and management of acute pain in other clinical settings. One reason for this is an unsophisticated approach to the use of opioid analgesics for pain management. This applies to haematologists who are responsible for developing acute sickle pain management protocols for their patients, and to health care staff in the acute care setting. The objective of this article is to evaluate the evidence for use of opioids in APC management. We have highlighted the possibilities for improving management by using alternatives to morphine, and intranasal (IN) or transmucosal routes of administration for rapid onset of analgesia in the emergency department (ED). We suggest how experience gained in managing acute sickle pain in children could be extrapolated to adolescents and young adults. We have also questioned whether patients given strong opioids in the acute setting are being safely monitored and what resources are required to ensure efficacy, safety and patient satisfaction. We also identify aspects of care where there are significant differences of opinion, which require further study by randomized controlled trial. © 2014 John Wiley & Sons Ltd.

US health care crisis.

PubMed

Cirić, Ivan

2013-01-01

The United States health care is presently challenged by a significant economic crisis. The purpose of this report is to introduce the readers of Medicinski Pregled to the root causes of this crisis and to explain the steps undertaken to reform health care in order to solve the crisis. It is hoped that the information contained in this report will be of value, if only in small measure, to the shaping of health care in Serbia.

Keeping Cool in a Crisis

ERIC Educational Resources Information Center

Padgett, Raven

2006-01-01

Many schools are able to avoid disasters by creating a strong, deliberate crisis plan and knowing how to implement it effectively. Good crisis preparedness requires leadership from the top, a critical mass of trained staff members, careful planning, and excellent communication. This article discusses how to prepare for a crisis.

The Achievement Crisis Is Real: A Review of "The Manufactured Crisis."

ERIC Educational Resources Information Center

Stedman, Lawrence C.

1996-01-01

In "The Manufactured Crisis," D. Berliner and B. Biddle argue that there has been no decline in achievement test scores, that today's students outperform their parents and do well in international examinations, and that the supposed crisis in American education does not exist. This review refutes all these claims. (SLD)

Revisiting Communication during a Crisis: Insights from Kenneth Trump

ERIC Educational Resources Information Center

Kowalski, Theodore J.

2005-01-01

In the aftermath of several tragic incidents of school violence, school administrators began focusing more directly on crisis management. Those who actually had to activate their plans often discovered that communication--with the media and with the general community--was one of the most challenging tasks they faced. In an effort to determine if…

Hypertensive crisis.

PubMed

Rodriguez, Maria Alexandra; Kumar, Siva K; De Caro, Matthew

2010-01-01

Hypertension is a common chronic medical condition affecting over 65 million Americans. Uncontrolled hypertension can progress to a hypertensive crisis defined as a systolic blood pressure >180 mm Hg or a diastolic blood pressure >120 mm Hg. Hypertensive crisis can be further classified as a hypertensive urgency or hypertensive emergency depending on end-organ involvement including cardiac, renal, and neurologic injury. The prompt recognition of a hypertensive emergency with the appropriate diagnostic tests and triage will lead to the adequate reduction of blood pressure, ameliorating the incidence of fatal outcomes. Severely hypertensive patients with acute end-organ damage (hypertensive emergencies) warrant admission to an intensive care unit for immediate reduction of blood pressure with a short-acting titratable intravenous antihypertensive medication. Hypertensive urgencies (severe hypertension with no or minimal end-organ damage) may in general be treated with oral antihypertensives as an outpatient. Rapid and short-lived intravenous medications commonly used are labetalol, esmolol, fenoldopam, nicardipine, sodium nitroprusside, and clevidipine. Medications such as hydralazine, immediate release nifedipine, and nitroglycerin should be avoided. Sodium nitroprusside should be used with caution because of its toxicity. The risk factors and prognosticators of a hypertensive crisis are still under recognized. Physicians should perform complete evaluations in patients who present with a hypertensive crisis to effectively reverse, intervene, and correct the underlying trigger, as well as improve long-term outcomes after the episode.

Creativity in Crisis.

ERIC Educational Resources Information Center

Roff, Glenn

This paper suggests that educational resources and opportunities currently in operation in rural Australia are brought forward during times of crisis. The paper discusses five aspects of education in rural Australia that are a response to the perceived sense of crisis and that have improved the general and comparative quality of rural education,…

The Reform Movement and the Quiet Crisis in Gifted Education.

ERIC Educational Resources Information Center

Renzulli, Joseph S.; Reis, Sally M.

1991-01-01

Gifted education faces a quiet crisis as reform movements focus on cosmetic administrative changes in school organization and management rather than interaction among teachers, students, and the material to be learned. Two goals of American education are presented: providing the best possible education to promising students and improving the…

Sins of the Father: Revisiting Best Practices of Public Relations and Crisis Management through Case Study Analysis

ERIC Educational Resources Information Center

Hancox, Melissa K. Gibson; Allen, Jennifer R.

2007-01-01

This article examines a 2004 crisis event that occurred when the president of a small private Catholic college was accused of sexually molesting boys earlier in his career. It discusses the crisis response of college officials with the institution's various publics, including students, faculty, alumni, and the media. Our purpose is twofold. First,…

When Crisis Strikes on Campus.

ERIC Educational Resources Information Center

Larson, Wendy Ann, Ed.

This handbook aids in planning for effective crisis communication at institutions of higher education. The book opens with a behind-the-scenes look at a particular crisis--the 1990 murders of five students at the University of Florida. This first section offers tested advice from a campus communicator, an account of the crisis and the…

Crisis in the Curriculum? New Counselors' Crisis Preparation, Experiences, and Self-Efficacy

ERIC Educational Resources Information Center

Morris, Carrie A. Wachter; Minton, Casey A. Barrio

2012-01-01

Professional counselors are responsible for providing crisis assessment, referral, and intervention (Council for Accreditation of Counseling and Related Educational Programs, 2009); however, little is known about their preparation and experiences in these areas. This study examined new professional counselors' (N= 193) crisis intervention…

Modeling social crowds. Comment on "Human behaviours in evacuation crowd dynamics: From modelling to "big data" toward crisis management" by Nicola Bellomo et al.

NASA Astrophysics Data System (ADS)

Poyato, David; Soler, Juan

2016-09-01

The study of human behavior is a complex task, but modeling some aspects of this behavior is an even more complicated and exciting idea. From crisis management to decision making in evacuation protocols, understanding the complexity of humans in stress situations is more and more demanded in our society by obvious reasons [5,6,8,12]. In this context, [4] deals with crowd dynamics with special attention to evacuation.

Randomised controlled trial of the clinical and cost-effectiveness of a peer-delivered self-management intervention to prevent relapse in crisis resolution team users: study protocol.

PubMed

Johnson, Sonia; Mason, Oliver; Osborn, David; Milton, Alyssa; Henderson, Claire; Marston, Louise; Ambler, Gareth; Hunter, Rachael; Pilling, Stephen; Morant, Nicola; Gray, Richard; Weaver, Tim; Nolan, Fiona; Lloyd-Evans, Brynmor

2017-10-27

Crisis resolution teams (CRTs) provide assessment and intensive home treatment in a crisis, aiming to offer an alternative for people who would otherwise require a psychiatric inpatient admission. They are available in most areas in England. Despite some evidence for their clinical and cost-effectiveness, recurrent concerns are expressed regarding discontinuity with other services and lack of focus on preventing future relapse and readmission to acute care. Currently evidence on how to prevent readmissions to acute care is limited. Self-management interventions, involving supporting service users in recognising and managing signs of their own illness and in actively planning their recovery, have some supporting evidence, but have not been tested as a means of preventing readmission to acute care in people leaving community crisis care. We thus proposed the current study to test the effectiveness of such an intervention. We selected peer support workers as the preferred staff to deliver such an intervention, as they are well-placed to model and encourage active and autonomous recovery from mental health problems. The CORE (CRT Optimisation and Relapse Prevention) self-management trial compares the effectiveness of a peer-provided self-management intervention for people leaving CRT care, with treatment as usual supplemented by a booklet on self-management. The planned sample is 440 participants, including 40 participants in an internal pilot. The primary outcome measure is whether participants are readmitted to acute care over 1 year of follow-up following entry to the trial. Secondary outcomes include self-rated recovery at 4 and at 18 months following trial entry, measured using the Questionnaire on the Process of Recovery. Analysis will follow an intention to treatment principle. Random effects logistic regression modelling with adjustment for clustering by peer support worker will be used to test the primary hypothesis. The CORE self-management trial was approved

["Crisis"--oscillating between keyword and buzzword. On the discourse about a "crisis of medicine" in the Weimar Republic].

PubMed

Geiger, Karin

2010-01-01

The buzzword "crisis" has not only become omnipresent since the recent financial crisis. The term that originated in Ancient Greece underwent several different usages--quantitatively as well as qualitatively; especially in the Weimar Republic, the time period that has long been considered as the crisis era par excellence. Using the discourse about the "crisis of medicine" in the 1920s and the early 1930s as an example, the article attempts to provide a critical reflection on the concept of "crisis". The focus of this article is on the idea's construction, the different semantic usages of "crisis" and the motives of the different authors for their respective rhetorical applications of this term. The analysis of the examined publications on the "crisis of medicine", how they influenced other periods and the reconstruction of their origin show that the semantics of the word "crisis" went far beyond a simply negative connotation, and with regard to its rhetorical usage have oscillated between keyword and a meaningless but catchy buzzword.

Talking to Parents: Communication in Times of Crisis and Beyond.

ERIC Educational Resources Information Center

Wendell, Charlene

2002-01-01

Camps should always have a crisis management plan, but the events of September 11, 2001, make it especially important. Honest communication with parents is paramount--directors should choose their words carefully and control the tone of their voices. Examples are given of crises involving weather, transportation, and a shooting. Questions to…

Crisis management during anaesthesia: embolism

PubMed Central

Williamson, J; Helps, S; Westhorpe, R; Mackay, P

2005-01-01

Background: Embolism with gas, thrombus, fat, amniotic fluid, or particulate matter may occur suddenly and unexpectedly during anaesthesia, posing a diagnostic and management problem for the anaesthetist. Objectives: To examine the role of a previously described core algorithm "COVER ABCD–A SWIFT CHECK" supplemented by a specific sub-algorithm for embolism, in the management of embolism occurring in association with anaesthesia. Methods: The potential performance of this structured approach for each of the relevant incidents among the first 4000 reported to the Australian Incident Monitoring Study (AIMS) was compared with the actual management as reported by the anaesthetists involved. Results: Among the first 4000 incidents reported to AIMS, 38 reports of embolism were found. A sudden fall in end-tidal carbon dioxide and oxygen saturation were the cardinal signs of embolism, each occurring in about two thirds of cases, with hypotension and electrocardiographic changes each occurring in about one third of cases. Conclusion: The potential value of an explicit structured approach to the diagnosis and management of embolism was assessed in the light of AIMS reports. It was considered that, correctly applied, it potentially would have led to earlier recognition of the problem and/or better management in over 40% of cases. PMID:15933290

The Managing Emergencies in Paediatric Anaesthesia global rating scale is a reliable tool for simulation-based assessment in pediatric anesthesia crisis management.

PubMed

Everett, Tobias C; Ng, Elaine; Power, Daniel; Marsh, Christopher; Tolchard, Stephen; Shadrina, Anna; Bould, Matthew D

2013-12-01

The use of simulation-based assessments for high-stakes physician examinations remains controversial. The Managing Emergencies in Paediatric Anaesthesia course uses simulation to teach evidence-based management of anesthesia crises to trainee anesthetists in the United Kingdom (UK) and Canada. In this study, we investigated the feasibility and reliability of custom-designed scenario-specific performance checklists and a global rating scale (GRS) assessing readiness for independent practice. After research ethics board approval, subjects were videoed managing simulated pediatric anesthesia crises in a single Canadian teaching hospital. Each subject was randomized to two of six different scenarios. All 60 scenarios were subsequently rated by four blinded raters (two in the UK, two in Canada) using the checklists and GRS. The actual and predicted reliability of the tools was calculated for different numbers of raters using the intraclass correlation coefficient (ICC) and the Spearman-Brown prophecy formula. Average measures ICCs ranged from 'substantial' to 'near perfect' (P ≤ 0.001). The reliability of the checklists and the GRS was similar. Single measures ICCs showed more variability than average measures ICC. At least two raters would be required to achieve acceptable reliability. We have established the reliability of a GRS to assess the management of simulated crisis scenarios in pediatric anesthesia, and this tool is feasible within the setting of a research study. The global rating scale allows raters to make a judgement regarding a participant's readiness for independent practice. These tools may be used in the future research examining simulation-based assessment. © 2013 John Wiley & Sons Ltd.

The Crisis Map of the Czech Republic: the nationwide deployment of an Ushahidi application for disasters.

PubMed

Pánek, Jiří; Marek, Lukáš; Pászto, Vít; Valůch, Jaroslav

2017-10-01

Crisis mapping is a legitimate component of both crisis informatics and disaster risk management. It has become an effective tool for humanitarian workers, especially after the earthquake in Haiti in 2010. Ushahidi is among the many mapping platforms on offer in the growing field of crisis mapping, and involves the application of crowdsourcing to create online and interactive maps of areas in turmoil. This paper presents the Crisis Map of the Czech Republic, which is the first such instrument to be deployed nationwide in Central Europe. It describes the methodologies used in the preparatory work phase and details some practices identified during the creation and actual employment of the map. In addition, the paper assesses its structure and technological architecture, as well as its potential possible development in the future. Lastly, it evaluates the utilisation of the Crisis Map during the floods in the Czech Republic in 2013. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

Economic crisis and blood donation: How are donors' motivations changing?

PubMed

Alfieri, Sara; Guiddi, Paolo; Marta, Elena; Saturni, Vincenzo

2016-06-01

The economic crisis has exasperated people's feelings of loneliness; job instability often does not allow people to commit to voluntary work. The present work proposes to examine whether the motivations to donate blood have changed before and during the period of economic crisis, taking into consideration donors' gender. We adopted Omoto & Snyder's functionalist approach, which states that blood donation serves different functions for any one person, who may have different motivations from those held by other people. We compared six-year pre-post (t1 "pre-crisis": 2008 - t2 "during the crisis": 2014) data on a sample of blood donors in a single blood donation center situated in Northern Italy. T-test was used for data analysis. Three hundred thirty donors (age range 18-60, M = 32.6, SD = 9.53; 54.5% male) were administered a survey at t1 and 444 (age range 18-60, M = 37.8, SD = 10.16; 68% male) six years later at t2. In both surveys, participants were administered a questionnaire with socio-demographic items and a version of Omoto & Snyder's Motivations to Volunteer scale adapted to blood donation. Donors' motivation priorities did not vary over time. Values and Self-enhancement motivations are the most prevalent. Knowledge and Ego-protection motivations decreased with the upsurge of the crisis. Women, in general, report higher mean values than men do for Values and Ego-protection motivations. These results can offer valuable clues for the agencies that manage blood collection. Copyright © 2016. Published by Elsevier Ltd.

Evaluating multidisciplinary health care teams: taking the crisis out of CRM.

PubMed

Sutton, Gigi

2009-08-01

High-reliability organisations are those, such as within the aviation industry, which operate in complex, hazardous environments and yet despite this are able to balance safety and effectiveness. Crew resource management (CRM) training is used to improve the non-technical skills of aviation crews and other high-reliability teams. To date, CRM within the health sector has been restricted to use with "crisis teams" and "crisis events". The purpose of this discussion paper is to examine the application of CRM to acute, ward-based multidisciplinary health care teams and more broadly to argue for the repositioning of health-based CRM to address effective everyday function, of which "crisis events" form just one part. It is argued that CRM methodology could be applied to evaluate ward-based health care teams and design non-technical skills training to increase their efficacy, promote better patient outcomes, and facilitate a range of positive personal and organisational level outcomes.

Development of a peer-supported, self-management intervention for people following mental health crisis.

PubMed

Milton, Alyssa; Lloyd-Evans, Brynmor; Fullarton, Kate; Morant, Nicola; Paterson, Bethan; Hindle, David; Kelly, Kathleen; Mason, Oliver; Lambert, Marissa; Johnson, Sonia

2017-11-09

A documented gap in support exists for service users following discharge from acute mental health services, and structured interventions to reduce relapse are rarely provided. Peer-facilitated self-management interventions have potential to meet this need, but evidence for their effectiveness is limited. This paper describes the development of a peer-provided self-management intervention for mental health service users following discharge from crisis resolution teams (CRTs). A five-stage iterative mixed-methods approach of sequential data collection and intervention development was adopted, following the development and piloting stages of the MRC framework for developing and evaluating complex interventions. Evidence review (stage 1) included systematic reviews of both peer support and self-management literature. Interviews with CRT service users (n = 41) regarding needs and priorities for support following CRT discharge were conducted (stage 2). Focus group consultations (n = 12) were held with CRT service-users, staff and carers to assess the acceptability and feasibility of a proposed intervention, and to refine intervention organisation and content (stage 3). Qualitative evaluation of a refined, peer-provided, self-management intervention involved qualitative interviews with CRT service user participants (n = 9; n = 18) in feasibility testing (stage 4) and a pilot trial (stage 5), and a focus group at each stage with the peer worker providers (n = 4). Existing evidence suggests self-management interventions can reduce relapse and improve recovery. Initial interviews and focus groups indicated support for the overall purpose and planned content of a recovery-focused self-management intervention for people leaving CRT care adapted from an existing resource: The personal recovery plan (developed by Repper and Perkins), and for peer support workers (PSWs) as providers. Participant feedback after feasibility testing was positive regarding facilitation of

The Annual Third-Year Resident Rampage: A Separation Crisis of Manageable Proportions.

ERIC Educational Resources Information Center

Merkel, William T.; Walbroehl, Gordon S.

1980-01-01

Third-year residents nearing completion of their training and preparing to leave for independent practice often appear to experience anxieties that suggest a form of separation crisis. Their negative behavior may be a way of making the old milieu less welcoming and thus easier to leave. Advice for easing the transition is offered. (JMD)

Treating Chronic Crisis Bearers and Their Families

ERIC Educational Resources Information Center

Doyle, Averil Marie; Dorlac, Charles

1978-01-01

This article presents a method for family crisis intervention. The goal is extended from restoring the crisis bearing unit to its pre-crisis level of coping to a basic restructuring of maladaptive pre-crisis behaviors. It is aimed at general behavior change as well as resolution of the immediate situation. (Author)

Crisis response to schools.

PubMed

Johnson, K

2000-01-01

While community based crisis response teams offer needed resources to schools impacted by crisis, they are often not asked to help. Reports from crisis team leaders at the school shooting incidents at James W. Parker Middle School, Edinboro, Pennsylvania and Columbine High School, Littleton, Colorado are contrasted regarding utilization of community resources. Factors limiting the usefulness of community based teams include unfamiliarity with school organization, culture, and procedures. Key differences in school vs. community team precepts, decision-making, and strategic paradigms render team coordination difficult. Successful cross training presents opportunities for school-community partnership and utilization of community teams for school duty.

The disruption management model.

PubMed

McAlister, James

2011-10-01

Within all organisations, business continuity disruptions present a set of dilemmas that managers may not have dealt with before in their normal daily duties. The disruption management model provides a simple but effective management tool to enable crisis management teams to stay focused on recovery in the midst of a business continuity incident. The model has four chronological primary headlines, which steer the team through a quick-time crisis decision-making process. The procedure facilitates timely, systematic, rationalised and justified decisions, which can withstand post-event scrutiny. The disruption management model has been thoroughly tested within an emergency services environment and is proven to significantly support clear and concise decision making in a business continuity context.

Pediatric crisis resource management training improves emergency medicine trainees' perceived ability to manage emergencies and ability to identify teamwork errors.

PubMed

Bank, Ilana; Snell, Linda; Bhanji, Farhan

2014-12-01

Improved pediatric crisis resource management (CRM) training is needed in emergency medicine residencies because of the variable nature of exposure to critically ill pediatric patients during training. We created a short, needs-based pediatric CRM simulation workshop with postactivity follow-up to determine retention of CRM knowledge. Our aims were to provide a realistic learning experience for residents and to help the learners recognize common errors in teamwork and improve their perceived abilities to manage ill pediatric patients. Residents participated in a 4-hour objectives-based workshop derived from a formal needs assessment. To quantify their subjective abilities to manage pediatric cases, the residents completed a postworkshop survey (with a retrospective precomponent to assess perceived change). Ability to identify CRM errors was determined via a written assessment of scripted errors in a prerecorded video observed before and 1 month after completion of the workshop. Fifteen of the 16 eligible emergency medicine residents (postgraduate year 1-5) attended the workshop and completed the surveys. There were significant differences in 15 of 16 retrospective pre to post survey items using the Wilcoxon rank sum test for non-parametric data. These included ability to be an effective team leader in general (P < 0.008), delegating tasks appropriately (P < 0.009), and ability to ensure closed-loop communication (P < 0.008). There was a significant improvement in identification of CRM errors through the use of the video assessment from 3 of the 12 CRM errors to 7 of the 12 CRM errors (P < 0.006). The pediatric CRM simulation-based workshop improved the residents' self-perceptions of their pediatric CRM abilities and improved their performance on a video assessment task.

The Crisis "Hotline" as Mediated Therapeutic Communication.

ERIC Educational Resources Information Center

Fish, Sandra L.

Hotlines, or telephone crisis-lines, begun in the 1960s and currently numbering in the hundreds provide assistance to callers in crisis, frequently around the clock. Crisis-line communication can be seen as a form of mediated therapeutic communication premised on the existence of a crisis and the medium of the telephone which shapes the…

Sleep America: managing the crisis of adult chronic insomnia and associated conditions.

PubMed

Kraus, Stefanie S; Rabin, Laura A

2012-05-01

Chronic insomnia, a public health crisis affecting 10-15% of the U.S. population and costing billions of dollars annually, typically presents with one or more comorbid psychiatric or organic conditions. Historical classification of chronic insomnia as "secondary" to a presenting comorbid condition has resulted in under-recognition and under-treatment of both the insomnia and comorbid condition(s). Though critical in any model of comorbid disease management, chronic insomnia receives little, if any, public policy attention. We conducted a systematic review of recent empirical studies, review papers, books, government documents, press releases, advertisements, and articles pertaining to the classification, epidemiology, treatment, and physiology of sleep, insomnia, and comorbid conditions. Data were located primarily through MEDLINE, PsycINFO, SCOPUS, and PUBMED databases. Our goal was to provide an overview of the systems for classifying insomnia and available epidemiological data, and to review theoretical models regarding the etiology and maintaining factors of chronic insomnia along with research on the complex, bidirectional associations between chronic insomnia and various affective (and other) conditions. After thorough review of the literature, we propose several public policy measures as an initial step in managing chronic insomnia in the United States. These include introducing a nation-wide multi-modal educational and awareness campaign titled "Sleep America;" increasing the availability and demand for behavioral sleep medicine - the initially preferred treatment approach; and increasing the use of monitoring and enforcement activities by regulatory authorities to curtail false and misleading claims by sponsors of supplements or treatments for insomnia. Through the adoption of such measures, we hope to galvanize a national interest in healthy sleep and the evidence-based treatment of chronic insomnia. Copyright © 2011 Elsevier B.V. All rights reserved.

Spontaneous extradural and subgaleal hematoma: A rare neurosurgical crisis of sickle cell disease

PubMed Central

Mishra, Sudhansu S.; Senapati, Satya B.; Gouda, Amiya K.; Behera, Sanjay K.; Patnaik, Ashis

2017-01-01

Extradural hematoma (EDH) in absence of trauma is a rare entity with only few cases reported in literature. The various causes reported include: Vascular malformation of dura, coagulopathies, sinus infection, middle ear or orbital infection, and tumor. Occurrence of spontaneous EDH as a complication of sickle cell disease is even much rarer. We report a case with sickle cell disease who presented with spontaneous extradural and subgaleal hematomas following an episode of vaso-oclusive crisis. He was managed successfully with surgery. The association of epidural hematomas in sickling hemoglobinopathies is reviewed. In all cases, we noticed one episode of sickle cell crisis just before the occurrence of spontaneous EDH. Perhaps this crisis puts an extra demand over the hematopoietic skull tissue disrupting inner and outer skull margins leading to spontaneous EDH and subgaleal hematoma. PMID:28413532

Rhetorics of Regulation in Education after the Global Economic Crisis

ERIC Educational Resources Information Center

Hartley, David

2010-01-01

Economic crises such as those of 1929, 1973 and 2008 appear to associate with shifts in the rhetorics of management. These dates mark the end of expansionary phases within an economic cycle, and they portend what James O'Connor has called a "fiscal crisis of the state". It is argued, speculatively, that immediately before and after an…

Air and Space Expeditionary Force Crisis Action Leadership for Commanders

DTIC Science & Technology

2004-04-01

2002), 337. 2 Mark, Friedman, M.D., Everyday Crisis Management (Naperville, IL: First Decision Press, 2002), 5. 3 Stephen R. Covey, The 7 Habits of Highly Effective People (New...Berkley Publishing Group, 2002), 9. 12 Lt Col Bryan Gallagher, USAF, interviewed by author, February 2004. 13 Stephen R. Covey, The 7 Habits of Highly Effective People (New

Costs of treating patients with schizophrenia who have illness-related crisis events.

PubMed

Zhu, Baojin; Ascher-Svanum, Haya; Faries, Douglas E; Peng, Xiaomei; Salkever, David; Slade, Eric P

2008-08-26

Relatively little is known about the relationship between psychosocial crises and treatment costs for persons with schizophrenia. This naturalistic prospective study assessed the association of recent crises with mental health treatment costs among persons receiving treatment for schizophrenia. Data were drawn from a large multi-site, non-interventional study of schizophrenia patients in the United States, conducted between 1997 and 2003. Participants were treated at mental health treatment systems, including the Department of Veterans Affairs (VA) hospitals, community mental health centers, community and state hospitals, and university health care service systems. Total costs over a 1-year period for mental health services and component costs (psychiatric hospitalizations, antipsychotic medications, other psychotropic medications, day treatment, emergency psychiatric services, psychosocial/rehabilitation group therapy, individual therapy, medication management, and case management) were calculated for 1557 patients with complete medical information. Direct mental health treatment costs for patients who had experienced 1 or more of 5 recent crisis events were compared to propensity-matched samples of persons who had not experienced a crisis event. The 5 non-mutually exclusive crisis event subgroups were: suicide attempt in the past 4 weeks (n = 18), psychiatric hospitalization in the past 6 months (n = 240), arrest in the past 6 months (n = 56), violent behaviors in the past 4 weeks (n = 62), and diagnosis of a co-occurring substance use disorder (n = 413). Across all 5 categories of crisis events, patients who had a recent crisis had higher average annual mental health treatment costs than patients in propensity-score matched comparison samples. Average annual mental health treatment costs were significantly higher for persons who attempted suicide ($46,024), followed by persons with psychiatric hospitalization in the past 6 months ($37,329), persons with prior

Costs of treating patients with schizophrenia who have illness-related crisis events

PubMed Central

Zhu, Baojin; Ascher-Svanum, Haya; Faries, Douglas E; Peng, Xiaomei; Salkever, David; Slade, Eric P

2008-01-01

Background Relatively little is known about the relationship between psychosocial crises and treatment costs for persons with schizophrenia. This naturalistic prospective study assessed the association of recent crises with mental health treatment costs among persons receiving treatment for schizophrenia. Methods Data were drawn from a large multi-site, non-interventional study of schizophrenia patients in the United States, conducted between 1997 and 2003. Participants were treated at mental health treatment systems, including the Department of Veterans Affairs (VA) hospitals, community mental health centers, community and state hospitals, and university health care service systems. Total costs over a 1-year period for mental health services and component costs (psychiatric hospitalizations, antipsychotic medications, other psychotropic medications, day treatment, emergency psychiatric services, psychosocial/rehabilitation group therapy, individual therapy, medication management, and case management) were calculated for 1557 patients with complete medical information. Direct mental health treatment costs for patients who had experienced 1 or more of 5 recent crisis events were compared to propensity-matched samples of persons who had not experienced a crisis event. The 5 non-mutually exclusive crisis event subgroups were: suicide attempt in the past 4 weeks (n = 18), psychiatric hospitalization in the past 6 months (n = 240), arrest in the past 6 months (n = 56), violent behaviors in the past 4 weeks (n = 62), and diagnosis of a co-occurring substance use disorder (n = 413). Results Across all 5 categories of crisis events, patients who had a recent crisis had higher average annual mental health treatment costs than patients in propensity-score matched comparison samples. Average annual mental health treatment costs were significantly higher for persons who attempted suicide ($46,024), followed by persons with psychiatric hospitalization in the past 6 months ($37

Rethinking Combat Identification. Joint Center for Lessons Learned Quarterly Bulletin. Volume 4, Issue 3, June 2002

DTIC Science & Technology

2002-06-01

Countermeasures Unit Chief Special Events Management Unit Chief Domestic Terrorism/ Counterterrorism Section Chief International Terrorism Section...Asstistant Director Counter- Terrorism Division Figure 3 Division/Section/Unit Hierarchies The LNO also supports the Special Events Management Unit (SEMU

Management of Mental Health Crises Among Youths With and Without ASD: A National Survey of Child Psychiatrists.

PubMed

Kalb, Luther G; Stuart, Elizabeth A; Mandell, David S; Olfson, Mark; Vasa, Roma A

2017-10-01

This study compared management by child psychiatrists of mental health crises among youths with and without autism spectrum disorder (ASD). A custom online mental health crisis services survey was administered to members of the American Academy of Child and Adolescent Psychiatry. The survey probed three domains of crisis management: willingness to work with youths with a history of mental health crisis, comfort level in managing a mental health crisis, and availability of external resources during a crisis. Child psychiatrists reporting on management of youths with ASD (N=492) and without ASD (N=374) completed the survey. About 75% of psychiatrists in both groups were willing to accept a child with a history of a mental health crisis in their practice. During a crisis, psychiatrists caring for youths with ASD had less access to external consultation resources, such as a crisis evaluation center or other mental health professionals, compared with those caring for youths without ASD. Psychiatrists also expressed concerns about the ability of emergency department professionals and emergency responders to manage mental health crises among youths in a safe and developmentally appropriate manner, particularly among those with ASD. Child psychiatrists are in need of more external resources to manage youths with ASD who are experiencing a mental health crisis. There is also a need to develop best practice procedures for emergency responders who are working with youths experiencing a mental health crisis.

Maintenance Crisis vs Solutions.

ERIC Educational Resources Information Center

Haggard, Susie

Industrial maintenance in Northeast Georgia is facing an acute crisis. Contributing factors are economic development that is depleting the work force, aging of the population, downsizing of the military, and lack of technical school graduates. Solutions to the crisis fall into three categories: short-term, mid-term, and long-term. For short-term…

The Little-Known Crisis

ERIC Educational Resources Information Center

Eckholm, Erik P.

1975-01-01

For one-third of the world's people, the energy crisis means the daily scramble to find the wood they need to cook. The accelerating destruction of forests throughout Africa, Asia and Latin America and the utilization of manure as a firewood substitute may produce the most profound ecological crisis of this century. (BT)

Commercial speech in crisis: Crisis Pregnancy Center regulations and definitions of commercial speech.

PubMed

Gilbert, Kathryn E

2013-02-01

Recent attempts to regulate Crisis Pregnancy Centers, pseudoclinics that surreptitiously aim to dissuade pregnant women from choosing abortion, have confronted the thorny problem of how to define commercial speech. The Supreme Court has offered three potential answers to this definitional quandary. This Note uses the Crisis Pregnancy Center cases to demonstrate that courts should use one of these solutions, the factor-based approach of Bolger v. Youngs Drugs Products Corp., to define commercial speech in the Crisis Pregnancy Center cases and elsewhere. In principle and in application, the Bolger factor-based approach succeeds in structuring commercial speech analysis at the margins of the doctrine.

Timing crisis information release via television.

PubMed

Wei, Jiuchang; Zhao, Dingtao; Yang, Feng; Du, Shaofu; Marinova, Dora

2010-10-01

When and how often to release information on television are important issues in crisis and emergency risk communication. There is a lot of crisis information, including warnings and news, to which people should have access, but most of it is not significantly urgent to interrupt the broadcasting of television programmes. Hence, the right timing for the release of crisis information should be selected based on the importance of the crisis and any associated communication requirements. Using recursive methods, this paper builds an audience coverage model of crisis information release. Based on 2007 Household Using TV (HUT) data for Hefei City, China, the optimal combination of broadcasting sequence (with frequencies between one and eight times) is obtained using the implicit enumeration method. The developed model is applicable to effective transmission of crisis information, with the aim of reducing interference with the normal television transmission process and decreasing the psychological effect on audiences. The same model can be employed for other purposes, such as news coverage and weather and road information. © 2010 The Author(s). Journal compilation © Overseas Development Institute, 2010.

Sickle cell crisis and endothelin antagonists.

PubMed

Angerio, Allan D; Lee, Nicole D

2003-01-01

Sickle cell crisis may be more complex than a vaso-occlusive event in response to hypoxia. Endothelin-1 (ET-1) is a potent vasoconstrictor and mitogen secreted in response to hypoxia. ET-1 contributes to the vaso-occlusion and inflammation in sickle cell crisis. ET-1 antagonists may be useful in the prevention and treatment of crisis.

The looming retirement crisis.

PubMed

Walker, D M

1997-06-01

A retirement crisis looms in the United States due to a number of recent and emerging trends that affect government retirement programs, employer- and union-sponsored retirement benefits and personal savings arrangements. The crisis can be averted, but only with well-thought-out action on a number of issues, particularly Social Security and Medicare reform.

[Crisis intervention--the summary of a unique interventional program for medical students].

PubMed

Perry, Zvi; Busiba, Ziva; Uziel, Elia; Meiri, Gal

2009-02-01

In their daily work, physicians encounter varied illnesses, often accompanied with an emotional crisis that engulfs both the patient and his/her family. Research has shown that physicians find this part of their occupation extremely harsh, especially when conveying to the patient the initial bad news about his condition. Most medical school curricula published do not have any training programs for medical students in this expertise. The Patient's Rights Act and the current need of patients to be involved in their treatment have made it even more important to train would-be physicians on how to convey bad news. The Faculty of Health Sciences at the Ben-Gurion University is among the pioneers in articulating a formal curriculum on how to convey bad news and crisis intervention. The clinical workshop "Crisis Intervention" is aimed at 2nd year medical students, and has been taught at this school for the last 15 years, confronting these issues head-on. The course is conducted by an expert psychiatrist and an experienced social worker. The course is aimed at providing the students with theoretical background on the crisis and the emotional turmoil caused by medical emergencies, as well as to expose the students to real life crisis situations of patients and their families, thereby exposing them to optimal management of these situations. During this 4-day workshop, students learn how to convey bad news, as well as to understand its impact upon patients and their families. In the workshop emphasis is placed on the ethical and legal issues that evolve when caring for extremely ill patients. In the current article the authors unfold the techniques, theoretical and pedagogical issues of the workshop. The authors used semi-structured questionnaires to evaluate the course, and found that the students considered this workshop to be an interesting and relevant course. Using the results shown, as well as an oral debriefing after the course with class representatives, the authors

Immigration And Its Effects On The National Security Of Sri Lanka

DTIC Science & Technology

2016-12-01

Management and Budget, Paperwork Reduction Project (0704-0188) Washington DC 20503. 1. AGENCY USE ONLY (Leave blank) 2. REPORT DATE December 2016 3...conflict, counter-terrorism, border security management , diaspora, census, ideologies, refugees, human smuggling, trafficking, trans-border... MANAGEMENT ................................................................71 1. Domestic Control Measures

Validity evidence of non-technical skills assessment instruments in simulated anaesthesia crisis management.

PubMed

Jirativanont, T; Raksamani, K; Aroonpruksakul, N; Apidechakul, P; Suraseranivongse, S

2017-07-01

We sought to evaluate the validity of two non-technical skills evaluation instruments, the Anaesthetists' Non-Technical Skills (ANTS) behavioural marker system and the Ottawa Global Rating Scale (GRS), to apply them to anaesthesia training. The content validity, response process, internal structure, relations with other variables and consequences were described for validity evidence. Simulated crisis management sessions were initiated during which two trained raters evaluated the performance of postgraduate first-, second- and third-year (PGY-1, PGY-2 and PGY-3) anaesthesia residents. The study included 70 participants, composed of 24 PGY-1, 24 PGY-2 and 22 PGY-3 residents. Both instruments differentiated the non-technical skills of PGY-1 from PGY-3 residents ( P <0.05). Inter-rater agreement was measured using the intraclass correlation coefficient (ICC). For the ANTS instrument, the intraclass correlation coefficients for task management, team-working, situation awareness and decision-making were 0.79, 0.34, 0.81 and 0.70, respectively. For the Ottawa GRS, the intraclass correlation coefficients for overall performance, leadership, problem-solving, situation awareness, resource utilisation and communication skills were 0.86, 0.83, 0.84, 0.87, 0.80 and 0.86, respectively. The Cronbach's alpha for internal consistency of the ANTS instrument was 0.93, and was 0.96 for the Ottawa GRS. There was a high correlation between the ANTS and Ottawa GRS. The raters reported the ease of use of the Ottawa GRS compared to the ANTS. We found sufficient evidence of validity in the ANTS instrument and the Ottawa GRS for the evaluation of non-technical skills in a simulated anaesthesia setting, but the Ottawa GRS was more practical and had higher reliability.

Organizational Crisis Experience and Public Relations Roles.

ERIC Educational Resources Information Center

Guth, David W.

1995-01-01

Suggests a relationship between organizational crisis experience and the placement of the public relations function. Notes a relationship between organization size and crisis experience. Uncovers an alarming absence of crisis planning and training in organizations. (SR)