WorldWideScience

Sample records for preparedness frontline healthcare

  1. Cancer Training for Frontline Healthcare Providers in Tanzania.

    Science.gov (United States)

    Rick, Tara J; Deming, Cassondra M; Helland, Janey R; Hartwig, Kari A

    2017-08-16

    Cervical and breast cancer are responsible for the highest cancer-related mortality in Tanzania, although both are preventable or curable if diagnosed at an early stage. Limited knowledge of cervical cancer by clinic and dispensary level healthcare providers in Tanzania is a barrier for prevention and control strategies. The purpose of the study was to provide basic oncology training to frontline healthcare workers with a focus on cervical and breast cancer in order to increase knowledge. A 1-day cancer training symposium was conducted in Arusha, Tanzania, with 43 clinicians. Pre- and post-intervention surveys assessed cancer knowledge and confidence of clinicians in risk assessment. Sixty-nine percent of the participants reported never receiving any cervical cancer training in the past. A significant difference was found between the pre- and post-test in a majority of knowledge questions and in reported confidence recognizing signs and symptoms of breast and cervical cancer (p < 0.05). The 1-day community oncology training symposium was effective in delivering and increasing basic knowledge about cervical and breast cancers to these healthcare providers. The low level of baseline cancer knowledge among frontline medical providers in Tanzania illustrates the need for increased training around the country.

  2. The challenges of leading change in health-care delivery from the front-line.

    Science.gov (United States)

    Byers, Vivienne

    2017-09-01

    The public sector is facing turbulent times and this challenges nurses, who are expected to serve both patient interests and the efficiency drives of their organisations. In the context of implementing person-centred health policy, this paper explores the evolving role of front-line nurses as leaders and champions of change. Nurses can be seen to have some autonomy in health-care delivery. However, they are subject to systems of social control. In implementing person-centred policy, nurses can be seen to be doing the best they can within a constrained environment. A survey of nursing practice in person-centred health-policy implementation is presented. Despite much being written about managing health-professional resistance to policy implementation, there is a gap between what is being asked of nurses and the resources made available to them to deliver. In this milieu, nurses are utilising their discretion and leading from the front-line in championing change. Empowering nurses who seek to lead patient involvement could be the key to unlocking health-care improvement. Health services tend to be over-managed and under-led and there is a need to harness the potential of front-line nurses by facilitating leadership development through appropriate organisational support. © 2015 John Wiley & Sons Ltd.

  3. A roadmap for acute care training of frontline Healthcare workers in LMICs.

    Science.gov (United States)

    Shah, Nirupa; Bhagwanjee, Satish; Diaz, Janet; Gopalan, P D; Appiah, John Adabie

    2017-10-01

    This 10-step roadmap outlines explicit procedures for developing, implementing and evaluating short focused training programs for acute care in low and middle income countries (LMICs). A roadmap is necessary to develop resilient training programs that achieve equivalent outcomes despite regional variability in human capacity and infrastructure. Programs based on the roadmap should address shortfalls in human capacity and access to care in the short term and establish the ground work for health systems strengthening in the long term. The primary targets for acute care training are frontline healthcare workers at the clinic level. The programs will differ from others currently available with respect to the timelines, triage method, therapeutic interventions and potential for secondary prevention. The roadmap encompasses multiple iterative cycles of the Plan-Do-Study-Act framework. Core features are integration of frontline trainees with the referral system while promoting research, quality improvement and evaluation from the bottom-up. Training programs must be evidence based, developed along action timelines and use adaptive training methods. A systems approach is essential because training programs that take cognizance of all factors that influence health care delivery have the potential to produce health systems strengthening (HSS). Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Mumps Virus: Modification of the Identify-Isolate-Inform Tool for Frontline Healthcare Providers

    Directory of Open Access Journals (Sweden)

    Kristi L. Koenig

    2016-09-01

    Full Text Available Mumps is a highly contagious viral infection that became rare in most industrialized countries following the introduction of measles-mumps-rubella (MMR vaccine in 1967. The disease, however, has been re-emerging with several outbreaks over the past decade. Many clinicians have never seen a case of mumps. To assist frontline healthcare providers with detecting potential cases and initiating critical actions, investigators modified the “Identify-Isolate-Inform” tool for mumps infection. The tool is applicable to regions with rare incidences or local outbreaks, especially seen in college students, as well as globally in areas where vaccination is less common. Mumps begins with a prodrome of low-grade fever, myalgias and malaise/anorexia, followed by development of nonsuppurative parotitis, which is the pathognomonic finding associated with acute mumps infection. Orchitis and meningitis are the two most common serious complications, with hearing loss and infertility occurring rarely. Providers should consider mumps in patients with exposure to a known case or international travel to endemic regions who present with consistent signs and symptoms. If mumps is suspected, healthcare providers must immediately implement standard and droplet precautions and notify the local health department and hospital infection control personnel.

  5. Primary care nurses' experiences of how the mass media influence frontline healthcare in the UK.

    Science.gov (United States)

    van Bekkum, Jennifer E; Hilton, Shona

    2013-11-24

    Mass media plays an important role in communicating about health research and services to patients, and in shaping public perceptions and decisions about health. Healthcare professionals also play an important role in providing patients with credible, evidence-based and up-to-date information on a wide range of health issues. This study aims to explore primary care nurses' experiences of how mass media influences frontline healthcare. In-depth telephone interviews were carried out with 18 primary care nurses (nine health visitors and nine practice nurses) working in the United Kingdom (UK). Interviews were recorded and transcribed. The data was analysed using thematic analysis, with a focus on constant comparative analysis. Three themes emerged from the data. First, participants reported that their patients were frequently influenced by controversial health stories reported in the media, which affected their perceptions of, and decisions about, care. This, in turn, impinged upon participants' workloads as they had to spend additional time discussing information and reassuring patients. Second, participants also recalled times in their own careers when media reports had contributed to a decline in their confidence in current healthcare practices and treatments. Third, the participants in this study suggested a real need for additional resources to support and expand their own media literacy skills, which could be shared with patients. In an ever expanding media landscape with greater reporting on health, nurses working in the primary care setting face increasing pressure to effectively manage media stories that dispute current health policies and practices. These primary care nurses were keen to expand their media literacy skills to develop critical autonomy in relation to all media, and to facilitate more meaningful conversations with their patients about their health concerns and choices.

  6. "You have to keep fighting": maintaining healthcare services and professionalism on the frontline of austerity in Greece.

    Science.gov (United States)

    Kerasidou, Angeliki; Kingori, Patricia; Legido-Quigley, Helena

    2016-07-26

    Greece has been severely affected by the 2008 global economic crisis and its health system was, and still is, among the national institutions most shaped by its effects. In 2014, this qualitative study examined these changes through in-depth interviews with 22 frontline healthcare professionals in five different locations in mainland Greece. These interviews with nurses, doctors and pharmacists explored perceptions of austerity and how ideas of professionalism were challenged and revised by these measures. Participants reported working conditions characterised by dramatic increases in public hospital admissions alongside decreases in personnel, consumables, materials, and also many hospital closures. Many drew on analogies of war and fighting to describe the effects of healthcare reforms on their working lives and professional conduct. Despite accounts of deteriorating conditions and numerous challenges, healthcare professionals presented themselves as making every effort to meet patients' needs, while battling to resist guidelines which they perceived diminished their roles to production-line operatives. Participants considered it their duty to defend their professional ethos and serve patients without compromising standards, even if this meant liberal interpretation and implementation of regulations. These professionals regarded themselves on the frontline of healthcare provision but also the frontline defence in a war on their professional standards from austerity.

  7. Machinima and Video-Based Soft-Skills Training for Frontline Healthcare Workers.

    Science.gov (United States)

    Conkey, Curtis A; Bowers, Clint; Cannon-Bowers, Janis; Sanchez, Alicia

    2013-02-01

    Multimedia training methods have traditionally relied heavily on video-based technologies, and significant research has shown these to be very effective training tools. However, production of video is time and resource intensive. Machinima technologies are based on videogaming technology. Machinima technology allows videogame technology to be manipulated into unique scenarios based on entertainment or training and practice applications. Machinima is the converting of these unique scenarios into video vignettes that tell a story. These vignettes can be interconnected with branching points in much the same way that education videos are interconnected as vignettes between decision points. This study addressed the effectiveness of machinima-based soft-skills education using avatar actors versus the traditional video teaching application using human actors in the training of frontline healthcare workers. This research also investigated the difference between presence reactions when using avatar actor-produced video vignettes as compared with human actor-produced video vignettes. Results indicated that the difference in training and/or practice effectiveness is statistically insignificant for presence, interactivity, quality, and the skill of assertiveness. The skill of active listening presented a mixed result indicating the need for careful attention to detail in situations where body language and facial expressions are critical to communication. This study demonstrates that a significant opportunity exists for the exploitation of avatar actors in video-based instruction.

  8. Challenges of the New Zealand healthcare disaster preparedness prior to the Canterbury earthquakes: a qualitative analysis.

    Science.gov (United States)

    Al-Shaqsi, Sultan; Gauld, Robin; Lovell, Sarah; McBride, David; Al-Kashmiri, Ammar; Al-Harthy, Abdullah

    2013-03-15

    Disasters are a growing global phenomenon. New Zealand has suffered several major disasters in recent times. The state of healthcare disaster preparedness in New Zealand prior to the Canterbury earthquakes is not well documented. To investigate the challenges of the New Zealand healthcare disaster preparedness prior to the Canterbury earthquakes. Semi-structured interviews with emergency planners in all the District Health Boards (DHBs) in New Zealand in the period between January and March 2010. The interview protocol revolved around the domains of emergency planning adopted by the World Health Organization. Seventeen interviews were conducted. The main themes included disinterest of clinical personnel in emergency planning, the need for communication backup, the integration of private services in disaster preparedness, the value of volunteers, the requirement for regular disaster training, and the need to enhance surge capability of the New Zealand healthcare system to respond to disasters. Prior to the Canterbury earthquakes, healthcare disaster preparedness faced multiple challenges. Despite these challenges, New Zealand's healthcare response was adequate. Future preparedness has to consider the lessons learnt from the 2011 earthquakes to improve healthcare disaster planning in New Zealand.

  9. Measuring healthcare preparedness: an all-hazards approach

    Directory of Open Access Journals (Sweden)

    Marcozzi David E

    2012-10-01

    Full Text Available Abstract In a paper appearing in this issue, Adini, et al. describe a struggle familiar to many emergency planners—the challenge of planning for all scenarios. The authors contend that all-hazards, or capabilities-based planning, in which a set of core capabilities applicable to numerous types of events is developed, is a more efficient way to achieve general health care system emergency preparedness than scenario-based planning. Essentially, the core of what is necessary to plan for and respond to one kind of disaster (e.g. a biologic event is also necessary for planning and responding to other types of disasters, allowing for improvements in planning and maximizing efficiencies. While Adini, et al. have advanced the science of health care emergency preparedness through their consideration of 490 measures to assess preparedness, a shorter set of validated preparedness measures would support the dual goals of accountability and improved outcomes and could provide the basis for determining which actions in the name of preparedness really matter.

  10. Rationing access to care to the medically uninsured: the role of bureaucratic front-line discretion at large healthcare institutions.

    Science.gov (United States)

    Weiner, Saul J; Laporte, Margaret; Abrams, Richard I; Moswin, Arthur; Warnecke, Richard

    2004-04-01

    Medically uninsured patients seeking nonemergency care are not guaranteed access to services at most healthcare institutions. They must first register with a clerk who could require a deposit and/or payment on an outstanding debt. This study examines the factors that influence whether nonmedical bureaucratic staff sign in or turn away uninsured patients who cannot meet prepayment requirements. The study was conducted at a for-profit, a not-for-profit, and a public healthcare institution in a metropolitan area. The authors explored the relevant policy environment through interviews with senior administrators and a review of documents pertaining to the management of self-pay patients. Then they examined how policies affecting access were implemented through in-depth, semistructured, audiotaped interviews with 55 front-line clerical personnel. At all 3 institutions, policies were ambiguous about what to do when uninsured patients cannot afford required prepayments. Seventy-one percent of staff reported they do not turn patients away; the remainder stated that on occasion they do. A variety of rationales were provided for how decisions are made. Those with the lowest-level positions were significantly more likely to be sympathetic to indigent patients and less likely to report turning patients away. Consistent with other studies of front-line bureaucracies indicating that low-level personnel who interface with clients make discretionary decisions, particularly when organizations pursue potentially conflicting priorities, this preliminary investigation found that nonmedical personnel play a significant role in decisions affecting access to care for medically indigent patients.

  11. Resource allocation on the frontlines of public health preparedness and response: report of a summit on legal and ethical issues.

    Science.gov (United States)

    Barnett, Daniel J; Taylor, Holly A; Hodge, James G; Links, Jonathan M

    2009-01-01

    In the face of all-hazards preparedness challenges, local and state health department personnel have to date lacked a discrete set of legally and ethically informed public health principles to guide the distribution of scarce resources in crisis settings. To help address this gap, we convened a Summit of academic and practice experts to develop a set of principles for legally and ethically sound public health resource triage decision-making in emergencies. The invitation-only Summit, held in Washington, D.C., on June 29, 2006, assembled 20 experts from a combination of academic institutions and nonacademic leadership, policy, and practice settings. The Summit featured a tabletop exercise designed to highlight resource scarcity challenges in a public health infectious disease emergency. This exercise served as a springboard for Summit participants' subsequent identification of 10 public health emergency resource allocation principles through an iterative process. The final product of the Summit was a set of 10 principles to guide allocation decisions involving scarce resources in public health emergencies. The principles are grouped into three categories: obligations to community; balancing personal autonomy and community well-being/benefit; and good preparedness practice. The 10 Summit-derived principles represent an attempt to link law, ethics, and real-world public health emergency resource allocation practices, and can serve as a useful starting framework to guide further systematic approaches and future research on addressing public health resource scarcity in an all-hazards context.

  12. Preparedness of Lithuanian general practitioners to provide mental healthcare services

    DEFF Research Database (Denmark)

    Jaruseviciene, Lina; Sauliune, Skirmante; Jarusevicius, Gediminas

    2014-01-01

    BACKGROUND: A large unmet need for mental healthcare in Lithuania is partially attributable to a lack of primary care providers with skills in this area. The aim of this study was to assess general practitioners' (GPs) experience in mental healthcare and their perceptions about how to increase th...

  13. Caring Wisely: A Program to Support Frontline Clinicians and Staff in Improving Healthcare Delivery and Reducing Costs.

    Science.gov (United States)

    Gonzales, Ralph; Moriates, Christopher; Lau, Catherine; Valencia, Victoria; Imershein, Sarah; Rajkomar, Alvin; Prasad, Priya; Boscardin, Christy; Grady, Deborah; Johnston, S

    2017-08-01

    We describe a program called "Caring Wisely"®, developed by the University of California, San Francisco's (UCSF), Center for Healthcare Value, to increase the value of services provided at UCSF Health. The overarching goal of the Caring Wisely® program is to catalyze and advance delivery system redesign and innovations that reduce costs, enhance healthcare quality, and improve health outcomes. The program is designed to engage frontline clinicians and staff-aided by experienced implementation scientists-to develop and implement interventions specifically designed to address overuse, underuse, or misuse of services. Financial savings of the program are intended to cover the program costs. The theoretical underpinnings for the design of the Caring Wisely® program emphasize the importance of stakeholder engagement, behavior change theory, market (target audience) segmentation, and process measurement and feedback. The Caring Wisely® program provides an institutional model for using crowdsourcing to identify "hot spot" areas of low-value care, inefficiency and waste, and for implementing robust interventions to address these areas. © 2017 Society of Hospital Medicine.

  14. How front-line healthcare workers respond to stock-outs of essential medicines in the Eastern Cape Province of South Africa.

    Science.gov (United States)

    Hodes, R; Price, I; Bungane, N; Toska, E; Cluver, L

    2017-08-25

    Shortages of essential medicines are a daily occurrence in many of South Africa (SA)'s public health facilities. This study focuses on the responses of healthcare workers to stock-outs, investigating how actors at the 'front line' of public health delivery understand, experience and respond to shortages of essential medicines and equipment in their facilities. Findings are based on focus groups, observations and interviews with healthcare workers and patients at healthcare facilities in the Eastern Cape Province of SA, conducted as part of the Mzantsi Wakho study. The research revealed a discrepancy between 'informal' definitions of stock-outs and their reporting through formal stock-out management channels. Front-line healthcare workers had designed their own systems for classifying the severity of stock-outs, based on the product in question, and on their potential to access stocks from other facilities. Beyond formal systems of procurement and supply, healthcare workers had established vast networks of alternative communication and action, often using personal resources to procure medical supplies. Stock-outs were only reported when informal methods of stock-sharing did not secure top-up supplies. These findings have implications for understanding the frequency and severity of stock-outs, and for taking action to prevent and manage stock-outs effectively.

  15. Benchmarking working conditions for health and safety in the frontline healthcare industry: Perspectives from Australia and Malaysia.

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    McLinton, Sarven S; Loh, May Young; Dollard, Maureen F; Tuckey, Michelle M R; Idris, Mohd Awang; Morton, Sharon

    2018-04-06

    To present benchmarks for working conditions in healthcare industries as an initial effort into international surveillance. The healthcare industry is fundamental to sustaining the health of Australians, yet it is under immense pressure. Budgets are limited, demands are increasing as are workplace injuries and all of these factors compromise patient care. Urgent attention is needed to reduce strains on workers and costs in health care, however, little work has been done to benchmark psychosocial factors in healthcare working conditions in the Asia-Pacific. Intercultural comparisons are important to provide an evidence base for public policy. A cross-sectional design was used (like other studies of prevalence), including a mixed-methods approach with qualitative interviews to better contextualize the results. Data on psychosocial factors and other work variables were collected from healthcare workers in three hospitals in Australia (N = 1,258) and Malaysia (N = 1,125). 2015 benchmarks were calculated for each variable and comparison was conducted via independent samples t tests. Healthcare samples were also compared with benchmarks for non-healthcare general working populations from their respective countries: Australia (N = 973) and Malaysia (N = 225). Our study benchmarks healthcare working conditions in Australia and Malaysia against the general working population, identifying trends that indicate the industry is in need of intervention strategies and job redesign initiatives that better support psychological health and safety. We move toward a better understanding of the precursors of psychosocial safety climate in a broader context, including similarities and differences between Australia and Malaysia in national culture, government occupational health and safety policies and top-level management practices. © 2018 John Wiley & Sons Ltd.

  16. Language-specific skills in intercultural healthcare communication: Comparing perceived preparedness and skills in nurses' first and second languages.

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    Gasiorek, Jessica; van de Poel, Kris

    2018-02-01

    Interactions between people from different cultures are becoming increasingly commonplace in contemporary healthcare settings. To date, most research evaluating cross-cultural preparedness has assumed that medical professionals are speaking their first language (L1). However, as healthcare workers are increasingly mobile and patient populations are increasingly diverse, more and more interactions are likely to occur in a professional's non-native language (L2). This study assessed and compared nurses' perceived cross-cultural preparedness and skillfulness in their interactions with patients from other cultures when speaking both their L1 and L2. The goal of this project was to inform the creation of a communication skills training program. Nurses reported their perceived cross-cultural preparedness and skillfulness (scales adapted from Park et al., 2009) in their L1 and L2 via an online questionnaire. This questionnaire was distributed among nurses working in Vienna, Austria, through the Vienna Hospital Association (VHA). Nurses and nurses-in-training working in VHA hospitals participated. Most participants who provided demographic information were currently nurses (n=179) with an average of 16.88years (SD=11.50) of professional experience (range: 0-40); n=40 were nurses-in-training with an average of 2.13years (SD=0.88) of experience (range: 1-5). Descriptive statistics for each cross-cultural preparedness and skillfulness (in each language) are reported; comparisons between L1 and L2 responses were also conducted. Multiple regression analyses were used to identify predictors of preparedness and L1/L2 skillfulness. Nurses reported feeling significantly less confident in their skills when working in an L2, across a range of culture-related issues. Having had previous communication skills training predicted (better) self-reported L2 skillfulness, although it did not predict L1 skillfulness. These results indicate that there is a language-specific component to cross

  17. Hepatitis A Virus: Essential Knowledge and a Novel Identify-Isolate-Inform Tool for Frontline Healthcare Providers

    Directory of Open Access Journals (Sweden)

    Kristi L. Koenig

    2017-10-01

    Full Text Available Infection with hepatitis A virus (HAV causes a highly contagious illness that can lead to serious morbidity and occasional mortality. Although the overall incidence of HAV has been declining since the introduction of the HAV vaccine, there have been an increasing number of outbreaks within the United States and elsewhere between 2016 and 2017. These outbreaks have had far-reaching consequences, with a large number of patients requiring hospitalization and several deaths. Accordingly, HAV is proving to present a renewed public health challenge. Through use of the “Identify-Isolate-Inform” tool as adapted for HAV, emergency physicians can become more familiar with the identification and management of patients presenting to the emergency department (ED with exposure, infection, or risk of contracting disease. While it can be asymptomatic, HAV typically presents with a prodrome of fever, nausea/vomiting, and abdominal pain followed by jaundice. Healthcare providers should maintain strict standard precautions for all patients suspected of having HAV infection as well as contact precautions in special cases. Hand hygiene with soap and warm water should be emphasized, and affected patients should be counseled to avoid food preparation and close contact with vulnerable populations. Additionally, ED providers should offer post-exposure prophylaxis to exposed contacts and encourage vaccination as well as other preventive measures for at-risk individuals. ED personnel should inform local public health departments of any suspected case.

  18. New York City's healthcare transportation during a disaster: a preparedness framework for a wicked problem.

    Science.gov (United States)

    Sternberg, Ernest; Lee, George C

    2009-01-01

    During a disaster, victims with varied morbidities are located at incident sites, while healthcare facilities with varied healthcare resources are distributed elsewhere. Transportation serves an essential equilibrating role: it helps balance the patients' need for care with the supply of care. Studying the special case of New York City, this article sets out the healthcare transportation components as: (1) incident morbidity; (2) transportation assets; and (3) healthcare capacity. The relationship between these three components raises an assignment problem: the management of healthcare transportation within a dynamic and partly unpredictable incident-transportation-healthcare nexus, under urban disruption. While the routine dispatch problem can be tackled through better geographic allocation software and technical algorithms, the disaster assignment problem must be confronted through real-time, mutual adjustment between institutions. This article outlines institutional alternatives for managing the assignment problem and calls for further research on the merits of alternative institutional models.

  19. Preparedness and the importance of meeting the needs of healthcare workers : A qualitative study on Ebola

    NARCIS (Netherlands)

    Belfroid, E.; van Steenbergen, J.; Timen, A.; Ellerbroek, P.; van Huis, A.M.; Hulscher, M.

    Background: Healthcare workers (HCWs) face specific challenges in infectious disease outbreaks, which provide unusual, new events with exposure risk. The fear of infection or new, unknown tasks in an unfamiliar setting, for example, may complicate outbreak management. Aim: To gain insight into how

  20. Is the Front Line Prepared for the Changing Faces of Patients? Predictors of Cross-Cultural Preparedness Among Clinical Nurses and Resident Physicians in Lausanne, Switzerland.

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    Casillas, Alejandra; Paroz, Sophie; Green, Alexander R; Wolff, Hans; Weber, Orest; Faucherre, Florence; Ninane, Françoise; Bodenmann, Patrick

    2015-01-01

    PHENOMENON: Assuring quality medical care for all persons requires that healthcare providers understand how sociocultural factors affect a patient's health beliefs/behaviors. Switzerland's changing demographics highlight the importance of provider cross-cultural preparedness for all patients-especially those at risk for social/health precarity. We evaluated healthcare provider cross-cultural preparedness for commonly encountered vulnerable patient profiles. A survey on cross-cultural care was mailed to Lausanne University hospital's "front-line healthcare providers": clinical nurses and resident physicians at our institution. Preparedness items asked "How prepared do you feel to care for … ?" (referring to example patient profiles) on an ascending 5-point Likert scale. We examined proportions of "4 - well/5 - very well prepared" and the mean composite score for preparedness. We used linear regression to examine the adjusted effect of demographics, work context, cultural-competence training, and cross-cultural care problem awareness, on preparedness. Of 885 questionnaires, 368 (41.2%) were returned: 124 (33.6%) physicians and 244 (66.4%) nurses. Mean preparedness composite was 3.30 (SD = 0.70), with the lowest proportion of healthcare providers feeling prepared for patients "whose religious beliefs affect treatment" (22%). After adjustment, working in a sensitized department (β = 0.21, p = .01), training on the history/culture of a specific group (β = 0.25, p = .03), and awareness regarding (a) a lack of practical experience caring for diverse populations (β = 0.25, p = .004) and (b) inadequate cross-cultural training (β = 0.18, p = .04) were associated with higher preparedness. Speaking French as a dominant language and physician role (vs. nurse) were negatively associated with preparedness (β = -0.26, p = .01; β = -0.22, p = .01). INSIGHTS: The state of cross-cultural care preparedness among Lausanne's front-line healthcare providers leaves room for

  1. The Relationship between Knowledge and Attitude of Managers with Preparedness of Healthcare Centers in Rey Health Network against Earthquake Risk - 2013

    Directory of Open Access Journals (Sweden)

    Mohammad Asadzadeh

    2014-06-01

    Conclusions: Considering that managers’ knowledge was rather low, preparedness among centers was low as well. According to low knowledge and unsuitable preparedness, more theoretical and practical trainings and maneuvers were necessary to be held for managers about earthquake preparedness.

  2. Listening to Those at the Frontline: Patient and Healthcare Personnel Perspectives on Tuberculosis Treatment Barriers and Facilitators in High TB Burden Regions of Argentina

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    Sarah J. Iribarren

    2014-01-01

    Full Text Available Purpose. In Argentina, tuberculosis (TB control measures have not achieved key treatment targets. The purpose of this study was to identify modes of treatment delivery and explore patient and healthcare personnel perceptions of barriers and facilitators to treatment success. Methods. We used semistructured group and individual interviews for this descriptive qualitative study. Eight high burden municipalities were purposively selected. Patients in treatment for active TB (n=16, multidisciplinary TB team members (n=26, and TB program directors (n=12 at local, municipal, regional, and national levels were interviewed. Interviews were recorded, transcribed verbatim, and analyzed using thematic analysis. Results. Modes of treatment delivery varied across municipalities and types of healthcare facility and were highly negotiated with patients. Self-administration of treatment was common in hospital-based and some community clinics. Barriers to TB treatment success were concentrated at the system level. This level relied heavily on individual personal commitment, and many system facilitators were operating in isolation or in limited settings. Conclusions. We outline experiences and perspectives of the facilitating and challenging factors at the individual, structural, social, and organizational levels. Establishing strong patient-healthcare personnel relationships, responding to patient needs, capitalizing on community resources, and maximizing established decentralized system could mitigate some of the barriers.

  3. Talent Characteristics among frontline bankers

    DEFF Research Database (Denmark)

    Raalskov, Jesper; Liempd, Dennis van; Warming-Rasmussen, Bent

    a talented frontline banker? The literature on talented bankers is scarce, implicit and takes a unilateral approach to the definition of talent. Based on a qualitative case study among talented frontline bankers in the Danish banking industry, this paper offers definitional characteristics that constitute...

  4. Emergency Preparedness

    CERN Document Server

    2001-01-01

    The trends of RPC work in the area of preparedness for nuclear and radiological accidents are listed. RPC in cooperation with Swedish Government developed the project on preparation for iodine prophylaxis in case of accident at Ignalina NPP and arranged seminar on emergency preparedness issues in 2001.

  5. Emergency preparedness

    Energy Technology Data Exchange (ETDEWEB)

    Yanev, P.I.; Hom, S.; Kircher, C.A.; Bailey, N.D.

    1985-01-01

    These lecture notes include the following subject areas: (1) earthquake mitigation planning - general approach and in-house program; (2) seismic protection of equipment and non-structural systems; and (3) disaster preparedness and self help program. (ACR)

  6. Emergency preparedness

    International Nuclear Information System (INIS)

    Yanev, P.I.; Hom, S.; Kircher, C.A.; Bailey, N.D.

    1985-01-01

    These lecture notes include the following subject areas: (1) earthquake mitigation planning - general approach and in-house program; (2) seismic protection of equipment and non-structural systems; and (3) disaster preparedness and self help program

  7. Emergency preparedness

    CERN Document Server

    Cennini, E; Oortman Gerlings, P

    2009-01-01

    On September 19th 2008, a technical fault was at the centre of a sequence of events which hampered the performance of certain equipments of the LHC 3-4 sector. Once the first effects of this sequence of events were detected, the behaviour of the CERN staff confronted to this complex and critical situation became the centre of the risk control process. During such a downward spiral the preparation of all stakeholders is essential and should respect the (apparently) basic principles of emergency preparedness. Preparedness towards normal operation of CERN facilities towards minor up to major emergency situations will be presented. The main technical, organisational and legal frameworks of the CERN emergency preparedness will be recalled, highlighting the CERN risk management and risk control strategy. Then, the sequence of events experienced by different stakeholders on September 19th will be reported, thus starting the learned lessons process.

  8. Healthcare

    Science.gov (United States)

    Carnevale, Anthony P.; Smith, Nicole; Gulish, Artem; Beach, Bennett H.

    2012-01-01

    This report, provides detailed analyses and projections of occupations in healthcare fields, and wages earned. In addition, the important skills and work values associated with workers in those fields of healthcare are discussed. Finally, the authors analyze the implications of research findings for the racial, ethnic, and class diversity of the…

  9. Institutional change on the frontlines

    DEFF Research Database (Denmark)

    Bjerregaard, Toke

    2011-01-01

    Purpose – The purpose of this paper is to shed light on how actors within, on the surface, similar organizations cope and work with imposed institutional changes. Design methodology/approach – This research is based on an ethnographic field study addressing why, despite being exposed to the same...... institutional demands, organizational actors respond by developing diverging institutional orders of appropriate organizational conduct. This research examines how middle managers and frontline staff in two similar Danish social care organizations respond to demands to adopt a New Public Management (NPM...... organizational changes. The findings illustrate how differential institutional orders are maintained by middle managers and frontline staff despite exposure to the same demands. Research limitations/implications – There are different limitations to this ethnographic field study due to the character...

  10. Meaningfully incorporating staff input to enhance frontline engagement.

    Science.gov (United States)

    Strumwasser, Sarah; Virkstis, Katherine

    2015-04-01

    Nurses play a critical role in care transformation. To achieve transformation, frontline staff must be engaged in their work, committed to their organization's mission, and capable of delivering high-quality care. Data from the Advisory Board Survey Solutions show that nurses are both the least engaged and most disengaged among all frontline staff. To identify the most promising opportunities for driving engagement, researchers from The Advisory Board Company analyzed engagement survey responses from more than 343,000 employees at 575 healthcare organizations. This article describes 3 strategies for addressing 1 of the greatest opportunities identified from the data: ensuring that nurses feel that their ideas and suggestions are valued by the organization.

  11. Emergency Medicine: On the Frontlines of Medical Education Transformation.

    Science.gov (United States)

    Holmboe, Eric S

    2015-11-01

    Emergency medicine (EM) has always been on the frontlines of healthcare in the United States. I experienced this reality first hand as a young general medical officer assigned to an emergency department (ED) in a small naval hospital in the 1980s. For decades the ED has been the only site where patients could not be legally denied care. Despite increased insurance coverage for millions of Americans as a result of the Affordable Care Act, ED directors report an increase in patient volumes in a recent survey.1 EDs care for patients from across the socioeconomic spectrum suffering from a wide range of clinical conditions. As a result, the ED is still one of few components of the American healthcare system where social justice is enacted on a regular basis. Constant turbulence in the healthcare system, major changes in healthcare delivery, technological advances and shifting demographic trends necessitate that EM constantly adapt and evolve as a discipline in this complex environment.

  12. Preparedness 101: Zombie Pandemic

    Science.gov (United States)

    ... Partner Tools and Resources Communication Resources Blog Infographics Social Media Graphics Videos CDC Workshop for Risk-based Funding Campaigns Safe and Well Selfie Preparedness Month Preparedness Month ...

  13. Workplace Preparedness for Terrorism

    National Research Council Canada - National Science Library

    Ursano, Robert J

    2006-01-01

    Comprehensive workplace preparedness for terrorism must address and integrate the psychological and behavioral aspects of terrorism preparedness and response in order to address issues of human continuity...

  14. A multifaceted strategy using mobile technology to assist rural primary healthcare doctors and frontline health workers in cardiovascular disease risk management: protocol for the SMARTHealth India cluster randomised controlled trial.

    Science.gov (United States)

    Praveen, Devarsetty; Patel, Anushka; McMahon, Stephen; Prabhakaran, Dorairaj; Clifford, Gari D; Maulik, Pallab K; Joshi, Rohina; Jan, Stephen; Heritier, Stephane; Peiris, David

    2013-11-25

    Blood Pressure related disease affected 118 million people in India in the year 2000; this figure will double by 2025. Around one in four adults in rural India have hypertension, and of those, only a minority are accessing appropriate care. Health systems in India face substantial challenges to meet these gaps in care, and innovative solutions are needed. We hypothesise that a multifaceted intervention involving capacity strengthening of primary healthcare doctors and non-physician healthcare workers through use of a mobile device-based clinical decision support system will result in improved blood pressure control for individuals at high risk of a cardiovascular disease event when compared with usual healthcare. This intervention will be implemented as a stepped wedge, cluster randomised controlled trial in 18 primary health centres and 54 villages in rural Andhra Pradesh involving adults aged ≥40 years at high cardiovascular disease event risk (approximately 15,000 people). Cardiovascular disease event risk will be calculated based on World Health Organisation/International Society of Hypertension's region-specific risk charts. Cluster randomisation will occur at the level of the primary health centres. Outcome analyses will be conducted blinded to intervention allocation. The primary study outcome is the difference in the proportion of people meeting guideline-recommended blood pressure targets in the intervention period vs. the control period. Secondary outcomes include mean reduction in blood pressure levels; change in other cardiovascular disease risk factors, including body mass index, current smoking, reported healthy eating habits, and reported physical activity levels; self-reported use of blood pressure and other cardiovascular medicines; quality of life (using the EQ-5D); and cardiovascular disease events (using hospitalisation data). Trial outcomes will be accompanied by detailed process and economic evaluations. The findings are likely to inform

  15. Emergency preparedness

    Energy Technology Data Exchange (ETDEWEB)

    Jackson, J. [Key Safety and Blowout Control Corp., Sylvan Lake, AB (Canada)

    2001-07-01

    This presentation included several slides depicting well control and emergency preparedness. It provided information to help in pre-emergency planning for potential well control situations. Key Safety and Blowout Control Corp has gained experience in the Canadian and International well control industry as well as from the fires of Kuwait. The president of the company lectures on the complications and concerns of managers, wellsite supervisors, service companies, the public sector, land owners, government agencies and the media. The slides presented scenarios based on actual blowout recovery assignments and described what types of resources are needed by a well control team. The presentation addressed issues such as the responsibility of a well control team and what they can be expected to do. The issue of how government agencies become involved was also discussed. The presentation combines important information and descriptive images of personal experiences in fire fighting and well control. The emergency situations presented here demonstrate the need for a thorough understanding of preplanning for emergencies and what to expect when a typical day in the oil patch turns into a high stress, volatile situation. tabs., figs.

  16. Facilitating central line-associated bloodstream infection prevention: a qualitative study comparing perspectives of infection control professionals and frontline staff.

    Science.gov (United States)

    McAlearney, Ann Scheck; Hefner, Jennifer L

    2014-10-01

    Infection control professionals (ICPs) play a critical role in implementing and managing healthcare-associated infection reduction interventions, whereas frontline staff are responsible for delivering direct and ongoing patient care. The objective of our study was to determine if ICPs and frontline staff have different perspectives about the facilitators and challenges of central line-associated bloodstream infection (CLABSI) prevention program success. We conducted key informant interviews at 8 hospitals that participated in the Agency for Healthcare Research and Quality CLABSI prevention initiative called "On the CUSP: Stop BSI." We analyzed interview data from 50 frontline nurses and 26 ICPs to identify common themes related to program facilitators and challenges. We identified 4 facilitators of CLABSI program success: education, leadership, data, and consistency. We also identified 3 common challenges: lack of resources, competing priorities, and physician resistance. However, the perspective of ICPs and frontline nurses differed. Whereas ICPs tended to focus on general descriptions, frontline staff noted program specifics and often discussed concrete examples. Our results suggest that ICPs need to take into account the perspectives of staff nurses when implementing infection control and broader quality improvement initiatives. Further, the deliberate inclusion of frontline staff in the implementation of these programs may be critical to program success. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  17. TEKNA - preparedness seminary

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-07-01

    The seminary contains several presentations on various aspects of preparedness in the offshore petroleum sector. The authority organization, Norwegian regulations, industrial management, planning and principles are discussed. Risk assessment and preparedness analysis is emphasized. Some technological aspects are also discussed.

  18. Emergency preparedness

    International Nuclear Information System (INIS)

    1998-01-01

    According the conception of the Emergency Response Centre (ERC) of the Nuclear Regulatory Authority of the Slovak Republic (NRA), and the obtained experience from exercises, and as well as on the basis of recommendations of international missions, the NRA SR started, in 1997 the ERC extension. The new room enable the work for radiation protection group, reactor safety and logistic group separately. At the same time special room was build for work of the NECRA Technical Support Group of the Emergency Commission for Radiation Accidents of the SR.This group co-operates closely with ERC while evaluation the situation, and by using the information system of the NRA and database of ERC to generate the conditions of nuclear facilities in once of emergency. Extension of the mentioned rooms was carried out. The financing by the European Union helped to build the project RAMG. In this way the NRA gained a working site which, with its equipment and parameters belongs to the top working sites of regulatory bodies of developed European countries. The NRA preparation of exercise and special staff education was carried out in 1997, for employees of the NRA and members of Emergency Headquarters (EH) for work in ERC in case of nuclear installation accident. The task of education of member of EH was their preparation for carrying out three exercises. These exercises are described. In the area of emergency preparedness, in accordance with inspection plan of the Office, 7 team inspections were carried out in individual localities; in NPP Bohunice, two in NPP Mochovce and one in Bohunice Conditioning Centre for radioactive wastes. Solution of the task of development of science and technology in the area of 'Development of technical and programme means for analyses of accidents and solutions of crisis situations'continued in 1997. Another regulations were elaborated for activity of members of EH of the NRA. The following was was carried out: selection of data for transfer and the

  19. Coping on the Front-line

    DEFF Research Database (Denmark)

    Sanden, Guro Refsum; Lønsmann, Dorte

    language boundaries in their everyday work. Despite official English language policies in the three companies, our findings show that employees face a number of different language boundaries, and that ad hoc and informal solutions in many cases are vital for successful cross-language communication. Drawing......This article investigates how front-line employees respond to English language policies implemented by the management of three multinational corporations (MNCs) headquartered in Scandinavia. Based on interview and document data the article examines the ways in which front-line employees cross...

  20. State of emergency preparedness for US health insurance plans.

    Science.gov (United States)

    Merchant, Raina M; Finne, Kristen; Lardy, Barbara; Veselovskiy, German; Korba, Caey; Margolis, Gregg S; Lurie, Nicole

    2015-01-01

    Health insurance plans serve a critical role in public health emergencies, yet little has been published about their collective emergency preparedness practices and policies. We evaluated, on a national scale, the state of health insurance plans' emergency preparedness and policies. A survey of health insurance plans. We queried members of America's Health Insurance Plans, the national trade association representing the health insurance industry, about issues related to emergency preparedness issues: infrastructure, adaptability, connectedness, and best practices. Of 137 health insurance plans queried, 63% responded, representing 190.6 million members and 81% of US plan enrollment. All respondents had emergency plans for business continuity, and most (85%) had infrastructure for emergency teams. Some health plans also have established benchmarks for preparedness (eg, response time). Regarding adaptability, 85% had protocols to extend claim filing time and 71% could temporarily suspend prior medical authorization rules. Regarding connectedness, many plans shared their contingency plans with health officials, but often cited challenges in identifying regulatory agency contacts. Some health insurance plans had specific policies for assisting individuals dependent on durable medical equipment or home healthcare. Many plans (60%) expressed interest in sharing best practices. Health insurance plans are prioritizing emergency preparedness. We identified 6 policy modifications that health insurance plans could undertake to potentially improve healthcare system preparedness: establishing metrics and benchmarks for emergency preparedness; identifying disaster-specific policy modifications, enhancing stakeholder connectedness, considering digital strategies to enhance communication, improving support and access for special-needs individuals, and developing regular forums for knowledge exchange about emergency preparedness.

  1. A national survey of terrorism preparedness training among pediatric, family practice, and emergency medicine programs.

    Science.gov (United States)

    Martin, Shelly D; Bush, Anneke C; Lynch, Julia A

    2006-09-01

    Domestic terrorism is a real threat focusing on a need to engage in effective emergency preparedness planning and training. Front-line physicians are an important component of any emergency preparedness plan. Potential victims of an attack include children who have unique physiologic and psychological vulnerabilities in disasters. Front-line providers need to have adequate training to effectively participate in local planning initiatives and to recognize and treat casualties including children. The goal of the survey was to assess the current state of terrorism preparedness training, including child victims, by emergency medicine, family practice, and pediatric residency programs in the United States and to assess methods of training and barriers to establishing effective training. A survey was e-mailed to a comprehensive list of all US pediatric, family practice, and emergency medicine residency programs 3 times between September 2003 and January 2004. The survey measured the perceived risk of terrorist attack, level of training by type of attack, level of training regarding children, method of training, and barriers to training. Overall, 21% of programs responded (46 of 182 pediatric, 75 of 400 family practice, and 29 of 125 emergency medicine programs). Across all of the event types, emergency medicine programs were more likely to report adequate/comprehensive training. However, terrorism preparedness funding, these data suggest that we are failing to provide adequate training to front-line providers who may care for children in a catastrophic domestic terrorist event.

  2. Emergency preparedness in Finland

    International Nuclear Information System (INIS)

    Koivukoski, J.

    1993-01-01

    Although the menace of nuclear war still persists, the focus in national emergency preparedness in Finland is presently on emergencies involving nuclear installations. The nuclear power plants, nuclear submarines and other installations in the former USSR are a major reason for this. In this article the main features and organization of emergency preparedness in Finland are described. (orig.)

  3. Preparedness events in 2008

    International Nuclear Information System (INIS)

    2009-01-01

    NRPA have as Secretariat for the Crisis Committee and the nuclear preparedness organization in 2008 published several reports of incidents of radioactivity and radioactive pollution to the nuclear preparedness organization, media and the public. In addition to these events, there have been some incidents with radiation and small radioactive sources in Norway during this year. (AG)

  4. Legal preparedness: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement.

    Science.gov (United States)

    Courtney, Brooke; Hodge, James G; Toner, Eric S; Roxland, Beth E; Penn, Matthew S; Devereaux, Asha V; Dichter, Jeffrey R; Kissoon, Niranjan; Christian, Michael D; Powell, Tia

    2014-10-01

    Significant legal challenges arise when health-care resources become scarce and population-based approaches to care are implemented during severe disasters and pandemics. Recent emergencies highlight the serious legal, economic, and health impacts that can be associated with responding in austere conditions and the critical importance of comprehensive, collaborative health response system planning. This article discusses legal suggestions developed by the American College of Chest Physicians (CHEST) Task Force for Mass Critical Care to support planning and response efforts for mass casualty incidents involving critically ill or injured patients. The suggestions in this chapter are important for all of those involved in a pandemic or disaster with multiple critically ill or injured patients, including front-line clinicians, hospital administrators, and public health or government officials. Following the CHEST Guidelines Oversight Committee's methodology, the Legal Panel developed 35 key questions for which specific literature searches were then conducted. The literature in this field is not suitable to provide support for evidence-based recommendations. Therefore, the panel developed expert opinion-based suggestions using a modified Delphi process resulting in seven final suggestions. Acceptance is widespread for the health-care community's duty to appropriately plan for and respond to severe disasters and pandemics. Hospitals, public health entities, and clinicians have an obligation to develop comprehensive, vetted plans for mass casualty incidents involving critically ill or injured patients. Such plans should address processes for evacuation and limited appeals and reviews of care decisions. To legitimize responses, deter independent actions, and trigger liability protections, mass critical care (MCC) plans should be formally activated when facilities and practitioners shift to providing MCC. Adherence to official MCC plans should contribute to protecting

  5. Hacking Health: Bottom-up Innovation for Healthcare

    Directory of Open Access Journals (Sweden)

    Jeeshan Chowdhury

    2012-07-01

    Full Text Available Healthcare is not sustainable and still functions with outdated technology (e.g., pagers, paper records. Top-down approaches by governments and corporations have failed to deliver digital technologies to modernize healthcare. Disruptive innovation must come from the ground up by bridging the gap between front-line health experts and innovators in the latest web and mobile technology. Hacking Health is a hackathon that is focused on social innovation more than technical innovation. Our approach to improve healthcare is to pair technological innovators with healthcare experts to build realistic, human-centric solutions to front-line healthcare problems.

  6. OEM Emergency Preparedness Information

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Office of Emergency Management compiles a wide variety of information in support of Emergency Preparedness, including certain elements of the System for Risk...

  7. Discretionary Power on the Front-line

    DEFF Research Database (Denmark)

    Sanden, Guro Refsum; Lønsmann, Dorte

    This article investigates the communication practices used by front-line employees to cross language boundaries in the context of English language policies implemented by the management of three multinational corporations (MNCs) headquartered in Scandinavia. Based on an analysis of interview...... and document data, our findings show that employees face a number of different language boundaries in their everyday work, and that ad hoc and informal solutions in many cases are vital for successful cross-language communication. We introduce the concept of ‘discretionary power’ to explain how and why front...

  8. Discretionary power on the front-line

    DEFF Research Database (Denmark)

    Sanden, Guro Refsum; Lønsmann, Dorte

    2018-01-01

    This article investigates the communication practices used by front-line employees to cross language boundaries in the context of English language policies implemented by the management of three multinational corporations headquartered in Scandinavia. Based on an analysis of interview and document...... data, our findings show that employees face a number of different language boundaries in their everyday work, and that ad hoc and informal solutions in many cases are vital for successful cross-language communication. We introduce the concept of discretionary power to explain how and why front...

  9. Paradise nearly Gained. Volume 1: Developing the Frontline Management Initiative.

    Science.gov (United States)

    Barratt-Pugh, Llandis; Soutar, Geoffrey N.

    The Frontline Management Initiative (FMI) provides a framework for competency-based development of frontline managers in Australian enterprises. The FMI's impact on businesses was examined in a national study that included the following activities: focus groups; a national survey of management development and targeted national survey of FMI users;…

  10. Front-line ordering clinicians: matching workforce to workload.

    Science.gov (United States)

    Fieldston, Evan S; Zaoutis, Lisa B; Hicks, Patricia J; Kolb, Susan; Sladek, Erin; Geiger, Debra; Agosto, Paula M; Boswinkel, Jan P; Bell, Louis M

    2014-07-01

    Matching workforce to workload is particularly important in healthcare delivery, where an excess of workload for the available workforce may negatively impact processes and outcomes of patient care and resident learning. Hospitals currently lack a means to measure and match dynamic workload and workforce factors. This article describes our work to develop and obtain consensus for use of an objective tool to dynamically match the front-line ordering clinician (FLOC) workforce to clinical workload in a variety of inpatient settings. We undertook development of a tool to represent hospital workload and workforce based on literature reviews, discussions with clinical leadership, and repeated validation sessions. We met with physicians and nurses from every clinical care area of our large, urban children's hospital at least twice. We successfully created a tool in a matrix format that is objective and flexible and can be applied to a variety of settings. We presented the tool in 14 hospital divisions and received widespread acceptance among physician, nursing, and administrative leadership. The hospital uses the tool to identify gaps in FLOC coverage and guide staffing decisions. Hospitals can better match workload to workforce if they can define and measure these elements. The Care Model Matrix is a flexible, objective tool that quantifies the multidimensional aspects of workload and workforce. The tool, which uses multiple variables that are easily modifiable, can be adapted to a variety of settings. © 2014 Society of Hospital Medicine.

  11. Preparedness of frontline health workers for tobacco cessation: An exploratory study from two states of India

    Directory of Open Access Journals (Sweden)

    Rajmohan Panda

    2015-01-01

    Full Text Available Background: The 5As approach is a clinic-based approach and has been developed for primary health care providers who are uniquely positioned to interact with tobacco users. The 5As stands for: Ask about tobacco use at every visit, advise tobacco users to quit, assess readiness to quit, assist quit attempts through counseling and pharmacotherapy and arrange follow-up to prevent relapse. The present study explores whether auxiliary nurse midwives (ANMs adhere to the 3As from the recommended 5As model for tobacco cessation. Materials and Methods: The study was a cross-sectional study conducted among 501 ANMs in the state of Gujarat and Andhra Pradesh. Descriptive analysis and chi-square test were employed to test the differences in knowledge levels and practices of ANMs. Bivariate logistic regression was used to examine the association between each predictor variable separately and the outcome variables after adjusting for age and location. Data was analyzed using SPSS version 17 software. Results: Majority of ANMs reported that they were aware of respiratory illnesses, tuberculosis, lung and oral cancer as conditions caused due to tobacco consumption. Awareness of adverse reproductive and child health effects associated with tobacco use was very low. Only about one third of respondents informed all patients about harmful effects. Only 16% of ANMs reported having ever received any on-job training related to tobacco control. ANMs who reported receiving training in tobacco control were about two times more likely to provide information on health effects of tobacco as compared to those who reported not being trained in tobacco control in the state of Gujarat. Conclusions: A majority of ANMs ask patients about tobacco use but provide advice only to patients suffering from specific diseases. A context-specific capacity building package needs to be designed to equip ANMs in recommended 5As approach in tobacco cessation.

  12. Leadership behaviors of frontline staff nurses.

    Science.gov (United States)

    Fardellone, Christine; Musil, Carol M; Smith, Elaine; Click, Elizabeth R

    2014-11-01

    A recommendation in the Institute of Medicine's report, The Future of Nursing: Leading Change, Advancing Health, challenges the nursing profession to enhance nursing's leadership role in health care redesign. This descriptive, correlational, cross-sectional study examined the self-perceived leadership behaviors of RNs enrolled in a clinical ladder career pathway. A self-report survey was conducted using the Leadership Practice Inventory and a demographic questionnaire. Significant associations between continuous and categorical demographic factors and ladder levels were reported. Nurses with more experience showed fewer leadership behaviors. Leadership development is necessary for nurses in all areas of practice. The findings from this study provide evidence of the strengths and weaknesses in leadership behaviors of staff clinical RNs who often make frontline decisions for patients. Copyright 2014, SLACK Incorporated.

  13. Bridge to shared governance: developing leadership of frontline nurses.

    Science.gov (United States)

    Dearmon, Valorie A; Riley, Bettina H; Mestas, Lisa G; Buckner, Ellen B

    2015-01-01

    Transforming health care systems to improve quality is the responsibility of nurse executives and frontline nurses alike, yet frontline nurses are often ill-prepared to share leadership and accountability needed for transformation. The aim of this qualitative study was to describe the process used to build leadership capacity of frontline nurses engaged in resolving operational failures interrupting nursing care. The leadership development process served to bridge staff transition to shared governance. This institutional review board-approved qualitative research was designed to identify the effects of mentoring by the chief nursing officer and faculty partners on leadership development of frontline nurses working to find solutions to operational failures. Twelve nurses from 4 medical surgical units participated in a Frontline Innovations' nurse-led interdisciplinary group, which met over 18 months. Transcriptions of audiotaped meetings were analyzed for emerging process and outcome themes. The transcripts revealed a robust leadership development journey of frontline nurses engaged in process improvement. Themes that emerged from the mentoring process included engagement, collaboration, empowerment, confidence, and lifelong learning. The mentoring process provided frontline nurses the leadership foundation necessary to initiate shared governance.

  14. Innovative package for frontline maternal, newborn and child health ...

    African Journals Online (AJOL)

    of Global Health and Human Rights (Department of Emergency Medicine, Massachusetts ... The purpose of MNCS is to build frontline health worker capacity through a training ... This innovative training package may also serve as a model for.

  15. Risk from the frontlines of a hidden epidemic sexuality, masculinities ...

    African Journals Online (AJOL)

    Risk from the frontlines of a hidden epidemic sexuality, masculinities and social pressures ... It frames risk in the context of the dynamics governing sexuality, underlined ... MSM risk and practice, in these contexts, are consequently shaped by ...

  16. Emergency preparedness and response

    International Nuclear Information System (INIS)

    Griffiths, M.

    1996-01-01

    After the Chernobyl accident, it became painfully obvious to the international community that there was an urgent need to establish a system for the coordination of international disaster assistance. It became the task of the United Nations Office for Disaster Relief (UNDRO) to develop such a system. The former UNDRO was subsumed into the Department of Humanitarian Affairs (DHA), established in January 1992 on the basis of UN General Assembly Resolution 46/182 adopted in December 1991, and the disaster relief system presently found in DHA is a further evolution of the system established by UNDRO. One particular importance in relation to nuclear accidents is the fact that UNDRO and the International Atomic Energy Agency (IAEA) signed a Memorandum of Understanding defining their respective responsibilities and the need for cooperation in case of accidents involving the unintentional release of nuclear radiation. In essence, the MOU makes it clear that the responsibilities of the IAEA, in connection with accidents at Nuclear Power Plants, related to the technical and radiological aspects, in particular to accident prevention, to the on-site preparedness, and to remedial measures within the 30-km zone outside the NPP. DHA's responsibilities, on the other hand, relate to the general preparedness and the rescue efforts outside the 30 km zone. In this respect, the preparedness and emergency response system is no different from the system employed in any other type of sudden-onset emergency

  17. Emergency preparedness in obstetrics.

    Science.gov (United States)

    Haeri, Sina; Marcozzi, David

    2015-04-01

    During and after disasters, focus is directed toward meeting the immediate needs of the general population. As a result, the routine health care and the special needs of some vulnerable populations such as pregnant and postpartum women may be overlooked within a resource-limited setting. In the event of hazards such as natural disasters, manmade disasters, and terrorism, knowledge of emergency preparedness strategies is imperative for the pregnant woman and her family, obstetric providers, and hospitals. Individualized plans for the pregnant woman and her family should include knowledge of shelter in place, birth at home, and evacuation. Obstetric providers need to have a personal disaster plan in place that accounts for work responsibilities in case of an emergency and business continuity strategies to continue to provide care to their communities. Hospitals should have a comprehensive emergency preparedness program utilizing an "all hazards" approach to meet the needs of pregnant and postpartum women and other vulnerable populations during disasters. With lessons learned in recent tragedies such as Hurricane Katrina in mind, we hope this review will stimulate emergency preparedness discussions and actions among obstetric providers and attenuate adverse outcomes related to catastrophes in the future.

  18. A review of critical care nursing and disease outbreak preparedness.

    Science.gov (United States)

    Makamure, Miranda; Makamure, Muriel; Mendiola, Williane; Renteria, Daisy; Repp, Melissa; Willden, Azshwee

    2013-01-01

    The impact of disease outbreaks continues to increase globally. As frontline staff, critical care nurses (CCNs) are more likely to be confronted with the need to care for affected patients. With different pathological diseases emerging, CCNs play an integral role in disease outbreaks. The advanced skill set of CCNs is pivotal in the management and care of patients during an outbreak. Lack of planning and preparation before disease outbreaks leads to detrimental patient outcomes. Panic, chaos, and fear for personal safety cause stress and anxiety for unprepared nurses. However, this problem can be resolved. Comprehensive planning, training, and education can better prepare intensive care unit nurses for disease outbreaks. This article reviews some of the current literature on intensive care unit nurse preparedness for disease outbreaks in the United States. This article also offers strategies that may be used to better prepare CCNs for disease outbreaks.

  19. Preparedness and Emergency Response Learning Centers: supporting the workforce for national health security.

    Science.gov (United States)

    Richmond, Alyson L; Sobelson, Robyn K; Cioffi, Joan P

    2014-01-01

    The importance of a competent and prepared national public health workforce, ready to respond to threats to the public's health, has been acknowledged in numerous publications since the 1980s. The Preparedness and Emergency Response Learning Centers (PERLCs) were funded by the Centers for Disease Control and Prevention in 2010 to continue to build upon a decade of focused activities in public health workforce preparedness development initiated under the Centers for Public Health Preparedness program (http://www.cdc.gov/phpr/cphp/). All 14 PERLCs were located within Council on Education for Public Health (CEPH) accredited schools of public health. These centers aimed to improve workforce readiness and competence through the development, delivery, and evaluation of targeted learning programs designed to meet specific requirements of state, local, and tribal partners. The PERLCs supported organizational and community readiness locally, regionally, or nationally through the provision of technical consultation and dissemination of specific, practical tools aligned with national preparedness competency frameworks and public health preparedness capabilities. Public health agencies strive to address growing public needs and a continuous stream of current and emerging public health threats. The PERLC network represented a flexible, scalable, and experienced national learning system linking academia with practice. This system improved national health security by enhancing individual, organizational, and community performance through the application of public health science and learning technologies to frontline practice.

  20. Bridging the Gap in Hospital Preparedness

    National Research Council Canada - National Science Library

    Adwell, James P

    2007-01-01

    .... This paper reviews personnel attitudes towards preparedness at Johns Hopkins Hospital, types of training used in disaster preparedness and their effectiveness, the use of individual and family...

  1. Effects of a new parallel primary healthcare centre and on-campus training programme on history taking, physical examination skills and medical students’ preparedness: a prospective comparative study in Taiwan

    Science.gov (United States)

    Yang, Ying-Ying; Wang, Shuu-Jiun; Yang, Ling-Yu; Lirng, Jiing-Feng; Huang, Chia-Chang; Liang, Jen-Feng; Lee, Fa-Yauh; Hwang, Shinn-Jang; Huang, Chin-Chou; Kirby, Ralph

    2017-01-01

    Objectives The primary healthcarecentre (PHCC) is the first place that medical students experience patient contact. Usually, medical students are frustrated by a lack of proper skills training for on-campus history taking (HT), physical examination (PE) and self-directed learning (SDL) to prepare for their PHCC and inhospital patient contact. For pre-clerks, this study aims to compare the effectiveness of PHCC training and PHCC training in combination with on-campus HT and PE training modules (PHCC+on-campus) on their clerkship preparedness. Design This comparative study utilised prospective, consecutive, end of pre-clerkship group objective structured clinical examination (GOSCE), beginning of clerkship OSCE and self-administered Preparation for Hospital Practice Questionnaire (PHPQ). Setting/participants 128 pre-clinical clerk volunteers (64 each year) receiving PHCC training (7 week PHCCtraining in addition to 7 week assignment based group learning, academic year 2014, controls) and PHCC training in combination with on-campus module training (academic year 2015, 7 week PHCCtraining in addition to 7 week on-campus sessions) were sequentially assessed before the module (week 1), at the end of the module (week 14) and at the beginning of clerkship (week 25). Results For overall HT and PE skills, both PHCC and PHCC+on-campus module trained pre-clerks performed better on OSCE than GOSCE. Additionally, the improvement was accompanied by higher self-reported PHPQ scores in ‘confidence/coping’ and ‘SDL’ domains. At the end of the pre-clerkship and the beginning of the clerkship stages, the degree of improvement in preparedness in ‘confidence/coping’ and ‘SDL’ domains was higher for those in the PHCC+on-campus group than for those in the PHCC group. Among the PHCC+on-campus module participants, a positive association was observed between high mean PHPQ-SDL scores and high OSCE scores. Conclusions Our study suggests that the PHCC+on-campus module

  2. Effects of a new parallel primary healthcare centre and on-campus training programme on history taking, physical examination skills and medical students' preparedness: a prospective comparative study in Taiwan.

    Science.gov (United States)

    Yang, Ying-Ying; Wang, Shuu-Jiun; Yang, Ling-Yu; Lirng, Jiing-Feng; Huang, Chia-Chang; Liang, Jen-Feng; Lee, Fa-Yauh; Hwang, Shinn-Jang; Huang, Chin-Chou; Kirby, Ralph

    2017-09-25

    The primary healthcarecentre (PHCC) is the first place that medical students experience patient contact. Usually, medical students are frustrated by a lack of proper skills training for on-campus history taking (HT), physical examination (PE) and self-directed learning (SDL) to prepare for their PHCC and inhospital patient contact. For pre-clerks, this study aims to compare the effectiveness of PHCC training and PHCC training in combination with on-campus HT and PE training modules (PHCC+on-campus) on their clerkship preparedness. This comparative study utilised prospective, consecutive, end of pre-clerkship group objective structured clinical examination (GOSCE), beginning of clerkship OSCE and self-administered Preparation for Hospital Practice Questionnaire (PHPQ). 128 pre-clinical clerk volunteers (64 each year) receiving PHCC training (7 week PHCCtraining in addition to 7 week assignment based group learning, academic year 2014, controls) and PHCC training in combination with on-campus module training (academic year 2015, 7 week PHCCtraining in addition to 7 week on-campus sessions) were sequentially assessed before the module (week 1), at the end of the module (week 14) and at the beginning of clerkship (week 25). For overall HT and PE skills, both PHCC and PHCC+on-campus module trained pre-clerks performed better on OSCE than GOSCE. Additionally, the improvement was accompanied by higher self-reported PHPQ scores in 'confidence/coping' and 'SDL' domains. At the end of the pre-clerkship and the beginning of the clerkship stages, the degree of improvement in preparedness in 'confidence/coping' and 'SDL' domains was higher for those in the PHCC+on-campus group than for those in the PHCC group. Among the PHCC+on-campus module participants, a positive association was observed between high mean PHPQ-SDL scores and high OSCE scores. Our study suggests that the PHCC+on-campus module, which is paired faculty led and pre-trained dyad student assisted, is

  3. Frontline police employees’ social construction of client service

    Directory of Open Access Journals (Sweden)

    Karel Stanz

    2007-07-01

    Full Text Available The social construction of frontline employees’ client service plays a major role in organisational success. This study illuminated why frontline personnel are reluctant to accept organisational change which is in line with new policing philosophies. Applying modernist qualitative methodology, and particularly grounded theory within a case study design a ‘process satisfaction model’ was developed with the aim to improve employee satisfaction with internal processes and ultimately service delivery. This model may be used for change in the South African Police Service SAPS and other government departments.

  4. On Frontline Workers as Bureau-Political Actors: The Case of Civil–Military Crisis Management

    NARCIS (Netherlands)

    Kalkman, J.P.; Groenewegen, Peter

    2018-01-01

    We focus attention on the public policy-making influence of frontline bureaucrats. They are increasingly operating in interorganizational partnerships and networks in which they develop collaborative relations with frontline workers of other public organizations. We theorize that their embeddedness

  5. The influence of frontline manager job strain on burnout, commitment and turnover intention: a cross-sectional study.

    Science.gov (United States)

    Wong, Carol A; Spence Laschinger, Heather K

    2015-12-01

    The frontline clinical manager role in healthcare is pivotal to the development of safe and healthy working conditions and optimal staff and patient care outcomes. However, in today's dynamic healthcare organizations managers face constant job demands from wider spans of control and complex role responsibilities but may not have adequate decisional authority to support effective work performance resulting in unnecessary job strain. Prolonged job strain can lead to burnout, health complaints, and increased turnover intention. Yet, there is limited research that examines frontline manager job strain and its impact on their well-being and work outcomes. The substantial cost associated with replacing experienced managers calls attention to the need to address job strain in order to retain this valuable organizational asset. Using Karasek's Job Demands-Control theory of job strain, a model was tested examining the effects of frontline manager job strain on their burnout (emotional exhaustion and cynicism), organizational commitment and ultimately, turnover intentions. Secondary analysis of data collected in an online cross-sectional survey of frontline managers was conducted using structural equation modeling. All 500 eligible frontline managers from 14 teaching hospitals in Ontario, Canada, were invited to participate and 159 responded for a 32% response rate. Participants received an email invitation with a secure link for the online survey. Ethics approval was obtained from the university ethics board and the respective ethics review boards of the 14 organizations involved in the study. The model was tested using path analysis techniques within structural equation modeling with maximum likelihood estimation. The final model fit the data acceptably (χ(2)=6.62, df=4, p=.16, IFI=99, CFI=.99, SRMR=.03, RMSEA=.06). Manager job strain was significantly positively associated with burnout which contributed to both lower organizational commitment and higher turnover

  6. An Examination of Organizations' Frontline Service Employee Development Practices

    Science.gov (United States)

    Ellinger, Alexander E.; Elmadag, Ayse Banu; Ellinger, Andrea D.

    2007-01-01

    Firms with the ability to provide superior customer service can accrue significant competitive advantage and research suggests that frontline service employees' (FLSEs) actions have a considerable influence on the success of service operations. Yet, the high level of customer defections consistently attributed to poor and indifferent service…

  7. Protecting front-line survey and rescue teams during emergencies

    International Nuclear Information System (INIS)

    Tresise, H.

    1980-01-01

    Means of protecting front-line survey and rescue teams during emergencies are described. The team composition, their apparatus, the selection of the incident control point, the use of guidelines and breathing apparatus and control point trolley and equipment are discussed. (H.K.)

  8. Rural transportation emergency preparedness plans.

    Science.gov (United States)

    2009-07-01

    Improving the emergency preparedness of rural transportation systems is the overall goal of this research. Unique characteristics exist in rural transportation systems including widely dispersed and diverse populations and geographic areas. Exploring...

  9. Towards high-reliability organising in healthcare: a strategy for building organisational capacity.

    Science.gov (United States)

    Aboumatar, Hanan J; Weaver, Sallie J; Rees, Dianne; Rosen, Michael A; Sawyer, Melinda D; Pronovost, Peter J

    2017-08-01

    In a high-reliability organisation (HRO), safety and quality (SQ) is an organisational priority, and all workforce members are engaged, continuously learning and improving their work. To build organisational capacity for SQ work, we have developed a role-tailored capacity-building framework that we are currently employing at the Johns Hopkins Armstrong Institute for Patient Safety and Quality as part of an organisational strategy towards HRO. This framework considers organisation-wide competencies for SQ that includes all staff and faculty and is integrated into a broader organisation-wide operating management system for improving quality. In this framework, achieving safe, high-quality care is connected to healthcare workforce preparedness. Capacity-building efforts are tailored to the needs of distinct groups within the workforce that fall within three categories: (1) front-line providers and staff, (2) managers and local improvement personnel and (3) SQ leaders and experts. In this paper we describe this framework, our implementation efforts to date, challenges met and lessons learnt. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  10. Radiological emergencies - planning and preparedness

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1986-12-31

    This information and training film in three parts deals with the technical background for emergency planning, emergency planning concepts and emergency preparedness. It describes the technical characteristics of radiological emergencies on which important emergency planning concepts are based and the purpose of those concepts. The film also demonstrates how emergency organizations must work together to ensure adequate preparedness. The programme reflects the standards, guidance and recommendations of the International Atomic Energy Agency

  11. Transportation Emergency Preparedness Program (TEPP)

    International Nuclear Information System (INIS)

    1991-04-01

    The Transportation Emergency Preparedness Program (TEPP) will develop and enhance integrated emergency preparedness capabilities in two major areas. First, the program is responsible for planning and ensuring proper DOE response to transportation incidents involving DOE shipments. Second, the program is responsible for ensuring DOE can carry out its responsibilities under regulations, the National Contingency Plan (NCP) and the Federal Radiological Emergency Response Plan (FRERP) to provide technical advice and assistance as needed for any transportation incident involving radioactive or mixed hazard materials. This plan proposes a strategy for developing a comprehensive Transportation Emergency Preparedness Program, including a well organized central management and coordination structure, that serves as a process to identify, verify, and establish a consolidated effort across the Department in this very important area. This plan assumes Emergency Management to be the full range of emergency activities necessary for mitigation, preparedness, response and recovery while Emergency Preparedness activities are primarily those necessary in preparation for Incident Response Emergency Preparedness, which is the focus of this strategy plan, requires a well organized central coordination structure to be effective. 7 refs

  12. [Disaster nursing and primary school teachers' disaster-related healthcare knowledge and skills].

    Science.gov (United States)

    Lai, Fu-Chih; Lei, Hsin-Min; Fang, Chao-Ming; Chen, Jiun-Jung; Chen, Bor-An

    2012-06-01

    The World Bank has ranked Taiwan as the 5th highest risk country in the world in terms of full-spectrum disaster risk. With volatile social, economic, and geologic environments and the real threat of typhoons, earthquakes, and nuclear disasters, the government has made a public appeal to raise awareness and reduce the impact of disasters. Disasters not only devastate property and the ecology, but also cause striking and long-lasting impacts on life and health. Thus, healthcare preparation and capabilities are critical to reducing their impact. Relevant disaster studies indicate children as a particularly vulnerable group during a disaster due to elevated risks of physical injury, infectious disease, malnutrition, and post-traumatic stress disorder. Primary school teachers are frontline educators, responders, and rehabilitators, respectively, prior to, during, and after disasters. The disaster prevention project implemented by the Taiwan Ministry of Education provides national guidelines for disaster prevention and education. However, within these guidelines, the focus of elementary school disaster prevention education is on disaster prevention and mitigation. Little guidance or focus has been given to disaster nursing response protocols necessary to handle issues such as post-disaster infectious diseases, chronic disease management, and psychological health and rehabilitation. Disaster nursing can strengthen the disaster healthcare response capabilities of school teachers, school nurses, and children as well as facilitate effective cooperation among communities, disaster relief institutes, and schools. Disaster nursing can also provide healthcare knowledge essential to increase disaster awareness, preparation, response, and rehabilitation. Implementing proper disaster nursing response protocols in Taiwan's education system is critical to enhancing disaster preparedness in Taiwan.

  13. The changing health priorities of earthquake response and implications for preparedness: a scoping review.

    Science.gov (United States)

    Cartwright, C; Hall, M; Lee, A C K

    2017-09-01

    Earthquakes have substantial impacts on mortality in low- and middle-income countries (LMIC). The academic evidence base to support Disaster Risk Reduction activities in LMIC settings is, however, limited. We sought to address this gap by identifying the health and healthcare impacts of earthquakes in LMICs and to identify the implications of these findings for future earthquake preparedness. Scoping review. A scoping review was undertaken with systematic searches of indexed databases to identify relevant literature. Key study details, findings, recommendations or lessons learnt were extracted and analysed across individual earthquake events. Findings were categorised by time frame relative to earthquakes and linked to the disaster preparedness cycle, enabling a profile of health and healthcare impacts and implications for future preparedness to be established. Health services need to prepare for changing health priorities with a shift from initial treatment of earthquake-related injuries to more general health needs occurring within the first few weeks. Preparedness is required to address mental health and rehabilitation needs in the medium to longer term. Inequalities of the impact of earthquakes on health were noted in particular for women, children, the elderly, disabled and rural communities. The need to maintain access to essential services such as reproductive health and preventative health services were identified. Key preparedness actions include identification of appropriate leaders, planning and training of staff. Testing of plans was advocated within the literature with evidence that this is possible in LMIC settings. Whilst there are a range of health and healthcare impacts of earthquakes, common themes emerged in different settings and from different earthquake events. Preparedness of healthcare systems is essential and possible, in order to mitigate the adverse health impacts of earthquakes in LMIC settings. Preparedness is needed at the community

  14. Biodosimetry: emergency preparedness

    International Nuclear Information System (INIS)

    Pradeepkumar, K.S.

    2016-01-01

    Biodosimetry assays are the only methods available for ascertaining and estimating biological dose for suspected over-exposures and manage radiological emergency situations. These methods also plays a major role in medical management and triage. In the eventuality of radiological emergency, it becomes inevitable to provide care for exposed individuals. However, large numbers of unexposed individuals or those with clinically insignificant doses are to be screened off for effective medical management of those who really need the specialized medical attention. Majority of individuals involved in radiological accidents may not need any medical attention but will need ascertainment of dose estimation and counselling. The decision making and counselling is possible only with the evidence of dose estimation. Though Biodosimetry procedures-are known for their inherent delay, since radiation effects are very slow in nature, give ample time for such investigations to be completed without any hurry to take medical actions in most cases. High throughput facilities in the state of the art Biodosimetry lab established at HS and EG, BARC has helped us to address many small scale radiological emergencies in the past. These experiences also helped the lab to prepare itself for large scale scenario and support the emergency management with continually improving preparedness and indigenous development of facilities. (author)

  15. Selecting the Best Frontline Treatment in Chronic Myeloid Leukemia

    Science.gov (United States)

    Yilmaz, Musa; Abaza, Yasmin; Jabbour, Elias

    2017-01-01

    With the discovery of Philadelphia chromosome, understanding of chronic myeloid leukemia (CML) pathobiology has tremendously increased. Development of tyrosine kinase inhibitors (TKI) targeting the BCR/ABL1 oncoprotein has changed the landscape of the disease. Today, the expected survival of CML patients, if properly managed, is likely to be similar to the general population. Imatinib is the first approved TKI in CML treatment, and for several years, it was the only option in the frontline setting. Four years ago, second generation TKIs (nilotinib and dasatinib) were approved as alternative frontline options. Now, clinicians are faced the challenge of making decision for which TKI to chose upfront. Second generation TKIs have been demonstrated to induce deeper and faster responses compared to imatinib, however, none of 3 TKIs have been shown to have a clear survival advantage, they all are reasonable options. In contrast, when considering therapy in individual patients, the case may be stronger for a specific TKI. Co-morbidities of the patient and side effect profile of the TKI of interest should be an important consideration in decision making. At present, the cost nilotinib or dasatinib is not remarkably different from imatinib. However, patent for imatinib is expected to expire soon, and it will be available as a generic. Clinicians, then, need to weigh the advantages some patients gain with nilotinib or dasatinib in the frontline setting against the difference in cost. Whatever TKI is chosen as frontline, intolerance, non-compliance or treatment failure should be recognized early as a prompt intervention increases the chance of achieving best possible response. PMID:25921387

  16. Factors influencing advanced practice nurses' ability to promote evidence-based practice among frontline nurses.

    Science.gov (United States)

    Gerrish, Kate; Nolan, Mike; McDonnell, Ann; Tod, Angela; Kirshbaum, Marilyn; Guillaume, Louise

    2012-02-01

    Advanced practice nurses (APNs) have an important role in promoting evidence-based practice (EBP) among frontline nurses (FLNs). Factors influencing FLNs' engagement with EBP are well documented but little is known about factors that affect APNs' ability to facilitate evidence in practice. To identify factors that influence APNs' ability to promote EBP among FLNs. A multiple case study of 23 APNs from hospital and primary care settings across seven English health authorities was undertaken. Data collection comprised interviews and observation of APNs and interviews with FLNs and other healthcare professionals. Data were analysed using the Framework approach. Four groups of influencing factors were identified: (1) Personal attributes of APNs included knowledge and skills in EBP, clinical credibility with frontline staff and leadership style. (2) Relationships with stakeholders included APNs' interactions with FLNs and the level of support from managers and medical colleagues. (3) Aspects of the APN role included their sphere of responsibility and workload. (4) Organisational context included the organisational culture, FLNs' workload, professional networks and available resources. Educational preparation for APNs should enable them to develop expertise in EBP plus interpersonal and leadership skills to manage relational dynamics in clinical settings. APN role specifications should provide the opportunity to promote EBP. The organisational culture should be conducive to enabling EBP with managers supportive of this aspect of the APNs' role. APNs need to be supported to address the individual, interpersonal and organisational factors, which influence their ability to promote EBP. Organisational commitment at the highest level is key to APNs' ability to fulfil this aspect of their role. ©2011 Sigma Theta Tau International.

  17. 78 FR 54743 - National Preparedness Month, 2013

    Science.gov (United States)

    2013-09-06

    ... like hurricanes, tornadoes, and floods to shootings, cyber incidents, and even acts of terrorism. While... Preparedness Month. I encourage all Americans to recognize the importance of preparedness and work together to enhance our national security, resilience, and readiness. [[Page 54744

  18. Ebola virus disease: radiology preparedness.

    Science.gov (United States)

    Bluemke, David A; Meltzer, Carolyn C

    2015-02-01

    At present, there is a major emphasis on Ebola virus disease (EVD) preparedness training at medical facilities throughout the United States. Failure to have proper EVD procedures in place was cited as a major reason for infection of medical personnel in the United States. Medical imaging does not provide diagnosis of EVD, but patient assessment in the emergency department and treatment isolation care unit is likely to require imaging services. The purpose of this article is to present an overview of relevant aspects of EVD disease and preparedness relevant to the radiologic community. © RSNA, 2014.

  19. Psychological Correlates of Civilian Preparedness for Conflicts.

    Science.gov (United States)

    Bodas, Moran; Siman-Tov, Maya; Kreitler, Shulamith; Peleg, Kobi

    2017-08-01

    Preparedness for emergencies and disasters is imperative for public resilience. Previous studies have revealed low levels of civilian preparedness for conflicts. Classic behavioral models prove inapt in describing preparedness patterns in victimized populations chronically exposed to this threat. In an effort to expand this perspective, we hypothesized that other psychological constructs are correlated with preparedness. A cross-sectional, Internet-based study was performed in Israel in early 2016. A sociodemographically diverse sample included 385 participants, Jews and Arabs. The tools included a preparedness index, sense of preparedness questionnaire, Trait Anxiety Inventory, Life Orientation Test, Behavioral Inhibition & Activation System scales, and ego defenses. The results suggested that optimistic and rational individuals reported significantly higher levels of preparedness, whereas those who scored highly on the trait anxiety scale and those with a tendency to use denial coping mechanisms reported significantly lower levels of preparedness. The findings suggest that additional constructs, other than classic threat perception components, might play a key role in governing preparedness behavior. In particular, psychological manipulation of dispositional optimism or optimistic thinking might be effective in motivating preparedness behavior. Future research should explore such innovative ways to promoting preparedness. (Disaster Med Public Health Preparedness. 2017;11:451-459).

  20. Situating Preparedness Education within Public Pedagogy

    Science.gov (United States)

    Kitagawa, Kaori

    2017-01-01

    Both "disaster preparedness" and "public pedagogy" have been broadly defined and diversely utilised. Preparedness has been dealt with in disciplines such as civil engineering, the sociology of disasters, public health and psychology, rather than education. Recently, inquiries into the learning and teaching of preparedness have…

  1. Back-to-School Preparedness

    Centers for Disease Control (CDC) Podcasts

    2014-07-28

    CDC provides direction, support, and coordination to help the public be prepared. This podcast discusses how parents and students can be prepared at school.  Created: 7/28/2014 by Office of Public Health Preparedness and Response (PHPR).   Date Released: 7/31/2014.

  2. Assessing School Emergency Care Preparedness.

    Science.gov (United States)

    Hale, Charles; Varnes, Jill

    A study assessed the emergency health care preparedness of a north central Florida public school district in light of seven criteria: (1) school policies regarding delivery of emergency health care; (2) identification of school personnel responsible for rendering emergency care; (3) training levels of emergency health care providers (first aid and…

  3. Emergency preparedness at Ignalina NPP

    International Nuclear Information System (INIS)

    Kairys, A.

    1998-01-01

    Brief review of Ignalina NPP safety upgrading and personnel preparedness to act in cases of accidents is presented. Though great activities are performed in enhancing the plant operation safety, the Ignalina NPP management pays a lot of attention to preparedness for emergency elimination and take measures to stop emergency spreading. A new Ignalina NPP emergency preparedness plan was drawn up and became operational. It is the main document to carry out organizational, technical, medical, evacuation and other activities to protect plant personnel, population, the plant and the environment from accident consequences. Great assistance was rendered by Swedish experts in drawing this new emergency preparedness plan. The plan consists of 3 parts: general part, operative part and appendixes. The plan is applied to the Ignalina NPP personnel, Special and Fire Brigade and also to other contractor organizations personnel carrying out works at Ignalina NPP. There are set the following emergency classes: incident, emergency situation, alert, local emergency, general emergency. Separate intervention level corresponds to each emergency class. Overview of personnel training to act in case of an emergency is also presented

  4. Disaster: Prevention, Preparedness and Action.

    Science.gov (United States)

    Buchanan, Sally

    1981-01-01

    Discission of threat of disaster to library archival materials focuses on prevention (building maintenance, materials storage, fire prevention), preparedness (preplanning, procedures for handling emergencies, finances of recovery operation), and action (instructions for handling damaged materials). Current library activities in disaster planning…

  5. Preparedness Now! An Emergency Survival Guide

    CERN Document Server

    Edwards, Aton

    2009-01-01

    In uncertain times, a solid preparedness plan is essential for every individual and family. PREPAREDNESS NOW! navigates the new realities of twenty-first century living: extreme weather, economic instability, terror attacks, and more. Packed with checklists, resources, and step-by-step instructions, PREPAREDNESS NOW! details everything needed for office, car, and home preparedness. This newly expanded and revised edition includes an extended chapter on food and water storage and urban gardening, techniques in personal defense, and the latest and best preparedness products on the market. This b

  6. Information needs of the 'frontline' public health workforce.

    Science.gov (United States)

    Rutland, J D; Smith, A M

    2010-11-01

    To explore the information needs of the 'frontline' public health workforce, whether needs are being met and barriers to meeting needs. A qualitative research study using in-depth semi-structured interviews. A qualitative study, comprising eight semi-structured interviews, was conducted with one representative of each of eight categories of frontline public health professional (children's centre manager, community development worker, community midwife, district nurse, health visitor, community pharmacist, practice nurse and school nurse) to determine their public health role, information needs and barriers to meeting needs. Interviews were tape-recorded and data were analysed to identify themes for each category and common themes. Respondents expressed similar needs, some of which could be met by a dedicated library and knowledge service, given adequate funding, and some of which need input from management. The library could supply: news bulletins and up-to-date information, especially local information; targeted local websites and databases; training in literature-searching skills, basic information technology (IT) skills and critical appraisal; course and work support, with access to local library facilities; a literature search support service; signposting, with a named library contact; and access to information for patients. Management input is required to remedy basic structural barriers, including: lack of IT equipment and training; lack of time to access information; lack of funding for courses and professional development; and lack of communication of information from higher levels. Some information needs can be met by improvements and widening of access to library services, which may need increased funding. However, some barriers to meeting information needs require action elsewhere in the public health management structure. Changes need to be made in communication of public health strategy, and engagement needs to be improved between higher managerial

  7. How well are healthcare institutions prepared for disasters?

    NARCIS (Netherlands)

    Yzermans, J.

    2009-01-01

    Introduction: The better healthcare providers are educated and trained and the more they practice their skills, the more they are prepared when disaster strikes. However, little is known about the current state of preparedness for managing disasters among healthcare providers. Methods:

  8. Harnessing the Frontline Employee Sensing of Capabilities for Decision Support

    DEFF Research Database (Denmark)

    Hallin, Carina Antonia; Andersen, Torben Juul; Tveterås, Sigbjørn

    2017-01-01

    The ability to sense developments in operational (steady-state) and dynamic (growth) capabilities provides early signals about how the firm adapts its operations to ongoing changes in the environment. Frontline employees engage in the daily transactions and sense the firm's operating conditions......, this article develops a sensing instrument an employee-sensed operational conduct (ESOC) index for updated information as an essential decision support mechanism. This sensing capacity is firm-specific and difficult to replicate once in place and thus can provide a basis for sustainable competitive advantage....

  9. Tribute to a frontline scientist in marine pollution research

    Digital Repository Service at National Institute of Oceanography (India)

    Sarkar, A

    frontline scientist in marine pollution research Anupam Sarkar Accepted: 1 February 2006 / Published online: 4 May 2006 C211 Springer Science+Business Media, LLC 2006 Dr. Simao Nascimento de Sousa This special issue of Ecotoxicology is dedicated to a... stream_size 2562 stream_content_type text/plain stream_name Ecotoxicology_15_329.pdf.txt stream_source_info Ecotoxicology_15_329.pdf.txt Content-Encoding UTF-8 Content-Type text/plain; charset=UTF-8 Tribute to a...

  10. Responsibility of a frontline manager regarding staff bullying.

    Science.gov (United States)

    Rocker, Carol F

    2012-09-24

    Canadian frontline nursing managers are observing an increase in the reporting of workplace bullying as more nurses become aware of their employers' legal obligations to provide employees with a respectful workplace, per the Canada Human Rights Code, Canada Labor Code, and Canada Occupational Health and Safety Regulations. One problem with this reporting is that the victim's reports of bullying may become overshadowed by the bully's reports of victim incompetence, resulting in the victim experiencing further victimization. Bullies may report the victim (target) as inept, deficient in knowledge, or lacking ability. Fear of re-victimization plays a significant role in the victim's failure to report workplace bullying. It is important that managers focus on the bullying and not on the perceived character flaws described by the bully. The author begins by describing workplace bullying and reviewing the workplace bullying literature. She then presents and discusses a composite case study. To assist managers in discouraging bullying she shares supports for addressing bullying, specifically workplace policies, collective agreements, human resources departments, mediation, alternative dispute resolution, and arbitration, and concludes by reminding frontline managers of their important role in identifying bullying and understanding the victim's fears of further victimization.

  11. Emergency preparedness in the future

    International Nuclear Information System (INIS)

    Desrosiers, A.E.

    1983-03-01

    This speech discusses safety issues facing nuclear power generation in terms of their contribution to increased costs of construction. The view is advanced that improvements in regulatory methods could be achieved by improvements in probabilistic risk assessment. The major deficiency in risk assessment is that the consequence assessments are not realistic and accident consequences not well understood. It is demonstrated that realistic modelling of evacuation times and other emergency preparedness capabilities can significantly reduce the calculated risk of operating nuclear power plants

  12. Developing utility emergency preparedness exercises

    International Nuclear Information System (INIS)

    Sjoeblom, K.

    1986-01-01

    Utility emergency preparedness exercises constitute an important link in upgrading the response to nuclear power plant emergencies. Various emergency exercises are arranged annually at the Loviisa nuclear power plant. The on-site simulator is a practical tool in developing suitable accident scenarios and demonstrating them to the site emergency players and spectators. The exercises concentrate on emergency management and radiological activities. It is important to create a high degree of motivation. (author)

  13. Radiological emergency preparedness (REP) program

    International Nuclear Information System (INIS)

    Kwiatkowski, D.H.

    1995-01-01

    This talk focuses on the accomplishments of Radiological Emergency Preparedness Program. Major topics include the following: strengthening the partnership between FEMA, the States, and the Industry; the Standard Exercise Report Format (SERF); Multi-year performance partnership agreement (MYPPA); new REP Program guidance; comprehensive exercise program; federal radiological emergency response plan (FRERP); international interest; REP user fee; implementation EPA PAGs and Dose Limits; Contamination monitoring standard for portal monitors; guidance documents and training

  14. Frontline health care can be improved by bringing research into the clinic

    DEFF Research Database (Denmark)

    Steinhausen, Kirsten; Berghmans, Stephane; Højgaard, Liselotte

    2011-01-01

    Progress in clinical research has played a huge role in the great improvements in frontline health care achieved over the last 50 years, both in general practice and in hospitals.......Progress in clinical research has played a huge role in the great improvements in frontline health care achieved over the last 50 years, both in general practice and in hospitals....

  15. Vocational Education and Training Manager Discursive Practices at the Frontline: Alternative Possibilities in a Victorian Setting

    Science.gov (United States)

    Foley, Annette

    2011-01-01

    This article looks at how the neoliberal reform process is affecting the professional identity of frontline managers in the Australian vocational education and training sector. The article examines how frontline managers are required to negotiate their working practices between their understandings and experiences as educators and the new…

  16. Beyond the organisational accident: the need for "error wisdom" on the frontline.

    Science.gov (United States)

    Reason, J

    2004-12-01

    Complex, well defended, high technology systems are subject to rare but usually catastrophic organisational accidents in which a variety of contributing factors combine to breach the many barriers and safeguards. To the extent that healthcare institutions share these properties, they too are subject to organisational accidents. A detailed case study of such an accident is described. However, it is important to recognise that health care possesses a number of characteristics that set it apart from other hazardous domains. These include the diversity of activity and equipment, a high degree of uncertainty, the vulnerability of patients, and a one to one or few to one mode of delivery. Those in direct contact with patients, particularly nurses and junior doctors, often have little opportunity to reform the system's defences. It is argued that some organisational accident sequences could be thwarted at the last minute if those on the frontline had acquired some degree of error wisdom. Some mental skills are outlined that could alert junior doctors and nurses to situations likely to promote damaging errors.

  17. Emergency planning and response preparedness in Slovenia

    International Nuclear Information System (INIS)

    Martincic, R.; Frlin-Lubi, A.; Usenicnik, B.

    2000-01-01

    Disasters do occur and so do nuclear or radiological accidents. Experience has shown that advance emergency response preparedness is essential in order to mitigate the consequences of an accident. In Slovenia, the Civil Protection Organization is the responsible authority for emergency preparedness and response to any kind of disasters. The Krko Nuclear Power Plant is the only nuclear power plant in Slovenia. To date the plant has operated safely and no serious incidents have been recorded. Slovenia nevertheless, maintains a high level of emergency preparedness, which is reflected in the area of prevention and safety and in the area of emergency response preparedness. The emergency management system for nuclear emergencies is incorporated into an overall preparedness and response system. The paper presents an overview of nuclear or radiological emergency response preparedness in Slovenia and its harmonization with the international guidelines. (author)

  18. PERCC Tools: Public Health Preparedness for Clinicians

    Centers for Disease Control (CDC) Podcasts

    2011-08-29

    CDC’s Office of Public Health Preparedness and Response funds Preparedness and Emergency Response Research Centers (PERRCs) to examine components of the public health system. This podcast is an overview of mental and behavioral health tools developed by the Johns Hopkins PERRC.  Created: 8/29/2011 by Emergency Risk Communication Branch (ERCB)/Joint Information Center (JIC); Office of Public Health Preparedness and Response (OPHPR).   Date Released: 8/30/2011.

  19. Mapping individuals' earthquake preparedness in China

    Science.gov (United States)

    Wu, Guochun; Han, Ziqiang; Xu, Weijin; Gong, Yue

    2018-05-01

    Disaster preparedness is critical for reducing potential impact. This paper contributes to current knowledge of disaster preparedness using representative national sample data from China, which faces high earthquake risks in many areas of the country. The adoption of earthquake preparedness activities by the general public, including five indicators of material preparedness and five indicators of awareness preparedness, were surveyed and 3245 respondents from all 31 provinces of Mainland China participated in the survey. Linear regression models and logit regression models were used to analyze the effects of potential influencing factors. Overall, the preparedness levels are not satisfied, with a material preparation score of 3.02 (1-5), and awareness preparation score of 2.79 (1-5), nationally. Meanwhile, residents from western China, which has higher earthquake risk, have higher degrees of preparedness. The concern for disaster risk reduction (DRR) and the concern for building safety and participation in public affairs are consistent positive predictors of both material and awareness preparedness. The demographic and socioeconomic variables' effects, such as gender, age, education, income, urban/rural division, and building size, vary according to different preparedness activities. Finally, the paper concludes with a discussion of the theoretical contribution and potential implementation.

  20. Mapping individuals' earthquake preparedness in China

    Directory of Open Access Journals (Sweden)

    G. Wu

    2018-05-01

    Full Text Available Disaster preparedness is critical for reducing potential impact. This paper contributes to current knowledge of disaster preparedness using representative national sample data from China, which faces high earthquake risks in many areas of the country. The adoption of earthquake preparedness activities by the general public, including five indicators of material preparedness and five indicators of awareness preparedness, were surveyed and 3245 respondents from all 31 provinces of Mainland China participated in the survey. Linear regression models and logit regression models were used to analyze the effects of potential influencing factors. Overall, the preparedness levels are not satisfied, with a material preparation score of 3.02 (1–5, and awareness preparation score of 2.79 (1–5, nationally. Meanwhile, residents from western China, which has higher earthquake risk, have higher degrees of preparedness. The concern for disaster risk reduction (DRR and the concern for building safety and participation in public affairs are consistent positive predictors of both material and awareness preparedness. The demographic and socioeconomic variables' effects, such as gender, age, education, income, urban/rural division, and building size, vary according to different preparedness activities. Finally, the paper concludes with a discussion of the theoretical contribution and potential implementation.

  1. How front-line healthcare workers respond to stock-outs of essential ...

    African Journals Online (AJOL)

    care.[14-19]. While the National Department of Health is committed to ... 1 AIDS and Society Research Unit, Centre for Social Science Research, University of Cape Town, ... clinic manager laughed when asked if her facility had a pharmacist.

  2. Evaluation of a Tabletop Emergency Preparedness Exercise for Pharmacy Students

    OpenAIRE

    Pate, Adam; Bratberg, Jeffrey P.; Robertson, Courtney; Smith, Gregory

    2016-01-01

    Objective. To describe the implementation and effect of an emergency preparedness laboratory activity on student knowledge, willingness to participate in emergency preparedness training, current level of preparedness, and the importance of a pharmacist’s role in disaster response.

  3. A Concept for Support of Firefighter Frontline Communication

    Directory of Open Access Journals (Sweden)

    Tobias Dyrks

    2013-04-01

    Full Text Available In an indoor firefighter mission, coordination and communication support are of the utmost importance. We present our experience from over five years of research with current firefighter support technology. In contrast to some large scale emergency response research, our work is focused on the frontline interaction between teams of firefighters and the incident commander on a single site. In this paper we investigate the flaws in firefighter communication systems. Frequent technical failures and the high cognitive costs incurred by communicating impede coordination. We then extract a list of requirements for an assistant emergency management technology from expert interviews. Thirdly, we provide a system concept and explore challenges for building a novel firefighter support system based on our previous work. The system has three key features: robust ad-hoc network, telemetry and text messaging, as well as implicit interaction. The result would provide a complementary mode of communication in addition to the current trunked radio.

  4. Distance education for tobacco reduction with Inuit frontline health workers.

    Science.gov (United States)

    Collins, Rob; Hammond, Merryl; Carry, Catherine L; Kinnon, Dianne; Killulark, Joan; Nevala, Janet

    2013-01-01

    Tobacco reduction is a major priority in Canadian Inuit communities. However, many Inuit frontline health workers lacked the knowledge, confidence and support to address the tobacco epidemic. Given vast distances, high costs of face-to-face training and previous successful pilots using distance education, this method was chosen for a national tobacco reduction course. To provide distance education about tobacco reduction to at least 25 frontline health workers from all Inuit regions of Canada. Promising practices globally were assessed in a literature survey. The National Inuit Tobacco Task Group guided the project. Participants were selected from across Inuit Nunangat. They chose a focus from a "menu" of 6 course options, completed a pre-test to assess individual learning needs and chose which community project(s) to complete. Course materials were mailed, and trainers provided intensive, individualized support through telephone, fax and e-mail. The course ended with an open-book post-test. Follow-up support continued for several months post-training. Of the 30 participants, 27 (90%) completed the course. The mean pre-test score was 72% (range: 38-98%). As the post-test was done using open books, everyone scored 100%, with a mean improvement of 28% (range: 2-62%). Although it was often challenging to contact participants through phone, a distance education approach was very practical in a northern context. Learning is more concrete when it happens in a real-life context. As long as adequate support is provided, we recommend individualized distance education to others working in circumpolar regions.

  5. Enhancing frontline clinical leadership in an acute hospital trust.

    Science.gov (United States)

    Phillips, Natasha; Byrne, Geraldine

    2013-09-01

    To report on a leadership programme for ward managers in one National Health Service Trust that aimed to enhance their contribution to the delivery of the organisation's key objectives to support excellent patient experience. Effective ward leadership has been recognised as vital to the quality of care, resource management and interprofessional working. However, there is evidence that, at present, front-line nurse leaders are ill equipped to lead effectively and lack confidence in their ability to do so. The project aimed to provide a tailored programme for ward managers to develop their portfolio of skills to perform this pivotal role. The course contained two key elements: an integrated teaching programme to enhance leadership knowledge and skills and action learning to facilitate application to individual's own leadership practice. Both were underpinned by a change project where each individual identified, undertook and evaluated an innovation in practice. Twenty-two ward managers completed the leadership programme. Participants completed semi-structured questionnaires after each taught module. Action learning was evaluated through a combined structured and semi-structured questionnaire. All participants evaluated the programme as increasing their repertoire of leadership skills. Following completion of the programme, ward managers continue to work together as an evolving community of practice. Ward managers' development is enhanced by a programme integrating theory, action learning and completion of a ward-based project. Ward managers cannot be effectively developed in isolation. Leadership development is best supported where the organisation is also committed to developing. A leadership development programme that incorporates knowledge from within the organisation with external expertise can be an effective method to enhance front-line clinical leadership. © 2013 Blackwell Publishing Ltd.

  6. Social justice in pandemic preparedness.

    Science.gov (United States)

    DeBruin, Debra; Liaschenko, Joan; Marshall, Mary Faith

    2012-04-01

    Pandemic influenza planning in the United States violates the demands of social justice in 2 fundamental respects: it embraces the neutrality of procedural justice at the expense of more substantive concern with health disparities, thus perpetuating a predictable and preventable social injustice, and it fails to move beyond lament to practical planning for alleviating barriers to accessing care. A pragmatic social justice approach, addressing both health disparities and access barriers, should inform pandemic preparedness. Achieving social justice goals in pandemic response is challenging, but strategies are available to overcome the obstacles. The public engagement process of one state's pandemic ethics project influenced the development of these strategies.

  7. PERCC Tools: Public Health Preparedness for Clinicians

    Centers for Disease Control (CDC) Podcasts

    CDC’s Office of Public Health Preparedness and Response funds Preparedness and Emergency Response Research Centers (PERRCs) to examine components of the public health system. This podcast is an overview of mental and behavioral health tools developed by the Johns Hopkins PERRC.

  8. Evidence on feasibility and effective use of mHealth strategies by frontline health workers in developing countries: systematic review*

    Science.gov (United States)

    Agarwal, Smisha; Perry, Henry B; Long, Lesley-Anne; Labrique, Alain B

    2015-01-01

    Objectives Given the large-scale adoption and deployment of mobile phones by health services and frontline health workers (FHW), we aimed to review and synthesise the evidence on the feasibility and effectiveness of mobile-based services for healthcare delivery. Methods Five databases – MEDLINE, EMBASE, Global Health, Google Scholar and Scopus – were systematically searched for relevant peer-reviewed articles published between 2000 and 2013. Data were extracted and synthesised across three themes as follows: feasibility of use of mobile tools by FHWs, training required for adoption of mobile tools and effectiveness of such interventions. Results Forty-two studies were included in this review. With adequate training, FHWs were able to use mobile phones to enhance various aspects of their work activities. Training of FHWs to use mobile phones for healthcare delivery ranged from a few hours to about 1 week. Five key thematic areas for the use of mobile phones by FHWs were identified as follows: data collection and reporting, training and decision support, emergency referrals, work planning through alerts and reminders, and improved supervision of and communication between healthcare workers. Findings suggest that mobile based data collection improves promptness of data collection, reduces error rates and improves data completeness. Two methodologically robust studies suggest that regular access to health information via SMS or mobile-based decision-support systems may improve the adherence of the FHWs to treatment algorithms. The evidence on the effectiveness of the other approaches was largely descriptive and inconclusive. Conclusions Use of mHealth strategies by FHWs might offer some promising approaches to improving healthcare delivery; however, the evidence on the effectiveness of such strategies on healthcare outcomes is insufficient. PMID:25881735

  9. Examining the importance of incorporating emergency preparedness and disaster training core competencies into allied health curricula.

    Science.gov (United States)

    Curtis, Tammy

    2015-01-01

    Preparation for responding to emergency events that does not warrant outside help beyond the local community resources or responding to disaster events that is beyond the capabilities of the local community both require first responders and healthcare professionals to have interdisciplinary skills needed to function as a team for saving lives. To date, there is no core emergency preparedness and disaster planning competencies that have been standardized at all levels across the various allied health curricula disciplines. To identify if emergency preparedness and disaster training content are currently being taught in allied health program courses, to identify possible gaps within allied health curricula, and to explore the perceptions of allied health college educators for implementing emergency preparedness and disaster training core competencies into their existing curricula, if not already included. A quantitative Internet-based survey was conducted in 2013. Convenient sample. Fifty-one allied health college educators completed the survey. Descriptive statistics indicated that the majority of allied health college instructors do not currently teach emergency preparedness and disaster training core competency content within their current allied health discipline; however, their perceived level of importance for inclusion of the competencies was high. The results of this study supported the need for developing and establishing a basic national set of standardized core emergency preparedness and disaster planning competencies at all levels across various allied health curricula disciplines to ensure victims receive the best patient care and have the best possible chance of survival.

  10. A new preparedness policy for EMS logistics.

    Science.gov (United States)

    Lee, Seokcheon

    2017-03-01

    Response time in emergency medical services (EMS) is defined as the interval for an ambulance to arrive the scene after receipt of a 911 call. When several ambulances are available upon the receipt of a new call, a decision of selecting an ambulance has to be made in an effort to reduce response time. Dispatching the closest unit available is commonly used in practice; however, recently the Preparedness policy was designed that is in a simplistic form yet being capable of securing a long-term efficiency. This research aims to improve the Preparedness policy, resolving several critical issues inherent in the current form of the policy. The new Preparedness policy incorporates a new metric of preparedness based on the notion of centrality and involves a tuning parameter, weight on preparedness, which has to be appropriately chosen according to operational scenario. Computational experiment shows that the new policy significantly improves the former policy robustly in various scenarios.

  11. Nuclear emergency preparedness in Canada

    International Nuclear Information System (INIS)

    1993-03-01

    The preparedness of utilities and government agencies at various levels for dealing with nuclear emergencies occurring at nuclear reactors in Canada is reviewed and assessed. The review is centered on power reactors, but selected research reactors are included also. Emergency planning in the U.S.A., Germany and France, and international recommendations on emergency planning are reviewed to provide background and a basis for comparison. The findings are that Canadians are generally well protected by existing nuclear emergency plans at the electric utility and provincial levels but there are improvements that can be made, mainly at the federal level and in federal-provincial coordination. Ten issues of importance are identified: commitment to nuclear emergency planning by the federal government; division of federal and provincial roles and responsibilities; auditing of nuclear emergency preparedness of all levels of government and of electric utilities; the availability of technical guidance appropriate to Canada; protective action levels for public health and safety; communication with the public; planning and response for the later phases of a nuclear emergency; off-site exercises and training; coordination of international assistance; and emergency planning for research reactors. (L.L.) 79 refs., 2 tabs

  12. Don't fix it, make it better! : using frontline service employees to improve recovery performance

    NARCIS (Netherlands)

    Heijden, van der G.A.H.; Schepers, J.J.L.; Nijssen, E.J.; Ordanini, A.

    2013-01-01

    This study examines how frontline service employees (FSEs) can learn from recovery services and improve their performance accordingly. While research recognizes that FSEs can fulfill an innovation role by sourcing customer knowledge and developing ideas for performance improvement, it remains

  13. Health care workers indicate ill preparedness for Ebola Virus Disease outbreak in Ashanti Region of Ghana

    OpenAIRE

    Augustina Angelina Annan; Denis Dekugmen Yar; Michael Owusu; Eno Akua Biney; Paa Kobina Forson; Portia Boakye Okyere; Akosua Adumea Gyimah; Ellis Owusu-Dabo

    2017-01-01

    Abstract Background The recent Ebola Virus Disease (EVD) epidemic that hit some countries in West Africa underscores the need to train front line high-risk health workers on disease prevention skills. Although Ghana did not record (and is yet to) any case, and several health workers have received numerous training schemes, there is no record of any study that assessed preparedness of healthcare workers (HCWS) regarding EVD and any emergency prone disease in Ghana. We therefore conducted a hos...

  14. Act global, but think local: accountability at the frontlines.

    Science.gov (United States)

    Freedman, Lynn P; Schaaf, Marta

    2013-11-01

    There is a worrying divergence between the way that sexual and reproductive health and rights problems and solutions are framed in advocacy at the global level and the complex reality that people experience in health services on the ground. An analysis of approaches to accountability used in advocacy at these different levels highlights the different assumptions at play as to how change happens. This paper makes the case for a reinvigorated approach to accountability that begins with the dynamics of power at the frontlines, where people encounter health providers and institutions. Conventional approaches to accountability avoid grappling with these dynamics, and as a result, many accountability efforts do not lead to transformative change. Implementation science and systems science are promising sources for fresh approaches, beginning with the understanding of health systems as complex adaptive systems embedded in the broader political dynamics of their societies. By drawing insights from disciplines such as political economy, ethnography, and organizational change management - and applying them creatively to the experience of people in health systems - the workings of power can begin to be uncovered and tackled, sharpening accountability towards those whose health and rights are at stake and generating meaningful change. Copyright © 2013 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  15. Coordination of frontline defense mechanisms under severe oxidative stress.

    Science.gov (United States)

    Kaur, Amardeep; Van, Phu T; Busch, Courtney R; Robinson, Courtney K; Pan, Min; Pang, Wyming Lee; Reiss, David J; DiRuggiero, Jocelyne; Baliga, Nitin S

    2010-07-01

    Complexity of cellular response to oxidative stress (OS) stems from its wide-ranging damage to nucleic acids, proteins, carbohydrates, and lipids. We have constructed a systems model of OS response (OSR) for Halobacterium salinarum NRC-1 in an attempt to understand the architecture of its regulatory network that coordinates this complex response. This has revealed a multi-tiered OS-management program to transcriptionally coordinate three peroxidase/catalase enzymes, two superoxide dismutases, production of rhodopsins, carotenoids and gas vesicles, metal trafficking, and various other aspects of metabolism. Through experimental validation of interactions within the OSR regulatory network, we show that despite their inability to directly sense reactive oxygen species, general transcription factors have an important function in coordinating this response. Remarkably, a significant fraction of this OSR was accurately recapitulated by a model that was earlier constructed from cellular responses to diverse environmental perturbations--this constitutes the general stress response component. Notwithstanding this observation, comparison of the two models has identified the coordination of frontline defense and repair systems by regulatory mechanisms that are triggered uniquely by severe OS and not by other environmental stressors, including sub-inhibitory levels of redox-active metals, extreme changes in oxygen tension, and a sub-lethal dose of gamma rays.

  16. Frontline nurse managers' confidence and self-efficacy.

    Science.gov (United States)

    Van Dyk, Jennifer; Siedlecki, Sandra L; Fitzpatrick, Joyce J

    2016-05-01

    This study was focused on determining relationships between confidence levels and self-efficacy among nurse managers. Frontline nurse managers have a pivotal role in delivering high-quality patient care while managing the associated costs and resources. The competency and skill of nurse managers affect every aspect of patient care and staff well-being as nurse managers are largely responsible for creating work environments in which clinical nurses are able to provide high-quality, patient-centred, holistic care. A descriptive, correlational survey design was used; 85 nurse managers participated. Years in a formal leadership role and confidence scores were found to be significant predictors of self-efficacy scores. Experience as a nurse manager is an important component of confidence and self-efficacy. There is a need to develop educational programmes for nurse managers to enhance their self-confidence and self-efficacy, and to maintain experienced nurse managers in the role. © 2016 John Wiley & Sons Ltd.

  17. Front-Line Physicians' Satisfaction with Information Systems in Hospitals.

    Science.gov (United States)

    Peltonen, Laura-Maria; Junttila, Kristiina; Salanterä, Sanna

    2018-01-01

    Day-to-day operations management in hospital units is difficult due to continuously varying situations, several actors involved and a vast number of information systems in use. The aim of this study was to describe front-line physicians' satisfaction with existing information systems needed to support the day-to-day operations management in hospitals. A cross-sectional survey was used and data chosen with stratified random sampling were collected in nine hospitals. Data were analyzed with descriptive and inferential statistical methods. The response rate was 65 % (n = 111). The physicians reported that information systems support their decision making to some extent, but they do not improve access to information nor are they tailored for physicians. The respondents also reported that they need to use several information systems to support decision making and that they would prefer one information system to access important information. Improved information access would better support physicians' decision making and has the potential to improve the quality of decisions and speed up the decision making process.

  18. The safety of women health workers at the frontlines.

    Science.gov (United States)

    Dasgupta, Jashodhara; Velankar, Jayashree; Borah, Pritisha; Nath, Gangotri Hazarika

    2017-01-01

    This article, based on the report of the fact-finding team on the gang rape and death of an accredited social health activist (ASHA) in Muzaffarnagar in January 2016, attempts to analyse the issues of the safety and mobility of front-line women health workers. It argues that although the National Health Mission is often alluded to as a flagship programme of the government, it has failed in its basic responsibility as an ethical employer, since there is no support and back-up system that can be easily accessed by ASHAs in terms of dealing with the fallout of their social role as "change agents" in rural areas, and community reactions to their mobility and public exposure. The report stresses the need to consider the deeply patriarchal system within which ASHAs function in states such as Uttar Pradesh. It also discusses the fact that the workforce is increasingly shifting from the formal to the informal sector, which has given rise to an assumption that the employer is no longer accountable for women workers' safety at the workplace.

  19. Does hope buffer the impacts of stress and exhaustion on frontline hotel employees’ turnover intentions?

    OpenAIRE

    Yavas, Ugur; Karatepe, Osman M.; Babakus,, Emin

    2013-01-01

    This study investigates the effects of challenge and hindrance stressors and exhaustion on frontline hotel employees’ turnover intentions and whether hope, as a personal resource, can moderate the deleterious effects of these antecedents on turnover intentions. Data were collected from a sample of 183 full-time frontline employees working in 5-star and 4-star hotels in Northern Cyprus. To ensure the temporal separation of measures, data pertaining to the independent and dependent variables we...

  20. Emergency preparedness lessons from Chernobyl

    International Nuclear Information System (INIS)

    Martin, J.B.

    1987-09-01

    Emergency preparedness at nuclear power plants in the US has been considerably enhanced since the Three Mile Island accident. The Chernobyl accident has provided valuable data that can be used to evaluate the merit of some of these enhancements and to determine the need for additional improvements. For example, the USSR intervention levels of 25 rem and 75 rem for evacuation are contrasted with US Environmental Protection Agency protective action guides. The manner in which 135,000 persons were evacuated from the 30-km zone around Chernobyl is constrasted with typical US evacuation plans. Meteorological conditions and particulate deposition patterns were studied to infer characteristics of the radioactive plume from Chernobyl. Typical plume monitoring techniques are examined in light of lessons learned by the Soviets about plume behavior. This review has indicated a need for additional improvements in utility and government emergency plans, procedures, equipment, and training. 12 refs., 1 fig., 2 tabs

  1. On-site emergency preparedness in Finland

    International Nuclear Information System (INIS)

    Vilkamo, O.

    1998-01-01

    General scheme of emergency preparedness in Finland is presented including legal framework, emergency organization and detailed description of plans and procedures. Emergency plan in Finland cover the following matters: classification of emergency situations and description of events and accidents, description of emergency organization, description of the arrangements for alerting and data transfer, management of an emergency situation and radiation protection, worker safety and radiation protection, on- and off-site radiation measurements during a preparedness situation, provision of information, rooms, equipment and facilities, post emergency debriefing and measures, a description of the maintenance of preparedness

  2. Mental health/illness and prisons as place: frontline clinicians׳ perspectives of mental health work in a penal setting.

    Science.gov (United States)

    Wright, Nicola; Jordan, Melanie; Kane, Eddie

    2014-09-01

    This article takes mental health and prisons as its two foci. It explores the links between social and structural aspects of the penal setting, the provision of mental healthcare in prisons, and mental health work in this environment. This analysis utilises qualitative interview data from prison-based fieldwork undertaken in Her Majesty׳s Prison Service, England. Two themes are discussed: (1) the desire and practicalities of doing mental health work and (2) prison staff as mental health work allies. Concepts covered include equivalence, training, ownership, informal communication, mental health knowledge, service gatekeepers, case identification, and unmet need. Implications for practice are (1) the mental health knowledge and understanding of prison wing staff could be appraised and developed to improve mental healthcare and address unmet need. Their role as observers and gatekeepers could be considered. (2) The realities of frontline mental health work for clinicians in the penal environment should be embraced and used to produce and implement improved policy and practice guidance, which is in better accord with the actuality of the context - both socially and structurally. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Lean healthcare.

    Science.gov (United States)

    Weinstock, Donna

    2008-01-01

    As healthcare organizations look for new and improved ways to reduce costs and still offer quality healthcare, many are turning to the Toyota Production System of doing business. Rather than focusing on cutting personnel and assets, "lean healthcare" looks to improve patient satisfaction through improved actions and processes.

  4. Introducing Emergency Preparedness in Childbirth Education Classes

    OpenAIRE

    DeWald, Lauren; Fountain, Lily

    2006-01-01

    In the wake of recent natural and man-made disasters and emergency situations, pregnant women are especially vulnerable. The authors of this column encourage childbirth educators to include disaster preparedness instruction and emergency childbirth techniques in their class content.

  5. INPP Handbook for the Emergency Preparedness Organization

    International Nuclear Information System (INIS)

    Ushpuras, E.

    1997-01-01

    This publication provides an overview of the emergency preparedness organization and principles for protection of public in the Baltic States in the case of the nuclear (radiological) accident at Ignalina NPP. (author)

  6. Preparedness for clinical practice - Perceptions of graduates and their work supervisors

    International Nuclear Information System (INIS)

    Mackay, S.J.; Anderson, A.C.; Hogg, P.

    2008-01-01

    Purpose: The standards of performance of healthcare professionals are now well defined and used to determine health professional curricula. Empirical research evidence exists in medicine and nursing which explores how well these curricula prepare their students for clinical practice but not in the radiography profession. This research aims to determine how well prepared newly qualified radiographers were for clinical practice and to identify strengths and weaknesses in their preparedness to inform curriculum development. Methods: A postal questionnaire and semi-structured interview were used to obtain data from newly qualified diagnostic radiographers and their work-based supervisors. The questionnaire assessed graduate preparedness against a number of items drawn from published documents which define UK radiographic practice. Statistical analysis, using ANOVA and Wilcoxon, examined differences between the groups' perception of preparedness. A sample of graduates and their work supervisors were interviewed to explore preparedness. Results: There were significant differences (p ≤ 0.05) between; the preparedness scores of the graduates and supervisors, with supervisors rating the graduates higher than the graduates themselves; subscales of teamwork (p ≤ 0.05), personal attributes (p ≤ 0.05) and digital skills (p ≤ 0.01). No significant differences were found between graduates employed in their training hospital and those employed elsewhere. Interview data revealed perceived areas of graduate strength, weaknesses and areas for curriculum development. Suggestions for improvement to the methodology were identified for exploring preparedness in other health professional programmes. Conclusion: The graduates were well prepared for their role as a diagnostic radiographer. Some curriculum development is needed in specific areas and advice on methodological improvement is offered

  7. Importance of International Cooperation for Emergency Preparedness

    International Nuclear Information System (INIS)

    Gregoric, M.; Grlicarev, I.

    1998-01-01

    The paper contains a brief review of reactor accidents and their consequences. The bilateral, regional and interregional agreements on early exchange of information and mutual assistance in case of a nuclear and radiological accident are presented in a table and discussed. The international projects in emergency preparedness are briefly outlined and the situation in the field of emergency preparedness in Slovenia is given for the comparison. (author)

  8. Engaging Frontline Leaders and Staff in Real-Time Improvement.

    Science.gov (United States)

    Phillips, Jennifer; Hebish, Linda J; Mann, Sharon; Ching, Joan M; Blackmore, C Craig

    2016-04-01

    The relationship of staff satisfaction and engagement to organizational success, along with the integral influence of frontline managers on this dimension, is well established in health care and other industries. To specifically address staff engagement, Virginia Mason Medical Center, an integrated, single-hospital health system, developed an approach that involved leaders, through the daily use of standard work for leaders, as well as staff, through a Lean-inspired staff idea system. Kaizen Promotion Office (KPO) staff members established three guiding principles: (1) Staff engagement begins with leader engagement; (2) Integrate daily improve- ment (kaizen) as a habitual way of life not as an add-on; and (3) Create an environment in which staff feel psycho- logically safe and valued. Two design elements--Standard Work for Leaders (SWL) and Everyday Lean Ideas (ELIs) were implemented. For the emergency department (ED), an early adopter of the staff engagement work, the challenge was to apply the guiding principles to improve staff engagement while improving quality and patient and staff satisfaction, even as patient volumes were increasing. Daily huddles for the KPO staff members and weekly leader rounds are used to elicit staff ideas and foster ELIs in real time. Overall progress to date has been tracked in terms of staff satisfaction surveys, voluntary staff turnover, adoption of SWL, and testing and implementation of staff ideas. For example, voluntary turnover of ED staff decreased from 14.6% in 2011 to 7.5% in 2012, and 2.0% in 2013. Organizationwide, at least 800 staff ideas are in motion at any given time, with finished ones posted in an idea supermarket website. A leadership and staff engagement approach that focuses on SWL and on capturing staff ideas for daily problem solving and improvement can contribute to organization success and improve the quality of health care delivery.

  9. Ebola in the Netherlands, 2014-2015: costs of preparedness and response.

    Science.gov (United States)

    Suijkerbuijk, Anita W M; Swaan, Corien M; Mangen, Marie-Josee J; Polder, Johan J; Timen, Aura; Ruijs, Wilhelmina L M

    2017-11-17

    The recent epidemic of Ebola virus disease (EVD) resulted in countries worldwide to prepare for the possibility of having an EVD patient. In this study, we estimate the costs of Ebola preparedness and response borne by the Dutch health system. An activity-based costing method was used, in which the cost of staff time spent in preparedness and response activities was calculated based on a time-recording system and interviews with key professionals at the healthcare organizations involved. In addition, the organizations provided cost information on patient days of hospitalization, laboratory tests, personal protective equipment (PPE), as well as the additional cleaning and disinfection required. The estimated total costs averaged €12.6 million, ranging from €6.7 to €22.5 million. The main cost drivers were PPE expenditures and preparedness activities of personnel, especially those associated with ambulance services and hospitals. There were 13 possible cases clinically evaluated and one confirmed case admitted to hospital. The estimated total cost of EVD preparedness and response in the Netherlands was substantial. Future costs might be reduced and efficiency increased by designating one ambulance service for transportation and fewer hospitals for the assessment of possible patients with a highly infectious disease of high consequences.

  10. Healthcare Robotics

    OpenAIRE

    Riek, Laurel D.

    2017-01-01

    Robots have the potential to be a game changer in healthcare: improving health and well-being, filling care gaps, supporting care givers, and aiding health care workers. However, before robots are able to be widely deployed, it is crucial that both the research and industrial communities work together to establish a strong evidence-base for healthcare robotics, and surmount likely adoption barriers. This article presents a broad contextualization of robots in healthcare by identifying key sta...

  11. Radioanalytical chemistry in emergency preparedness

    International Nuclear Information System (INIS)

    Nygren, U.

    2001-11-01

    Radioactive nuclides present a potential health hazard due to the ionising radiation emitted during their decay. The release of large amounts of radioactive nuclides is of concern both for man and the environment. In cases of an accidental (or intentional) release, it is important with early warning systems and rapid methods to determine the extent and composition of the radioactive contamination. Many of the radionuclides released from a nuclear power plant accident or the detonation of a nuclear weapon can be determined by the use of gamma spectrometry. There are, however, some nuclides that are considered to be among the more hazardous that cannot be well determined by this technique, e.g. 90 Sr and the actinides. The determination of these nuclides is usually very time consuming due to the need for their chemical separation prior to counting. Two methods developed for the determination of 90 Sr and actinides in preparedness situations are described in this thesis. The determination of 90 Sr is based on a rapid decomposition of inorganic sample matrixes by lithium-borate fusion and preconcentration of Sr by coprecipitation with calcium oxalate with HF acting as a hold-back carrier for silica. The separation of Sr is then performed by extraction chromatography and measurement by gas-flow proportional counting. The method for actinide-determination is based on collection of the elements from various kinds of sample-materials by the use of two different actinide selective resins. The sample is, in this way, pre concentrated and partially purified prior to the analysis with low-energy gamma spectrometry. Sample preparation by this method only requires 1.5 - 2.5 hours and the sensitivity is sufficient for many of the nuclides of interest. For those nuclides that require a more sensitive analytical finish, the actinides can be removed from the resin and processed further for, e.g., alpha spectrometric determinations

  12. Radioanalytical chemistry in emergency preparedness

    Energy Technology Data Exchange (ETDEWEB)

    Nygren, U

    2001-11-01

    Radioactive nuclides present a potential health hazard due to the ionising radiation emitted during their decay. The release of large amounts of radioactive nuclides is of concern both for man and the environment. In cases of an accidental (or intentional) release, it is important with early warning systems and rapid methods to determine the extent and composition of the radioactive contamination. Many of the radionuclides released from a nuclear power plant accident or the detonation of a nuclear weapon can be determined by the use of gamma spectrometry. There are, however, some nuclides that are considered to be among the more hazardous that cannot be well determined by this technique, e.g. {sup 90}Sr and the actinides. The determination of these nuclides is usually very time consuming due to the need for their chemical separation prior to counting. Two methods developed for the determination of {sup 90}Sr and actinides in preparedness situations are described in this thesis. The determination of {sup 90}Sr is based on a rapid decomposition of inorganic sample matrixes by lithium-borate fusion and preconcentration of Sr by coprecipitation with calcium oxalate with HF acting as a hold-back carrier for silica. The separation of Sr is then performed by extraction chromatography and measurement by gas-flow proportional counting. The method for actinide-determination is based on collection of the elements from various kinds of sample-materials by the use of two different actinide selective resins. The sample is, in this way, pre concentrated and partially purified prior to the analysis with low-energy gamma spectrometry. Sample preparation by this method only requires 1.5 - 2.5 hours and the sensitivity is sufficient for many of the nuclides of interest. For those nuclides that require a more sensitive analytical finish, the actinides can be removed from the resin and processed further for, e.g., alpha spectrometric determinations.

  13. Frontline CALS - Extranet Enabled Support of Customer Relations Based on Product State Information

    DEFF Research Database (Denmark)

    Larsen, Michael Holm; Franck, Lesley Robert; Pedersen, Mogens Kühn

    1999-01-01

    commerce called Frontline CALS. Frontline CALS integrate three bodies of knowledge, i.e. Continuous Acquisition and Lifecycle Support, Electronic Commerce, and the Customer Consumption Chain in order to construct a concept that enhances the service quality for customers with time critical operations....... The essence of Frontline CALS is that it combines a product and a customer view with the aim of enhancing the service quality offered by the dealers in collaboration with the producer. The article further provides empirical insight from an early prototype implementation of a Web Service System intended......The electronic economy has proliferated during the past decade. Many initiatives are launched in order to support customer's interaction with the company, however, often fragmented. A more holistic approach is provided in this article. The article suggests a business model in the era of electronic...

  14. Spotlight on ibrutinib and its potential in frontline treatment of chronic lymphocytic leukemia

    Directory of Open Access Journals (Sweden)

    Khan M

    2017-03-01

    Full Text Available Maliha Khan, Jamie L Gibbons, Alessandra Ferrajoli Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Abstract: Chronic lymphocytic leukemia (CLL is the most prevalent leukemia in the adult population. Current efforts are focused on better understanding the intricate pathophysiology of the disease to develop successful targeted therapies. Ibrutinib is emerging as an important agent in this new age of targeted treatment for CLL. As a Bruton’s tyrosine kinase inhibitor, it blocks the signaling pathway that malignant B-lymphocytes need for growth and maturation. Ibrutinib’s role in therapy was further expanded recently when the US Food and Drug Administration approved its use in both frontline and salvage treatment for patients with CLL. This review assesses the effectiveness of ibrutinib in the frontline setting, its efficacy in various types of patients with CLL, and its safety and tolerability. Keywords: ibrutinib, CLL, frontline therapy

  15. Impact of patient suicide on front-line staff in Ireland.

    LENUS (Irish Health Repository)

    Gaffney, Paul

    2009-08-01

    Research and anecdotal evidence suggests that coming to terms with the suicide of a patient can be extremely distressing for front-line professionals. Some research also suggests that exposure to such situations can undermine professionals\\' functioning and feelings of competence, cause them to question their professional standing and ultimately contribute to burnout. A survey of 447 front-line professionals\\' experiences of patient suicide was undertaken to further explore these issues. Thematic analysis of open-ended questionnaire items revealed that concerns for the bereaved family, feelings of responsibility for the death and having a close therapeutic relationship with the client are key factors that influence the adjustment and coping of a health professional in the aftermath of the death of a client by suicide. The results are discussed with a focus on the impact of suicide on front-line staff, the need for ongoing support and training and the development of specific post-suicide protocols.

  16. Investigating role stress in frontline bank employees: A cluster based approach

    Directory of Open Access Journals (Sweden)

    Arti Devi

    2013-09-01

    Full Text Available An effective role stress management programme would benefit from a segmentation of employees based on their experience of role stressors. This study explores role stressor based segments of frontline bank employees towards providing a framework for designing such a programme. Cluster analysis on a random sample of 501 frontline employees of commercial banks in Jammu and Kashmir (India revealed three distinct segments – “overloaded employees”, “unclear employees”, and “underutilised employees”, based on their experience of role stressors. The findings suggest a customised approach to role stress management, with the role stress management programme designed to address cluster specific needs.

  17. Handling stress during policy implementation: Developing a classification of “coping” by frontline workers based on a systematic review

    NARCIS (Netherlands)

    L.G. Tummers (Lars); V.J.J.M. Bekkers (Victor); E. Vink (Evelien); M. Musheno (Michael)

    2013-01-01

    textabstractStress is endemic to street-level work. How frontline workers handle conflicting pressures and changes in their environment bears substantially on policy performance and the delivery of human services. ‘Coping’ is the current term for understanding frontline workers responses to stress.

  18. Health care workers indicate ill preparedness for Ebola Virus Disease outbreak in Ashanti Region of Ghana

    Directory of Open Access Journals (Sweden)

    Augustina Angelina Annan

    2017-06-01

    Full Text Available Abstract Background The recent Ebola Virus Disease (EVD epidemic that hit some countries in West Africa underscores the need to train front line high-risk health workers on disease prevention skills. Although Ghana did not record (and is yet to any case, and several health workers have received numerous training schemes, there is no record of any study that assessed preparedness of healthcare workers (HCWS regarding EVD and any emergency prone disease in Ghana. We therefore conducted a hospital based cross sectional study involving 101 HCWs from two facilities in Kumasi, Ghana to assess the level of preparedness of HCWs to respond to any possible EVD. Methods We administered a face-to-face questionnaire using an adapted WHO (2015 and CDC (2014 Checklist for Ebola Preparedness and assessed overall knowledge gaps, and preparedness of the Ghanaian HCWs in selected health facilities of the Ashanti Region of Ghana from October to December 2015. Results A total 92 (91.09% HCWs indicated they were not adequately trained to handle an EVD suspected case. Only 25.74% (n = 26 considered their facilities sufficiently equipped to handle and manage EVD patients. When asked which disinfectant to use after attending to and caring for a suspected patient with EVD, only 8.91% (n = 9 could correctly identify the right disinfectant (χ2 = 28.52, p = 0.001. Conclusion Our study demonstrates poor knowledge and ill preparedness and unwillingness of many HCWs to attend to EVD. Beyond knowledge acquisition, there is the need for more training from time to time to fully prepare HCWs to handle any possible EVD case.

  19. Radiation Emergency Preparedness Tools: Psychological First Aid

    Centers for Disease Control (CDC) Podcasts

    2010-12-30

    This podcast is an overview of the Clinician Outreach and Communication Activity (COCA) Call: Practical Tools for Radiation Emergency Preparedness. A specialist working with CDC's Radiation Studies Branch describes Psychological First Aid and a newly developed multimedia training program, entitled "Psychological First Aid in Radiation Disasters.".  Created: 12/30/2010 by National Center for Environmental Health (NCEH) Radiation Studies Branch and Emergency Risk Communication Branch (ERCB)/Joint Information Center (JIC); Office of Public Health Preparedness and Response (OPHPR).   Date Released: 1/13/2011.

  20. Civil emergency preparedness at the Ignalina nuclear power plant

    International Nuclear Information System (INIS)

    1998-12-01

    Workshop was held in the frame of Lithuania's cooperation with NATO on disasters management subject and was concentrated on the preparation of management of nuclear accident at Ignalina NPP. The following topics were covered: emergency preparedness inside Ignalina NPP, preparedness for nuclear accidents at national level, experience in Nordic countries and IAEA activities in harmonization of nuclear emergency preparedness in different countries

  1. 'Your health our concern, our health whose concern?': perceptions of injustice in organizational relationships and processes and frontline health worker motivation in Ghana

    NARCIS (Netherlands)

    Aberese-Ako, M.; van Dijk, H.; Gerrits, T.; Arhinful, D.K.; Agyepong, I.A.

    2014-01-01

    Taking a perspective of frontline health workers as internal clients within health systems, this study explored how perceived injustice in policy and organizational matters influence frontline health worker motivation and the consequent effect on workers’ attitudes and performance in delivering

  2. Your health our concern, our health whose concern? : perceptions of injustice in organizational relationships and processes and frontline health worker motivation in Ghana

    NARCIS (Netherlands)

    Aberese-Ako, M.; Dijk, van H.; Gerrits, T.; Arhinful, D.K.; Agyepong, I.A.

    2014-01-01

    Taking a perspective of frontline health workers as internal clients within health systems, this study explored how perceived injustice in policy and organizational matters influence frontline health worker motivation and the consequent effect on workers’ attitudes and performance in delivering

  3. Perceptions of preparedness for the first medical clerkship: a systematic review and synthesis.

    Science.gov (United States)

    Surmon, Laura; Bialocerkowski, Andrea; Hu, Wendy

    2016-03-12

    life experiences and learning. Eight of the ten themes related to perceptions of preparedness are potentially amenable to curricula strategies to improve the transition experience. The evidence supports clinical skills refreshers, clarification of roles and expectations, demystification of healthcare hierarchy and assessment processes and student-student handovers. Evidence also supports preclinical educational strategies such as enhancing content contextualization, further opportunities for the application of knowledge and skills, and constructive alignment of assessment tasks and pedagogical aims.

  4. Ready or not: does household preparedness prevent absenteeism among emergency department staff during a disaster?

    Science.gov (United States)

    Mercer, Mary P; Ancock, Benedict; Levis, Joel T; Reyes, Vivian

    2014-01-01

    During major disasters, hospitals experience varied levels of absenteeism among healthcare workers (HCWs) in the immediate response period. Loss of critical hospital personnel, including Emergency Department (ED) staff, during this time can negatively impact a facility's ability to effectively treat large numbers of ill and injured patients. Prior studies have examined factors contributing to HCW ability and willingness to report for duty during a disaster. The purpose of this study was to determine if the degree of readiness of ED personnel, as measured by household preparedness, is associated with predicted likelihood of reporting for duty. Additionally, the authors sought to elucidate other factors associated with absenteeism among ED staff during a disaster. ED staff of five hospitals participated in this survey-based study, answering questions regarding demographic information, past disaster experience, household disaster preparedness (using a novel,15-point scale), and likelihood of reporting to work during various categories of disaster. The primary outcome was personal predicted likelihood of reporting for duty following a disaster. A total of 399 subjects participated in the study. ED staffs were most likely to report for duty in the setting of an earthquake (95 percent) or other natural disaster, followed by an epidemic (90 percent) and were less likely to report for work during a biological, chemical, or a nuclear event (63 percent). Degree of household preparedness was determined to have no association with an ED HCW's predicted likelihood of reporting for duty. Factors associated with predicted absenteeism varied based on type of disaster and included having dependents in the home, female gender, past disaster relief experience, having a spouse or domestic partner, and not owning pets. Having dependents in the home was associated with predicted absenteeism for all disaster types (OR 0.30-0.66). However, when stratified by gender, the presence of

  5. Hospital capacity and management preparedness for pandemic influenza in Victoria.

    Science.gov (United States)

    Dewar, Ben; Barr, Ian; Robinson, Priscilla

    2014-04-01

    This study was designed to investigate acute hospital pandemic influenza preparedness in Victoria, Australia, particularly focussing on planning and management efforts. A prospective study was conducted by questionnaire and semi-structured interview of health managers across the Victorian hospital system from July to October 2011. Participants with responsibility for emergency management, planning and operations were selected from every hospital in Victoria with an emergency department to complete a questionnaire (response rate 22/43 = 51%). Each respondent was invited to participate in a phone-based semi-structured interview (response rate 11/22 = 50%). Rural/regional hospitals demonstrated higher levels of clinical (86%) and non-clinical (86%) staff contingency planning than metropolitan hospitals (60% and 40% respectively). Pandemic plans were not being sufficiently tested in exercises or drills, which is likely to undermine their effectiveness. All respondents reported hand hygiene and standard precautions programs in place, although only one-third (33%) of metropolitan respondents and no rural/regional respondents reported being able to meet patient needs with high levels of staff absenteeism. Almost half Victoria's healthcare workers were unvaccinated against influenza. Hospitals across Victoria demonstrated different levels of influenza pandemic preparedness and planning. If a more severe influenza pandemic than that of 2009 arose, Victorian hospitals would struggle with workforce and infrastructure problems, particularly in rural/regional areas. Staff absenteeism threatens to undermine hospital pandemic responses. Various strategies, including education and communication, should be included with in-service training to provide staff with confidence in their ability to work safely during a future pandemic. © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia.

  6. Decision making at the frontline: Exploring coping with moral conflicts during public service delivery

    NARCIS (Netherlands)

    Vink, E.; Tummers, L.G.; Bekkers, V.J.J.M.; Musheno, M.

    2015-01-01

    Moral conflicts, where a person is confronted with two or more clashing values, norms or responsibilities, are common in public service delivery. Choosing one is realized at the cost of the other(s). Frontline professionals, such as physicians and police officers, often experience clashes over the

  7. Adaptation of a nursing home culture change research instrument for frontline staff quality improvement use.

    Science.gov (United States)

    Hartmann, Christine W; Palmer, Jennifer A; Mills, Whitney L; Pimentel, Camilla B; Allen, Rebecca S; Wewiorski, Nancy J; Dillon, Kristen R; Snow, A Lynn

    2017-08-01

    Enhanced interpersonal relationships and meaningful resident engagement in daily life are central to nursing home cultural transformation, yet these critical components of person-centered care may be difficult for frontline staff to measure using traditional research instruments. To address the need for easy-to-use instruments to help nursing home staff members evaluate and improve person-centered care, the psychometric method of cognitive-based interviewing was used to adapt a structured observation instrument originally developed for researchers and nursing home surveyors. Twenty-eight staff members from 2 Veterans Health Administration (VHA) nursing homes participated in 1 of 3 rounds of cognitive-based interviews, using the instrument in real-life situations. Modifications to the original instrument were guided by a cognitive processing model of instrument refinement. Following 2 rounds of cognitive interviews, pretesting of the revised instrument, and another round of cognitive interviews, the resulting set of 3 short instruments mirrored the concepts of the original longer instrument but were significantly easier for frontline staff to understand and use. Final results indicated frontline staff found the revised instruments feasible to use and clinically relevant in measuring and improving the lived experience of a changing culture. This article provides a framework for developing or adapting other measurement tools for frontline culture change efforts in nursing homes, in addition to reporting on a practical set of instruments to measure aspects of person-centered care. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  8. Frontline employees' intercultural competence: Does it impact customers' evaluations of intercultural service encounters?

    NARCIS (Netherlands)

    Hoefnagels, A.H.J.M.; Bloemer, J.M.M.; Pluymaekers, M.

    2014-01-01

    Globalization has led to an exponential growth of intercultural service encounters. In view of the importance of customer-orientation in services, we investigate the effect of the frontline employee’s intercultural competence on customer’s affective and cognitive evaluations of intercultural

  9. Frontline Leaders: The Entry Point for Leadership Development in the Manufacturing Industry

    Science.gov (United States)

    Liu, Lucy; McMurray, Adela J.

    2004-01-01

    This multi-method case study examined the roles, functions, capabilities, job satisfaction, strengths, weaknesses and skill gaps of frontline team leaders working on the shopfloor in the Australian automobile industry. The study was conducted in a large automobile manufacturing company employing 4,500 employees and rated as one of the top 22…

  10. Poverty, Place and Pedagogy in Education: Research Stories from Front-Line Workers

    Science.gov (United States)

    Comber, Barbara

    2016-01-01

    This article considers what it means to teach and learn in places of poverty through the narratives of front-line workers--particularly students and teachers. What is the work of teaching and learning in places of poverty in current times? How has this changed? What can be learned from both the haunting and hopeful narratives of front-line…

  11. Cultural Complementarity : Reshaping Professional and Organizational Logics in Developing Frontline Medical Leadership

    NARCIS (Netherlands)

    Noordegraaf, Mirko; Schneider, Magriet; Boselie, Paul; van Rensen, E.L.J.

    2016-01-01

    With the rise of clinical management, new skills of medical doctors stand out, including leadership skills. Medical doctors organize medical work and improve patient care. The training of frontline leadership skills, however, is weakly developed in residency programmes. Medical professional cultures

  12. Brand advocacy in the frontline : how does it affect customer satisfaction?

    NARCIS (Netherlands)

    Schepers, J.J.L.; Nijssen, E.J.

    Purpose Many organizations expect their service engineers, or frontline employees (FLEs), to behave as brand advocates by engaging in favorable communication about the brand and its offerings towards customers. However, this approach is not without risk as customers may be disappointed or even

  13. Family emergency preparedness plans in severe tornadoes.

    Science.gov (United States)

    Cong, Zhen; Liang, Daan; Luo, Jianjun

    2014-01-01

    Tornadoes, with warnings usually issued just minutes before their touchdowns, pose great threats to properties and people's physical and mental health. Few studies have empirically investigated the association of family emergency preparedness planning and observed protective behaviors in the context of tornadoes. The purpose of this study was to examine predictors for the action of taking shelter at the time of tornadoes. Specifically, this study investigated whether having a family emergency preparedness plan was associated with higher likelihood of taking shelter upon receiving tornado warnings. This study also examined the effects of socioeconomic status and functional limitations on taking such actions. A telephone survey based on random sampling was conducted in 2012 with residents in Tuscaloosa AL and Joplin MO. Each city experienced considerable damages, injuries, and casualties after severe tornadoes (EF-4 and EF-5) in 2011. The working sample included 892 respondents. Analysis was conducted in early 2013. Logistic regression identified emergency preparedness planning as the only shared factor that increased the likelihood of taking shelter in both cities and the only significant factor in Joplin. In Tuscaloosa, being female and white also increased the likelihood of taking shelter. Disability was not found to have an effect. This study provided empirical evidence on the importance of having a family emergency preparedness plan in mitigating the risk of tornadoes. The findings could be applied to other rapid-onset disasters. © 2013 American Journal of Preventive Medicine Published by American Journal of Preventive Medicine All rights reserved.

  14. Relationship between student preparedness, learning experiences ...

    African Journals Online (AJOL)

    Background. One of the more discernible needs that challenges universities is addressing the level of preparedness of students entering the higher education environment. Students expect to participate in active learning, while at the same time adopting a certain level of agency to successfully pass through higher ...

  15. Emergency preparedness at Barsebaeck NPP in Sweden

    International Nuclear Information System (INIS)

    Olsson, R.; Lindvall, C.

    1998-01-01

    On-site emergency preparedness plan at Barsebaeck NPP is presented. In an emergency the responsibility of the NPP is to alarm the emergency organizations, spend all efforts to restore safe operation, assess the potential source term as to size and time, protect their own personnel, inform personnel and public. Detailed emergency procedures overview is provided

  16. 33 CFR 101.300 - Preparedness communications.

    Science.gov (United States)

    2010-07-01

    ... MARITIME SECURITY MARITIME SECURITY: GENERAL Communication (Port-Facility-Vessel) § 101.300 Preparedness... transportation security incident, the COTP will, when appropriate, communicate to the port stakeholders, vessels... risk. (c) Attainment. (1) Each owner or operator of a vessel or facility required to have a security...

  17. Radiation Emergency Preparedness Tools: Psychological First Aid

    Centers for Disease Control (CDC) Podcasts

    This podcast is an overview of the Clinician Outreach and Communication Activity (COCA) Call: Practical Tools for Radiation Emergency Preparedness. A specialist working with CDC's Radiation Studies Branch describes Psychological First Aid and a newly developed multimedia training program, entitled "Psychological First Aid in Radiation Disasters."

  18. Birth Preparedness and Complication Readiness of Pregnant ...

    African Journals Online (AJOL)

    Birth Preparedness and Complication Readiness of Pregnant Women Attending the Three Levels of Health Facilities in Ife Central Local Government, Nigeria. ... Only 24 (6.0%) had adequate knowledge of obstetric danger signs without prompting. Three hundred and forty (84.8%) and 312 (78.3%) women respectively had ...

  19. 75 FR 53563 - National Preparedness Month, 2010

    Science.gov (United States)

    2010-09-01

    ... America A Proclamation During National Preparedness Month, we stress the importance of strengthening the security and resiliency of our Nation through systematic preparation for the full range of hazards threatening the United States in the 21st century, including natural disasters, cyber attacks, pandemic...

  20. 77 FR 55097 - National Preparedness Month, 2012

    Science.gov (United States)

    2012-09-06

    ... disasters of all types--from cyber incidents and acts of terrorism to tornadoes and flooding. That is why my... all Americans to recognize the importance of preparedness and observe this month by working together to enhance our national security, resilience, and readiness. [[Page 55098

  1. Nuclear threats and emergency preparedness in Finland

    International Nuclear Information System (INIS)

    Mustonen, R.; Aaltonen, H.; Laaksonen, J.; Lahtinen, J.; Rantavaara, A.; Reponen, H.; Rytoemaa, T.; Suomela, M.; Toivonen, H.; Varjoranta, T.

    1995-10-01

    The political and economic upheavals which have taken place in Eastern Europe have had an impact on radiation and nuclear safety throughout Europe. Emergency preparedness systems for unexpected nuclear events have been developed further in all European countries, and prosperous western nations have invested in improving the safety of East European nuclear power plants. The economic crisis facing countries of the former Soviet Union has also promoted illicit trade in nuclear materials; this has made it necessary for various border guards and police authorities to intensify their collaboration and to tighten border controls. On 3-4 October 1995, Finnish Centre for Radiation and Nuclear Safety (STUK) arranged a seminar on nuclear threats and emergency preparedness in Finland. In addition to STUK experts, a wide range of rescue and civil defence authorities, environmental health specialists and other persons engaged in emergency preparedness attended the seminar. The publication contains a compilation of reports presented at the seminar. The reports cover a broad spectrum of nuclear threats analyzed at STUK, the impacts of radioactive fallout on human beings and on the environment, and preparedness systems by which the harmful effects of radiation or nuclear accidents can, if necessary, be minimized. (33 figs., 5 tabs.)

  2. Leading Preparedness for Local Fire Agencies

    Science.gov (United States)

    2014-12-01

    Preparedness System .........................................73 Figure 2. Deming Cycle—PDCA Model...76 Figure 3. NFPA 1600 Management System Model ........................................................79 Figure 4. Deming Cycle with...organization that has built a reputation as the authority for standards for the fire service.108 The Deming Cycle, also known as the plan–do–check–act

  3. Emergency Preparedness Concerns for Older Adults

    Centers for Disease Control (CDC) Podcasts

    2009-01-26

    This podcast discusses the special concerns many older adults face during a disaster. It is primarily targeted to public health and aging services professionals.  Created: 1/26/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) and Coordinating Office for Terrorism Preparedness and Emergency Response (COTPER).   Date Released: 1/26/2009.

  4. Study of dynamics of level of physical preparedness of students.

    Directory of Open Access Journals (Sweden)

    Коvalenko Y.A.

    2010-12-01

    Full Text Available The dynamics of level of physical preparedness of students is studied in the article. A tendency is marked to the decline of level of physical preparedness of students of 1-3 courses. Methodical recommendations are presented on the improvement of the system of organization of physical education of students of the Zaporizhzhya national university. The dynamics of indexes of physical preparedness of students 1, 2, 3 courses of different years of teaching is studied. Principal reasons of decline of level of physical preparedness of students are certain. There are recommendations the department of physical education in relation to physical preparedness of students.

  5. Emergency preparedness at the UJD

    International Nuclear Information System (INIS)

    Seliga, Mojmir

    2001-01-01

    and international agreements as well as the information for media and public. Information group was in all these exercises responsible for co-ordination the technical briefing material prepared by the Reactor Safety Group and Radiological Assessment Group. The Information Group was also preparing messages, which were sent to international bodies such as IAEA and, to neighbouring countries as a part of Slovak Republic bilateral arrangements. The endeavour of the UJD is to create in the emergency response centre such a room, logistic, hardware and software base that the emergency headquarters could act timely and operatively. The protection measures proposed by the emergency headquarters, however, can be realised neither by the emergency headquarters nor by the UJD - it has no executive power in this area. That is why the emergency headquarters prepares, in co-operation with the operative expert group of the National Commission for Nuclear Accidents, optimum measures to cope with the situation and submits them to the National Emergency Commission for Radiation accidents, which co-ordinates realisation of protective measures on the national level. The emergency preparedness is verified by various types emergency exercises at national as well as international level

  6. Emergency Preparedness and Role Clarity among Rescue Workers during the Terror Attacks in Norway July 22, 2011.

    Directory of Open Access Journals (Sweden)

    May Janne Botha Pedersen

    Full Text Available Few studies address preparedness and role clarity in rescue workers after a disaster. On July 22, 2011, Norway was struck by two terror attacks; 77 people were killed and many injured. Healthcare providers, police officers and firefighters worked under demanding conditions. The aims of this study were to examine the level of preparedness, exposure and role clarity. In addition, the relationship between demographic variables, preparedness and exposure and a role clarity during the rescue operations and; b achieved mastering for future disaster operations.In this cross-sectional study, healthcare providers (n = 859, police officers (n = 252 and firefighters (n = 102 returned a questionnaire approximately 10 months after the terror attacks.The rescue personnel were trained and experienced, and the majority knew their professional role (healthcare providers M = 4.1 vs. police officers: M = 3.9 vs. firefighters: M = 4.2, p 5 fatalities (OR 1.6, p < .05 were all associated with role clarity, together with a feeling of control, not being obstructed in work and perceiving the rescue work as a success. Moreover, independent predictors of being more prepared for future operations were arousal during the operation (OR 2.0, p < .001 and perceiving the rescue work as a success (OR 1.5, p < .001.Most of the rescue workers were experienced and knew their professional role. Training and everyday-work-experience must be a focal point when preparing rescue workers for disaster.

  7. Trends in Perinatal Care and Implications for Frontline Nurse Leaders.

    Science.gov (United States)

    Crenshaw, Jeannette T; Adams, Ellise D; Amis, Debby

    2016-01-01

    The perinatal trends presented in this article are based on recent topics from conferences, journals, the media, as well as from input from perinatal nurses. Trends in patient care are influenced by evidence known for decades, new research, emerging and innovative concepts in healthcare, patient and family preferences, and the media. Trends discussed in this article are rethinking the due date, birth outside the hospital setting, obstetric hospitalists as birth attendants, nitrous oxide for pain in childbirth, hydrotherapy and waterbirth in the hospital setting, delayed cord clamping, disrupters of an optimal infant microbiome, skin-to-skin care during cesarean surgery, and breast-sleeping and the breast-feeding dyad. In addition, the authors developed implications for perinatal nurses related to each trend. The goal is to stimulate reflection on evidence that supports or does not support current practice and to stimulate future research by discussing some of the current trends that may influence the care that perinatal nurses provide during the birthing year.

  8. Doing implementation research on health governance: a frontline researcher's reflexive account of field-level challenges and their management.

    Science.gov (United States)

    Patel, Gupteswar; Garimella, Surekha; Scott, Kerry; Mondal, Shinjini; George, Asha; Sheikh, Kabir

    2017-11-15

    Implementation Research (IR) in and around health systems comes with unique challenges for researchers including implementation, multi-layer governance, and ethical issues. Partnerships between researchers, implementers, policy makers and community members are central to IR and come with additional challenges. In this paper, we elaborate on the challenges faced by frontline field researchers, drawing from experience with an IR study on Village Health Sanitation and Nutrition Committees (VHSNCs). The IR on VHSNC took place in one state/province in India over an 18-month research period. The IR study had twin components; intervention and in-depth research. The intervention sought to strengthen the VHSNC functioning, and concurrently the research arm sought to understand the contextual factors, pathways and mechanism affecting VHSNC functions. Frontline researchers were employed for data collection and a research assistant was living in the study sites. The frontline research assistant experienced a range of challenges, while collecting data from the study sites, which were documented as field memos and analysed using inductive content analysis approach. Due to the relational nature of IR, the challenges coalesced around two sets of relationships (a) between the community and frontline researchers and (b) between implementers and frontline researchers. In the community, the frontline researcher was viewed as the supervisor of the intervention and was perceived by the community to have power to bring about beneficial changes with public services and facilities. Implementers expected help from the frontline researcher in problem-solving in VHSNCs, and feedback on community mobilization to improve their approaches. A concerted effort was undertaken by the whole research team to clarify and dispel concerns among the community and implementers through careful and constant communication. The strategies employed were both managerial, relational and reflexive in nature

  9. Front-line perspectives on 'joined-up' working relationships: a qualitative study of social prescribing in the west of Scotland.

    Science.gov (United States)

    White, Jane M; Cornish, Flora; Kerr, Susan

    2017-01-01

    Cross-sector collaboration has been promoted by government policies in the United Kingdom and many western welfare states for decades. Literature on joint working has focused predominantly on the strategic level, neglecting the role of individual practitioners in putting 'joined-up working' into practice. This paper takes the case of 'social prescribing' in the west of Scotland as an instance of joined-up working, in which primary healthcare professionals are encouraged to refer patients to non-medical sources of support in the third sector. This study draws on social capital theory to analyse the quality of the relationships between primary healthcare professionals and third sector practitioners. Eighteen health professionals and 15 representatives of third sector organisations participated in a qualitative interview study. Significant barriers to collaborative working were evident. The two stakeholder groups expressed different understandings of health, with few primary healthcare professionals considering non-medical sources of support to be useful or relevant. Health professionals were mistrustful of unknown third sector organisations, and concerned about their accountability for referrals that were not successful or positive for the patient. Third sector practitioners sought to build trust through face-to-face interactions with health professionals. However, primary healthcare professionals and third sector practitioners were not connected in effective networks. We highlight the ongoing imbalance of power between primary healthcare professionals and third sector organisations. Strategic collaborations should be complemented by efforts to build shared understandings, trust and connections between the diverse front-line workers whose mutual co-operation is necessary to achieve effective joined-up working. © 2015 John Wiley & Sons Ltd.

  10. Healthcare personnel perceptions of hand hygiene monitoring technology.

    Science.gov (United States)

    Ellingson, Katherine; Polgreen, Philip M; Schneider, Amy; Shinkunas, Laura; Kaldjian, Lauris C; Wright, Donald; Thomas, Geb W; Segre, Alberto M; Herman, Ted; McDonald, L Clifford; Sinkowitz-Cochran, Ronda

    2011-11-01

    To assess healthcare personnel (HCP) perceptions regarding implementation of sensor-based electronic systems for automated hand hygiene adherence monitoring. Using a mixed-methods approach, structured focus groups were designed to elicit quantitative and qualitative responses on familiarity, comfort level, and perceived impact of sensor-based hand hygiene adherence monitoring. A university hospital, a Veterans Affairs hospital, and a community hospital in the Midwest. Focus groups were homogenous by HCP type, with separate groups held for leadership, midlevel management, and frontline personnel at each hospital. Overall, 89 HCP participated in 10 focus groups. Levels of familiarity and comfort with electronic oversight technology varied by HCP type; when compared with frontline HCP, those in leadership positions were significantly more familiar with ([Formula: see text]) and more comfortable with ([Formula: see text]) the technology. The most common concerns cited by participants across groups included lack of accuracy in the data produced, such as the inability of the technology to assess the situational context of hand hygiene opportunities, and the potential punitive use of data produced. Across groups, HCP had decreased tolerance for electronic collection of spatial-temporal data, describing such oversight as Big Brother. While substantial concerns were expressed by all types of HCP, participants' recommendations for effective implementation of electronic oversight technologies for hand hygiene monitoring included addressing accuracy issues before implementation and transparent communication with frontline HCP about the intended use of the data.

  11. Emergency planning and preparedness for nuclear facilities

    International Nuclear Information System (INIS)

    1986-01-01

    In order to review the advances made over the past seven years in the area of emergency planning and preparedness supporting nuclear facilities and consider developments which are on the horizon, the IAEA at the invitation of the Government of Italy, organized this International Symposium in co-operation with the Italian Commission for Nuclear and Alternative Energy Sources, Directorate of Nuclear Safety and Health Protection (ENEA-DISP). There were over 250 designated participants and some 70 observers from 37 Member States and four international organizations in attendance at the Symposium. The Symposium presentations were divided into sessions devoted to the following topics: emergency planning (20 papers), accident assessment (30 papers), protective measures and recovery operations (10 papers) and emergency preparedness (16 papers). A separate abstract was prepared for each of these papers

  12. Healthcare Lean.

    Science.gov (United States)

    Long, John C

    2003-01-01

    Lean Thinking is an integrated approach to designing, doing and improving the work of people that have come together to produce and deliver goods, services and information. Healthcare Lean is based on the Toyota production system and applies concepts and techniques of Lean Thinking to hospitals and physician practices.

  13. Strategic learning in healthcare organizations.

    Science.gov (United States)

    O'Sullivan, M J

    1999-01-01

    the answers; to concede that we do not always know what to do; to admit that past actions and solutions may no longer be appropriate, in fact may have been the incubators of today's problems; to question basic assumptions long held about running the institution; and to make ourselves vulnerable to the political dynamics prevalent in all organizations. Hospitals and other healthcare organizations must seek to develop and maintain a continuing state of readiness in which everyone in the organization, from front-line clinician to senior management, is poised to act in anticipation of and in response to unforeseen changes in the environment and to learn from their own experiences in confronting the future.

  14. Emergency Preparedness: A Handbook for Families.

    Science.gov (United States)

    1982-06-01

    Advancement of Science, 1966. FAMILY HANDYMAN MAGAZINE. America’s Handyman Book. New York: Charles Scribner’s Sons, 1980. FARACE , Richard V., Kenneth...1972. FARACE , Richard V. Communication Strategies for Crisis Relocation Planning. Washington, D.C.: Defense Civil Preparedness Agency, November 1975... FARACE , Richard V., Kenneth L. Villard, and L. Edna Rogers. Family Communication About Plans for Natural and Nuclear Disasters. Washington, D.C

  15. Medical preparedness for radiation emergency in Japan

    International Nuclear Information System (INIS)

    Akashi, Makoto

    1997-01-01

    Medical preparedness for radiation emergency in Japan is primary for off-site public protection. Many things remains to be discussed about on-site emergency medical problems. On the other hand, each nuclear facility should have a countermeasure plan of radiation emergency including medical measures for the emergency. Disaster countermeasure act and a guideline from NSC entitled 'Off-site emergency planning and preparedness for nuclear power plants' establish the system for countermeasures in radiation emergencies. The guideline also establishes medical plans in radiation emergencies, including care system for the severely contaminated or injured. NIRS is designated by the guideline as the definite care hospital for radiation injuries and is prepared to dispatch medical specialists and to receive the injured. NIRS conducts clinical follow-up studies of the injured, researches of diagnosis and treatments for radiation injuries, and education and training for medical personnel. NIRS has the plans to serve as the reference center for emergency in Japan and also in Asia, if necessary. NIRS would like to serve as a member of WHO Collaborating Center for Radiation Emergency Medical Preparedness and Assistance (REMPAN). Now NIRS is making preparation for providing 24-hours direct or consultative assistance with medical problems associated with radiation accidents in local, national, and hopefully international incidents. (author)

  16. Development of effective emergency preparedness and response

    International Nuclear Information System (INIS)

    2012-01-01

    It has been discussed that there were many differences to international standards and the delay for prior planning implementation of unclear emergency preparedness. Therefore, it was necessary to promote the study to take the concept of the international standard to the Guide 'Emergency Preparedness for Nuclear Facilities', and to apply the Precautionary Action Zone (PAZ) etc. as the protective actions procedure. This study was started since the fiscal year 2010 to enhance the effectiveness of the protective actions, which are corresponding to these requirements based on international aspects in the nuclear disaster occurrence. And the study was conducted to introduce the emergency action level (EAL) as decision criteria and to apply urgent protective action considering PAZ, and the results from this study will be used as the basic data necessary to modify and improve the Guide. In order to fulfill the purposes described above, in fiscal year 2011, followings are executed, (1) analysis and verification for basic evacuation area such as the PAZ, (2) analysis with regard to the EAL and prototype of protective actions for public, and (3) analysis with regard to prototype of protective actions for public including evacuation plan. However, taking account of the significance of the Fukushima Daiichi Nuclear Power Plant accident, Japanese emergency preparedness strategy should be studied and reconstructed in logically, systematically, and with international standard, but also being based on the reflection of individual lessons from this accident. (author)

  17. A Probabilistic Risk Assessment For Emergency Preparedness

    International Nuclear Information System (INIS)

    Lee, Joomyung; Jae, Moosung; Ahn, Kwangil

    2013-01-01

    The importance of nuclear power plant PSA has grown up all over the world due to this incident. The main concern of this study is to develop a methodology to carry on an emergency preparedness evaluation and to set an exclusive area, or the emergency response area boundary in order to apply it to domestic reference plants. This study also focuses on evaluating the risk parameter of major nuclides through a sensitivity analysis and a safety assessment by calculating the population dose, early fatality, and cancer fatality rates. A methodology for an emergency preparedness, which can be applied to evaluate the damage of the radioactive release as well as to assess the safety of the accident scenario of a nuclear power plant, has been developed and applied for the reference plants in Korea. By applying a source term analysis, an exclusive zone based on the radioactive dose is obtained. And the results of the health effect assessment based on the release fraction of specific nuclides to public with an effective emergency response activity have been simulated. A methodology utilizing the Level 3 PSA with the actual emergency response activities has been developed and applied to typical nuclear accident situations. The plausible standard for performing an emergency plan is suggested and the valuable information regarding emergency preparedness has been produced in this study. For further works, the sensitivity study on important parameters will be performed to simulate the actual severe accident situations such as sheltering, evacuation, and emergency response activities

  18. The Norwegian nuclear emergency preparedness system

    International Nuclear Information System (INIS)

    Naadland, E.; Stranden, E.

    1995-01-01

    A new national organisation for nuclear emergency preparedness was established in Norway in 1993, based on experiences from the Chernobyl accident. This organisation is based on authorities and research institutions which in a normal situation have responsibilities and knowledge in fields that are also of major importance in a nuclear accident situation. The national emergency preparedness organisation consists of the Ministerial Co-ordination Committee, the Advisory Committee for Nuclear Accidents and their secretariat at the Norwegian Radiation Protection Authority, and an Information Group. The organisations participating in the Advisory Committee operate measuring networks, stations and laboratories. In an early phase of an accident, a minor group from the Advisory Committee forms a Crisis Committee for Nuclear Accidents. This committee has been delegated the authority to make decisions in this phase. The organisation represented by its secretariat at the Norwegian Radiation Protection Authority is responsible for coordinating the emergency planning, the measuring capacities and the professional needs ordinarily. The secretariat is on call 24 hours a day as point of contact according to bilateral and international agreements on early notification. In this paper the features of the emergency preparedness organisation are presented. (Author)

  19. Working at the frontline in cases of elder abuse: 'it keeps me awake at night'.

    Science.gov (United States)

    Cairns, Jane; Vreugdenhil, Anthea

    2014-03-01

    To explore the experiences of frontline health and welfare practitioners in working with older people experiencing abuse. In-depth interviews with 16 Tasmanian community-based health and welfare practitioners regarding their experiences of working in 49 recent cases of elder abuse. Interview transcripts were analysed using thematic analysis. All participants found working in cases of elder abuse challenging and the work itself was perceived as difficult, complex and at times dangerous. The cumulative effect of intimidating work contexts, practice dilemmas and a lack of support resulted in frustration and stress for many practitioners. Nevertheless, participants were committed to providing ongoing services and support for older people experiencing abuse. Frontline practitioners working in cases of elder abuse face significant challenges and could be better supported through strengthening organisational elder abuse policies, increased management support and more age-inclusive family violence support services. © 2013 The Authors. Australasian Journal on Ageing © 2013 ACOTA.

  20. Genome-wide mutagenesis and multi-drug resistance in American trypanosomes induced by the front-line drug benznidazole

    KAUST Repository

    Campos, Mô nica C.; Phelan, Jody; Francisco, Amanda F.; Taylor, Martin C.; Lewis, Michael D.; Pain, Arnab; Clark, Taane G.; Kelly, John M.

    2017-01-01

    Chagas disease is caused by the protozoan parasite Trypanosoma cruzi and affects 5–8 million people in Latin America. Although the nitroheterocyclic compound benznidazole has been the front-line drug for several decades, treatment failures

  1. Estimation of functional preparedness of young handballers in setup time

    Directory of Open Access Journals (Sweden)

    Favoritоv V.N.

    2012-11-01

    Full Text Available The dynamics of level of functional preparedness of young handballers in setup time is shown. It was foreseen to make alteration in educational-training process with the purpose of optimization of their functional preparedness. 11 youths were plugged in research, calendar age 14 - 15 years. For determination of level of their functional preparedness the computer program "SVSM" was applied. It is set that at the beginning of setup time of 18,18% of all respondent functional preparedness is characterized by a "middle" level, 27,27% - below the "average", 54,54% - "above" the average. At the end of setup time among sportsmen representatives prevailed with the level of functional preparedness "above" average - 63,63%, with level "high" - 27,27%, sportsmen with level below the average were not observed. Efficiency of the offered system of trainings employments for optimization of functional preparedness of young handballers is well-proven.

  2. Exploring the Predictors of Organizational Preparedness for Natural Disasters.

    Science.gov (United States)

    Sadiq, Abdul-Akeem; Graham, John D

    2016-05-01

    There is an extensive body of research on the determinants of disaster preparedness at the individual and household levels. The same cannot be said for the organizational level. Hence, the purpose of this study is to shed light on the predictors of organizational preparedness for natural disasters. Since leaders of organizations have an incentive to overstate their level of preparedness and because surveys of organizational leaders suffer from selection bias and low response rates, we take the novel approach of interviewing employees about the organizations that employ them. Using an online survey, we collected information from a national sample of 2,008 U.S. employees and estimated the predictors of preparedness at the organizational level. We find, among other results, that organization size (facility level) is a consistent predictor of preparedness at the organizational level. We conclude with policy recommendations and outline an agenda for future research on organizational preparedness for natural disasters. © 2015 Society for Risk Analysis.

  3. The role of ASTRO and the radiation oncologist in preparedness

    International Nuclear Information System (INIS)

    Daly, N.

    2003-01-01

    The events on September 11, 2001 were unpredictable and tragic, however it is not inconceivable that a similar terrorist event could occur again, this time involving radiologic or nuclear material. In order to prepare for this American Society for Therapeutic Radiology and Oncology (ASTRO) convened a task force. Initially the task force worked with the American College of Radiology (ACR)and the American Society of Physicists in Medicine (AAPM)to publish a PRIMER entitled 'Disaster Preparedness for Radiology Professionals'. The PRIMER serve as a quick reference in the event of a radiation disaster and is available on the ASTRO Web site (www.astro.org). The task force has also developed a detailed and extensive training program, in partnership with the U.S. Department of Energy's Radiation Emergency Assistance Center/Training Site (REAC/TS) in Oak Ridge (TN), that will equip radiation oncologists with the necessary expertise to train hospital radiation oncology departments and other healthcare personnel who are responsible for implementing and carrying out hospital planning for disasters involving radioactive materials. This presentation will outline the effort ASTRO has been involved with since September 11, 2001 to prepare the professional community it represent in the event of a radiation/nuclear disaster

  4. Emergency Preparedness Education for Nurses: Core Competency Familiarity Measured Utilizing an Adapted Emergency Preparedness Information Questionnaire.

    Science.gov (United States)

    Georgino, Madeline M; Kress, Terri; Alexander, Sheila; Beach, Michael

    2015-01-01

    The purpose of this project was to measure trauma nurse improvement in familiarity with emergency preparedness and disaster response core competencies as originally defined by the Emergency Preparedness Information Questionnaire after a focused educational program. An adapted version of the Emergency Preparedness Information Questionnaire was utilized to measure familiarity of nurses with core competencies pertinent to first responder capabilities. This project utilized a pre- and postsurvey descriptive design and integrated education sessions into the preexisting, mandatory "Trauma Nurse Course" at large, level I trauma center. A total of 63 nurses completed the intervention during May and September 2014 sessions. Overall, all 8 competencies demonstrated significant (P < .001; 98% confidence interval) improvements in familiarity. In conclusion, this pilot quality improvement project demonstrated a unique approach to educating nurses to be more ready and comfortable when treating victims of a disaster.

  5. Revisiting public health preparedness: Incorporating social justice principles into pandemic preparedness planning for influenza.

    Science.gov (United States)

    Kayman, Harvey; Ablorh-Odjidja, Angela

    2006-01-01

    Public health professionals are responsible for ensuring the health of the nation, which requires that planners for public health emergencies recognize that not including protection for underserved or marginalized communities poses a risk to the entire population. To assure the protection of these populations in the event of a pandemic outbreak, preparedness planning will benefit from the application of several principles of social justice in assuring the protection of all individuals. This article will review the history between public health and social justice, provide a brief review of pandemic preparedness planning efforts, discuss the importance of and make recommendations for the incorporation of principles of social justice in the development of pandemic preparedness plans, and highlight some of the challenges faced by public health in effectively and equitably meeting its charge to protect the nation's health.

  6. Determinants of job motivation among frontline employees at hospitals in Tehran.

    Science.gov (United States)

    Zarei, Ehsan; Najafi, Marziye; Rajaee, Roya; Shamseddini, Abbas

    2016-04-01

    Human resources are the most strategic resource and the most significant input for health systems. Their behavior and motivation can strongly affect the overall performance of the health systems. The aim of this study was to determine the factors that affect motivation in frontline employees at teaching hospitals affiliated with Shahid Beheshti University of Medical Sciences (SBMU) in Tehran, Iran. This cross-sectional study was conducted in 2015. The participants (nurses, physiotherapists, radiology and laboratory technicians, operating room and pharmacy staff) were 300 employees selected by the stratified random sampling method from two general and teaching hospitals. The data collection instrument was a questionnaire that consisted of 42 questions in the 7 domains of motivational factors. Data analysis was performed using descriptive statistics and independent samples t-test by SPSS software, version 23. The findings indicated that working relationships (mean of 3.95) were the main determinant of job motivation of frontline employees. Job content (3.76) career development (3.75), social respect (3.75), and autonomy (3.30) were the next four affective factors. Recognition and remuneration had the least influence on the job motivation of frontline employees. The results of the Friedman test indicated that the difference between the mean scores of different dimensions was significant (χ(2) (6) = 607.00, p motivation of its frontline employees should have in place a human resources strategy that includes facilitating communication between personnel and management, supporting employees in the community, and promoting social respect for health professions, providing educational opportunities and career development, development of appropriate promotional policies, employee participation in goal setting, facilitating a good working environment and job security, job enrichment, and delegation.

  7. Pregnancy outcomes in Ghana : Relavance of clinical decision making support tools for frontline providers of care

    OpenAIRE

    Amoakoh-Coleman, M.

    2016-01-01

    Ghana’s slow progress towards attaining millennium development goal 5 has been associated with gaps in quality of care, particularly quality of clinical decision making for clients. This thesis reviews the relevance and effect of clinical decision making support tools on pregnancy outcomes. Relevance of three clinical decision making support tools available to frontline providers of care in the Greater Accra region is discussed. These are routine maternal health service delivery data populati...

  8. Determinants of job motivation among frontline employees at hospitals in Tehran

    Science.gov (United States)

    Zarei, Ehsan; Najafi, Marziye; Rajaee, Roya; Shamseddini, Abbas

    2016-01-01

    Introduction Human resources are the most strategic resource and the most significant input for health systems. Their behavior and motivation can strongly affect the overall performance of the health systems. The aim of this study was to determine the factors that affect motivation in frontline employees at teaching hospitals affiliated with Shahid Beheshti University of Medical Sciences (SBMU) in Tehran, Iran. Methods This cross-sectional study was conducted in 2015. The participants (nurses, physiotherapists, radiology and laboratory technicians, operating room and pharmacy staff) were 300 employees selected by the stratified random sampling method from two general and teaching hospitals. The data collection instrument was a questionnaire that consisted of 42 questions in the 7 domains of motivational factors. Data analysis was performed using descriptive statistics and independent samples t-test by SPSS software, version 23. Results The findings indicated that working relationships (mean of 3.95) were the main determinant of job motivation of frontline employees. Job content (3.76) career development (3.75), social respect (3.75), and autonomy (3.30) were the next four affective factors. Recognition and remuneration had the least influence on the job motivation of frontline employees. The results of the Friedman test indicated that the difference between the mean scores of different dimensions was significant (χ2(6) = 607.00, p motivation of its frontline employees should have in place a human resources strategy that includes facilitating communication between personnel and management, supporting employees in the community, and promoting social respect for health professions, providing educational opportunities and career development, development of appropriate promotional policies, employee participation in goal setting, facilitating a good working environment and job security, job enrichment, and delegation. PMID:27280000

  9. Ageing of people with an intellectual disability: Effective training for frontline workers

    OpenAIRE

    Adrienne McGhee; Pat Dorsett

    2011-01-01

    Abstract While the attainment of late life represents a significant achievement for people with an intellectual disability, increased life expectancy has resulted in growing concerns about the extent to which disability service providers are ready to meet the changing needs of increasing numbers of older people and facilitate their ongoing social inclusion. Training of frontline disability staff is widely accepted as an effective strategy for increasing organisational capacity to contribu...

  10. An exploratory study of work-family conflicts and enrichment of front-line hotel employees in the Philippines

    OpenAIRE

    Nabong, Tristan Kirby Mansueto

    2012-01-01

    Master's thesis in International hotel and tourism management The study aims to explore and identify the front-line hotel employees’ issues and perceptions of work-life balance in the Philippine context. The respondents were front-line hotel personnel assigned to various departments of selected top luxury hotels in the Philippines. Self-administered questionnaires were used to collect the data. Factor analysis discovered five factors: (1) time-based conflict; (2) strain-based conflict; (3...

  11. Hungarian system for nuclear emergency preparedness

    International Nuclear Information System (INIS)

    Borsi, Laszlo; Szabo, Laszlo; Ronaky, Jozsef

    2000-01-01

    The Hungarian Government had established in 1989 on the basis of national and international experience the National System for Nuclear Emergency Preparedness (NSNEP). Its guidance is ad-ministered by the Governmental Commission for Nuclear Emergency Preparedness (GCNEP). The work of the Governmental Commission is designated to be assisted by the Secretariat, the Operational Staff and by the Technical Scientific Council. The leading and guiding duties of the relevant ministries and national agencies are performed by the Sectional Organisations for Nuclear Emergency Preparedness (SONEP), together with those of the Metropolitan Agencies and of the county agencies by the Metropolitan Local Committee (MLCNEP) and by County Local Committees. The chairman of the Governmental Commission is the Minister of the Interior whose authority covers the guidance of the NSNEP's activities. The Secretariat of the Governmental Commission (SGC) co-ordinates the activities of the bodies of the Governmental Commission, the sectional organisations, the local committees for nuclear emergency preparedness and those of the other bodies responsible for implementing action. The Emergency Information Centre (EIC) of GCNEP as the central body of the National Radiation Monitoring, Warning and Surveillance System provides the information needed for preparing decisions at Governmental Commission level. The technical-scientific establishment of the governmental decisions in preparation for nuclear emergency situations and the elimination of their consequences are tasks of the Technical-Scientific Council. The Centre for Emergency Response, Training and Analysis (CERTA) of the Hungarian Atomic Energy Authority (HAEA) may be treated as a body of the Governmental Commission as well. The National Radiation Monitoring, Warning and Surveillance System (NRMWSS) is integral part of the NSNEP. The NRMWSS consists of the elements operated by the ministries and the operation of nation-wide measuring network in

  12. A cascade model of mentorship for frontline health workers in rural health facilities in Eastern Uganda: processes, achievements and lessons.

    Science.gov (United States)

    Ajeani, Judith; Mangwi Ayiasi, Richard; Tetui, Moses; Ekirapa-Kiracho, Elizabeth; Namazzi, Gertrude; Muhumuza Kananura, Ronald; Namusoke Kiwanuka, Suzanne; Beyeza-Kashesya, Jolly

    2017-08-01

    There is increasing demand for trainers to shift from traditional didactic training to innovative approaches that are more results-oriented. Mentorship is one such approach that could bridge the clinical knowledge gap among health workers. This paper describes the experiences of an attempt to improve health-worker performance in maternal and newborn health in three rural districts through a mentoring process using the cascade model. The paper further highlights achievements and lessons learnt during implementation of the cascade model. The cascade model started with initial training of health workers from three districts of Pallisa, Kibuku and Kamuli from where potential local mentors were selected for further training and mentorship by central mentors. These local mentors then went on to conduct mentorship visits supported by the external mentors. The mentorship process concentrated on partograph use, newborn resuscitation, prevention and management of Post-Partum Haemorrhage (PPH), including active management of third stage of labour, preeclampsia management and management of the sick newborn. Data for this paper was obtained from key informant interviews with district-level managers and local mentors. Mentorship improved several aspects of health-care delivery, ranging from improved competencies and responsiveness to emergencies and health-worker professionalism. In addition, due to better district leadership for Maternal and Newborn Health (MNH), there were improved supplies/medicine availability, team work and innovative local problem-solving approaches. Health workers were ultimately empowered to perform better. The study demonstrated that it is possible to improve the competencies of frontline health workers through performance enhancement for MNH services using locally built capacity in clinical mentorship for Emergency Obstetric and Newborn Care (EmONC). The cascade mentoring process needed strong external mentorship support at the start to ensure improved

  13. Revisiting the Impact of Perceived Empowerment on Job Performance: Results from Front-Line Employees

    Directory of Open Access Journals (Sweden)

    Ozgur Devrim Yilmaz

    2015-01-01

    Full Text Available This study was conducted to examine the probable effect of perceived empowerment on job performance and the sample of research consisted of 230 participants working in tourism sector as front-line employees. The outcomes of this study indicated that psychological empowerment was positively correlated with employee job performance and employees’ job performance were mostly effected from self-determination and impact dimensions of empowerment. Moreover, tests were conducted to analyze the significant differences in participants’ perception of empowerment and job performance according to their demographic characteristics. There was a significant difference between perceived empowerment and gender, age and work experience where as there was no significant difference between empowerment and education levels. On the other hand, the relationship between job performance and work experience was supported however no relationship was found between job performance and gender, age and education level of the participants. Trying to find out what might possibly lead front-line employees to increased job performance, it can be claimed that psychological empowerment still turns out to be a central issue and therefore this research makes useful contributions to the current knowledge by entirely investigating the direct effect of perceived empowerment on employee job performance in hospitality industry where especially front-line employees spend most of their time directly with customers.

  14. Mentoring frontline managers: the vital force in stimulating innovation at the point of care.

    Science.gov (United States)

    Shiparski, Laurie; Authier, Philip

    2013-01-01

    Frontline managers in health care are the keepers of culture, the gateway to evoking a grass roots intelligence network, and they hold a pivotal role in advancing innovation at the point of care. Their roles are ever expanding and include knowledge and skills in managing the business, leading the people, and advancing their own leadership development. In all 3 areas, the impact of their leadership exponentially increases if they maximize innovative thinking and action. Health care executives need to establish the expectations for an innovative culture and the role of frontline managers. They must model the behaviors they promote and take the time to develop these frontline managers who are the hub for innovative success in the organization. This article offers insights and practical applications while exploring the innovation keystones of the following: creating an organizational culture of innovation, igniting collaboration that fuels diverse thinking and creativity, utilizing meaningful data to drive innovative decisions, and assessing and monitoring the ongoing climate and outcomes of innovation.

  15. A telephone survey of cancer awareness among frontline staff: informing training needs

    Science.gov (United States)

    Cook, N; Hart, A; Nuttall, K; Simpson, K; Turnill, N; Grant-Pearce, C; Damms, P; Allen, V; Slade, K; Dey, P

    2011-01-01

    Background: Studies have shown limited awareness about cancer risk factors among hospital-based staff. Less is known about general cancer awareness among community frontline National Health Service and social care staff. Methods: A cross-sectional computer-assisted telephone survey of 4664 frontline community-based health and social care staff in North West England. Results: A total of 671 out of 4664 (14.4%) potentially eligible subjects agreed to take part. Over 92% of staff recognised most warning signs, except an unexplained pain (88.8%, n=596), cough or hoarseness (86.9%, n=583) and a sore that does not heal (77.3%, n=519). The bowel cancer-screening programme was recognised by 61.8% (n=415) of staff. Most staff agreed that smoking and passive smoking ‘increased the chance of getting cancer.' Fewer agreed about getting sunburnt more than once as a child (78.0%, n=523), being overweight (73.5%, n=493), drinking more than one unit of alcohol per day (50.2%, n=337) or doing less than 30 min of moderate physical exercise five times a week (41.1%, n=276). Conclusion: Cancer awareness is generally good among frontline staff, but important gaps exist, which might be improved by targeted education and training and through developing clearer messages about cancer risk factors. PMID:21750554

  16. Measuring disaster preparedness of local emergency medical services agencies

    OpenAIRE

    Elliott, Ross W.

    2010-01-01

    CHDS State/Local Approved for public release; distribution is unlimited Emergency Medical Services (EMS) plays a key role in disaster response. Yet, determining how much preparedness is enough to achieve an acceptable level of preparedness is challenging. After conducting an extensive literature review, it is evident no nationally accepted method exists to evaluate an EMS system's level of disaster preparedness systematically. Research was conducted to define the skills and equipmen...

  17. Medical students' preparedness for professional activities in early clerkships.

    Science.gov (United States)

    Bosch, Josefin; Maaz, Asja; Hitzblech, Tanja; Holzhausen, Ylva; Peters, Harm

    2017-08-22

    Sufficient preparedness is important for transitions to workplace participation and learning in clinical settings. This study aims to analyse medical students' preparedness for early clerkships using a three-dimensional, socio-cognitive, theory-based model of preparedness anchored in specific professional activities and their supervision level. Medical students from a competency-based undergraduate curriculum were surveyed about preparedness for 21 professional activities and level of perceived supervision during their early clerkships via an online questionnaire. Preparedness was operationalized by the three dimensions of confidence to carry out clerkship activities, being prepared through university teaching and coping with failure by seeking support. Factors influencing preparedness and perceived stress as outcomes were analysed through step-wise regression. Professional activities carried out by the students (n = 147; 19.0%) and their supervision levels varied. While most students reported high confidence to perform the tasks, the activity-specific analysis revealed important gaps in preparation through university teaching. Students regularly searched for support in case of difficulty. One quarter of the variance of each preparedness dimension was explained by self-efficacy, supervision quality, amount of prior clerkship experience and nature of professional activities. Preparedness contributed to predicting perceived stress. The applied three-dimensional concept of preparedness and the task-specific approach provided a detailed and meaningful view on medical students' workplace participation and experiences in early clerkships.

  18. Planning and preparedness for radiological emergencies at nuclear power stations

    International Nuclear Information System (INIS)

    Thomson, R.; Muzzarelli, J.

    1996-01-01

    The Radiological Emergency Preparedness (REP) Program was created after the March 1979 accident at the Three Mile Island nuclear power station. The Federal Emergency Management Agency (FEMA) assists state and local governments in reviewing and evaluating state and local REP plans and preparedness for accidents at nuclear power plants, in partnership with the US Nuclear Regulatory Commission (NRC), which evaluates safety and emergency preparedness at the power stations themselves. Argonne National Laboratory provides support and technical assistance to FEMA in evaluating nuclear power plant emergency response exercises, radiological emergency plans, and preparedness

  19. The Effect of Risk Reduction Intervention on Earthquake Disaster Preparedness of the Elderly People

    Directory of Open Access Journals (Sweden)

    Kian Nourozi

    2016-01-01

    Conclusion: Preparedness programs for disaster risk reduction has a positive effect on the elders’ preparedness. Thus, similar multimodal preparedness programs should be used more frequently for this vulnerable community citizens.

  20. Why healthcare workers are sick of TB

    Directory of Open Access Journals (Sweden)

    Arne von Delft

    2015-03-01

    Full Text Available Dr Thato Mosidi never expected to be diagnosed with tuberculosis (TB, despite widely prevalent exposure and very limited infection control measures. The life-threatening diagnosis of primary extensively drug-resistant TB (XDR-TB came as an even greater shock. The inconvenient truth is that, rather than being protected, Dr Mosidi and thousands of her healthcare colleagues are at an increased risk of TB and especially drug-resistant TB. In this viewpoint paper we debunk the widely held false belief that healthcare workers are somehow immune to TB disease (TB-proof and explore some of the key factors contributing to the pervasive stigmatization and subsequent non-disclosure of occupational TB. Our front-line workers are some of the first to suffer the consequences of a progressively more resistant and fatal TB epidemic, and urgent interventions are needed to ensure the safety and continued availability of these precious healthcare resources. These include the rapid development and scale-up of improved diagnostic and treatment options, strengthened infection control measures, and focused interventions to tackle stigma and discrimination in all its forms. We call our colleagues to action to protect themselves and those they care for.

  1. Radiation emergency preparedness in nuclear power plants

    International Nuclear Information System (INIS)

    Geetha, P.V.; Ramamirtham, B.; Khot, P.

    2008-01-01

    The purpose of planning for radiation emergency response is to ensure adequate preparedness for protection of the plant personnel and members of the public from significant radiation exposures in the unlikely event of an accident. With a number of safety features in the reactor design and sound operating procedures, the probability of a major accident resulting in the releases of large quantities of radioactivity is extremely small. However, as an abundant cautious approach a comprehensive radiation emergency response preparedness is in place in all the nuclear power plants (NPPs). Radiation Emergency in NPPs is broadly categorized into three types; plant emergency, site emergency and off-site emergency. During off site emergency conditions, based on levels of radiation in the environment, Civil Authorities may impose several counter measures such as sheltering, administering prophylaxis (stable iodine for thyroid blocking) and evacuation of people from the affected area. Environmental Survey Laboratory (ESL) carries out environmental survey extensively in the affected sector identified by the meteorological survey laboratory. To handle emergency situations, Emergency Control Centre with all communication facility and Emergency Equipment Centre having radiation measuring instruments and protective equipment are functional at all NPPs. AERB stipulates certain periodicity for conducting the exercises on plant, site and off site emergency. These exercises are conducted and deficiencies corrected for strengthening the emergency preparedness system. In the case of off site emergency exercise, observers are invited from AERB and Crisis Management Group of Department of Atomic Energy (DAE). The emergency exercises conducted by Nuclear Power Plant Sites have been very satisfactory. (author)

  2. Preparedness of Iranian Hospitals Against Disasters

    Directory of Open Access Journals (Sweden)

    Asefzadeh

    2016-08-01

    Full Text Available Context Over the past decade the number of accidents and disasters has been growing around the world. In addition to damaging communities and infrastructures, unexpected disasters also affect service providers. This study aimed to evaluate the readiness of hospitals when confronted with unexpected disasters. Evidence Acquisition The present study was a simple review article, which was conducted via searching different sites, such as: Web of Science, Scopus, Science Direct and PubMed, using different key words such as: Disasters, Crisis, Hospital and preparedness. The relationship between the articles found in relation to our subject was investigated through the title and abstract of articles. The relationship between the articles, which were found in relation to our subject, was investigated through the title and abstract of the articles. Our search included papers published during the period between 2007 and 2015 and we only considered studies that measured the preparedness of hospitals in critical conditions. Among the 30 articles, which were found, 17 were excluded from the study due to lack of relevant data. Hence, 15 papers, which were of proper design and robust data analysis, were included in the current study. Results Hospital preparedness in disaster was evaluated in three dimensions: structural, non-structural factors and vulnerability management performance. A total of readiness of hospitals in three dimensions was mediocre. Conclusions Overall, the results derived from these studies indicated that hospital safety levels in most of the surveyed hospitals were moderate. Although the situation in hospitals is not critical, there is a need to plan and take appropriate measures to improve the safety level of the hospitals.

  3. Morphologic analysis of the SKI preparedness

    International Nuclear Information System (INIS)

    Stenstroem, Maria

    2003-08-01

    The Swedish Nuclear Power Inspectorate (SKI) is an independent government agency responsible for technical assessments and information concerning accidents involving nuclear facilities at home and abroad. With the events of September 11 in New York and Washington D.C., circumstances have also changed for Swedish government agencies. Increased focus had been placed on a broadened threat spectrum, especially as concerns terrorism and the use of non-conventional weapons and methods. This means that SKI must develop adequate preparedness for new types of threats and events. What types of threats, and how SKI's preparedness planning should be developed, are questions which were addressed in a study by a working group from SKI and FOI -the Swedish National Defence Research Agency. The purpose of the study was to identify serious threats and events, which would require SKI's involvement, and to analyze what resources and competencies would by needed in order for SKI to fulfill it responsibilities. Investigating a broadened threat spectrum involves defining and analyzing a multi-dimensional problem complex, which is both difficult to quantify and involves very complicated internal relationships. Morphological analysis is a method for structuring and analyzing such problem complexes, and for developing models based on natural language concepts. The working group developed and studied ten different scenarios, which defined the parameter space for a broadened threat spectrum for SKI. On the basis of these scenarios, a morphological model was developed which describes the demands that these scenarios place on SKI as an organization. On the basis of this, a further morphological model was developed, in order to systematically dimension the resources that would be needed in the face of these demands. Through this analysis, a clearer picture of the demands and required resources for future threats has emerged. The information and insights generated will serve to better develop

  4. Improving Latino disaster preparedness using social networks.

    Science.gov (United States)

    Eisenman, David P; Glik, Deborah; Gonzalez, Lupe; Maranon, Richard; Zhou, Qiong; Tseng, Chi-Hong; Asch, Steven M

    2009-12-01

    Culturally targeted, informal social networking approaches to improving disaster preparedness have not been empirically tested. In partnership with community health promoters and the Los Angeles County Department of Public Health, this study tested a disaster preparedness program for Latino households. This study had a community-based, randomized, longitudinal cohort design with two groups and was conducted during February-October 2007. Assessments were made at baseline and 3 months. Analyses were carried out January-October 2008. Community-based study of 231 Latinos living in Los Angeles County. Participants were randomly assigned to attending platicas (small-group discussions led by a health promoter/promotora de salud) or receiving "media" (a culturally tailored mailer). A total of 187 (81.0%) completed the 3-month follow-up. A self-reported disaster preparedness checklist was used. Among participants who did not have emergency water pre-intervention, 93.3% of those in the platica arm had it at follow-up, compared to 66.7% in the media arm (p=0.003). Among participants who did not have food pre-intervention, 91.7% in the platica arm reported it at follow-up, compared to 60.6% in the media arm (p=0.013). Finally, among participants who did not have a family communication plan pre-intervention, 70.4% in the platica arm reported one at follow-up, compared to 42.3% in the media arm (p=0.002). Although both arms improved in stockpiling water and food and creating a communication plan, the platica arm showed greater improvement than the media group.

  5. State health policy for terrorism preparedness.

    Science.gov (United States)

    Ziskin, Leah Z; Harris, Drew A

    2007-09-01

    State health policy for terrorism preparedness began before the terrorist attacks on September 11, 2001, but was accelerated after that day. In a crisis atmosphere after September 11, the states found their policies changing rapidly, greatly influenced by federal policies and federal dollars. In the 5 years since September 11, these state health policies have been refined. This refinement has included a restatement of the goals and objectives of state programs, the modernization of emergency powers statutes, the education and training of the public health workforce, and a preparation of the health care system to better care for victims of disasters, including acts of terrorism.

  6. Emergency Planning and Preparedness in Belgium

    International Nuclear Information System (INIS)

    Degueldre, D.; Maris, M.

    1998-01-01

    The present Belgian nuclear emergency planning and preparedness is based on experience cumulated since the early eighties. This paper describes the organisation, actuation process, the emergency planning zones and the applicable intervention guidance levels. The role of AVN as on-site inspector, nuclear emergency adviser and emergency assessor is explained as well as its human and technical resources. Finally the paper presents briefly the experience feedback on emergency exercises and training in Belgium as well as AVN's views on some debatable topics. (author)

  7. Quality of healthcare in Canada: potential for a pan-Canadian measurement standard.

    Science.gov (United States)

    Florizone, Dan

    2012-01-01

    Saskatchewan has embarked on a journey to transform the quality of its healthcare. Through our experiences, we have learned many lessons that could be useful to the development of a pan-Canadian system of measurement aimed at bettering care. However, measurement in isolation is insufficient to achieve improved healthcare. The system needs to be linked to a common improvement agenda. Creating a systematic approach to improvement is only possible through developing the capacities of leaders and front-line staff, by alignment through a common purpose, by focusing on value from the perspective of the customer and by creating measures backed by best practice that are transparent and accountable.

  8. Being a valuable contributor on the frontline: The self-perception of staff in group homes for people with intellectual disability.

    Science.gov (United States)

    Quilliam, Claire; Bigby, Christine; Douglas, Jacinta

    2018-05-01

    Group home frontline staff have a critical role in implementing service policies, yet research typically examines implementation issues from an organisational perspective. The aim of this study was to explore the self-perception of frontline staff about their role in group homes for people with intellectual disability. Constructivist grounded theory methodology guided the study. Data were collected with frontline staff through semistructured interviews and participant observations. Coding and sorting methods were used to analyse participants' self-perception. Frontline staff felt they were valuable contributors who knew the service setting and residents well. Despite this staff felt powerless in their roles, excluded from organisational dialogue, stressed and exhausted. Frontline staff have critical insight into service implementation although disability service organisations may limit their capacity to contribute to this. Further action could explore new ways to better nurture frontline staff engagement in organisational dialogue. © 2017 The Authors Journal of Applied Research in Intellectual Disabilities Published by John Wiley & Sons Ltd.

  9. Buried Waste Integrated Demonstration Technology Preparedness and Status Report Guidance

    International Nuclear Information System (INIS)

    Blacker, P.B.; Bonnenberg, R.W.; Cannon, P.G.; Hyde, R.A.; Watson, L.R.

    1994-04-01

    A Technology Preparedness and Status Report is required for each Technical Task Plan funded by the Buried Waste Integrated Demonstration. This document provides guidance for the preparation of that report. Major sections of the report will include a subset of the need for the technology, objectives of the demonstration, technology description and readiness evaluation, demonstration requirements, and preparedness checklist and action plan

  10. Predictors of Healthcare Service Utilization for Mental Health Reasons

    Directory of Open Access Journals (Sweden)

    Marie-Josée Fleury

    2014-10-01

    Full Text Available This study was designed to identify: (1 predictors of 12-month healthcare service utilization for mental health reasons, framed by the Andersen model, among a population cohort in an epidemiological catchment area; and (2 correlates associated with healthcare service utilization for mental health reasons among individuals with and without mental disorders respectively. Analyses comprised univariate, bivariate, and multiple regression analyses. Being male, having poor quality of life, possessing better self-perception of physical health, and suffering from major depressive episodes, panic disorder, social phobia, and emotional problems predicted healthcare service utilization for mental health reasons. Among individuals with mental disorders, needs factors (psychological distress, impulsiveness, emotional problems, victim of violence, and aggressive behavior and visits to healthcare professionals were associated with healthcare service utilization for mental health reasons. Among individuals without mental disorders, healthcare service utilization for mental health reasons is strongly associated with enabling factors such as social support, income, environmental variables, and self-perception of the neighborhood. Interventions facilitating social cohesion and social solidarity in neighborhood settings may reduce the need to seek help among individuals without mental disorders. Furthermore, in their capacity as frontline professionals, general practitioners should be more sensitive in preventing, detecting, and treating mental disorders in routine primary care.

  11. Emergency Preparedness and Response: A Safety Net

    Energy Technology Data Exchange (ETDEWEB)

    Aaltonen, H., E-mail: hannele.aaltonen@stuk.fi [Radiation and Nuclear Safety Authority (STUK), Helsinki (Finland)

    2014-10-15

    Full text: The objective of nuclear regulatory work is to prevent accidents. Nevertheless, possibility of a severe accident cannot be totally excluded, which makes a safety net, efficient emergency preparedness and response, necessary. Should the possibility of accidents be rejected, the result would be in the worst case inadequate protection of population, functions of society, and environment from harmful effects of radiation. Adequate resources for maintenance and development of emergency arrangement are crucial. However, they need to be balanced taking into account risks assessments, justified expectations of society, and international requirements. To successfully respond to an emergency, effective emergency preparedness, such as up-to-date plans and procedures, robust arrangements and knowledgeable and regularly trained staff are required. These, however, are not enough without willingness and proactive attitude to • communicate in a timely manner; • co-operate and coordinate actions; • provide and receive assistance; and • evaluate and improve emergency arrangements. In the establishment and development of emergency arrangements, redundant and diverse means or tools used are needed in, for example, communication and assessment of hazard. Any severe nuclear emergency would affect all countries either directly or indirectly. Thus, national emergency arrangements have to be compatible to the extent practicable with international emergency arrangements. It is important to all countries that the safety nets of emergency arrangements are reliable - and operate efficiently in a coordinated manner when needed - on national, regional and international level. (author)

  12. A survey of pandemic influenza preparedness and response capabilities in Chicago area hospital security departments.

    Science.gov (United States)

    Kimmerly, David P

    2009-01-01

    This article is a summary based on a December 2007 paper prepared by the author in partial fulfillment of the requirements for a master's degree in business and organizational security management at Webster University. The project described was intended to assess Chicago-area healthcare organization security departments' preparedness and response capabilities for a potential influenza pandemic. While the author says healthcare organizations are learning from the pandemics of the past, little research has been conducted on the requirements necessary within hospital security departments. The article explores staffing, planning, preparation and response capabilities within a healthcare security context to determine existing resources available to the healthcare security community. Eleven completed surveys were received from hospital security managers throughout the geographical Chicago area. They reveal that hospital security managers are conscious of the risks of a pandemic influenza outbreak. Yet, it was found that several gaps existed within hospital security department staffing and response capabilities, as hospital security departments may not have the available resources necessary to adequately maintain their operations during a pandemic incident.

  13. PENGARUH PERUBAHAN BENTUK KELEMBAGAAN PROGRAM KB PADA PENGELOLAAN KAMPANYE PROGRAM KB DI TINGKAT FRONTLINER

    Directory of Open Access Journals (Sweden)

    Djoko Setyabudi

    2016-03-01

    Full Text Available This research is aimed at examining the effects of the form of family planning institutions on the ways family planning frontliner (PLKB in Central Java manage their campaign programs. The research findings indicate that the form of family planning institutions, the number of tasks, and incentives given to PLKB, influence the performance of PLKB. another important factor which is significant to the frontliner’s performances is not the form of the institutions, but the way the campaign is managed in each of family planning institution.

  14. Cytogenetic Alterations in Multiple Myeloma: Prognostic Significance and the Choice of Frontline Therapy.

    Science.gov (United States)

    Stella, Flavia; Pedrazzini, Estela; Agazzoni, Mara; Ballester, Oscar; Slavutsky, Irma

    2015-01-01

    Multiple myeloma tumor cells demonstrate multiple and often complex genetic lesions as evaluated by standard cytogenetic/FISH studies. Over the past decade, specific abnormalities have been associated with standard or high-risk clinical behavior and they have become strong prognostic indicators. Further, as evidenced by recent randomized clinical trials, the choice of front-line therapy (transplant vs. no transplant, inclusion of novel drugs such as bortezomib, thalidomide, and lenalidomide) may be able to overcome the adverse effect of high-risk genetic lesions.

  15. e-Health preparedness assessment in the context of an influenza pandemic: a qualitative study in China.

    Science.gov (United States)

    Li, Junhua; Seale, Holly; Ray, Pradeep; Wang, Quanyi; Yang, Peng; Li, Shuang; Zhang, Yi; Macintyre, C Raina

    2013-03-13

    To assess the preparedness status of a hospital in Beijing, China for implementation of an e-Health system in the context of a pandemic response. This research project used qualitative methods and involved two phases: (1) group interviews were conducted with key stakeholders to examine how the surveillance system worked with information and communication technology (ICT) support in Beijing, the results of which provided background information for a case study at the second phase and (2) individual interviews were conducted in order to gather a rich data set in relation to e-Health preparedness at the selected hospital. In phase 1, group interviews were conducted at Centres for Disease Prevention and Control (CDC) in Beijing. In phase 2, individual interviews were performed at a secondary hospital selected for the case study. In phase 1, three group interviews were undertaken with 12 key stakeholders (public health/medical practitioners from the Beijing city CDC, two district CDCs and a tertiary hospital) who were involved in the 2009 influenza A (H1N1) pandemic response in Beijing. In phase 2, individual interviews were conducted with 23 participants (including physicians across medical departments, an IT manager and a general administrative officer). PRIMARY AND SECONDARY MEASURES: For the case study, five areas were examined to assess the hospital's preparedness for implementation of an e-Health system in the context of a pandemic response: (1) motivational forces for change; (2) healthcare providers' exposure to e-Health; (3) technological preparedness; (4) organisational non-technical ability to support a clinical ICT innovation and (5) sociocultural issues at the organisation in association with e-Health implementation and a pandemic response. This article reports a small subset of the case study results from which major issues were identified under three main themes in relation to the hospital's preparedness. These issues include a poor sharing of patient

  16. Preparedness for and response to a radiological or nuclear incident

    International Nuclear Information System (INIS)

    Norman Coleman, C.

    2014-01-01

    Public health and medical planning for a nuclear or radiological incident requires a complex, multi-faceted systematic approach involving federal, state and local governments, private sector organizations, academia, industry, international partners and individual experts and volunteers. The approach developed by the U.S. Department of Health and Human Services in collaboration with other U.S. Departments is the result of efforts from government and non-government experts that connect the available capabilities, resources, guidance tools, underlying concepts and science into the Nuclear Incident Medical Enterprise (NlME). It is a systems approach that can be used to support planning for, response to, and recovery from the effects of a nuclear incident. Experience is gained in exercises specific to radiation but also from other mass casualty incidents as there are many principles and components in common. Resilience and the ability to mitigate the consequences of a nuclear incident are enhanced by effective planning, preparation and training, timely response, clear communication, and continuous improvements based on new science, technology, experience and ideas. Recognizing that preparation for a radiological or nuclear incident will be a lower priority for healthcare workers and responders due to other demands, the Radiation Emergency Medical Management website has been developed with the National Library of Medicine. This includes tools for education and training, just-in-time medical management and triage among others. Most of the components of NIME are published in the peer review medical and disaster medicine literature to help ensure high quality and accessibility. While NIME is a continuous work-in-progress, the current status of the public health and medical preparedness and response for a nuclear incident is presented. (author)

  17. Measures of emergency preparedness contributing to nursing home resilience.

    Science.gov (United States)

    Lane, Sandi J; McGrady, Elizabeth

    2017-12-13

    Resilience approaches have been successfully applied in crisis management, disaster response, and high reliability organizations and have the potential to enhance existing systems of nursing home disaster preparedness. This study's purpose was to determine how the Center for Medicare and Medicaid Services (CMS) "Emergency Preparedness Checklist Recommended Tool for Effective Health Care Facility Planning" contributes to organizational resilience by identifying the benchmark resilience items addressed by the CMS Emergency Preparedness Checklist and items not addressed by the CMS Emergency Preparedness Checklist, and to recommend tools and processes to improve resilience for nursing homes. The CMS Emergency Preparedness Checklist items were compared to the Resilience Benchmark Tool items; similar items were considered matches. Resilience Benchmark Tool items with no CMS Emergency Preparedness Checklist item matches were considered breaches in nursing home resilience. The findings suggest that the CMS Emergency Preparedness Checklist can be used to measure some aspects of resilience, however, there were many resilience factors not addressed. For nursing homes to prepare and respond to crisis situations, organizations need to embrace a culture that promotes individual resilience-related competencies that when aggregated enable the organization to improve its resiliency. Social workers have the skills and experience to facilitate this change.

  18. Perceived coping & concern predict terrorism preparedness in Australia

    Directory of Open Access Journals (Sweden)

    Stevens Garry

    2012-12-01

    Full Text Available Abstract Background In the aftermath of major terrorist incidents research shows population shifts towards protective behaviours, including specific preparedness and avoidance responses. Less is known about individual preparedness in populations with high assumed threat but limited direct exposure, such as Australia. In this study we aimed to determine whether individuals with high perceived coping and higher concern would show greater preparedness to respond to terrorism threats. Methods Adults in New South Wales (NSW completed terrorism perception and response questions as part of computer assisted telephone interviews (CATI in 2010 (N=2038. Responses were weighted against the NSW population. Multiple logistic regression analyses were conducted to evaluate the relationship between personal coping/concern factors and terrorism-related preparedness and avoidance behaviours, and to control for potential confounders such as socio-demographic and threat perception factors. Results Increased vigilance for suspicious behaviours was the most commonly reported behavioural response to perceived terrorism threat. Multivariate analyses showed that the factor combination of high perceived coping and higher concern was the most consistent predictor of terrorism preparedness behaviours and evacuation intentions, including increased vigilance (Adjusted Odd Ratios (AOR=2.07, p=0.001 learning evacuation plans (AOR=1.61, p=0.05, establishing emergency contact plans (AOR=2.73, p Conclusion The findings of this study suggest that terrorism preparedness behaviours are strongly associated with perceived high coping but that this relationship is also mediated by personal concerns relating to this threat. Cognitive variables such as coping self-efficacy are increasingly targeted as part of natural hazard preparedness and are a viable intervention target for terrorism preparedness initiatives. Raising individual coping perceptions may promote greater general and

  19. Perceived coping & concern predict terrorism preparedness in Australia.

    Science.gov (United States)

    Stevens, Garry; Agho, Kingsley; Taylor, Melanie; Jones, Alison L; Barr, Margo; Raphael, Beverley

    2012-12-27

    In the aftermath of major terrorist incidents research shows population shifts towards protective behaviours, including specific preparedness and avoidance responses. Less is known about individual preparedness in populations with high assumed threat but limited direct exposure, such as Australia. In this study we aimed to determine whether individuals with high perceived coping and higher concern would show greater preparedness to respond to terrorism threats. Adults in New South Wales (NSW) completed terrorism perception and response questions as part of computer assisted telephone interviews (CATI) in 2010 (N=2038). Responses were weighted against the NSW population. Multiple logistic regression analyses were conducted to evaluate the relationship between personal coping/concern factors and terrorism-related preparedness and avoidance behaviours, and to control for potential confounders such as socio-demographic and threat perception factors. Increased vigilance for suspicious behaviours was the most commonly reported behavioural response to perceived terrorism threat. Multivariate analyses showed that the factor combination of high perceived coping and higher concern was the most consistent predictor of terrorism preparedness behaviours and evacuation intentions, including increased vigilance (Adjusted Odd Ratios (AOR)=2.07, p=0.001) learning evacuation plans (AOR=1.61, p=0.05), establishing emergency contact plans (AOR=2.73, pterrorism preparedness behaviours are strongly associated with perceived high coping but that this relationship is also mediated by personal concerns relating to this threat. Cognitive variables such as coping self-efficacy are increasingly targeted as part of natural hazard preparedness and are a viable intervention target for terrorism preparedness initiatives. Raising individual coping perceptions may promote greater general and incident-specific preparedness and could form an integral element of community resilience strategies

  20. Employee engagement, boredom and frontline construction workers feeling safe in their workplace.

    Science.gov (United States)

    Whiteoak, John W; Mohamed, Sherif

    2016-08-01

    Systems thinking is a philosophy currently prevalent within construction safety literature that is applied to understand and improve safety in sociotechnical systems. Among systems, the site-project organizational system is of particular interest to this paper. Using focus group and survey feedback research to learn about how safety incidents effect levels of construction workers engagement this paper reveals how a safety incident provides an opportunity to create a potential quality (productivity) upgrade within an organization. The research approach involved a qualitative study involving 27 frontline supervisors and a follow-up survey completed by 207 frontline workers in the Australian Asphalt and Pavement Industry. The focus group interviews supported the articulation of the concepts of tacit safety, explicit safety, situational awareness, foresight ability, practical intelligence and crew synergy. Our findings indicate that having regular shift changes and other job site workers being fatigued are influential on perceptions of tacit safety. An individual's foresight ability was found to be the most potent predictor of worker perceptions of work engagement. The paper explains that relatively small improvements in worker perceptions of safety can bring about significant improvements in employee engagement and productivity. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Front-line managers as boundary spanners: effects of span and time on nurse supervision satisfaction.

    Science.gov (United States)

    Meyer, Raquel M; O'Brien-Pallas, Linda; Doran, Diane; Streiner, David; Ferguson-Paré, Mary; Duffield, Christine

    2011-07-01

    To examine the influence of nurse manager span (number of direct report staff), time in staff contact, transformational leadership practices and operational hours on nurse supervision satisfaction. Increasing role complexity has intensified the boundary spanning functions of managers. Because work demands and scope vary by management position, time in staff contact rather than span may better explain managers' capacity to support staff. A descriptive, correlational design was used to collect cross-sectional survey and prospective work log and administrative data from a convenience sample of 558 nurses in 51 clinical areas and 31 front-line nurse managers from four acute care hospitals in 2007-2008. Data were analysed using hierarchical linear modelling. Span, but not time in staff contact, interacted with leadership and operational hours to explain supervision satisfaction. With compressed operational hours, supervision satisfaction was lower with highly transformational leadership in combination with wider spans. With extended operational hours, supervision satisfaction was higher with highly transformational leadership, and this effect was more pronounced under wider spans. Operational hours, which influence the manager's daily span (average number of direct report staff working per weekday), should be factored into the design of front-line management positions. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

  2. Should EGFR mutations be tested in advanced lung squamous cell carcinomas to guide frontline treatment?

    Science.gov (United States)

    Chiu, Chao-Hua; Chou, Teh-Ying; Chiang, Chi-Lu; Tsai, Chun-Ming

    2014-10-01

    There is no argument over using epidermal growth factor receptor (EGFR) mutation status to guide the frontline treatment for advanced lung adenocarcinoma (LADC); however, the role of the testing in lung squamous cell carcinoma (LSQC) remains controversial. Currently, the guidelines/consensus statements regarding EGFR mutation testing in LSQC are not consistent among different oncology societies. American Society of Clinical Oncology recommends performing EGFR mutation testing in all patients; European Society for Medical Oncology, College of American Pathologists/International Association for the Study of Lung Cancer/Association for Molecular Pathology, and National Comprehensive Cancer Network suggest for some selected group. EGFR mutation is rarely found in LSQC; however, more importantly, it is not a valid predictive biomarker for EGFR tyrosine kinase inhibitors (EGFR-TKI) in LSQC as it has been shown in LADC. Available data showed that the response rate and progression-free survival in EGFR mutant LSQC patients treated with EGFR-TKI are not better than that observed in patients treated with platinum-doublet chemotherapy in the first-line setting. Therefore, in contrast to advanced LADC, EGFR mutation testing may not be necessarily performed upfront in advanced LSQC because not only the mutation rate is low, but also the predictive value is insufficient. For LSQC patients with known sensitizing-EGFR mutations, both conventional chemotherapy and EGFR-TKI are acceptable frontline treatment options.

  3. Faith and Superstitions in the Frontline and in the Rear in Wartime (1941-1945

    Directory of Open Access Journals (Sweden)

    Evgeny F. Krinko

    2013-09-01

    Full Text Available The article deals with the faith and superstitions of the Soviet citizens in the frontline and in the rear during the Great Patriotic War. The study of the religion history in the USSR in 1941-1945 was significantly influenced by ideology. This theme has been thoroughly studied in recent years, but the attention is mainly attached to its institutional aspects and the role of religion in lives of Soviet citizens is still little-studied. Nevertheless, by the start of war, considerable part of the population maintained its religious beliefs, despite the anti-religious policy of the Soviet authorities. The war increased the faith of Soviet citizens in the frontline, in the rear and within the occupied territory. It was mainly caused by the extreme wartime situation. Different superstitions and omens gained a wide circulation. Despite the fact that they had different content, both rites and prayers, acknowledged by the church and the omens and superstitions, rejected by the church have become the necessary ways of people psychological adaptation to wartime severities and hardships. The conclusions, which were made with the help of different sources, such as official documents, statistical data, both published and collected in the course of work under the theme of participants and eyewitnesses’ recollections, help us to imagine the collective consciousness of the Soviet society during the Great Patriotic War.

  4. Preparedness organisations at Nordic nuclear power plants

    International Nuclear Information System (INIS)

    Droeivoldsmo, A.; Porsmyr, J.; Nystad, E.

    2011-08-01

    The report presents an overview of Emergency Preparedness Organisations (EPO) in Sweden, Finland and Norway and presentations of insights from a study of the staff positions' work instructions in the command centre in an emergency situation. The results indicate potential for improvement in several areas. A number of the improvements are related to introduction of new technology and they should be seen in connection with ensuring safe and reliable communication lines and power supply. Analysis of the data identified four main categories where further studies could contribute to improvement: 1) Communication and exchange of information. 2) Tools and technology. 3) Staffing and organisation. 4) Procedures. The usefulness of the Man Technology and Organisation method in analysing the emergency management decision-making process within the authorities was considered as an interesting issue for continuation of the project. The interface between utility and authorities was pointed out as an important area for continuation. (Author)

  5. Emergency preparedness training for local communities

    International Nuclear Information System (INIS)

    Cooley, M.J.; Thompson, K.K.

    1987-01-01

    Detroit Edison, in cooperation with Monroe County, has developed a comprehensive training program for local emergency workers in the area surrounding the Fermi 2 Nuclear Power Plant. Using expertise from both organizations, a program consisting of two videotapes, two slide-tapes and nine narrated slide series was produced to address the worker-specific training needs of county emergency workers. In June of 185, the program was approved by Detroit Edison and the Monroe County Board of Commissioners. To date, Monroe County has trained more than 1000 emergency workers. This program has been so well received that the county staff has developed and presented a modified version of this program to the general public. The result of this cooperative effort is increased public confidence in emergency preparedness at the state, local and utility level and a renewed spirit of cooperation and trust between the utility and local units of government

  6. Technological considerations in emergency instrument preparedness

    International Nuclear Information System (INIS)

    Selby, J.M.

    1976-01-01

    Emergency preparedness has been emphasized during the development of the nuclear industry. Existing instrumentation technology has been effectively applied to minimizing the probability of accidents. Radiological instrumentation provided for the measurement of ambient radiation levels or routine releases of radioactive material is usually adequate to provide an early warning that an accident is occurring. In contrast, radiological instrumentation capable of providing a reasonable measure of the source term which could be involved in a severe accident has not received enough attention. In emergency planning the capability should be established for identifying as promptly as possible the need for evasive action out in the plant environs and for minimizing the consequences of an accident in terms of resultant human exposure. Therefore instrumentation is required to measure the source term no matter where the point of release might be, together with instrumentation for obtaining meteorological data sufficient to establish the path of the release in the environment

  7. Radiological emergency: Malaysian preparedness and response

    International Nuclear Information System (INIS)

    Yusof, M. A. W.; Ali, H. M.

    2011-01-01

    Planning and preparation in advance for radiological emergencies can help to minimise potential public health and environmental threats if and when an actual emergency occurs. During the planning process, emergency response organisations think through how they would respond to each type of incident and the resources that will be needed. In Malaysia, planning, preparation for and response to radiological emergencies involve many parties. In the event of a radiological emergency and if it is considered a disaster, the National Security Council, the Atomic Energy Licensing Board and the Malaysian Nuclear Agency (Nuclear Malaysia) will work together with other federal agencies, state and local governments, first responders and international organisations to monitor the situation, contain the release, and clean up the contaminated site. Throughout the response, these agencies use their protective action guidelines. This paper discusses Malaysian preparedness for, and response to, any potential radiological emergency. (authors)

  8. Preparedness organisations at Nordic nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Droeivoldsmo, A.; Porsmyr, J.; Nystad, E. (Institute for Energy Technology (IFE), Halden (Norway))

    2011-08-15

    The report presents an overview of Emergency Preparedness Organisations (EPO) in Sweden, Finland and Norway and presentations of insights from a study of the staff positions' work instructions in the command centre in an emergency situation. The results indicate potential for improvement in several areas. A number of the improvements are related to introduction of new technology and they should be seen in connection with ensuring safe and reliable communication lines and power supply. Analysis of the data identified four main categories where further studies could contribute to improvement: 1) Communication and exchange of information. 2) Tools and technology. 3) Staffing and organisation. 4) Procedures. The usefulness of the Man Technology and Organisation method in analysing the emergency management decision-making process within the authorities was considered as an interesting issue for continuation of the project. The interface between utility and authorities was pointed out as an important area for continuation. (Author)

  9. Personal characteristics associated with resident physicians' self perceptions of preparedness to deliver cross-cultural care.

    Science.gov (United States)

    Lopez, Lenny; Vranceanu, Ana-Maria; Cohen, Amy P; Betancourt, Joseph; Weissman, Joel S

    2008-12-01

    Recent reports from the Institute of Medicine emphasize patient-centered care and cross-cultural training as a means of improving the quality of medical care and eliminating racial and ethnic disparities. To determine whether, controlling for training received in medical school or during residency, resident physician socio-cultural characteristics influence self-perceived preparedness and skill in delivering cross-cultural care. National survey of resident physicians. A probability sample of residents in seven specialties in their final year of training at US academic health centers. Nine resident characteristics were analyzed. Differences in preparedness and skill were assessed using the chi(2) statistic and multivariate logistic regression. Fifty-eight percent (2047/3500) of residents responded. The most important factor associated with improved perceived skill level in performing selected tasks or services believed to be useful in treating culturally diverse patients was having received cross-cultural skills training during residency (OR range 1.71-4.22). Compared with white residents, African American physicians felt more prepared to deal with patients with distrust in the US healthcare system (OR 1.63) and with racial or ethnic minorities (OR 1.61), Latinos reported feeling more prepared to deal with new immigrants (OR 1.88) and Asians reported feeling more prepared to deal with patients with health beliefs at odds with Western medicine (1.43). Cross-cultural care skills training is associated with increased self-perceived preparedness to care for diverse patient populations providing support for the importance of such training in graduate medical education. In addition, selected resident characteristics are associated with being more or less prepared for different aspects of cross-cultural care. This underscores the need to both include medical residents from diverse backgrounds in all training programs and tailor such programs to individual resident needs in

  10. Assessing Hospital Disaster Preparedness of Bushehr province

    Directory of Open Access Journals (Sweden)

    Hakimeh Vahedparast

    2013-04-01

    Full Text Available Background: In disasters, large number of causalities rash into the hospitals in order to get health facilities. So, hospitals are the reference point for delivering the health services in all levels for helping to the most percent of injured people. Aim of study was to assess hospital disaster preparedness of Bushehr province. Maretial and Methods: This was a cross-sectional descriptive study which has been done in all Bushehr province hospitals. In order to collect data, we used 210 questions checklist with 10 different aims each aim had consisted of 6 different domains (equipment, working stuff, physical space, structure, protocols and functional chart. The checklists were completed by direct observation and evaluation of equipment, programs and documents based on their domains with different people. Results: The hospital preparedness in traffic base was very poor with mean number of 19/04±16/10 evaluation of security education and management domain with mean number 35/29±26/52, 38/65±19/46, 36/36±24/05, respectively were poor. In logistics, workforce, communications, excused transportation and addition to the hospitals with the mean number of 53/26±26/31, 49/65±27/61, 45/53±18/29, 43/33±19/72, and 40/47±20/37 were estimated as average. The most number was belonged to the emergency with the mean number of 53/80±19/18. Conclusion: The Bushehr province hospitals have not enough preparation against unexpected disasters and cannot be a good supporter for disaster happening, and in the occasions of happenings so many serious problems will occur. It will be suggested that the hospital managers should pay more attention to the unexpected disasters.

  11. Experiences of frontline nursing staff on workplace safety and occupational health hazards in two psychiatric hospitals in Ghana.

    Science.gov (United States)

    Alhassan, Robert Kaba; Poku, Kwabena Adu

    2018-06-06

    Psychiatric hospitals need safe working environments to promote productivity at the workplace. Even though occupational health and safety is not completely new to the corporate society, its scope is largely limited to the manufacturing/processing industries which are perceived to pose greater dangers to workers than the health sector. This paper sought to explore the experiences of frontline nursing personnel on the occupational health and safety conditions in two psychiatric hospitals in Ghana. This is an exploratory cross-sectional study among 296 nurses and nurse-assistants in Accra (n = 164) and Pantang (n = 132) psychiatric hospitals using the proportional stratified random sampling technique. Multivariate Ordinary Least Squares (OLS) regression test was conducted to ascertain the determinants of staff exposure to occupational health hazards and the frequency of exposure to these occupational health hazards on daily basis. Knowledge levels on occupational health hazards was high in Accra and Pantang psychiatric hospitals (i.e. 92 and 81% respectively), but barely 44% of the 296 interviewed staff in the two hospitals said they reported their most recent exposure to an occupational health hazard to hospital management. It was found that staff who worked for more years on the ward had higher likelihood of exposure to occupational health hazards than those who worked for lesser years (p = 0.002). The category of occupational health hazards reported most were the physical health hazards. Psychosocial hazards were the least reported health hazards. Frequency of exposure to occupational health hazards on daily basis was positively associated with work schedules of staff particularly, staff on routine day schedule (Coef = 4.49, p = 0.011) and those who alternated between day and night schedules (Coef = 4.48, p = 0.010). Occupational health and safety conditions in the two hospitals were found to be generally poor. Even though majority of

  12. Frontline health workers as brokers: provider perceptions, experiences and mitigating strategies to improve access to essential medicines in South Africa.

    Science.gov (United States)

    Magadzire, Bvudzai Priscilla; Budden, Ashwin; Ward, Kim; Jeffery, Roger; Sanders, David

    2014-11-05

    Front-line health providers have a unique role as brokers (patient advocates) between the health system and patients in ensuring access to medicines (ATM). ATM is a fundamental component of health systems. This paper examines in a South African context supply- and demand- ATM barriers from the provider perspective using a five dimensional framework: availability (fit between existing resources and clients' needs); accessibility (fit between physical location of healthcare and location of clients); accommodation (fit between the organisation of services and clients' practical circumstances); acceptability (fit between clients' and providers' mutual expectations and appropriateness of care) and affordability (fit between cost of care and ability to pay). This cross-sectional, qualitative study uses semi-structured interviews with nurses, pharmacy personnel and doctors. Thirty-six providers were purposively recruited from six public sector Community Health Centres in two districts in the Eastern Cape Province representing both rural and urban settings. Content analysis combined structured coding and grounded theory approaches. Finally, the five dimensional framework was applied to illustrate the interconnected facets of the issue. Factors perceived to affect ATM were identified. Availability of medicines was hampered by logistical bottlenecks in the medicines supply chain; poor public transport networks affected accessibility. Organization of disease programmes meshed poorly with the needs of patients with comorbidities and circular migrants who move between provinces searching for economic opportunities, proximity to services such as social grants and shopping centres influenced where patients obtain medicines. Acceptability was affected by, for example, HIV related stigma leading patients to seek distant services. Travel costs exacerbated by the interplay of several ATM barriers influenced affordability. Providers play a brokerage role by adopting flexible

  13. Effective Strategies to Spread Redesigning Care Processes Among Healthcare Teams.

    Science.gov (United States)

    Lavoie-Tremblay, Mélanie; O'Connor, Patricia; Lavigne, Geneviève L; Briand, Anaïck; Biron, Alain; Baillargeon, Sophie; MacGibbon, Brenda; Ringer, Justin; Cyr, Guylaine

    2015-07-01

    The purpose of this study was to describe how spread strategies facilitate the successful implementation of the Transforming Care at the Bedside (TCAB) program and their impact on healthcare workers and patients in a major Canadian healthcare organization. This study used a qualitative and descriptive design with focus groups and individual interviews held in May 2014. Participants included managers and healthcare providers from eight TCAB units in a university health center in Quebec, Canada. The sample was composed of 43 individuals. The data were analyzed using NVivo according to the method proposed by Miles and Huberman. The first two themes that emerged from the analysis are related to context (organizational transition requiring many changes) and spread strategies for the TCAB program (senior management support, release time and facilitation, rotation of team members, learning from previous TCAB teams, and engaging patients). The last theme that emerged from the analysis is the impact on healthcare professionals (providing front-line staff and managers with the training they need to make changes, team leadership, and increasing receptivity to hearing patients' and families' needs and requests). This study describes the perspectives of managers and team members to provide a better understanding of how spread strategies can facilitate the successful implementation of the TCAB program in a Canadian healthcare organization. Spread strategies facilitate the implementation of changes to improve the quality and safety of care provided to patients. © 2015 Sigma Theta Tau International.

  14. Electronic healthcare information security

    CERN Document Server

    Dube, Kudakwashe; Shoniregun, Charles A

    2010-01-01

    The ever-increasing healthcare expenditure and pressing demand for improved quality and efficiency of patient care services are driving innovation in healthcare information management. The domain of healthcare has become a challenging testing ground for information security due to the complex nature of healthcare information and individual privacy. ""Electronic Healthcare Information Security"" explores the challenges of e-healthcare information and security policy technologies. It evaluates the effectiveness of security and privacy implementation systems for anonymization methods and techniqu

  15. Licensed Healthcare Facilities

    Data.gov (United States)

    California Natural Resource Agency — The Licensed Healthcare Facilities point layer represents the locations of all healthcare facilities licensed by the State of California, Department of Health...

  16. Hospital-related incidents; causes and its impact on disaster preparedness and prehospital organisations

    Directory of Open Access Journals (Sweden)

    Khorram-Manesh Amir

    2009-06-01

    Full Text Available Abstract Background A hospital's capacity and preparedness is one of the important parts of disaster planning. Hospital-related incidents, a new phenomenon in Swedish healthcare, may lead to ambulance diversions, increased waiting time at emergency departments and treatment delay along with deterioration of disaster management and surge capacity. We aimed to identify the causes and impacts of hospital-related incidents in Region Västra Götaland (western region of Sweden. Methods The regional registry at the Prehospital and Disaster Medicine Center was reviewed (2006–2008. The number of hospital-related incidents and its causes were analyzed. Results There were an increasing number of hospital-related incidents mainly caused by emergency department's overcrowdings, the lack of beds at ordinary wards and/or intensive care units and technical problems at the radiology departments. These incidents resulted in ambulance diversions and reduced the prehospital capacity as well as endangering the patient safety. Conclusion Besides emergency department overcrowdings, ambulance diversions, endangering patient s safety and increasing risk for in-hospital mortality, hospital-related incidents reduces and limits the regional preparedness by minimizing the surge capacity. In order to prevent a future irreversible disaster, this problem should be avoided and addressed properly by further regional studies.

  17. The public transportation system security and emergency preparedness planning guide

    Science.gov (United States)

    2003-01-01

    Recent events have focused renewed attention on the vulnerability of the nation's critical infrastructure to major events, including terrorism. The Public Transportation System Security and Emergency Preparedness Planning Guide has been prepared to s...

  18. socio-economic determinants of birth preparedness and ...

    African Journals Online (AJOL)

    DGS-FUTO

    2018-05-31

    5 days ago ... COMPLICATION READINESS BEHAVIOUR AMONG PREGNANT. WOMEN IN UGHELLI .... logistic regression model was used to identify the factors affecting birth preparedness and .... Due to the rationality of human nature ...

  19. Engineering simulator applications to emergency preparedness at DOE reactor sites

    International Nuclear Information System (INIS)

    Beelman, R.J.

    1990-01-01

    This paper reports that since 1984 the Idaho National Engineering Laboratory (INEL) has conducted twenty-seven comprehensive emergency preparedness exercises at the U.S. Nuclear Regulatory Commission's (NRC) Headquarters Operations Center and Regional Incident Response Centers using the NRC's Nuclear Plant Analyzer (NPA), developed at the INEL, as an engineering simulator. The objective of these exercises has been to assist the NRC in upgrading its preparedness to provide technical support backup and oversight to U.S. commercial nuclear plant licensees during emergencies. With the current focus on Department of Energy (DOE) reactor operational safety and emergency preparedness, this capability is envisioned as a means of upgrading emergency preparedness at DOE production and test reactor sites such as the K-Reactor at Savannah River Laboratory (SRL) and the Advanced Test Reactor (ATR) at INEL

  20. Improving emergency preparedness and crisis management capabilities in transportation.

    Science.gov (United States)

    2009-11-30

    Despite the heightened attention disaster preparedness and emergency management have received over the past decade, serious weaknesses in the United States emergency response capabilities remain at all levels of government and across a wide range ...

  1. Connecting communities for climate and disaster risk preparedness ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Climate adaptation and disaster risk management and response are ... not only mitigate impact but to improve preparedness, risk management, and climate resilience. ... including heat stress, water management, and climate-related migration.

  2. Emergency preparedness at Oak Ridge National Laboratory, Oak Ridge, Tennessee

    International Nuclear Information System (INIS)

    Skipper, M.N.

    1990-03-01

    Emergency preparedness for industry was commonly believed to be an essential responsibility on the part of management. Therefore, this study was conducted to research and accumulate information and data on emergency preparedness at Oak Ridge National Laboratory (ORNL). The objective of this study was to conduct a thorough evaluation of emergency preparedness knowledge among employees to determine if they were properly informed or if they needed more training. Also, this study was conducted to provide insight to management as to what their responsibility was concerning this training. To assess employee emergency preparedness knowledge, a questionnaire was developed and administered to 100 employees at ORNL. The data was analyzed using frequencies and percentages of response and was displayed through the use of graphs within the report. 22 refs., 22 figs

  3. Emergency preparedness at Oak Ridge National Laboratory, Oak Ridge, Tennessee

    Energy Technology Data Exchange (ETDEWEB)

    Skipper, M.N.

    1990-03-01

    Emergency preparedness for industry was commonly believed to be an essential responsibility on the part of management. Therefore, this study was conducted to research and accumulate information and data on emergency preparedness at Oak Ridge National Laboratory (ORNL). The objective of this study was to conduct a thorough evaluation of emergency preparedness knowledge among employees to determine if they were properly informed or if they needed more training. Also, this study was conducted to provide insight to management as to what their responsibility was concerning this training. To assess employee emergency preparedness knowledge, a questionnaire was developed and administered to 100 employees at ORNL. The data was analyzed using frequencies and percentages of response and was displayed through the use of graphs within the report. 22 refs., 22 figs.

  4. 75 FR 67807 - Pipeline Safety: Emergency Preparedness Communications

    Science.gov (United States)

    2010-11-03

    ... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration [Docket No... is issuing an Advisory Bulletin to remind operators of gas and hazardous liquid pipeline facilities... Gas Pipeline Systems. Subject: Emergency Preparedness Communications. Advisory: To further enhance the...

  5. The case of cholera preparedness, response and prevention in the ...

    African Journals Online (AJOL)

    2011-10-07

    Oct 7, 2011 ... Keywords: Cholera prevention, preparedness and response, socio-political understanding of cholera, socio-cultural understanding .... cies of bacteria or viruses. ... quality such as boiling, chlorination, and filtration are not eco-.

  6. Preparedness of Government Owned Dental Clinics for the ...

    African Journals Online (AJOL)

    Preparedness of Government Owned Dental Clinics for the Management of Medical Emergencies: A Survey of Government Dental Clinics in Lagos. ... emergencies and the availability of emergency drugs and equipment in government dental ...

  7. Pandemic Influenza: An Analysis of State Preparedness and Response Plans

    National Research Council Canada - National Science Library

    Lister, Sarah A; Stockdale, Holly

    2007-01-01

    .... Since 2002, Congress has provided funding to all U.S. states, territories, and the District of Columbia, to enhance federal, state and local preparedness for public health threats in general, and an influenza ( flu...

  8. Future of Nuclear Power: NRC emergency preparedness licensing activities agenda

    International Nuclear Information System (INIS)

    Essig, T.H.

    1995-01-01

    This talk summary addresses the issue of how future policies of the NRC will affect nuclear power in areas such as construction, emergency preparedness, and licensing. Specific topics covered include the following: Emergent EP licensing issues for operating nuclear Power Plants; 10CFR Part 52 and the process for licensing of Advanced Light Water Reactors (ALWRs); and potential revisions to emergency preparedness programs for future nuclear power plants

  9. Brief on nuclear emergency planning and preparedness in Ontario

    International Nuclear Information System (INIS)

    1987-01-01

    Ontario has an excellent conceptual plan to ensure the safety of its inhabitants in the event of a nuclear accident anywhere in the world. This plan still needs to be translated into tangible preparedness to deal with such an emergency. The province is confident that, with the assistance of Ontario Hydro, a high level of nuclear emergency preparedness will soon be established for the people of the province

  10. Mathematical Assessment of Canada’s Pandemic Influenza Preparedness Plan

    Directory of Open Access Journals (Sweden)

    Abba B Gumel

    2008-01-01

    Full Text Available OBJECTIVE: The presence of the highly pathogenic avian H5N1 virus in wild bird populations in several regions of the world, together with recurrent cases of H5N1 influenza arising primarily from direct contact with poultry, have highlighted the urgent need for prepared-ness and coordinated global strategies to effectively combat a potential influenza pandemic. The purpose of the present study was to evaluate the Canadian pandemic influenza preparedness plan.

  11. The Future of Responder Family Preparedness: The New Normal

    Science.gov (United States)

    2013-12-01

    smart practices. Though responder family preparedness measures may be occurring on a very limited basis, it was found that nothing was prevalent in the...family preparedness for their employees. If any such programs exist, they are not well known or prevalent in the literature. First responders are... Beaver and Harriet Nelson of Father Knows Best. This predominant family structure was the societal norm and framed Killian’s problem and analysis

  12. Emergency preparedness exercises for nuclear facilities: Preparation, conduct and evaluation

    International Nuclear Information System (INIS)

    1985-01-01

    This publication offers guidance for operating organizations and public authorities on planning, organizing and conducting exercises, preparing scenarios and evaluating the results of exercises in order to make full use of the experience gained in improving the response planning and preparedness for radiation emergencies. The training aspects associated with achieving an adequate level of emergency preparedness are explored and examples of accident scenarios are presented

  13. Strengthening flood warning systems: the benefits of encouraging social preparedness

    Science.gov (United States)

    Girons Lopez, Marc; Di Baldassarre, Giuliano; Seibert, Jan

    2017-04-01

    Flood warning and response have normally been focused on the technical aspects and disregarded the connections and feedbacks between the hydrological and social dimensions. An increasing body of research, however, points at the importance of considering socio-hydrological aspects to improve flood damage mitigation. One of the key factors is the preparedness of the public and first responders during flood situations, which is influenced by many behavioural traits such as perceived benefits, risk awareness, or denial. In this study, we investigate the impact of social preparedness on the efficiency of flood early warning systems by using the recency of flood experience as a proxy for social preparedness. To this end, we developed a stylised model and a synthetic data-set to perform a hypothetical analysis. The main findings point to the importance of social preparedness for flood loss mitigation, especially when the technical forecasting and warning capabilities are limited. More specifically, efforts to promote and preserve social preparedness may help to reduce disaster-induced losses by almost one half. The findings from this study provide insights into the importance of considering social preparedness in decision-making for disaster risk reduction.

  14. (Geo)Ethics. Step 1: Preparedness.

    Science.gov (United States)

    Marone, Eduardo

    2015-04-01

    Natural hazards have been defined in several ways in recent decades. Whatever your choice, it will be fine provided you consider that they are complex physical phenomena that expose a natural area to risk of loss of life, environmental degradation and property damages. In a time-line, one may divide the hazards, particularly those considered extremes, in a pre-event phase, the event itself and a post-event period. At this moment, I would like to promote an initial reflection by focusing in the geoethical behaviour scientists have to bear in mind accordingly to the particular characteristics of the pre-event phase, considering ethics as a way of systematizing, defending and recommending concepts of right and wrong conduct. In an accelerated world, where the pressure of the every day life gives us little room to exercise our mind to think in such apparent démodé issues as ethics, society, nature, responsibilities and duties, I would like to invite you to stop few minutes and reflect on the ethical implications of being a geoscientists dealing with natural hazards in the XXI century. The most dangerous hazards are those extreme events with a rapid onset (earthquakes, tsunamis, etc.). Thus far, science has not found effective ways to predict and reduce most natural hazards. If we are not capable to forecast or minimize the effect of an extreme event, geosciences, and scientists, are responsible of in deep risk assessments for areas that might be subject to natural hazards also contributing to preparedness of society. However, we have been working on that issues, but it seems we are not being as efficient as needed. On the risk analysis, which includes forecast models, we use to be too Cartesians, taking too much time in arriving to conclusions when a non clear cause-effect chain can be identified. It is our ethical duty to evaluate when to stop searching for causes when dealing with complex systems. The search for a specific cause for a given extreme natural event

  15. Transition into adult care: factors associated with level of preparedness among adolescents living with HIV in Cambodia.

    Science.gov (United States)

    Yi, Siyan; Ngin, Chanrith; Pal, Khuondyla; Khol, Vohith; Tuot, Sovannary; Sau, Sokunmealiny; Chhoun, Pheak; Mburu, Gitau; Choub, Sok Chamreun; Chhim, Kolab; Ly, Penhsun

    2017-07-17

    transition preparedness among adolescents in Cambodia. Strengthening implementation of age-appropriate and individualized case management transition at all sites, while creating supportive family, peer, and healthcare environments for adolescent transition is required.

  16. Implications of climate change (global warming) for the healthcare system.

    Science.gov (United States)

    Raffa, R B; Eltoukhy, N S; Raffa, K F

    2012-10-01

    Temperature-sensitive pathogenic species and their vectors and hosts are emerging in previously colder regions as a consequence of several factors, including global warming. As a result, an increasing number of people will be exposed to pathogens against which they have not previously needed defences. We illustrate this with a specific example of recent emergence of Cryptococcus gattii infections in more temperate climates. The outbreaks in more temperate climates of the highly virulent--but usually tropically restricted--C. gattii is illustrative of an anticipated growing challenge for the healthcare system. There is a need for preparedness by healthcare professionals in anticipation and for management of such outbreaks, including other infections whose recent increased prevalence in temperate climates can be at least partly associated with global warming. (Re)emergence of temperature-sensitive pathogenic species in more temperate climates will present new challenges for healthcare systems. Preparation for outbreaks should precede their occurrence. © 2012 Blackwell Publishing Ltd.

  17. Managing Contradictions from the Middle: A Cultural Historical Activity Theory Investigation of Front-Line Supervisors' Learning Lives

    Science.gov (United States)

    Lord, Ramo J.

    2009-01-01

    This study focused on front-line supervisors in a union shop, steel-production plant and how they learn to successfully negotiate their role with in the corporation's division of labor. Negotiating their role means continued practice in how issues of standpoint, agency, power, oppression, habits, knowledge, related business concerns, mediating…

  18. Developing a Forensic Approach to Process Improvement: The Relationship between Curriculum and Impact in Frontline Operator Education

    Science.gov (United States)

    Croom, Simon; Betts, Alan

    2011-01-01

    The authors present a comparative study of 2 in-company educational programs aimed at developing frontline operator capabilities in forensic methods. They discuss the relationship between the application of various forensic tools and conceptual techniques, the process (i.e., curriculum) for developing employee knowledge and capability, and the…

  19. An assessment of consumers’ subconscious responses to frontline employees’ attractiveness in a service failure and recovery situation

    Directory of Open Access Journals (Sweden)

    Christo Boshoff

    2017-06-01

    Full Text Available Background: Initial analyses of the impact of physical attractiveness in a business context have supported the ‘what is beautiful is good’ contention. However, in circumstances characterised by negative emotions, duress and stress, very little is known about how human beings respond at the subconscious level to the attractiveness of frontline service providers. Aim: The purpose of this study was to assess whether consumers who complain to a frontline service provider about a service failure respond differently at the subconscious level when the service provider involved in the service encounter is attractive compared with one who is less attractive. Method: Forty respondents were exposed to a video clip of a service failure and service recovery situation. While viewing the hypothetical scenario, two neuro-physiological measurements were used to collect data at the subconscious level, namely galvanic skin response (GSR and electroencephalography (EEG. Results: The results suggest that, at the subconscious level, customers respond differently to the service recovery efforts depending on the attractiveness of the frontline service provider who attempts to rectify the service failure. Conclusion: The results seem to suggest that the physical attractiveness of a frontline service provider moderates (or softens the negative emotions that a complaining customer might experience during a service failure and complaint situation – consistent with the ‘what is beautiful is good’ contention.

  20. Principles and principals : do customer stewardship and agency control compete or complement when shaping frontline employee behavior?

    NARCIS (Netherlands)

    Schepers, J.J.L.; Falk, T.; Ruyter, de J.C.; Jong, de A.; Hammerschmidt, M.

    2012-01-01

    This article introduces customer stewardship control to the marketing field. This concept represents a frontline employee’s felt ownership of and moral responsibility for customers’ overall welfare. In two studies, the authors show that customer stewardship control is a more encompassing construct

  1. Coping with Challenging Behaviours of Children with Autism: Effectiveness of Brief Training Workshop for Frontline Staff in Special Education Settings

    Science.gov (United States)

    Ling, C. Y. M.; Mak, W. W. S.

    2012-01-01

    Background: The present study examined the effectiveness of three staff training elements: psychoeducation (PE) on autism, introduction of functional behavioural analysis (FBA) and emotional management (EM), on the reaction of challenging behaviours for frontline staff towards children with autism in Hong Kong special education settings. Methods:…

  2. Integrating hospitals into community emergency preparedness planning.

    Science.gov (United States)

    Braun, Barbara I; Wineman, Nicole V; Finn, Nicole L; Barbera, Joseph A; Schmaltz, Stephen P; Loeb, Jerod M

    2006-06-06

    Strong community linkages are essential to a health care organization's overall preparedness for emergencies. To assess community emergency preparedness linkages among hospitals, public health officials, and first responders and to investigate the influence of community hazards, previous preparation for an event requiring national security oversight, and experience responding to actual disasters. With expert advice from an advisory panel, a mailed questionnaire was used to assess linkage issues related to training and drills, equipment, surveillance, laboratory testing, surge capacity, incident management, and communication. A simple random sample of 1750 U.S. medical-surgical hospitals. Of 678 hospital representatives that agreed to participate, 575 (33%) completed the questionnaire in early 2004. Respondents were hospital personnel responsible for environmental safety, emergency management, infection control, administration, emergency services, and security. Prevalence and breadth of participation in community-wide planning; examination of 17 basic elements in a weighted analysis. In a weighted analysis, most hospitals (88.2% [95% CI, 84.1% to 92.3%]) engaged in community-wide drills and exercises, and most (82.2% [CI, 77.8% to 86.5%]) conducted a collaborative threat and vulnerability analysis with community responders. Of all respondents, 57.3% (CI, 52.1% to 62.5%) reported that their community plans addressed the hospital's need for additional supplies and equipment, and 73.0% (CI, 68.1% to 77.9%) reported that decontamination capacity needs were addressed. Fewer reported a direct link to the Health Alert Network (54.4% [CI, 49.3% to 59.5%]) and around-the-clock access to a live voice from a public health department (40.0% [CI, 35.0% to 45.0%]). Performance on many of 17 basic elements was better in large and urban hospitals and was associated with a high number of perceived hazards, previous national security event preparation, and experience in actual

  3. The establishment of the Croatian Dental Crops: the front-line experience of a dentist volunteer.

    Science.gov (United States)

    Jelaca-Bagić, S; Sipina, J; Visković, R; Cakarun, Z; Vlatković, I; Biloglav, D

    1997-01-01

    The establishment of the first dental office of the Croatian Dental Corps (CDC) in the city of Zadar represented at the same time the beginning of the CDC. This article describes the front-line experience of a dentist who volunteered to provide basic medical help, which eventually laid the groundwork for providing general dental care and establishing the first CDC dental office. The office was opened on December 16, 1991, and provided general dental care except prosthetics. Although faced with numerous problems and extremely difficult conditions, the office staff completed 1,913 initial and 1,157 control checkups and performed 4,002 services by treating 12 to 16 patients per day. The main causes for emergencies were caries (59%) and endodontic complications (28%). This variety of services in the proximity of the front line is considered extensive even for advanced medical corps of modern armies.

  4. Using the Collective Wisdom of Frontline Employees in Strategic Issue Management

    DEFF Research Database (Denmark)

    Lund Pedersen, Carsten

    The field of strategic management has long alluded to the idea that lower-level employees immersed in the day-to-day business have experiential insights of potential strategic value. This line of thought has predominantly been supported by anecdotal evidence and explored in meticulous case studies...... to uncover the evolutionary traits of autonomous ventures. In a related vein, studies of ‘strategic issue management’ (SIM) tried to uncover organizational processes to identify emerging issues in volatile environments and devise proper strategic responses. These conceptual models were introduced in the very...... first volume of ‘Strategic Management Journal’, but little empirical research has since tried to develop the conception of SIM. An underlying research aim of this dissertation is to address and bridge these two literature streams, honing the idea of utilizing the collective wisdom possessed by frontline...

  5. Imatinib mesylate in chronic myeloid leukemia: frontline treatment and long-term outcomes.

    Science.gov (United States)

    Stagno, Fabio; Stella, Stefania; Spitaleri, Antonio; Pennisi, Maria Stella; Di Raimondo, Francesco; Vigneri, Paolo

    2016-01-01

    The tyrosine kinase inhibitor Imatinib Mesylate has dramatically improved the clinical outcome of chronic myeloid leukemia (CML) patients in the chronic phase of the disease, generating unprecedented rates of complete hematologic and cytogenetic responses and sustained reductions in BCR-ABL transcripts. Here, we present an overview on the efficacy and safety of Imatinib and describe the most important clinical studies employing this drug for the frontline treatment of chronic phase CML. We also discuss recent reports describing the long-term outcome of patients receiving Imatinib for their disease. The imminent availability of generic forms of Imatinib coupled with the approval of expensive second-generation tyrosine kinase inhibitors underlines an unmet need for early molecular parameters that may distinguish CML patients likely to benefit from the drug from those that should receive alternative forms of treatment.

  6. A study on impact of Job role stressors on Frontline employee role performance towards the customers

    Directory of Open Access Journals (Sweden)

    Kasturi Naik

    2016-03-01

    Full Text Available Rapid developments in the Indian Economy post-liberalization in 1991 have prompted institutions like the World Bank to forecast that India would be the fourth largest economy in the world by 2020 (Budhwar and Bhatnagar, 2009. Following globalization this has attracted a large numbers of foreign investors and companies to India. HRM in India has evolved as a specialised function (Budhwar and Bhatnagar, 2009. According to Budhwar and Bhatnagar, 2009 India had a long history of labour legislation and industrial relations and there are many challenges to the HRM systems in India, due to the diverse nature of India’s society which is marked by regional, sectoral, socio-cultural and political variation. In such a climate it is extremely difficult to have a uniform HR system. According to Wheatherly and Tansik (1993 employees have to deal with the demands from superiors as well as the needs and wishes of customers. Because of such a boundary spanning role, the retail frontline employees are in dilemma whether to customize the retail services as per customers needs or to obey the organizational guidelines and procedures (Bitner, 1990. This dilemma often leads to job role stress. There are different types of job role stress (Pareek, 1993 of these the research under study deals with the two job role stressors prominent in retail industry job role conflict and job role ambiguity ( Kahn et.al, 1964. According to Heskett et al. (2003 front line employee’s behavior and perception affects the customer satisfaction and intent of buying behavior which in turn have impact on service productivity. There have been many studies conducted on job role stress and its impact on employee job performance but hardly any with respect to organized Indian retail sector.In the prior research studies it can be noted that employee point of view is hardly taken into consideration. Hence as an attempt to fill in this gap the research focuses on understanding how job role

  7. Liberia national disaster preparedness coordination exercise: Implementing lessons learned from the West African disaster preparedness initiative.

    Science.gov (United States)

    Hamer, Melinda J Morton; Reed, Paul L; Greulich, Jane D; Beadling, Charles W

    2017-01-01

    In light of the recent Ebola outbreak, there is a critical need for effective disaster management systems in Liberia and other West African nations. To this end, the West Africa Disaster Preparedness Initiative held a disaster management exercise in conjunction with the Liberian national government on November 24-25, 2015. During this tabletop exercise (TTX), interactions within and between the 15 counties and the Liberian national government were conducted and observed to refine and validate the county and national standard operating procedures (SOPs). The exercise took place in three regional locations throughout Liberia: Monrovia, Buchanan, and Bong. The TTX format allowed counties to collaborate utilizing open-source software platforms including Ushahidi, Sahana, QGIS, and KoBoCollect. Four hundred sixty-seven individuals (representing all 15 counties of Liberia) identified as key actors involved with emergency operations and disaster preparedness participated in the exercise. A qualitative survey with open-ended questions was administered to exercise participants to determine needed improvements in the disaster management system in Liberia. Key findings from the exercise and survey include the need for emergency management infrastructure to extend to the community level, establishment of a national disaster management agency and emergency operations center, customized local SOPs, ongoing surveillance, a disaster exercise program, and the need for effective data sharing and hazard maps. These regional exercises initiated the process of validating and refining Liberia's national and county-level SOPs. Liberia's participation in this exercise has provided a foundation for advancing its preparedness, response, and recovery capacities and could provide a template for other countries to use.

  8. Desmoid-type fibromatosis: a front-line conservative approach to select patients for surgical treatment.

    Science.gov (United States)

    Fiore, Marco; Rimareix, Françoise; Mariani, Luigi; Domont, Julien; Collini, Paola; Le Péchoux, Cecile; Casali, Paolo G; Le Cesne, Axel; Gronchi, Alessandro; Bonvalot, Sylvie

    2009-09-01

    Surgery is still the standard treatment for desmoid-type fibromatosis (DF). Recently, the Institut Gustave Roussy (IGR), Villejuif, France, reported a series of patients treated with a front-line conservative approach (no surgery and no radiotherapy). The disease remained stable in more than half of patients. This study was designed to evaluate this approach on the natural history of the disease in a larger series of patients. A total of 142 patients presenting to the IGR or Istituto Nazionale Tumori (INT), Milan, Italy, were initially treated using a front-line deliberately conservative policy. Their progression-free survival (PFS) was observed and a multivariate analysis was performed for major clinical variables. Seventy-four patients presented with primary tumor, 68 with recurrence. Eighty-three patients received a "wait & see" policy (W&S), whereas 59 were initially offered medical therapy (MT), mainly hormonal therapy and chemotherapy. A family history of sporadic colorectal cancer was present in 8% of patients. The 5-year PFS was 49.9% for the W&S group and 58.6% for the medically treated patients (P = 0.3196). Similar results emerged for primary and recurrent DF. Multivariate analysis identified no clinical variables as independent predictors of PFS. In the event of progression, all patients were subsequently managed safely. A conservative policy could be a safe approach to primary and recurrent DF, which could avoid unnecessary morbidity from surgery and/or radiation therapy. Half of patients had medium-term stable disease after W&S or MT. A multidisciplinary, stepwise approach should be prospectively tested in DF.

  9. Situational awareness in public health preparedness settings

    Science.gov (United States)

    Mirhaji, Parsa; Michea, Yanko F.; Zhang, Jiajie; Casscells, Samuel W.

    2005-05-01

    September 11 2001 attacks and following Anthrax mailings introduced emergent need for developing technologies that can distinguish between man made and natural incidents in the public health level. With this objective in mind, government agencies started a funding effort to foster the design, development and implementation of such systems on a wide scale. But the outcomes have not met the expectations set by the resources invested. Multiple elements explain this phenomenon: As it has been frequent with technology, introduction of new surveillance systems to the workflow equation has occurred without taking into consideration the need for understanding and inclusion of deeper personal, psychosocial, organizational and methodological concepts. The environment, in which these systems are operating, is complex, highly dynamic, uncertain, risky, and subject to intense time pressures. Such 'difficult' environments are very challenging to the human as a decision maker. In this paper we will challenge these systems from the perspective of human factors design. We will propose employment of systematic situational awareness research for design and implementation of the next generation public health preparedness infrastructures. We believe that systems designed based on results of such analytical definition of the domain enable public health practitioners to effectively collect the most important cues from the environment, process, interpret and understand the information in the context of organizational objectives and immediate tasks at hand, and use that understanding to forecast the short term and long term impact of the events in the safety and well being of the community.

  10. InaSAFE applications in disaster preparedness

    Science.gov (United States)

    Pranantyo, Ignatius Ryan; Fadmastuti, Mahardika; Chandra, Fredy

    2015-04-01

    Disaster preparedness activities aim to reduce the impact of disasters by being better prepared to respond when a disaster occurs. In order to better anticipate requirements during a disaster, contingency planning activities can be undertaken prior to a disaster based on a realistic disaster scenario. InaSAFE is a tool that can inform this process. InaSAFE is a free and open source software that estimates the impact to people and infrastructure from potential hazard scenarios. By using InaSAFE, disaster managers can develop scenarios of disaster impacts (people and infrastructures affected) to inform their contingency plan and emergency response operation plan. While InaSAFE provides the software framework exposure data and hazard data are needed as inputs to run this software. Then InaSAFE can be used to forecast the impact of the hazard scenario to the exposure data. InaSAFE outputs include estimates of the number of people, buildings and roads are affected, list of minimum needs (rice and clean water), and response checklist. InaSAFE is developed by Indonesia's National Disaster Management Agency (BNPB) and the Australian Government, through the Australia-Indonesia Facility for Disaster Reduction (AIFDR), in partnership with the World Bank - Global Facility for Disaster Reduction and Recovery (GFDRR). This software has been used in many parts of Indonesia, including Padang, Maumere, Jakarta, and Slamet Mountain for emergency response and contingency planning.

  11. Plan for national nuclear emergency preparedness

    International Nuclear Information System (INIS)

    1992-06-01

    The responsibility for Denmark's preparedness for nuclear emergencies lies with the Ministry of the Interior and the Civil Defense administration. The latter is particularly responsible for the presented plan which clarifies the organization and the measures to be taken in order to protect the public where, in the event of such an emergency, it could be in danger of radiation from radioactive materials. The main specifications of the plan, the activation of which covers the whole country, are that daily monitoring should be carried out so that warnings of nuclear accidents can be immediately conveyed to the relevant parties and that immediate action can be taken. These actions should result in the best possible protection against nuclear radiation so that acute and chronic damage to the health of members of the public can be restricted. The public, and relevant authorities should be informed of the situation and it should be attempted to regulate the reactions of individuals and of the society in general in such a way that damage to health, or social and economical conditions, can be restricted as much as possible. Denmark has not itself any atomic power plants, but some are located in neighbour countries and there are other sources such as nuclear research reactors, passing nuclear-driven ships etc. The detailed plan also covers possible sources of radiation, the nature of related damage to health, international cooperation, legal aspects, and a very detailed description of the overall administration and of the responsibilities of the organizations involved. (AB)

  12. Medical basis for radiation accident preparedness

    International Nuclear Information System (INIS)

    Huebner, K.F.; Fry, S.A.

    1980-01-01

    The International Conference on The Medical Basis for Radiation Accident Preparedness was organized by the staff of the Radiation Emergency Assistance Center/Training Site (REAC/TS) of the Medical and Health Sciences Division of Oak Ridge Associated Universities (ORAU). The philosophical importance of relating, through investigation and education, the intellectual resources of higher education to the important social problems associated with energy, health, and the environment was the foundation of the meeting. The symposium, held under the auspices of the US Department of Energy, was the ninth since 1960 of a series of international conferences addressing the various aspects of radiation accidents. The approach of this most recent conference differed somewhat from that of those preceding it, in that it sought an international review of the gamut of the medical aspects of radiation injury, not only for the experts in the field, but also for other physicians and scientists who, in view of current events, have had the need to know thrust upon them. Individual entries were made for the separate papers

  13. Prison health-care wings: psychiatry's forgotten frontier?

    Science.gov (United States)

    Forrester, Andrew; Chiu, Katrina; Dove, Samantha; Parrott, Janet

    2010-02-01

    There is worldwide evidence of high rates of mental disorder among prisoners, with significant co-morbidity. In England and Wales, mental health services have been introduced from the National Health Service to meet the need, but prison health-care wings have hardly been evaluated. To conduct a service evaluation of the health-care wing of a busy London remand (pre-trial) prison and examine the prevalence and range of mental health problems, including previously unrecognised psychosis. Service-use data were collected from prison medical records over a 20-week period in 2006-2007, and basic descriptive statistics were generated. Eighty-eight prisoners were admitted (4.4 per week). Most suffered from psychosis, a third of whom were not previously known to services. Eleven men were so ill that they required emergency compulsory treatment in the prison under Common Law before hospital transfer could take place. Over a quarter of the men required hospital transfer. Problem behaviours while on the prison health-care wing were common. Prison health-care wings operate front-line mental illness triaging and recognition functions and also provide care for complex individuals who display behavioural disturbance. Services are not equivalent to those in hospitals, nor the community, but instead reflect the needs of the prison in which they are situated. There is a recognised failure to divert at earlier points in the criminal justice pathway, which may be a consequence of national failure to fund services properly. Hospital treatment is often delayed.

  14. Weaving latino cultural concepts into Preparedness Core Competency training.

    Science.gov (United States)

    Riley-Jacome, Mary; Parker, Blanca Angelica Gonzalez; Waltz, Edward C

    2014-01-01

    The New York • New Jersey Preparedness and Emergency Response Learning Center (NY•NJ PERLC) is one of 14 Centers funded by the Centers for Disease Control and Prevention designed to address the preparedness and response training and education needs of the public health workforce. One of the important niches, or focus areas for the Center, is training to improve the capacity of public health workers to respond with competence to the needs of vulnerable populations. During every phase of a disaster, racial and ethnic minorities, including Latinos, suffer worse outcomes than the general population. Communities with diverse cultural origins and limited English speakers often present more complex issues during public health emergencies. Training that incorporates cultural concepts into the Preparedness Core Competencies may improve the ability of public health workers to engage the Latino community in preparedness activities and ultimately improve outcomes during disasters. This article describes initiatives undertaken by the NY•NJ PERLC to improve the capacity of the public health workforce to respond competently to the needs of Latino populations. In 2012, the Center collaborated with national, state, and local partners to develop a nationwide broadcast founded on the Preparedness Core Competencies, Latinos During Emergencies: Cultural Considerations Impacting Disaster Preparedness. The widely viewed broadcast (497 sites in 47 states and 13 nations) highlighted the commonalities and differences within Latino culture that can impact emergency preparedness and response and outlined practical strategies to enhance participation. The success of the broadcast spurred a number of partner requests for training and technical assistance. Lessons learned from these experiences, including our "undercover" work at local Points of Dispensing, are incorporated into subsequent interactive trainings to improve the competency of public health workers. Participants recommended

  15. Emergency preparedness and response plan for nuclear facilities in Indonesia

    International Nuclear Information System (INIS)

    Nur Rahmah Hidayati; Pande Made Udiyani

    2009-01-01

    All nuclear facilities in Indonesia are owned and operated by the National Nuclear Energy Agency (BATAN). The programs and activities of emergency planning and preparedness in Indonesia are based on the existing nuclear facilities, i.e. research reactors, research reactor fuel fabrication plant, radioactive waste treatment installation and radioisotopes production installation. The assessment is conducted to learn of status of emergency preparedness and response plan for nuclear facilities in Indonesia and to support the preparation of future Nuclear Power Plant. The assessment is conducted by comparing the emergency preparedness and response system in Indonesia to the system in other countries such as Japan and Republic of Korea, since the countries have many Nuclear Power Plants and other nuclear facilities. As a result, emergency preparedness response plan for existing nuclear facility in Indonesia has been implemented in many activities such as environmental monitoring program, facility monitoring equipment, and the continuous exercise of emergency preparedness and response. However, the implementation need law enforcement for imposing the responsibility of the coordinators in National Emergency Preparedness Plan. It also needs some additional technical support systems which refer to the system in Japan or Republic of Korea. The systems must be completed with some real time monitors which will support the emergency preparedness and response organization. The system should be built in NPP site before the first NPP will be operated. The system should be connected to an Off Site Emergency Center under coordination of BAPETEN as the regulatory body which has responsibility to control of nuclear energy in Indonesia. (Author)

  16. Practical Approaches for Assessment of Daily and Post-discharge Room Disinfection in Healthcare Facilities.

    Science.gov (United States)

    Deshpande, Abhishek; Donskey, Curtis J

    2017-09-01

    Cleaning and disinfection in healthcare facilities is essential to ensure patient safety. This review examines practical strategies used to assess and improve the effectiveness of daily and post-discharge manual cleaning in healthcare facilities. Effective implementation of cleaning interventions requires objective monitoring of staff performance with regular feedback on performance. Use of fluorescent markers to assess thoroughness of cleaning and measurement of residual ATP can provide rapid and objective feedback to personnel and have been associated with improved cleaning. Direct observation of cleaning and interviews with front-line staff are useful to identify variations and deficiencies in practice that may not be detected by other methods. Although not recommended for routine monitoring, cultures can be helpful for outbreak investigations. Monitoring and feedback can be effective in improving cleaning and disinfection in healthcare facilities. Ongoing commitment within institutions is needed to sustain successful cleaning and disinfection programs.

  17. It Takes Two to Tango: Customization and Standardization as Colluding Logics in Healthcare

    Science.gov (United States)

    Greenfield, David; Eljiz, Kathy; Butler-Henderson, Kerryn

    2018-01-01

    The healthcare context is characterized with new developments, technologies, ideas and expectations that are continually reshaping the frontline of care delivery. Mannion and Exworthy identify two key factors driving this complexity, ‘standardization’ and ‘customization,’ and their apparent resulting paradox to be negotiated by healthcare professionals, managers and policy makers. However, while they present a compelling argument an alternative viewpoint exists. An analysis is presented that shows instead of being ‘competing’ logics in healthcare, standardization and customization are long standing ‘colluding’ logics. Mannion and Exworthy’s call for further sustained work to understand this complex, contested space is endorsed, noting that it is critical to inform future debates and service decisions. PMID:29524942

  18. Assessment of Evacuation Protective Action Strategies For Emergency Preparedness Plan

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Joomyung; Jae, Moosung [Hanyang Univ., Seoul (Korea, Republic of); Ahn, Kwangil [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2013-10-15

    This report which studies about evacuation formation suggests some considerable factors to reduce damage of radiological accidents. Additional details would be required to study in depth and more elements should be considered for updating emergency preparedness. However, this methodology with sensitivity analysis could adapt to specific plant which has total information such as geological data, weather data and population data. In this point of view the evacuation study could be contribute to set up emergency preparedness plan and propose the direction to enhance protective action strategies. In radiological emergency, residents nearby nuclear power plant should perform protective action that is suggested by emergency preparedness plan. The objective of emergency preparedness plan is that damages, such as casualties and environmental damages, due to radioactive accident should be minimized. The recent PAR study includes a number of subjects to improve the quality of protective action strategies. For enhancing protective action strategies, researches that evaluate many factors related with emergency response scenario are essential parts to update emergency preparedness plan. Evacuation is very important response action as protective action strategy.

  19. 1986 viewpoint of emergency preparedness in the upper midwest

    International Nuclear Information System (INIS)

    Parkyn, J.D.

    1986-01-01

    The recent Soviet emergency preparedness disaster has started a new round of interactions between utilities and civil governments regarding the adequacy of emergency preparedness around nuclear plants. The 1986 annual meeting of the cooperative produced several questions regarding the potentials of the plant and its impact on the public and the cooperative in the event of an off-normal situation. Emergency preparedness requires a real partnership between local civil authorities and the utility in a close spirit of cooperation with local law enforcement, which is frequently charged with the strongest burdens of emergency planning. It is more evident that the virtual veto power of local branches of government over emergency preparedness needs to be more fully recognized by utilities. Early notification and warning systems are coming under a tighter scrutiny as public perception of their fallibility increases. Another continuing problem with emergency preparedness has been the recognition that guarantees of reaching every individual, particularly in more hostile environments, can not be easily made. The lessons learned in nuclear planning indicate that this is an area too often not given a high enough threshold in the total spectrum of nuclear safety and which, from the utility standpoint, needs to be elevated to a higher threshold of importance

  20. Assessment of Evacuation Protective Action Strategies For Emergency Preparedness Plan

    International Nuclear Information System (INIS)

    Lee, Joomyung; Jae, Moosung; Ahn, Kwangil

    2013-01-01

    This report which studies about evacuation formation suggests some considerable factors to reduce damage of radiological accidents. Additional details would be required to study in depth and more elements should be considered for updating emergency preparedness. However, this methodology with sensitivity analysis could adapt to specific plant which has total information such as geological data, weather data and population data. In this point of view the evacuation study could be contribute to set up emergency preparedness plan and propose the direction to enhance protective action strategies. In radiological emergency, residents nearby nuclear power plant should perform protective action that is suggested by emergency preparedness plan. The objective of emergency preparedness plan is that damages, such as casualties and environmental damages, due to radioactive accident should be minimized. The recent PAR study includes a number of subjects to improve the quality of protective action strategies. For enhancing protective action strategies, researches that evaluate many factors related with emergency response scenario are essential parts to update emergency preparedness plan. Evacuation is very important response action as protective action strategy

  1. Impact of social preparedness on flood early warning systems

    Science.gov (United States)

    Girons Lopez, M.; Di Baldassarre, G.; Seibert, J.

    2017-01-01

    Flood early warning systems play a major role in the disaster risk reduction paradigm as cost-effective methods to mitigate flood disaster damage. The connections and feedbacks between the hydrological and social spheres of early warning systems are increasingly being considered as key aspects for successful flood mitigation. The behavior of the public and first responders during flood situations, determined by their preparedness, is heavily influenced by many behavioral traits such as perceived benefits, risk awareness, or even denial. In this study, we use the recency of flood experiences as a proxy for social preparedness to assess its impact on the efficiency of flood early warning systems through a simple stylized model and implemented this model using a simple mathematical description. The main findings, which are based on synthetic data, point to the importance of social preparedness for flood loss mitigation, especially in circumstances where the technical forecasting and warning capabilities are limited. Furthermore, we found that efforts to promote and preserve social preparedness may help to reduce disaster-induced losses by almost one half. The findings provide important insights into the role of social preparedness that may help guide decision-making in the field of flood early warning systems.

  2. Design of the national health security preparedness index.

    Science.gov (United States)

    Uzun Jacobson, Evin; Inglesby, Tom; Khan, Ali S; Rajotte, James C; Burhans, Robert L; Slemp, Catherine C; Links, Jonathan M

    2014-01-01

    The importance of health security in the United States has been highlighted by recent emergencies such as the H1N1 influenza pandemic, Superstorm Sandy, and the Boston Marathon bombing. The nation's health security remains a high priority today, with federal, state, territorial, tribal, and local governments, as well as nongovernment organizations and the private sector, engaging in activities that prevent, protect, mitigate, respond to, and recover from health threats. The Association of State and Territorial Health Officials (ASTHO), through a cooperative agreement with the Centers for Disease Control and Prevention (CDC) Office of Public Health Preparedness and Response (OPHPR), led an effort to create an annual measure of health security preparedness at the national level. The collaborative released the National Health Security Preparedness Index (NHSPI(™)) in December 2013 and provided composite results for the 50 states and for the nation as a whole. The Index results represent current levels of health security preparedness in a consistent format and provide actionable information to drive decision making for continuous improvement of the nation's health security. The overall 2013 National Index result was 7.2 on the reported base-10 scale, with areas of greater strength in the domains of health surveillance, incident and information management, and countermeasure management. The strength of the Index relies on the interdependencies of the many elements in health security preparedness, making the sum greater than its parts. Moving forward, additional health security-related disciplines and measures will be included alongside continued validation efforts.

  3. 75 FR 42448 - Board of Scientific Counselors, Coordinating Office for Terrorism Preparedness and Emergency...

    Science.gov (United States)

    2010-07-21

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Board of Scientific Counselors, Coordinating Office for Terrorism Preparedness and Emergency Response; Notice of..., 1972, that the Board of Scientific Counselors, Coordinating Office for Terrorism Preparedness and...

  4. 78 FR 7784 - Office of the Secretary; Office of the Assistant Secretary for Preparedness and Response...

    Science.gov (United States)

    2013-02-04

    ... Center (ECCC) (ANC5) from under the Office of Preparedness and Emergency Operations (ANC) to operating... Preparedness and Emergency Operations (ANC), delete the following component ``Division of Emergency Care...

  5. 75 FR 34148 - Voluntary Private Sector Accreditation and Certification Preparedness Program

    Science.gov (United States)

    2010-06-16

    ...] Voluntary Private Sector Accreditation and Certification Preparedness Program AGENCY: Federal Emergency...) announces its adoption of three standards for the Voluntary Private Sector Accreditation and Certification... DHS to develop and implement a Voluntary Private Sector Preparedness Accreditation and Certification...

  6. Preparing supervisors to provide safeguarding supervision for healthcare staff.

    Science.gov (United States)

    Smikle, Marcia

    2017-11-28

    This paper outlines why experienced supervisors at a London healthcare provider received skills training so they could offer safeguarding supervision to front-line colleagues with case management responsibilities for vulnerable children and young people. It examines how supervisors use the main functions of supervision and a cycle of reflection in clinical practice with supervisees. As well as the professional issues encountered by supervisors in relation to the benefits, the challenges of providing supervision and the action required to make safeguarding supervision a part of the organisational culture are also explored. ©2017 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  7. [The disease and treatment of the frontline soldiers in Han dynasty].

    Science.gov (United States)

    Min, Hookie

    2015-04-01

    This paper purports to identify and analyze the medical information of the frontline soldiers in the Northwest borderland provinces of Han Dynasty, especially Juyan and Dunhuang region, through an heuristic reading of the Juyan Bamboo Slips and the Dunhuang Bamboo Slips of the Han Dynasty. My findings are as follows. The most frequent disease found in the bamboo slips was the external injury. The injury of the frontline soldiers mainly occurred from the quarrels among armed soldiers using weapons. The bamboo slips also demonstrate that the quarrels usually arose due to the fierce tension caused by the frontier line service such as heavy guard activity and labour duty. Undernourishment and chronic stress the soldiers suffered might be another reasons. The second most common disease harassing the soldiers was exogenous febrile disease. In most cases reviewed in this paper, the exogenous febrile disease was usually concurrent with complex symptoms such as chills, fever, headache, etc. The bamboo slips show that the exogenous febrile disease was related to the harsh climate of the Northwest provinces, featuring extremely dry weather and the large magnitude of diurnal temperature fluctuations. In addition, the annual temperature range in the Northwest province was huge, fluctuating between very cold and dry winter and very hot and dry summer. The third most common disease this study identified was the disorder of the digestive system and respiratory system. However, these two types of disease were virtually indistinguishable in the bamboo slips, because the ancient Chinese chroniclers did not distinguish them, usually dubbing both diseases simply 'abdominal pain.' It should be mentioned that a few slips mention contagious disease such as dysentery and dermatolosis, and sudden death, as well. Overall, the bamboo slips demonstrate extremely poor status of the soldiers' heath condition and poor medical environment surrounding the soldiers stationing in the Northwest

  8. The meta-leadership summit for preparedness initiative: an innovative model to advance public health preparedness and response.

    Science.gov (United States)

    Sobelson, Robyn K; Young, Andrea C; Marcus, Leonard J; Dorn, Barry C; Neslund, Verla S; McNulty, Eric J

    2013-12-01

    This article reports on the design, evaluation framework, and results from the Meta-Leadership Summit for Preparedness Initiative. The Meta-Leadership Summit for Preparedness was a 5-year initiative based on the premise that national preparedness and emergency response is not solely the responsibility of government. From 2006 to 2011, 36 Meta-Leadership Summits were delivered in communities across the country. Summits were customized, 10-hour leadership development, networking, and community action planning events. They included participation from targeted federal, state, local, nonprofit/philanthropic, and private sector leaders who are directly involved in decision making during a major community or state-wide emergency. A total of 4,971 government, nonprofit, and business leaders attended Meta-Leadership Summits; distribution of attendees by sector was balanced. Ninety-three percent of respondents reported the summit was a valuable use of time, 91% reported the overall quality as "good" or "outstanding," and 91% would recommend the summit to their colleagues. In addition, approximately 6 months after attending a summit, 80% of respondents reported that they had used meta-leadership concepts or principles. Of these, 93% reported that using meta-leadership concepts or principles had made a positive difference for them and their organizations. The Meta-Leadership Summit for Preparedness Initiative was a value-added opportunity for communities, providing the venue for learning the concepts and practice of meta-leadership, multisector collaboration, and resource sharing with the intent of substantively improving preparedness, response, and recovery efforts.

  9. The Legacy of Seligman's "Phobias and Preparedness" (1971).

    Science.gov (United States)

    McNally, Richard J

    2016-09-01

    Seligman's (1971) classic article, "Phobias and Preparedness," marked a break from traditional conditioning theories of the etiology of phobias, inspiring a line of research integrating evolutionary theory with learning theory. In this article, I briefly sketch the context motivating the preparedness theory of phobias before summarizing the initial wave of laboratory conditioning experiments pioneered by Öhman and conducted by his team and by others to test predictions derived from Seligman's theory. Finally, I review the legacy of Seligman's article, including theoretical developments embodied in Öhman and Mineka's fear module approach as well as alternatives for explaining "preparedness" phenomena, including the selective sensitization, expectancy, and nonassociative theories. Although Seligman himself soon moved on to other topics, his seminal article in Behavior Therapy continues to inspire research more than four decades later that has deepened our understanding of the etiology of phobias. Copyright © 2015. Published by Elsevier Ltd.

  10. Off-site emergency preparedness activities within the European Commission

    International Nuclear Information System (INIS)

    Kelly, G.N.

    1998-01-01

    Increasing attention is being given by the European Commission to off-site emergency preparedness as part of its broader contribution to improving nuclear safety in Eastern Europe. The main initiatives being taken or planned by the Commission in this area are summarised. Particular attention is given to two topics: Firstly, the development of the RODOS (Real-time On-line DecisiOn Support) system for supporting off-site emergency management in the event of a nuclear accident; and, secondly, the work of an Inter-Service Group on nuclear Off-Site Emergency Preparedness (OSEP) in Eastern Europe that has been established within the Commission. The contribution that each is making to improving emergency preparedness, both in Eastern Europe and in Europe more widely, is described. (orig.)

  11. European commission contribution to improving off-site emergency preparedness

    International Nuclear Information System (INIS)

    Kelly, G.N.

    1996-01-01

    Increasing attention is being given by the European Commission to off-site emergency preparedness as part of its broader contribution to improving nuclear safety in Eastern Europe. The main initiatives being taken or planned by the Commission in this area are summarized. Particular attention is given to two topics: firstly, the development of the RODOS (Real-time On-line Decision Support) system for supporting off-site emergency management in the event of a nuclear accident; and, secondly, the work of an Inter-Service Group on nuclear Off-Site Emergency Preparedness (OSEP) in Eastern Europe that has recently been established within the Commission. The contribution that each is making to improving emergency preparedness, both in Eastern Europe and in Europe more widely, is described

  12. Atomic energy in healthcare

    International Nuclear Information System (INIS)

    Gupta, Sudeep; Rangarajan, Venkatesh; Thakur, Meenakshi; Parmar, Vani; Jalali, Rakesh; Ashgar, Ali; Pramesh, C.S.; Shrivastava, Shyam; Badwe, Rajendra

    2013-01-01

    One of the socially important non-power programmes of the DAE is in the beneficial use of radiation and related techniques for healthcare. The diagnosis and therapy aspects of radiation based healthcare are discussed in this article. (author)

  13. Communicating with Healthcare Professionals

    Science.gov (United States)

    ... at follow-up appointments by talking with your healthcare team about your concerns, asking questions and getting ... from the time you spend with all your healthcare providers, not just your doctor. Use the skills ...

  14. Effects on costs of frontline diagnostic evaluation in patients suspected of angina: coronary computed tomography angiography vs. conventional ischaemia testing

    DEFF Research Database (Denmark)

    Nielsen, Lene H; Olsen, Jens; Markenvard, John

    2013-01-01

    group. The mean (SD) total costs per patient at the end of thefollow-up were 14% lower in the CTA group than in the ex-test group, € 1510 (3474) vs. €1777 (3746) (P = 0.03). CONCLUSION: Diagnostic assessment of symptomatic patients with a low-intermediate probability of CAD by CTA incurred lower costs......AIMS: The aim of this study was to investigate in patients with stable angina the effects on costs of frontline diagnostics by exercise-stress testing (ex-test) vs. coronary computed tomography angiography (CTA). METHODS AND RESULTS: In two coronary units at Lillebaelt Hospital, Denmark, 498...... patients were identified in whom either ex-test (n = 247) or CTA (n = 251) were applied as the frontline diagnostic strategy in symptomatic patients with a low-intermediate pre-test probability of coronary artery disease (CAD). During 12 months of follow-up, death, myocardial infarction and costs...

  15. Patterns of relapse and outcome of elderly multiple myeloma patients treated as front-line therapy with novel agents combinations

    Directory of Open Access Journals (Sweden)

    Aurelio Lopez

    2015-01-01

    Full Text Available We report the characteristics of relapse, treatment response, and outcomes of 145 elderly patients with multiple myeloma in first relapse after front-line treatment with VMP or VTP. Reappearance of CRAB symptoms (113 patients and more aggressive forms of disease (32 patients were the most common patterns of relapse. After second-line therapy, 75 (51.7% patients achieved at partial response and 16 (11% complete response (CR. Overall survival was longer among patients receiving VMP as front-line induction (21.4 vs. 14.4 months, P=0.037, in patients achieving CR (28.3 vs. 14.8 months; P=0.04, and in patients without aggressive relapse (28.6 vs. 7.6 months; P=0.0007.

  16. Patterns of relapse and outcome of elderly multiple myeloma patients treated as front-line therapy with novel agents combinations☆

    Science.gov (United States)

    Lopez, Aurelio; Mateos, Maria-Victoria; Oriol, Albert; Valero, Marta; Martínez, Joaquín; Lorenzo, Jose Ignacio; Perez, Montserrat; Martinez, Rafael; de Paz, Raquel; Granell, Miguel; De Arriba, Felipe; Blanchard, M. Jesús; Peñalver, Francisco Javier; Bello, Jose Luis; Martin, Maria Luisa; Bargay, Joan; Blade, Joan; Lahuerta, Juan Jose; San Miguel, Jesús F.; de la Rubia, Javier

    2015-01-01

    We report the characteristics of relapse, treatment response, and outcomes of 145 elderly patients with multiple myeloma in first relapse after front-line treatment with VMP or VTP. Reappearance of CRAB symptoms (113 patients) and more aggressive forms of disease (32 patients) were the most common patterns of relapse. After second-line therapy, 75 (51.7%) patients achieved at partial response and 16 (11%) complete response (CR). Overall survival was longer among patients receiving VMP as front-line induction (21.4 vs. 14.4 months, P=0.037), in patients achieving CR (28.3 vs. 14.8 months; P=0.04), and in patients without aggressive relapse (28.6 vs. 7.6 months; P=0.0007). PMID:26500850

  17. Front-line ownership: generating a cure mindset for patient safety.

    Science.gov (United States)

    Zimmerman, Brenda; Reason, Paige; Rykert, Liz; Gitterman, Leah; Christian, Jennifer; Gardam, Michael

    2013-01-01

    Great advances have been made in standardization and human factors engineering that have reduced variability and increased reliability in healthcare. As important as these advances are, the authors believe there is another important but largely ignored layer to the safety story in healthcare that has prevented us from progressing. In the field of infection prevention and control (IPAC), despite great attempts over several decades to improve compliance with hand hygiene, surveillance, environmental cleaning, isolation protocols and other control measures, very significant challenges remain. We believe this failure is in part due to the power gradients, often dysfunctional relationships and lack of safety mindfulness that exist in hospitals and healthcare more generally. Furthermore, safety culture requires different approaches and considerable ongoing attentiveness. If this is the case, and the authors contend in this paper that it is, then the role of the front line is much more important than many of our healthcare safety and IPAC approaches suggest. Copyright © 2013 Longwoods Publishing.

  18. Healthcare. Executive Summary

    Science.gov (United States)

    Carnevale, Anthony P.; Smith, Nicole; Gulish, Artem; Beach, Bennett H.

    2012-01-01

    This executive summary highlights several findings about healthcare. These are: (1) Healthcare is 18 percent of the U.S. economy, twice as high as in other countries; (2) There are two labor markets in healthcare: high-skill, high-wage professional and technical jobs and low-skill, low-wage support jobs; (3) Demand for postsecondary education in…

  19. A clean bill of health? The efficacy of an NHS commissioned outsourced police custody healthcare service.

    Science.gov (United States)

    de Viggiani, Nick

    2013-08-01

    Police custody healthcare services for detainees in the UK are most commonly outsourced to independent healthcare providers who employ custody nurses and forensic physicians to deliver forensic healthcare services. A pilot was introduced in 2008 by the Department of Health to explore the efficacy of commissioning custody healthcare via the NHS, in the wake of the 2005-2006 shift of prison healthcare to the NHS. The objective was to improve quality and accountability through NHS commissioning and the introduction of NHS governance to the management and delivery of custody healthcare. This article discusses key themes that arose from the project evaluation, which focused on the commissioning relationship between the police, the NHS commissioner and the private healthcare provider. The evaluation observed an evolving relationship between the police, the local NHS and the front-line nurses, which was complicated by the quite distinctive professional values and ideologies operating, with their contrasting organisational imperatives and discordant values and principles. A key challenge for commissioners is to develop synergy between operational and strategically located stakeholders so that they can work effectively towards common goals. Government policy appears to remain focused on creating safe, supportive and humane custody environments that balance criminal justice and health imperatives and support the rights and needs of detainees, victims, professionals and the public. This remains an ambitious agenda and presents a major challenge for new criminal justice health partnerships. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  20. Emergency preparedness and response for the non-reactor countries

    International Nuclear Information System (INIS)

    Buglova, E.

    2000-01-01

    Preparedness and response for nuclear and radiological accidents in the countries without nuclear power plants (NPP) have some peculiarities. Accident at the Chernobyl NPP clearly showed the necessity of effective response for non-reactor countries in the case of transboundary release. Experience obtained in Belarus is providing evidence for the necessity of changing some aspects of emergency preparedness. The results of analysis made of some protective actions taken during the early stage of the accident form the basis for recommendations provided this paper. Real experience is supported by model predictions of the consequences for the hypothetical accident at a NPP close to the Belarus. (author)

  1. Radiation Emergency Preparedness Tools: Virtual Community Reception Center

    Centers for Disease Control (CDC) Podcasts

    2011-02-28

    This podcast is an overview of resources from the Clinician Outreach and Communication Activity (COCA) Call: Practical Tools for Radiation Emergency Preparedness. A specialist working with CDC's Radiation Studies Branch describes a web-based training tool known as a Virtual Community Reception Center (vCRC).  Created: 2/28/2011 by National Center for Environmental Health (NCEH) Radiation Studies Branch and Emergency Risk Communication Branch (ERCB)/Joint Information Center (JIC); Office of Public Health Preparedness and Response (OPHPR).   Date Released: 2/28/2011.

  2. Pandemic influenza preparedness and health systems challenges in Asia: results from rapid analyses in 6 Asian countries

    Directory of Open Access Journals (Sweden)

    Putthasri Weerasak

    2010-06-01

    Full Text Available Abstract Background Since 2003, Asia-Pacific, particularly Southeast Asia, has received substantial attention because of the anticipation that it could be the epicentre of the next pandemic. There has been active investment but earlier review of pandemic preparedness plans in the region reveals that the translation of these strategic plans into operational plans is still lacking in some countries particularly those with low resources. The objective of this study is to understand the pandemic preparedness programmes, the health systems context, and challenges and constraints specific to the six Asian countries namely Cambodia, Indonesia, Lao PDR, Taiwan, Thailand, and Viet Nam in the prepandemic phase before the start of H1N1/2009. Methods The study relied on the Systemic Rapid Assessment (SYSRA toolkit, which evaluates priority disease programmes by taking into account the programmes, the general health system, and the wider socio-cultural and political context. The components under review were: external context; stewardship and organisational arrangements; financing, resource generation and allocation; healthcare provision; and information systems. Qualitative and quantitative data were collected in the second half of 2008 based on a review of published data and interviews with key informants, exploring past and current patterns of health programme and pandemic response. Results The study shows that health systems in the six countries varied in regard to the epidemiological context, health care financing, and health service provision patterns. For pandemic preparation, all six countries have developed national governance on pandemic preparedness as well as national pandemic influenza preparedness plans and Avian and Human Influenza (AHI response plans. However, the governance arrangements and the nature of the plans differed. In the five developing countries, the focus was on surveillance and rapid containment of poultry related transmission

  3. 78 FR 25277 - Office of the Secretary; Office of the Assistant Secretary for Preparedness and Response...

    Science.gov (United States)

    2013-04-30

    ... Office of Preparedness and Emergency Operations (ANC), establish five Divisions under the Office of Preparedness and Emergency Operations (ANC), and rename one existing Division. The changes are as follows. I..., Paragraph C, Office of Preparedness and Emergency Operations (ANC): a. Replace all references to the...

  4. 75 FR 60773 - Voluntary Private Sector Accreditation and Certification Preparedness Program

    Science.gov (United States)

    2010-10-01

    ...] Voluntary Private Sector Accreditation and Certification Preparedness Program AGENCY: Federal Emergency... concerns in the Voluntary Private Sector Accreditation and Certification Preparedness Program (PS-Prep...-53 (the 9/11 Act) mandated DHS to establish a voluntary private sector preparedness accreditation and...

  5. Disaster Preparedness, Adaptive Politics and Lifelong Learning: A Case of Japan

    Science.gov (United States)

    Kitagawa, Kaori

    2016-01-01

    Preparedness for disaster scenarios is progressively becoming an educational agenda for governments because of diversifying risks and threats worldwide. In disaster-prone Japan, disaster preparedness has been a prioritised national agenda, and preparedness education has been undertaken in both formal schooling and lifelong learning settings. This…

  6. Urban meteorological modelling for nuclear emergency preparedness

    International Nuclear Information System (INIS)

    Baklanov, Alexander; Sorensen, Jens Havskov; Hoe, Steen Cordt; Amstrup, Bjarne

    2006-01-01

    The main objectives of the current EU project 'Integrated Systems for Forecasting Urban Meteorology, Air Pollution and Population Exposure' (FUMAPEX) are the improvement of meteorological forecasts for urban areas, the connection of numerical weather prediction (NWP) models to urban air pollution and population dose models, the building of improved urban air quality information and forecasting systems, and their application in cities in various European climates. In addition to the forecast of the worst air-pollution episodes in large cities, the potential use of improved weather forecasts for nuclear emergency management in urban areas, in case of hazardous releases from nuclear accidents or terror acts, is considered. Such use of NWP data is tested for the Copenhagen metropolitan area and the Oresund region. The Danish Meteorological Institute (DMI) is running an experimental version of the HIRLAM NWP model over Zealand including the Copenhagen metropolitan area with a horizontal resolution of 1.4 km, thus approaching the city-scale. This involves 1-km resolution physiographic data with implications for the urban surface parameters, e.g. surface fluxes, roughness length and albedo. For the city of Copenhagen, the enhanced high-resolution NWP forecasting will be provided to demonstrate the improved dispersion forecasting capabilities of the Danish nuclear emergency preparedness decision-support system, the Accident Reporting and Guidance Operational System (ARGOS), used by the Danish Emergency Management Agency (DEMA). Recently, ARGOS has been extended with a capability of real-time calculation of regional-scale atmospheric dispersion of radioactive material from accidental releases. This is effectuated through on-line interfacing with the Danish Emergency Response Model of the Atmosphere (DERMA), which is run at DMI. For local-scale modelling of atmospheric dispersion, ARGOS utilises the Local-Scale Model Chain (LSMC), which makes use of high-resolution DMI

  7. Delighting the Customer: Creativity-Oriented High-Performance Work Systems, Frontline Employee Creative Performance, and Customer Satisfaction

    OpenAIRE

    Martinaityte, Ieva; Sacramento, Claudia; Aryee, Samuel

    2016-01-01

    Drawing on self-determination theory, we proposed and tested a cross-level model of how perceived creativity-oriented high-performance work systems (HPWS) influence customer satisfaction. Data were obtained from frontline employees (FLEs), their managers, and branch records of two organizations (retail bank and cosmetics) in Lithuania. Results of multilevel structural equation modeling analyses revealed partial support for our model. Although perceived creativity-oriented HPWS related to crea...

  8. Care decision making of frontline providers of maternal and newborn health services in the greater Accra region of Ghana.

    Directory of Open Access Journals (Sweden)

    Ebenezer Oduro-Mensah

    Full Text Available To explore the "how" and "why" of care decision making by frontline providers of maternal and newborn services in the Greater Accra region of Ghana and determine appropriate interventions needed to support its quality and related maternal and neonatal outcomes.A cross sectional and descriptive mixed method study involving a desk review of maternal and newborn care protocols and guidelines availability, focus group discussions and administration of a structured questionnaire and observational checklist to frontline providers of maternal and newborn care.Tacit knowledge or 'mind lines' was an important primary approach to care decision making. When available, protocols and guidelines were used as decision making aids, especially when they were simple handy tools and in situations where providers were not sure what their next step in management had to be. Expert opinion and peer consultation were also used through face to face discussions, phone calls, text messages, and occasional emails depending on the urgency and communication medium access. Health system constraints such as availability of staff, essential medicines, supplies and equipment; management issues (including leadership and interpersonal relations among staff, and barriers to referral were important influences in decision making. Frontline health providers welcomed the idea of interventions to support clinical decision making and made several proposals towards the development of such an intervention. They felt such an intervention ought to be multi-faceted to impact the multiple influences simultaneously. Effective interventions would also need to address immediate challenges as well as more long-term challenges influencing decision-making.Supporting frontline worker clinical decision making for maternal and newborn services is an important but neglected aspect of improved quality of care towards attainment of MDG 4 & 5. A multi-faceted intervention is probably the best way to make a

  9. [The five commandments for preparing the Israeli healthcare system for emergencies].

    Science.gov (United States)

    Adini, Bruria; Laor, Danny; Cohen, Robert; Lev, Boaz; Israeli, Avi

    2010-07-01

    In the last decade, the Israeli healthcare system dealt with many casualties that resulted from terrorist actions and at the same time maintained preparedness for other potential hazards such as natural disasters, toxicological, chemical, radiological and biological events. There are various models for emergency preparedness that are utilized in different countries. The aim of the article is to present the structure and the methodology of the Israeli healthcare system for emergencies. Assuring emergency preparedness for the different scenarios is based on 5 major components that include: comprehensive contingency planning; control and command of operations; central control of readiness; capacity building; coordination and collaboration among the numerous emergency agencies. CLose working relationships between the military and civilian systems characterize the operations of the emergency system. There is a mutual sharing of information, coordinated operations to achieve risk assessment and determine priorities, and consensual allocation of resources. The ability of the medical system to operate in optimal coordination with interface bodies, including the Israel Defense Forces, is derived from three main elements: the shortage of resources necessitate that all agencies work together to develop an effective response to emergencies; the Israeli society is characterized by transition of personnel from the military to the civilian system which promotes joint operations, whereas in most other countries these systems are completely separated; and also developing mechanisms for continuous and coordinated operation in routine and emergency times, such as the Supreme Health Authority. The Israeli healthcare system was put to the test several times in the Last decade, during the terror wave that occurred between 2001-2006, the 2nd Lebanon War and in operation "Cast Lead". An extensive process of learning lessons, conducted during and following each of these periods, and the

  10. How peer-review constrains cognition: on the frontline in the knowledge sector.

    Science.gov (United States)

    Cowley, Stephen J

    2015-01-01

    Peer-review is neither reliable, fair, nor a valid basis for predicting 'impact': as quality control, peer-review is not fit for purpose. Endorsing the consensus, I offer a reframing: while a normative social process, peer-review also shapes the writing of a scientific paper. In so far as 'cognition' describes enabling conditions for flexible behavior, the practices of peer-review thus constrain knowledge-making. To pursue cognitive functions of peer-review, however, manuscripts must be seen as 'symbolizations', replicable patterns that use technologically enabled activity. On this bio-cognitive view, peer-review constrains knowledge-making by writers, editors, reviewers. Authors are prompted to recursively re-aggregate symbolizations to present what are deemed acceptable knowledge claims. How, then, can recursive re-embodiment be explored? In illustration, I sketch how the paper's own content came to be re-aggregated: agonistic review drove reformatting of argument structure, changes in rhetorical ploys and careful choice of wordings. For this reason, the paper's knowledge-claims can be traced to human activity that occurs in distributed cognitive systems. Peer-review is on the frontline in the knowledge sector in that it delimits what can count as knowing. Its systemic nature is therefore crucial to not only discipline-centered 'real' science but also its 'post-academic' counterparts.

  11. A Hidden Markov Model for Analysis of Frontline Veterinary Data for Emerging Zoonotic Disease Surveillance

    Science.gov (United States)

    Robertson, Colin; Sawford, Kate; Gunawardana, Walimunige S. N.; Nelson, Trisalyn A.; Nathoo, Farouk; Stephen, Craig

    2011-01-01

    Surveillance systems tracking health patterns in animals have potential for early warning of infectious disease in humans, yet there are many challenges that remain before this can be realized. Specifically, there remains the challenge of detecting early warning signals for diseases that are not known or are not part of routine surveillance for named diseases. This paper reports on the development of a hidden Markov model for analysis of frontline veterinary sentinel surveillance data from Sri Lanka. Field veterinarians collected data on syndromes and diagnoses using mobile phones. A model for submission patterns accounts for both sentinel-related and disease-related variability. Models for commonly reported cattle diagnoses were estimated separately. Region-specific weekly average prevalence was estimated for each diagnoses and partitioned into normal and abnormal periods. Visualization of state probabilities was used to indicate areas and times of unusual disease prevalence. The analysis suggests that hidden Markov modelling is a useful approach for surveillance datasets from novel populations and/or having little historical baselines. PMID:21949763

  12. How peer-review constrains cognition: on the frontline in the knowledge sector

    Science.gov (United States)

    Cowley, Stephen J.

    2015-01-01

    Peer-review is neither reliable, fair, nor a valid basis for predicting ‘impact’: as quality control, peer-review is not fit for purpose. Endorsing the consensus, I offer a reframing: while a normative social process, peer-review also shapes the writing of a scientific paper. In so far as ‘cognition’ describes enabling conditions for flexible behavior, the practices of peer-review thus constrain knowledge-making. To pursue cognitive functions of peer-review, however, manuscripts must be seen as ‘symbolizations’, replicable patterns that use technologically enabled activity. On this bio-cognitive view, peer-review constrains knowledge-making by writers, editors, reviewers. Authors are prompted to recursively re-aggregate symbolizations to present what are deemed acceptable knowledge claims. How, then, can recursive re-embodiment be explored? In illustration, I sketch how the paper’s own content came to be re-aggregated: agonistic review drove reformatting of argument structure, changes in rhetorical ploys and careful choice of wordings. For this reason, the paper’s knowledge-claims can be traced to human activity that occurs in distributed cognitive systems. Peer-review is on the frontline in the knowledge sector in that it delimits what can count as knowing. Its systemic nature is therefore crucial to not only discipline-centered ‘real’ science but also its ‘post-academic’ counterparts. PMID:26579064

  13. Introduction to health economics and decision-making: Is economics relevant for the frontline clinician?

    Science.gov (United States)

    Goeree, Ron; Diaby, Vakaramoko

    2013-12-01

    In a climate of escalating demands for new health care services and significant constraints on new resources, the disciplines of health economics and health technology assessment (HTA) have increasingly been turned to as explicit evidence-based frameworks to help make tough health care access and reimbursement decisions. Health economics is the discipline of economics concerned with the efficient allocation of health care resources, essentially trying to maximize health benefits to society contingent upon available resources. HTA is a broader field drawing upon several disciplines, but which relies heavily upon the tools of health economics and economic evaluation. Traditionally, health economics and economic evaluation have been widely used at the political (macro) and local (meso) decision-making levels, and have progressively had an important role even at informing individual clinical decisions (micro level). The aim of this paper is to introduce readers to health economics and discuss its relevance to frontline clinicians. Particularly, the content of the paper will facilitate clinicians' understanding of the link between economics and their medical practice, and how clinical decision-making reflects on health care resource allocation. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Symptoms of PTSD in Frontline Journalists: A Retrospective Examination of 18 Years of War and Conflict.

    Science.gov (United States)

    Feinstein, Anthony; Osmann, Jonas; Patel, Viral

    2018-01-01

    The objective of the current study was to determine the frequency and severity of symptoms of posttraumatic stress disorder (PTSD) in journalists covering conflict. PTSD data (Impact of Event Scale-Revised) collected over an 18-year period from 684 conflict journalists were analyzed retrospectively for frequency and severity of reexperiencing, avoidance, and arousal symptoms. Conflicts covered were civil wars in the Balkans ( n = 140 journalists), 9/11 attack in New York City ( n = 46), Iraq war ( n = 84), Mexico drug wars ( n = 104), civil war in Syria ( n = 59), Kenya election violence/Al-Shabab terror ( n = 57), state-sanctioned media intimidation in Iran ( n = 114), and the current migration crisis in Europe ( n = 80). The mean age of the sample was 38.59 (SD = 8.35) years, 461 (67%) journalists were men, and the mean duration of conflict work was 13.42 (SD = 7.74) years. The 5 most frequently endorsed symptoms were in the reexperiencing/intrusion category. Mean intrusion (1.31, SD = 0.97), avoidance (1.08, SD = 0.89), and arousal (1.07, SD = 0.96) scores for the entire sample were in the mild range. Being female and less educated independently predicted PTSD symptoms. PTSD phenomenology in a group of conflict journalists with well over a decade of frontline experience is dominated by reexperiencing symptoms. While symptom severity is for the most part mild, group means can obscure those individuals with significantly more severe difficulties.

  15. Managing inadequate responses to frontline treatment of chronic myeloid leukemia: a case-based review.

    Science.gov (United States)

    Bixby, Dale L

    2013-05-01

    The tyrosine kinase inhibitors (TKIs) imatinib, nilotinib, and dasatinib are the standard of care for treating patients with newly diagnosed chronic-phase chronic myeloid leukemia (CML). Compared with interferon-based treatment, the previous standard of care, imatinib is associated with significantly higher cytogenetic response rates and prolonged overall survival. Nilotinib and dasatinib, both newer and more potent TKIs, significantly improve cytogenetic and molecular response rates compared with imatinib. Despite significant advances in CML treatment enabled by the TKIs, a fraction of patients who receive frontline treatment with a TKI demonstrate inadequate response. The reasons for this vary, but in many cases, inadequate response can be attributed to non-adherence to the treatment regimen, intolerance to the drug, intrinsic or acquired resistance to the drug, or a combination of reasons. More often than not, strategies to improve response necessitate a change in treatment plan, either a dose adjustment or a switch to an alternate drug, particularly in the case of drug intolerance or drug resistance. Improved physician-patient communication and patient education are effective strategies to address issues relating to adherence and intolerance. Because inadequate response to TKI treatment correlates with poor long-term outcomes, it is imperative that patients who experience intolerance or who fail to achieve appropriate responses are carefully evaluated so that appropriate treatment modifications can be made to maximize the likelihood of positive long-term outcome. Copyright © 2012. Published by Elsevier Ltd.

  16. CSR and the Frontline Context: How Social Programs Improve Customer Service

    Directory of Open Access Journals (Sweden)

    Korschun Daniel

    2016-05-01

    Full Text Available CSR activities such as charitable giving, environmental programs and ethical practices can motivate frontline employees. One of the key variables is organizational identification. CSR communicates values, and, if these values are consistent with a person’s own value system, it results in higher identification with the company. Employees who notice that consumers are fond of the company’s CSR activities will identify even more with the company. If CSR ranks high in their own personal value system and the value system of the consumer as well, they find common ground for conversations beyond immediate business talk. CSR can be an icebreaker in conversations with customers. Once service employees find out that customers share their passion for social or environmental causes, it creates a bond that is highly motivating. They become more confident that they know what the customers want. They are more motivated to serve those customers when they see that both of them care about the same sorts of things.

  17. How peer review constrains cognition: on the frontline in the knowledge sector

    Directory of Open Access Journals (Sweden)

    Stephen John Cowley

    2015-11-01

    Full Text Available Peer-review is neither reliable, fair, nor a valid basis for predicting ‘impact’: as quality control, peer-review is not fit for purpose. Given this consensus, I propose another framing: while a normative social process, peer-review also shapes the flexible behavior called ‘writing’ a scientific paper. In so far as ‘cognition’ describes the enabling conditions for flexible behaviour, the practices of peer-review thus constrain knowledge-making. To pursue cognitive functions of peer-review, however, manuscripts must be seen as ‘symbolizations’, replicable patterns that use technologically enabled activity. On this bio-cognitive view, peer-review constrains knowledge-making by writers, editors, reviewers. Authors are prompted to recursively re-aggregate symbolizations to present what are deemed acceptable knowledge claims. How, then, can recursive re-embodiment be explored? In illustration, I sketch how the paper’s own content came to be re-aggregated: agonistic review drove reformatting of argument structure, changes in rhetorical ploys and careful choice of wordings. For this reason, the paper’s knowledge-claims can be traced to human activity that occurs in distributed cognitive systems. Peer-review is on the frontline in the knowledge sector in that it delimits what can count as knowing. Its systemic nature is therefore crucial to not only discipline-centered ‘real’ science but also its ‘post-academic’ counterparts.

  18. Moral Stress and Job Burnout Among Frontline Staff Conducting Clinical Research on Affective and Anxiety Disorders.

    Science.gov (United States)

    Fried, Adam L; Fisher, Celia B

    2016-06-01

    There has been increased attention on job-related stress and burnout experienced by clinicians working with vulnerable and at-risk populations, including effects on personal mental health, therapeutic decision-making, and job effectiveness. Little is known, however, about the job-related stressors and symptoms of burnout experienced by clinical research staff working with similar populations, especially in terms of moral stress they may experience when adherence to scientific procedures appears to conflict with their personal commitment to address the clinical needs of their research participants or role as health care provider. In this national study, 125 frontline research workers conducting clinical research studies with individuals diagnosed with affective and anxiety disorders completed an online survey including measures assessing research work related moral stress, job burnout, organizational ethics climate and organizational research support. Results indicated that younger research workers, those whose research work was part of a graduate assistantship and perceptions of higher participant research risk were associated with higher levels of moral stress and job burnout. Supportive organizational climates were associated with lower levels of moral stress and job burnout. Recommendations for clinical research workers, supervisors and clinical training directors are discussed.

  19. Creating an Excellent Patient Experience Through Service Education: Content and Methods for Engaging and Motivating Front-Line Staff.

    Science.gov (United States)

    Kennedy, Denise M

    2017-12-01

    Service quality and patient satisfaction affect an organization's value-based payments. This new value paradigm calls for a new approach to service education and training for front-line staff. Thoughtfully conceived, department-specific content, infused with patient feedback, value creation, and science of service quality principles, was developed to give front-line staff a deeper understanding of the impact of their performance on patient experience, value creation, and value-based revenue. Feedback from nearly 1500 trainees in 60 educational sessions delivered over 7 years indicates good understanding of the content and appreciation of the targeted approach. On a 5-point scale ranging from 1 (least effective) to 5 (most effective), trainees' ratings of their understanding of service quality concepts and impact on value ranged from 4.7 to 4.9. Verbatim comments showed a positive impact on staff. Employee feedback suggests that value-based service education may be useful in motivating front-line staff, improving service quality, and creating value.

  20. How Does Supervisor Support Influence Turnover Intent Among Frontline Hospital Workers? The Mediating Role of Affective Commitment.

    Science.gov (United States)

    Nichols, Helen M; Swanberg, Jennifer E; Bright, Charlotte Lyn

    2016-01-01

    Turnover among frontline hospital service workers can disrupt organizational effectiveness, reduce profitability, and limit the ability to provide high-quality, patient-centered care. This concern is compounded by the increasing reliance on frontline supervisors to manage this workforce, often without necessary training and support. However, research addressing the relationship between frontline supervisor support and intent to turnover among service workers and the process by which these variables are related is limited. By surveying 270 housekeeping and dietary service workers employed at 2 US hospitals, this study examined the relationship between supervisor support and turnover intent and assessed the mediating role of affective commitment between supervisor support and intent to turnover. Turnover intentions were lower for workers who reported greater levels of supervisor support and affective commitment; both supervisor support and affective commitment were significant predictors of turnover intent when tested individually. However, when controlling for affective commitment, supervisor support no longer predicted turnover intent, indicating that affective commitment fully mediated the relationship between supervisor support and intent to turnover. Implications for further research and organizational practice are discussed.

  1. Frontline registered nurse job satisfaction and predictors over three decades: a meta-analysis from 1980 to 2009.

    Science.gov (United States)

    Saber, Deborah A

    2014-01-01

    Frontline registered nurses' job satisfaction is important because it is tied to retention, organizational commitment, workforce safety, patient safety, and cost savings. The purpose of this study was to comprehensively, quantitatively examine the largest, moderate, and smallest predictors of frontline registered nurse job satisfaction from 1980 to 2009. A non-a priori meta-analysis was used to analyze studies that met inclusion. Sixty-two studies and 27 job satisfaction predictors met inclusion for analysis. The largest effect sizes were found for task requirements (r = .61), empowerment (r = .55), and control (r = .52), and moderate effect sizes were found for 10 predictors. Fail-safe N indicates high reliability. Heterogeneity between studies was present in all of the 27 predictor analyses. The largest predictors of job satisfaction for the frontline registered nurse may be different than previously thought. Supporting past research, autonomy and stress were found to be moderate predictors of satisfaction. Heterogeneity indicates study differences or moderator influence in studies. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Healthcare professionals' work engagement in Finnish university hospitals.

    Science.gov (United States)

    Lepistö, Sari; Alanen, Seija; Aalto, Pirjo; Järvinen, Päivi; Leino, Kaija; Mattila, Elina; Kaunonen, Marja

    2017-10-10

    Concerns about the sufficiency and dedication of the healthcare workforce have arisen as the baby boomer generation is retiring and the generation Y might have different working environment demands. To describe the association between work engagement of healthcare professionals' and its background factors at five Finnish university hospitals. Survey data were collected from nurses, physicians and administrative staff (n = 561) at all five university hospitals in Finland. Data were collected using an electronic questionnaire that comprised the Utrecht Work Engagement Scale (9 items) and 13 questions regarding the respondents' backgrounds. Descriptive and correlational analyses were used to examine the data. Most respondents were female (85%) and nursing staff (72%). Baby boomers (49%) were the largest generational cohort. The work engagement composite mean for the total sample was 5.0, indicating high work engagement. Significant differences in work engagement existed only among sex and age groups. The highest work engagement scores were among administrative staff. Work engagement among healthcare professionals in Finnish university hospitals is high. High work engagement might be explained by suitable job resources and challenges, as well as opportunities provided by a frontline care environment. Attention should especially be paid to meeting the needs of young people entering the workforce to strengthen their dedication and absorption. © 2017 Nordic College of Caring Science.

  3. Survey of Hospital Employees' Personal Preparedness and Willingness to Work Following a Disaster.

    Science.gov (United States)

    Brice, Jane H; Gregg, David; Sawyer, Dalton; Cyr, Julianne M

    2017-08-01

    Little is known about the personal readiness of hospital staff for disasters. As many as 30% of hospital staff say that they plan not to report for work during a large-scale disaster. We sought to understand the personal disaster preparedness for hospital staff. Surveys were distributed to the staff of a large academic tertiary-care hospital by either a paper-based version distributed through the departmental safety coordinators or a Web-based version distributed through employee e-mail services, depending on employee familiarity with and access to computer services. Surveys assessed the demographic variables and characteristics of personal readiness for disaster. Of the individuals who accessed the survey, 1334 (95.9%) enrolled in it. Women made up 75% of the respondents, with a mean age of 43 years. Respondents had worked at the hospital an average of 9 years, with the majority (90%) being full-time employees. Most households (93%) reported ≤4 members, 6% supported a person with special medical needs, and 17% were headed by a single parent. A small number (24%) of respondents reported an established meeting place for reuniting households during a disaster. Many reported stockpiling a 3-day supply of food (86%) and a 3-day supply of water (51%). Eighteen percent of respondents were not aware of workplace evacuation plans. Most respondents were willing to report to work for natural disasters (eg, tornado, snowstorm; all categories >65%), but fewer respondents were willing to report during events such as an influenza epidemic (54%), a biological outbreak (41%), a chemical exposure, (40%), or a radiation exposure (39%). Multivariate analysis revealed being female, having a child in the household younger than 6 years old, and having a child in school lowered the likelihood of being willing to report to work in two or more event types, whereas pet ownership, being a clinical healthcare worker, and being familiar with the work emergency plan increased the likelihood

  4. Assessment of Emergency Preparedness of Households in Israel for War--Current Status.

    Science.gov (United States)

    Bodas, Moran; Siman-Tov, Maya; Kreitler, Shulamith; Peleg, Kobi

    2015-08-01

    In recent decades, many efforts have been made, both globally and locally, to enhance household preparedness for emergencies. In the State of Israel in particular, substantial investment has been made throughout the years in preparing the population for one of the major threats to the civilian population--a rapidly deteriorating regional conflict that involves high-trajectory weapons (ie, rocket and missile fire) launched at the home front. The purpose of this study was to examine the current preparedness level of the Israeli public for this threat and determine the correlates of such preparedness with known factors. A telephone-based, random sampling of 503 households representative of the Israeli population was carried out during October 2013. The questionnaire examined the level of household preparedness as well as attitudes towards threat perception, responsibility, willingness to search for information, and sense of preparedness. Statistical analysis was performed to determine the level of preparedness in the general population and to find correlates to this preparedness in attitudes and demographic variables. More than half of the sample reported complying with 50% or fewer of the actions recommended by the Israeli Home Front Command. Having an increased sense of preparedness and willingness to search for related information were positively correlated with actual household preparedness, and the latter was also found to be the most predictive variable of household preparedness. Although the overall household preparedness reported is mediocre, the level of preparedness found in this study suggests better preparedness of the population in Israel for its primary threat. The findings suggest that in order to promote preparedness of the Israeli public for war, emphasis should be put on increasing the public demand for information and encouraging people to evaluate their sense of preparedness.

  5. Harmonisation of Nuclear Emergency Preparedness in Central and Eastern Europe

    International Nuclear Information System (INIS)

    Buglova, E.; Crick, M.; Reed, J.; Winkler, G. L.; Martincic, R.

    2000-01-01

    Under its Technical Co-operation programme the International Atomic Energy Agency has implementing a Regional Project RER/9/050:- Harmonisation of Regional Nuclear Emergency Preparedness for its Member States in the Europe region since 1997. The background of the project together with its achievements and future plans are presented in this paper. (author)

  6. Off-site preparedness and nuclear-power-plant licensing

    International Nuclear Information System (INIS)

    Perry, S.W.

    1983-01-01

    The first year and a half in which off-site emergency preparedness issues have been litigated before the Atomic Safety and Licensing Boards of the NRC have surfaced unique problems of proof for the applicant as well as the staff. These problems seem to be abating as the boards and the parties become more comfortable with the field and its issues, and as FEMA-NRC emergency management expertise gains credibility. Emergency preparedness presentations have also improved as the parties have become more sensitive to the seasonality of the preparedness case, and have increasingly attempted to raise it at a time when a fully developed set of facts is available for the record. Off-site preparedness issues are only now beginning to be raised on appeal to the NRC appeals board, the full commission, and the courts. Helpful guidance on what constitutes an adequate record in this area will undoubtedly be forthcoming in decisions handed down by these bodies in the months ahead

  7. Transportation of Hazardous Materials Emergency Preparedness Hazards Assessment

    International Nuclear Information System (INIS)

    Blanchard, A.

    2000-01-01

    This report documents the Emergency Preparedness Hazards Assessment (EPHA) for the Transportation of Hazardous Materials (THM) at the Department of Energy (DOE) Savannah River Site (SRS). This hazards assessment is intended to identify and analyze those transportation hazards significant enough to warrant consideration in the SRS Emergency Management Program

  8. Emergency planning and preparedness for a nuclear accident

    International Nuclear Information System (INIS)

    Rahe, E.P.

    1985-01-01

    Based on current regulations, FEMA approves each site-specific plan of state and local governments for each power reactor site after 1) formal review offsite preparedness, 2) holding a public meeting at which the preparedness status has been reviewed, and 3) a satisfactory joint exercise has been conducted with both utility and local participation. Annually, each state, within any position of the 10-mile emergency planning zone, must conduct a joint exercise with the utility to demonstrate its preparedness for a nuclear accident. While it is unlikely that these extreme measures will be needed as a result of an accident at a nuclear power station, the fact that these plans have been well thought out and implemented have already proven their benefit to society. The preparedness for a nuclear accident can be of great advantage in other types of emergencies. For example, on December 11, 1982, a non-nuclear chemical storage tank exploded at a Union Carbide plant in Louisiana shortly after midnight. More than 20,000 people were evacuated from their homes. They were evacuated under the emergency response plan formulated for use in the event of a nuclear accident at the nearby Waterford Nuclear plants. Clearly, this illustrates how a plan conceived for one purpose is appropriate to handle other types of accidents that occur in a modern industrial society

  9. Transportation radiological emergency preparedness: STAR 95 Exercise final report

    International Nuclear Information System (INIS)

    1998-01-01

    Emergency response for a transportation accident involving radiological materials, while not inherently difficult, presents a challenge for several reasons. These accidents, although they can occur anywhere, are rare. Also, although the health consequences are usually slight, accidents involving radioactive materials generally cause a great deal of concern, both for the emergency responders and the general public. How can communities be prepared for an event that requires some technical knowledge, but is so rare that it will never occur in most areas, without expending an effort disproportionate to the actual risk? How can one appropriately deal with an event that may cause excessive public concern? These questions are at the heart of the preparedness issues this program addressed. The overall goal of the Transportation Emergency Preparedness Program was to establish the framework for a coordinated response by all levels of government to a transportation accident involving radioactive material. The Program involved both preparedness activities and the development, conduct and evaluation of a field exercise in Saratoga County, New York. This Report concentrates on the functional activities, lessons learned, recommendations, and action plans for improving preparedness and response to a transportation accident involving radioactive materials

  10. A Study of Terrorism Emergency Preparedness Policies in School Districts

    Science.gov (United States)

    Umoh, Emmanuel

    2013-01-01

    The threat of terrorism is a concern in public facilities including schools. This study focused on school districts in a southwestern state. Terrorism emergency preparedness policies are well-documented as measures to protect students and staff in school districts from terrorism threats and vulnerabilities. However, those threats and…

  11. Assessing Student Teaching Experiences: Teacher Candidates' Perceptions of Preparedness

    Science.gov (United States)

    Lee, Joohi; Tice, Kathleen; Collins, Denise; Brown, Amber; Smith, Cleta; Fox, Jill

    2012-01-01

    The purpose of this study is to investigate the effectiveness of student teaching experiences by measuring teacher candidates' perceptions of their preparedness. The participants were 130 teacher candidates who had completed their student teaching as part of a program preparing them to teach children in pre-K through grade 4. Teacher candidates…

  12. The case of cholera preparedness, response and prevention in the ...

    African Journals Online (AJOL)

    In this paper the authors seek to identify the most appropriate model for a regional co-ordination mechanism for cholera preparedness, response and prevention. The qualitative mixed-method data collection approach that was followed revealed the need for alternative solutions, including a socio-political understanding of ...

  13. Municipalities' Preparedness for Weather Hazards and Response to Weather Warnings.

    Science.gov (United States)

    Mehiriz, Kaddour; Gosselin, Pierre

    2016-01-01

    The study of the management of weather-related disaster risks by municipalities has attracted little attention even though these organizations play a key role in protecting the population from extreme meteorological conditions. This article contributes to filling this gap with new evidence on the level and determinants of Quebec municipalities' preparedness for weather hazards and response to related weather warnings. Using survey data from municipal emergency management coordinators and secondary data on the financial and demographic characteristics of municipalities, the study shows that most Quebec municipalities are sufficiently prepared for weather hazards and undertake measures to protect the population when informed of imminent extreme weather events. Significant differences between municipalities were noted though. Specifically, the level of preparedness was positively correlated with the municipalities' capacity and population support for weather-related disaster management policies. In addition, the risk of weather-related disasters increases the preparedness level through its effect on population support. We also found that the response to weather warnings depended on the risk of weather-related disasters, the preparedness level and the quality of weather warnings. These results highlight areas for improvement in the context of increasing frequency and/or severity of such events with current climate change.

  14. Radiation Emergency Preparedness Tools: Virtual Community Reception Center

    Centers for Disease Control (CDC) Podcasts

    This podcast is an overview of resources from the Clinician Outreach and Communication Activity (COCA) Call: Practical Tools for Radiation Emergency Preparedness. A specialist working with CDC's Radiation Studies Branch describes a web-based training tool known as a Virtual Community Reception Center (vCRC).

  15. Perceived Academic Preparedness of First-Generation Latino College Students

    Science.gov (United States)

    Boden, Karen

    2011-01-01

    First-generation Latino college students may be characterized as underprepared for college. Research points to low performance on placement tests. However, students may not perceive themselves as academically underprepared for college. This study explored first-generation Latino students' perceptions of their academic preparedness. Seven students…

  16. Preparedness to Implement Wellness Strategies: Perceptions of School Counselors

    Science.gov (United States)

    Burnett, Tena

    2012-01-01

    The purpose of this study is to survey school counselors to determine their knowledge and perceived preparedness to implement wellness strategies in school counseling programs. Wellness plans are a requirement for thousands of public school districts in the United States. There are no established standards for the training of school counselors in…

  17. Working with neighborhood organizations to promote wildfire preparedness

    Science.gov (United States)

    Holly Johnson Shiralipour; Martha C. Monroe; Michelle Payton

    2006-01-01

    Several government agencies and other natural resource managers have instituted outreach programs to promote wildfire preparedness in wildland-urban interface (WUI) neighborhoods that complement community-wide efforts. To help these programs become more effective, research was undertaken to gain a better understanding of the role that neighbors and neighborhood...

  18. Hospital disaster emergency preparedness: A study of Onandjokwe ...

    African Journals Online (AJOL)

    This study explored disaster emergency preparedness at Onandjokwe Lutheran Hospital in Northern Namibia. It utilized quantitative and qualitative research methods, using a self-administered questionnaire, semi-structured key informant interviews, and a hospital disaster plan checklist. A stratified sample of 120 ...

  19. 48 CFR 5152.208-9001 - Industrial preparedness planning.

    Science.gov (United States)

    2010-10-01

    ... planning. 5152.208-9001 Section 5152.208-9001 Federal Acquisition Regulations System DEPARTMENT OF THE ARMY... planning. As prescribed at 5108-070(g)(4) insert the following clause in full text in contracts where the contractor is designated a Limited Fee Planned Producer. Industrial Preparedness Planning (XXX 1989) (DEV) (a...

  20. Nuclear threats and emergency preparedness in Finland; Ydinuhkat ja varautuminen

    Energy Technology Data Exchange (ETDEWEB)

    Mustonen, R; Aaltonen, H; Laaksonen, J; Lahtinen, J; Rantavaara, A; Reponen, H; Rytoemaa, T; Suomela, M; Toivonen, H; Varjoranta, T

    1995-10-01

    The political and economic upheavals which have taken place in Eastern Europe have had an impact on radiation and nuclear safety throughout Europe. Emergency preparedness systems for unexpected nuclear events have been developed further in all European countries, and prosperous western nations have invested in improving the safety of East European nuclear power plants. The economic crisis facing countries of the former Soviet Union has also promoted illicit trade in nuclear materials; this has made it necessary for various border guards and police authorities to intensify their collaboration and to tighten border controls. On 3-4 October 1995, Finnish Centre for Radiation and Nuclear Safety (STUK) arranged a seminar on nuclear threats and emergency preparedness in Finland. In addition to STUK experts, a wide range of rescue and civil defence authorities, environmental health specialists and other persons engaged in emergency preparedness attended the seminar. The publication contains a compilation of reports presented at the seminar. The reports cover a broad spectrum of nuclear threats analyzed at STUK, the impacts of radioactive fallout on human beings and on the environment, and preparedness systems by which the harmful effects of radiation or nuclear accidents can, if necessary, be minimized. (33 figs., 5 tabs.).

  1. Challenge of hospital emergency preparedness: analysis and recommendations.

    Science.gov (United States)

    Barbera, Joseph A; Yeatts, Dale J; Macintyre, Anthony G

    2009-06-01

    In the United States, recent large-scale emergencies and disasters display some element of organized medical emergency response, and hospitals have played prominent roles in many of these incidents. These and other well-publicized incidents have captured the attention of government authorities, regulators, and the public. Health care has assumed a more prominent role as an integral component of any community emergency response. This has resulted in increased funding for hospital preparedness, along with a plethora of new preparedness guidance.Methods to objectively measure the results of these initiatives are only now being developed. It is clear that hospital readiness remains uneven across the United States. Without significant disaster experience, many hospitals remain unprepared for natural disasters. They may be even less ready to accept and care for patient surge from chemical or biological attacks, conventional or nuclear explosive detonations, unusual natural disasters, or novel infectious disease outbreaks.This article explores potential reasons for inconsistent emergency preparedness across the hospital industry. It identifies and discusses potential motivational factors that encourage effective emergency management and the obstacles that may impede it. Strategies are proposed to promote consistent, reproducible, and objectively measured preparedness across the US health care industry. The article also identifies issues requiring research.

  2. Teacher Education Admission Criteria as Measure of Preparedness for Teaching

    Science.gov (United States)

    Casey, Catherine; Childs, Ruth

    2011-01-01

    This study investigated the relationship between commonly used admission criteria, found in a one-year, post Bachelor's degree, initial, teacher education program, and the preparedness of teacher candidates in mathematics for independent teaching. The admission criteria used in this study were grade point average (GPA) and a written profile. The…

  3. Nurse Educators' Preceptions of Preparedness to Guide Clinical Learning

    Science.gov (United States)

    Jenkins-Cameron, Stella L.

    2014-01-01

    The purpose of the study was to examine nurse educators' (NEs) perceptions of their level of preparedness to guide learning in clinical rotations of associate degree pre-licensure nursing programs of a South Atlantic state. The study also sought to determine the relationship between clinical experience, formal education, and teaching experience to…

  4. School Security and Crisis Preparedness: Make It Your Business.

    Science.gov (United States)

    Trump, Kenneth S.

    1999-01-01

    The top five security risks in today's schools include aggressive behavior, weapons possession or use, drug trafficking, gangs, and "stranger danger." Home-made bomb threats are common. This article also discusses security system costs, risk-reduction frameworks, security assessments, crisis-preparedness guidelines, and security-related…

  5. Transportation of Hazardous Materials Emergency Preparedness Hazards Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Blanchard, A.

    2000-02-28

    This report documents the Emergency Preparedness Hazards Assessment (EPHA) for the Transportation of Hazardous Materials (THM) at the Department of Energy (DOE) Savannah River Site (SRS). This hazards assessment is intended to identify and analyze those transportation hazards significant enough to warrant consideration in the SRS Emergency Management Program.

  6. Enhancing Global Health Security: US Africa Command's Disaster Preparedness Program.

    Science.gov (United States)

    Morton Hamer, Melinda J; Reed, Paul L; Greulich, Jane D; Beadling, Charles W

    2018-03-07

    US Africa Command's Disaster Preparedness Program (DPP), implemented by the Center for Disaster and Humanitarian Assistance Medicine, partnered with US Government agencies and international organizations to promote stability and security on the African continent by engaging with African Partner Nations' (PN) civil and military authorities to improve disaster management capabilities. From 2008 to 2015, DPP conducted disaster preparedness and response programming with 17 PNs. DPP held a series of engagements with each, including workshops, strategic planning, developing preparedness and response plans, tabletop exercises, and prioritizing disaster management capability gaps identified through the engagements. DPP partners collected data for each PN to further capacity building efforts. Thus far, 9 countries have completed military pandemic plans, 10 have developed national pandemic influenza plans, 9 have developed military support to civil authorities plans, and 11 have developed disaster management strategic work plans. There have been 20 national exercises conducted since 2009. DPP was cited as key in implementation of Ebola response plans in PNs, facilitated development of disaster management agencies in DPP PNs, and trained nearly 800 individuals. DPP enhanced PNs' ability to prepare and respond to crises, fostering relationships between international agencies, and improving civil-military coordination through both national and regional capacity building. (Disaster Med Public Health Preparedness. 2018;page 1 of 11).

  7. Characterization of emergency preparedness at DOE contractor facilities

    International Nuclear Information System (INIS)

    Gillings, J.C.; Murphy, B.L.; Corbit, C.D.

    1984-07-01

    A study of emergency preparedness capabilities at DOE facilities was initiated following the incident at the Three Mile Island (TMI) Nuclear Power Station. It was designed to parallel but expand on a study on emergency preparedness instrumentation that was conducted in 1970 by Pacific Northwest Laboratory. The 1970 survey findings led to the publication of four reports on performance criteria for radiological emergency instrumentation. Three of these reports - BNWL-1635 (Selby et al. 1972), BNWL-1742 (Anderson et al. 1974) and BNWL-1857 (Andersen et al. 1976) - addressed the criteria for emergency instrumentation at reactors, mixed oxide fuel fabrication plants, and fuel reprocessing plants, respectively. The fourth report, BNWL-1991 (Bramson et al. 1976), addressed evaluation testing and calibration methodology for these instruments. This report is presented in three parts. Part One is a review of the BNWL documents to determine whether they are applicable to state-of-the-art instrument capabilities. The Appendix to Part One provides a comparison between the instrument performance criteria established in BNWL-1991 to applicable American National Standards Institute (ANSI) standards for portable survey and contamination meters, installed radiation and area monitors, effluent monitors, calibration techniques, criticality detection systems, alarm systems, and direct reading dosimeters. Part Two compares the 1970 survey results with the 1980 survey results to identify trends in emergency preparedness. Part Three is a discussion of the results of the 1980 emergency preparedness survey and the supporting data for each of the 15 modules. 8 references

  8. Corruption in cyclone preparedness and relief efforts in coastal Bangladesh

    DEFF Research Database (Denmark)

    Mahmud, Tanvir; Prowse, Martin

    2012-01-01

    This article seeks to draw possible lessons for adaptation programmes in Bangladesh by examining whether cyclone preparedness and relief interventions are subject to corrupt practices. Based on a random sample survey of 278 households, three focus-group discussions and seven key-informant...

  9. Mathematical preparedness for tertiary mathematics – a need for ...

    African Journals Online (AJOL)

    Ongoing action research at the University of Pretoria investigates first-year students' preparedness for a study in calculus. In 2005 first-year engineering students completed a mathematics diagnostic survey at the beginning and end of the year. In this article the results of the 2005 survey are compared with the students' final ...

  10. 77 FR 32877 - National Hurricane Preparedness Week, 2012

    Science.gov (United States)

    2012-06-01

    ... and throughout the private and non-profit sectors to develop robust systems for disaster preparedness..., let us recommit to ensuring the safety of our loved ones and our communities, and to building a... government agencies, private organizations, schools, media, and residents in the coastal areas of our Nation...

  11. Inequities in resources and preparedness for surgical complications ...

    African Journals Online (AJOL)

    Health-worker training and health-system strengthening are considered important ... To determine preparedness for, and health-system constraints to, safe caesarean section in southern Gauteng hospitals. Methods. This was a ... delivery constraints included an unequal staff distribution between central hospitals and lower ...

  12. Non-structural Components influencing Hospital Disaster Preparedness in Malaysia

    Science.gov (United States)

    Samsuddin, N. M.; Takim, R.; Nawawi, A. H.; Rosman, M. R.; SyedAlwee, S. N. A.

    2018-04-01

    Hospital disaster preparedness refers to measures taken by the hospital’s stakeholders to prepare, reduce the effects of disaster and ensure effective coordination during incident response. Among the measures, non-structural components (i.e., medical laboratory equipment & supplies; architectural; critical lifeline; external; updated building document; and equipment & furnishing) are critical towards hospital disaster preparedness. Nevertheless, over the past few years these components are badly affected due to various types of disasters. Hence, the objective of this paper is to investigate the non-structural components influencing hospital’s disaster preparedness. Cross-sectional survey was conducted among thirty-one (31) Malaysian hospital’s employees. A total of 6 main constructs with 107 non-structural components were analysed and ranked by using SPSS and Relative Importance Index (RII). The results revealed that 6 main constructs (i.e. medical laboratory equipment & supplies; architectural; critical lifeline; external; updated building document; and equipment & furnishing) are rated as ‘very critical’ by the respondents. Among others, availability of medical laboratory equipment and supplies for diagnostic and equipment was ranked first. The results could serve as indicators for the public hospitals to improve its disaster preparedness in terms of planning, organising, knowledge training, equipment, exercising, evaluating and corrective actions through non-structural components.

  13. Strengthening Emergency Preparedness in Higher Education through Hazard Vulnerability Analysis

    Science.gov (United States)

    Fifolt, Matthew; Burrowes, Jeffrey; McPherson, Tarrant; McCormick, Lisa C.

    2016-01-01

    Experts have noted a great deal of variability among U.S. higher education institutions' planning and preparedness for emergency situations. However, resources are available to help campus leaders effectively mitigate, prepare for, respond to, and recover from a multitude of disaster scenarios. One way for emergency managers and campus leaders to…

  14. assessment of the birth and emergency preparedness level of ...

    African Journals Online (AJOL)

    honey

    2014-03-31

    Mar 31, 2014 ... the birth and emergency preparedness level of 250 pregnant women attending Antenatal Care (ANC) in a Primary. Health Care (PHC) ... obtained from the hypothesis method and based on the following assumption: 95% confidence level, prevalence .... order to reduce morbidity and mortality in pregnancy.

  15. Flood preparedness : thoughts, feelings and intentions of the Dutch public

    NARCIS (Netherlands)

    Terpstra, Teun

    2010-01-01

    Despite the high levels of flood protection in the Netherlands, absolute safety is not guaranteed. Preparing Dutch society for potential flood disasters, including the preparedness of individual citizens, is one of the great challenges in future flood risk management. This thesis is aimed at

  16. Hospital all-risk emergency preparedness in Ghana | Norman ...

    African Journals Online (AJOL)

    (2) The hospitals' respective abilities to handle large scale RTA's were ... The biggest challenge facing the hospitals in their emergency intervention is the lack of preemergency and emergency preparedness plans as well as the coordination of the hospitals response mechanisms. Conclusion: The paper ended with ...

  17. Transportation of hazardous materials emergency preparedness hazards assessment

    International Nuclear Information System (INIS)

    Blanchard, A.

    2000-01-01

    This report documents the Emergency Preparedness Hazards Assessment (EPHA) for the Transportation of Hazardous Materials (THM) at the Department of Energy (DOE) Savannah River Site (SRS). This hazards assessment is intended to identify and analyze those transportation hazards significant enough to warrant consideration in the SRS Emergency Management Program

  18. Further development of nuclear emergency preparedness in Norway

    International Nuclear Information System (INIS)

    Harbitz, O.

    1995-06-01

    The threatpattern regarding nuclear accidents is summarized and the development of the Norwegian emergency preparedness through the last 10 years is examined. Relevant countermeasures during the acute phase of an accident is described and the sharing of responsibilities between central, regional and local level is presented. Suggestions on education and training are given. 9 refs., 2 figs

  19. APPROACH TO ASSESSING THE PREPAREDNESS OF HOSPITALS TO POWER OUTAGES

    Directory of Open Access Journals (Sweden)

    Lenka BREHOVSKÁ

    2017-06-01

    Full Text Available Within the secondary impacts of electricity blackouts, it is necessary to pay attention to facilities providing medical care for the population, namely the hospitals. Hospitals represent a key position in the provision of health care also in times of crisis. These facilities must provide constant care; it is therefore essential that the preparedness of such facilities is kept at a high level. The basic aim of this article is to analyse the preparedness of hospitals to power outages (power failures, blackouts within a pilot study. On that basis, a SWOT analysis is used to determine strengths and weaknesses of the system of preparedness of hospitals to power outages and solutions for better security of hospitals are defined. The sample investigated consists of four hospitals founded by the Regional Authority (hospitals Nos. 1-4 and one hospital founded by the Ministry of Health of the Czech Republic (hospital No. 5. The results of the study shows that most weaknesses of the preparedness of hospitals are represented by inadequately addressed reserves of fuel for the main backup power supply, poor knowledge of employees who are insufficiently retrained, and old backup power supplies (even 35 years in some cases.

  20. Mass-Fatality Incident Preparedness Among Faith-Based Organizations.

    Science.gov (United States)

    Zhi, Qi; Merrill, Jacqueline A; Gershon, Robyn R

    2017-12-01

    Introduction Members of faith-based organizations (FBOs) are in a unique position to provide support and services to their local communities during disasters. Because of their close community ties and well-established trust, they can play an especially critical role in helping communities heal in the aftermath of a mass-fatality incident (MFI). Faith-based organizations are considered an important disaster resource and partner under the National Response Plan (NRP) and National Response Framework; however, their level of preparedness and response capabilities with respect to MFIs has never been evaluated. The purpose of this study was threefold: (1) to develop appropriate measures of preparedness for this sector; (2) to assess MFI preparedness among United States FBOs; and (3) to identify key factors associated with MFI preparedness. Problem New metrics for MFI preparedness, comprised of three domains (organizational capabilities, operational capabilities, and resource sharing partnerships), were developed and tested in a national convenience sample of FBO members. Data were collected using an online anonymous survey that was distributed through two major, national faith-based associations and social media during a 6-week period in 2014. Descriptive, bivariate, and correlational analyses were conducted. One hundred twenty-four respondents completed the online survey. More than one-half of the FBOs had responded to MFIs in the previous five years. Only 20% of respondents thought that roughly three-quarters of FBO clergy would be able to respond to MFIs, with or without hazardous contamination. A higher proportion (45%) thought that most FBO clergy would be willing to respond, but only 37% thought they would be willing if hazardous contamination was involved. Almost all respondents reported that their FBO was capable of providing emotional care and grief counseling in response to MFIs. Resource sharing partnerships were typically in place with other voluntary

  1. Emergency preparedness and internal contamination monitoring

    International Nuclear Information System (INIS)

    Rahola, T.; Suomela, M.

    2000-01-01

    After the radiation accidents in Chernobyl, Ukraina in 1986 and in Goiania, Brasil in 1987, much resource have been spent on improving emergency preparedness. Especially regarding transfer of information using the most recent techniques and establishment of 24 hour emergency service of radiation safety experts the development has been fast. The very first measures in a possible emergency situation have been trained nationally and internationally. Less attention has been paid to measures in a somewhat later phase. To be able to react fast enough in an emergency situation it is essential to have well documented plans, written instructions and suitable measurement equipment ready for use. Equally important is that there is trained staff prepared to do measurements without delay. In the first phase of a nuclear accident radioactive iodine is of primary concern regarding internal contamination. After the Chernobyl accident the number of childhood thyroidea cancer clearly exceeded the expected number. Reliable direct measurements of I-131 in the thyroidea in Ukraina, Russia and Belarussia were done only to a limited number of children. Many uncertainties are involved in the data used for dose estimation. Later the body burdens of radiocesium or other radionuclides might be of most importance. Normal whole-body counting instruments can be used if only small groups need to be measured. For large groups of people in an emergency situation faster methods are needed. Different types of monitors installed at places where radiation workers are controlled for internal contamination as well as gamma cameras at hospitals can be used. Rapid field measurements of the whole-body and especially of the thyroid can been done with less sophisticated instruments. In the acute phase of a nuclear accident such measurements should be done without delay. Instruments and staff trained to use them should be available and plans for which groups of people to measure prepared. The detection level

  2. Knowledge, awareness, and preparedness unlinked in layperson

    Science.gov (United States)

    Oki, S.; Nakayachi, K.

    2012-12-01

    take action for disaster prevention. Examinees are 200 high school and undergraduate students who do not major in Earth science. We first gave them information of basic knowledge such as tectonic backgrounds of Japan and the latest research outcomes such as long-term evaluation of large earthquake occurrence or the strong ground motion, and then asked what they felt. The results show that neither the basic knowledge nor the latest research outcomes motivate examinees to take action for the disaster prevention or even to give awareness. We then showed them the movies of the past earthquake disasters and some episodes who had lost their loved ones from the recent earthquakes, and asked the same question. As psychology implies, this information made examinees feel dread and they became aware of the risks lie ahead. But still, they did not mention what to do to prevent the tragedy. In the presentation, we would like to show the difficulty to make people take action to protect their lives from earthquake disasters. We also show peoples' preparedness/unpreparedness with the information released by a Japanese research group in the late January saying the possibility of metropolitan Tokyo earthquake being 70% in this coming 4-year.

  3. Healthcare logistics in disaster planning and emergency management: A perspective.

    Science.gov (United States)

    VanVactor, Jerry D

    2017-12-01

    This paper discusses the role of healthcare supply chain management in disaster mitigation and management. While there is an abundance of literature examining emergency management and disaster preparedness efforts across an array of industries, little information has been directed specifically toward the emergency interface, interoperability and unconventional relationships among civilian institutions and the US Department of Defense (US DoD) or supply chain operations involved therein. To address this imbalance, this paper provides US DoD healthcare supply chain managers with concepts related to communicating and planning more effectively. It is worth remembering, however, that all disasters are local - under the auspice of tiered response involving federal agencies, the principal responsibility for responding to domestic disasters and emergencies rests with the lowest level of government equipped and able to deal with the incident effectively. As such, the findings are equally applicable to institutions outside the military. It also bears repeating that every crisis is unique: there is no such thing as a uniform response for every incident. The role of the US DoD in emergency preparedness and disaster planning is changing and will continue to do so as the need for roles in support of a larger effort also continues to change.

  4. The effects of the April 2011 tornado outbreak on personal preparedness in Jefferson County, Alabama.

    Science.gov (United States)

    McCormick, Lisa C; Pevear, Jesse; Rucks, Andrew C; Ginter, Peter M

    2014-01-01

    The purpose of this study was to examine the effects of a tornado disaster on the personal preparedness of local residents to determine (1) to what extent the tornado outbreak experience had altered preparedness awareness, willingness to act, and levels of personal preparedness of residents as measured by possession of a preparedness kit; and (2) what effect this experience had on the variables associated with having a complete disaster preparedness kit. Two random digit-dialed surveys were completed following the Behavioral Risk Factor Surveillance System protocols. The pre-tornado survey was conducted between October and December 2010 and the post-tornado survey was conducted between January and March 2012. After the April 2011 tornado outbreak, 86.08% of the respondents (n = 1364) reported that they had thought more about personal or family preparedness and 59.65% (n = 907) reported that they had taken actions to increase their level of preparedness. Overall, general awareness of preparedness media campaigns increased significantly (almost 24%; P < .0001), as did the percentage of those having a complete disaster preparedness kit (a 66% increase, not quite doubled from 2010 to 2012; P < .0001). Findings of the study indicate that the disaster had a significant impact on the local residents' (1) awareness of preparedness campaigns, (2) awareness of the need to be prepared, (3) willingness to become better prepared, and (4) possession of a disaster and emergency preparedness kit and its associated items.

  5. Spinoffs from radiological emergency preparedness programmes to generic emergency management

    International Nuclear Information System (INIS)

    Sanders, M.E.

    1986-01-01

    In the USA, the radiological emergency preparedness (REP) programme for nuclear power plants is being used to enhance emergency management programmes for other types of emergencies. The REP programme is particularly useful in developing plans and preparedness measures for chemical accidents. The Integrated Emergency Management System (IEMS) approach provides a means for maximizing relationships between the REP programme and other programmes. IEMS essentially involves applying common elements of planning and preparedness to all types of emergencies, while recognizing that unique characteristics of specific natural and man-made emergencies require special planning and preparedness considerations. Features of the REP programme that make it compatible with the IEMS approach and useful in coping with other types of emergencies are: (1) the close co-operation between the national nuclear regulatory and emergency management organizations; (2) the programme integration among all levels of government, the nuclear power industry, public interest groups and the general public and (3) the comprehensiveness and sophistication of the programme. The REP programme in the USA represents a state-of-the-art emergency management capability. Some of its elements are readily transferrable to most other types of emergency preparedness programmes, while other elements can be adapted more readily to other hazard-specific programmes. The Bhopal accident has been a catalyst for this adaptation to chemical accidents, in such areas as furnishing hazard-specific information to the public, alert and notification systems, definition of the hazards and risks involved, establishing planning zones and developing close working relationships among the industry, the public and government

  6. Public health preparedness in Alberta: a systems-level study.

    Science.gov (United States)

    Moore, Douglas; Shiell, Alan; Noseworthy, Tom; Russell, Margaret; Predy, Gerald

    2006-12-28

    Recent international and national events have brought critical attention to the Canadian public health system and how prepared the system is to respond to various types of contemporary public health threats. This article describes the study design and methods being used to conduct a systems-level analysis of public health preparedness in the province of Alberta, Canada. The project is being funded under the Health Research Fund, Alberta Heritage Foundation for Medical Research. We use an embedded, multiple-case study design, integrating qualitative and quantitative methods to measure empirically the degree of inter-organizational coordination existing among public health agencies in Alberta, Canada. We situate our measures of inter-organizational network ties within a systems-level framework to assess the relative influence of inter-organizational ties, individual organizational attributes, and institutional environmental features on public health preparedness. The relative contribution of each component is examined for two potential public health threats: pandemic influenza and West Nile virus. The organizational dimensions of public health preparedness depend on a complex mix of individual organizational characteristics, inter-agency relationships, and institutional environmental factors. Our study is designed to discriminate among these different system components and assess the independent influence of each on the other, as well as the overall level of public health preparedness in Alberta. While all agree that competent organizations and functioning networks are important components of public health preparedness, this study is one of the first to use formal network analysis to study the role of inter-agency networks in the development of prepared public health systems.

  7. Mathematical assessment of Canada's pandemic influenza preparedness plan.

    Science.gov (United States)

    Gumel, Abba B; Nuño, Miriam; Chowell, Gerardo

    2008-03-01

    The presence of the highly pathogenic avian H5N1 virus in wild bird populations in several regions of the world, together with recurrent cases of H5N1 influenza arising primarily from direct contact with poultry, have highlighted the urgent need for prepared-ness and coordinated global strategies to effectively combat a potential influenza pandemic. The purpose of the present study was to evaluate the Canadian pandemic influenza preparedness plan. A mathematical model of the transmission dynamics of influenza was used to keep track of the population according to risk of infection (low or high) and infection status (susceptible, exposed or infectious). The model was parametrized using available Canadian demographic data. The model was then used to evaluate the key components outlined in the Canadian plan. The results indicated that the number of cases, mortalities and hospitalizations estimated in the Canadian plan may have been underestimated; the use of antivirals, administered therapeutically, prophylactically or both, is the most effective single intervention followed by the use of a vaccine and basic public health measures; and the combined use of pharmaceutical interventions (antivirals and vaccine) can dramatically minimize the burden of the pending influenza pandemic in Canada. Based on increasing concerns of Oseltamivir resistance (wide-scale implementation), coupled with the expected unavailability of a suitable vaccine during the early stages of a pandemic, the present study evaluated the potential impact of non-pharmaceutical interventions (NPIs) which were not emphasized in the current Canadian plan. To this end, the findings suggest that the use of NPIs can drastically reduce the burden of a pandemic in Canada. A deterministic model was designed and used to assess Canada's pandemic preparedness plan. The study showed that the estimates of pandemic influenza burden given in the Canada pandemic preparedness plan may be an underestimate, and that Canada

  8. Public health preparedness in Alberta: a systems-level study

    Directory of Open Access Journals (Sweden)

    Noseworthy Tom

    2006-12-01

    Full Text Available Abstract Background Recent international and national events have brought critical attention to the Canadian public health system and how prepared the system is to respond to various types of contemporary public health threats. This article describes the study design and methods being used to conduct a systems-level analysis of public health preparedness in the province of Alberta, Canada. The project is being funded under the Health Research Fund, Alberta Heritage Foundation for Medical Research. Methods/Design We use an embedded, multiple-case study design, integrating qualitative and quantitative methods to measure empirically the degree of inter-organizational coordination existing among public health agencies in Alberta, Canada. We situate our measures of inter-organizational network ties within a systems-level framework to assess the relative influence of inter-organizational ties, individual organizational attributes, and institutional environmental features on public health preparedness. The relative contribution of each component is examined for two potential public health threats: pandemic influenza and West Nile virus. Discussion The organizational dimensions of public health preparedness depend on a complex mix of individual organizational characteristics, inter-agency relationships, and institutional environmental factors. Our study is designed to discriminate among these different system components and assess the independent influence of each on the other, as well as the overall level of public health preparedness in Alberta. While all agree that competent organizations and functioning networks are important components of public health preparedness, this study is one of the first to use formal network analysis to study the role of inter-agency networks in the development of prepared public health systems.

  9. Revolving drug funds at front-line health facilities in Vientiane, Lao PDR.

    Science.gov (United States)

    Murakami, H; Phommasack, B; Oula, R; Sinxomphou, S

    2001-03-01

    Pharmaceutical cost recovery programmes, which have been mainly implemented in Africa, are gradually spreading to Southeast Asian countries that formerly belonged to the socialist bloc. This report describes the economic and operational realities of revolving drug funds (RDFs) at district hospitals and health centres in the capital of the Lao PDR by reviewing research conducted by the implementing department. People in the municipality spent an average of US$11 on drugs in 1996. The RDFs comprised only 3% of the total yearly drug sales in the municipality, whereas private pharmacies accounted for 75%. The RDFs were forced to operate in conjunction with the remaining government drug endowment and the thriving private pharmacies. This scheme has provided a stable supply of essential drugs. The assurance of drug availability at the front-line health facilities has resulted in increased utilization of the facilities despite the introduction of a drug fee. The cost recovery rate was 107% at health centres and 108% at district hospitals in two monitored districts during the 10 months from November 1997. Decentralized financial management was essential for cost recovery, allowing timely adjustment of selling prices as purchase prices rapidly inflated after the Asian economic crisis. The health staff observed that the people perceived drugs as everyday commodities that they should buy and take based on self-diagnosis and personal preference. Adaptation of the public health authorities to market-oriented thinking along with the establishment of pharmaceutical cost recovery occurred with few problems. However, both financial and operational management capacity at the municipal level pose a major challenge to policy clarification and scheme setting, especially in procurement, control of prescribing practices and the integration of drug dispensing with other components of quality clinical care.

  10. A Questionnaire Study on the Attitudes and Previous Experience of Croatian Family Physicians toward their Preparedness for Disaster Management.

    Science.gov (United States)

    Pekez-Pavliško, Tanja; Račić, Maja; Jurišić, Dinka

    2018-04-01

    To explore family physicians' attitudes, previous experience and self-assessed preparedness to respond or to assist in mass casualty incidents in Croatia. The cross-sectional survey was carried out during January 2017. Study participants were recruited through a Facebook group that brings together family physicians from Croatia. They were asked to complete the questionnaire, which was distributed via google.docs. Knowledge and attitudes toward disaster preparedness were evaluated by 18 questions. Analysis of variance, Student t test and Kruskal-Wallis test t were used for statistical analysis. Risk awareness of disasters was high among respondents (M = 4.89, SD=0.450). Only 16.4 of respondents have participated in the management of disaster at the scene. The majority (73.8%) of physicians have not been participating in any educational activity dealing with disaster over the past two years. Family physicians believed they are not well prepared to participate in national (M = 3.02, SD=0.856) and local community emergency response system for disaster (M = 3.16, SD=1.119). Male physicians scored higher preparedness to participate in national emergency response system for disaster ( p =0.012), to carry out accepted triage principles used in the disaster situation ( p =0.003) and recognize differences in health assessments indicating potential exposure to specific agents ( p =0,001) compared to their female colleagues. Croatian primary healthcare system attracts many young physicians, who can be an important part of disaster and emergency management. However, the lack of experience despite a high motivation indicates a need for inclusion of disaster medicine training during undergraduate studies and annual educational activities.

  11. [The historical background and present development of evidence-based healthcare and clinical nursing].

    Science.gov (United States)

    Tsai, Jung-Mei

    2014-12-01

    Evidence-based healthcare (EBHC) emphasizes the integration of the best research evidence with patient values, specialist suggestions, and clinical circumstances during the process of clinical decision-making. EBHC is a recognized core competency in modern healthcare. Nursing is a professional discipline of empirical science that thrives in an environment marked by advances in knowledge and technology in medicine as well as in nursing. Clinical nurses must elevate their skills and professional qualifications, provide efficient and quality health services, and promote their proficiency in EBHC. The Institute of Medicine in the United States indicates that evidence-based research results often fail to disseminate efficiently to clinical decision makers. This problem highlights the importance of better promoting the evidence-based healthcare fundamentals and competencies to frontline clinical nurses. This article describes the historical background and present development of evidence-based healthcare from the perspective of modern clinical nursing in light of the importance of evidence-based healthcare in clinical nursing; describes the factors associated with evidence-based healthcare promotion; and suggests strategies and policies that may improve the promotion and application of EBHC in clinical settings. The authors hope that this paper provides a reference for efforts to improve clinical nursing in the realms of EBHC training, promotion, and application.

  12. The Meta-Leadership Summit for Preparedness Initiative: An Innovative Model to Advance Public Health Preparedness and Response

    Science.gov (United States)

    Sobelson, Robyn K.; Young, Andrea C.; Marcus, Leonard J.; Dorn, Barry C.; Neslund, Verla S.; McNulty, Eric J.

    2017-01-01

    This article reports on the design, evaluation framework, and results from the Meta-Leadership Summit for Preparedness Initiative. The Meta-Leadership Summit for Preparedness was a 5-year initiative based on the premise that national preparedness and emergency response is not solely the responsibility of government. From 2006 to 2011, 36 Meta-Leadership Summits were delivered in communities across the country. Summits were customized, 10-hour leadership development, networking, and community action planning events. They included participation from targeted federal, state, local, nonprofit/philanthropic, and private sector leaders who are directly involved in decision making during a major community or state-wide emergency. A total of 4,971 government, nonprofit, and business leaders attended Meta-Leadership Summits; distribution of attendees by sector was balanced. Ninety-three percent of respondents reported the summit was a valuable use of time, 91% reported the overall quality as “good” or “outstanding,” and 91% would recommend the summit to their colleagues. In addition, approximately 6 months after attending a summit, 80% of respondents reported that they had used meta-leadership concepts or principles. Of these, 93% reported that using meta-leadership concepts or principles had made a positive difference for them and their organizations. The Meta-Leadership Summit for Preparedness Initiative was a value-added opportunity for communities, providing the venue for learning the concepts and practice of meta-leadership, multisector collaboration, and resource sharing with the intent of substantively improving preparedness, response, and recovery efforts. PMID:24251597

  13. Why healthcare providers merge.

    Science.gov (United States)

    Postma, Jeroen; Roos, Anne-Fleur

    2016-04-01

    In many OECD countries, healthcare sectors have become increasingly concentrated as a result of mergers. However, detailed empirical insight into why healthcare providers merge is lacking. Also, we know little about the influence of national healthcare policies on mergers. We fill this gap in the literature by conducting a survey study on mergers among 848 Dutch healthcare executives, of which 35% responded (resulting in a study sample of 239 executives). A total of 65% of the respondents was involved in at least one merger between 2005 and 2012. During this period, Dutch healthcare providers faced a number of policy changes, including increasing competition, more pressure from purchasers, growing financial risks, de-institutionalisation of long-term care and decentralisation of healthcare services to municipalities. Our empirical study shows that healthcare providers predominantly merge to improve the provision of healthcare services and to strengthen their market position. Also efficiency and financial reasons are important drivers of merger activity in healthcare. We find that motives for merger are related to changes in health policies, in particular to the increasing pressure from competitors, insurers and municipalities.

  14. Healthcare financing in Croatia

    Directory of Open Access Journals (Sweden)

    Nevenka Kovač

    2013-12-01

    Full Text Available Healthcare financing system is of crucial importance for the functioning of any healthcare system, especially because there is no country in the world that is able to provide all its residents with access to all the benefits afforded by modern medicine. Lack of resources in general and rising healthcare expenditures are considered a difficult issue to solve in Croatia as well. Since Croatia gained its independence, its healthcare system has undergone a number of reforms, the primary objective of which was to optimize healthcare services to the actual monetary capacity of the Croatian economy. The objectives of the mentioned re - forms were partially achieved. The solutions that have been offered until now, i.e. consolidation measures undertaken in the last 10 years were necessary; however, they have not improved the operating conditions. There is still the issue of the deficit from the previous years, i.e. outstanding payments, the largest in the last decade. Analysis of the performance of healthcare institutions in 2011 shows that the decision makers will have to take up a major challenge of finding a solution to the difficulties the Croatian healthcare system has been struggling with for decades, causing a debt of 7 billion kuna. At the same time, they will need to uphold the basic principles of the Healthcare Act, i.e. to provide access to healthcare and ensure its continuity, comprehensiveness and solidarity, keeping in mind that the National Budget Act and Fiscal Responsibility Act have been adopted.

  15. Rural Community Disaster Preparedness and Risk Perception in Trujillo, Peru.

    Science.gov (United States)

    Stewart, Matthew; Grahmann, Bridget; Fillmore, Ariel; Benson, L Scott

    2017-08-01

    Introduction Disasters will continue to occur throughout the world and it is the responsibility of the government, health care systems, and communities to adequately prepare for potential catastrophic scenarios. Unfortunately, low-and-middle-income countries (LMICs) are especially vulnerable following a disaster. By understanding disaster preparedness and risk perception, interventions can be developed to improve community preparedness and avoid unnecessary mortality and morbidity following a natural disaster. Problem The purpose of this study was to assess disaster preparedness and risk perception in communities surrounding Trujillo, Peru. After designing a novel disaster preparedness and risk perception survey based on guidelines from the International Federation of Red Cross and Red Crescent Societies (IFRC; Geneva, Switzerland), investigators performed a cross-sectional survey of potentially vulnerable communities surrounding Trujillo, Peru. Data were entered and analyzed utilizing the Research Electronic Data Capture (REDCap; Harvard Catalyst; Boston, Massachusetts USA) database. A total of 230 study participants were surveyed, composed of 37% males, 63% females, with ages ranging from 18-85 years old. Those surveyed who had previously experienced a disaster (41%) had a higher perception of future disaster occurrence and potential disaster impact on their community. Overall, the study participants consistently perceived that earthquakes and infection had the highest potential impact of all disasters. Twenty-six percent of participants had an emergency supply of food, 24% had an emergency water plan, 24% had a first aid kit at home, and only 20% of the study participants had an established family evacuation plan. Natural and man-made disasters will remain a threat to the safety and health of communities in all parts of the world, especially within vulnerable communities in LMICs; however, little research has been done to identify disaster perception

  16. Stormy Weather in Healthcare

    DEFF Research Database (Denmark)

    Clemensen, Jane; Jakobsen, Pernille Ravn; Myhre Jensen, Charlotte

    2017-01-01

    and healthcare professionals, by a dominant paradigm. We suggest a shift in focus from valuing the neo-liberal approach, to focus on care by linking an Ecology of Care (EoC) approach to the healthcare context, as EoC can be used as a complementary philosophy to help change the paradigm and thereby secure...

  17. Healthcare. State Report

    Science.gov (United States)

    Carnevale, Anthony P.; Smith, Nicole; Gulish, Artem; Beach, Bennett H.

    2012-01-01

    This report projects education requirements linked to forecasted job growth in healthcare by state and the District of Columbia from 2010 through 2020. It complements a larger national report which projects educational demand for healthcare for the same time period. The national report shows that with or without Obamacare, the United States will…

  18. A Two-Year Multidisciplinary Training Program for the Frontline Workforce in Community Treatment of Severe Mental Illness.

    Science.gov (United States)

    Ruud, Torleif; Flage, Karin Blix; Kolbjørnsrud, Ole-Bjørn; Haugen, Gunnar Brox; Sørlie, Tore

    2016-01-01

    Since 1999, a national two-year multidisciplinary onsite training program has been in operation in Norway. The program trains frontline workforce personnel who provide community treatment to people with severe mental illness. A national network of mental health workers, consumers, caregivers, and others providing or supporting psychosocial treatment and rehabilitation for people with severe mental illness has organized local onsite part-time training programs in collaboration with community mental health centers (CMHCs), municipalities, and primary care providers. CMHC and primary care staff are trained together to increase collaboration. Nationwide dissemination has continued, with new local programs established every year. Evaluations have shown that the program is successful.

  19. Migrants' access to healthcare

    DEFF Research Database (Denmark)

    Norredam, Marie

    2011-01-01

    There are strong pragmatic and moral reasons for receiving societies to address access to healthcare for migrants. Receiving societies have a pragmatic interest in sustaining migrants' health to facilitate integration; they also have a moral obligation to ensure migrants' access to healthcare...... according to international human rights principles. The intention of this thesis is to increase the understanding of migrants' access to healthcare by exploring two study aims: 1) Are there differences in migrants' access to healthcare compared to that of non-migrants? (substudy I and II); and 2) Why...... are there possible differences in migrants' access to healthcare compared to that of non-migrants? (substudy III and IV). The thesis builds on different methodological approaches using both register-based retrospective cohort design, cross-sectional design and survey methods. Two different measures of access were...

  20. Importance ranking of various aspects of offsite radiological emergency preparedness

    International Nuclear Information System (INIS)

    Hockert, J.W.; Carter, T.F.

    1987-01-01

    Under contract to the Edison Electric Institute, IEAL developed a method to assess the relative importance of various aspects of offsite radiological emergency preparedness. The basic approach involved structuring the 35 objectives that the Federal Emergency Management Agency expects offsite emergency planners to demonstrate during nuclear power plant emergency preparedness exercises into a hierarchy based upon the emergency response capabilities they support. The analytical hierarchy process (AHP) was employed to derive the quantitative relative importance of each of the 35 objectives based upon its contribution to the overall capability of offsite agencies to assist in protecting public health and safety in the event of an emergency at a nuclear power plant. The judgments of a cross-section of state and local emergency planners, federal regulators, and intervenors were solicited to rank the 35 objectives

  1. IAEA New recommendations in the area of emergency preparedness

    International Nuclear Information System (INIS)

    Maresova, B.; Koc, J.; Burianova, J.

    2014-01-01

    The poster is based on the latest recommendations of the IAEA safety standards relating to a response to an occurrence of radiation emergency situations. One analyzes how to implement the reference levels of the general criteria in the current practice providing an emergency preparedness in the Czech Republic. However, as the general criteria are represented by dose values, it is proposed to introduce the predetermined operational intervention levels (OILs). The operational intervention levels expressed in directly measurable dosimetric parameters along with the values of emergency action levels (EALs) represent a new direction in the area of emergency preparedness which streamlines a choice of suitable protective actions in the event of radiological accident. The poster also presents the draft how to apply the general system for an assessment of radiological health risks based on the block schemes connecting directly measured dosimetric values with the corresponding radiation health risks. (authors)

  2. Application of Fuzzy Theory to Radiological Emergency Preparedness

    International Nuclear Information System (INIS)

    Han, Moon Hee; Jeong, Hyo Joon; Kim, Eun Han; Suh, Kyung Suk; Hwang, Won Tae

    2005-01-01

    Emergency preparedness for nuclear facility is considered as an important part for public health and safety. In an emergency, it is not easy to get the information which is needed for the operation of an emergency system. Even though the lack of the information, decision-maker should make an early decision for the public. And the real situation is often not crisp and deterministic. The concept of fuzzy set provides the mathematical formulations which can characterize the uncertain variables in the models related to radiological emergency preparedness. And it provides a method which can describe the characteristics of uncertain variables represented by the fuzzy membership functions, and the effects of distribution can be handled with the fuzzy relation and the fuzzy reasoning. By the application of linguistic variables and fuzzy algorithms, it is possible to provide an approximate and effective tool to describe the system which is too complex or ill defined to use precise mathematical analysis

  3. Do anticipatory grief and preparedness affect distress in bereaved caregivers?

    DEFF Research Database (Denmark)

    Nielsen, Mette Kjærgaard

    Objective Family caregivers of terminally ill patients are in a vulnerable position, and previous studies show that bereaved caregivers are at risk of psychological distress. Pre-loss grief symptoms seem to predict post-loss psychological distress, while preparedness for a looming loss tends...... to decrease distress. The aim of this nation-wide study was to investigate the association of both anticipatory grief symptoms and preparedness with psychological distress in bereaved family caregivers. Methods A list of all adult patients in Denmark receiving drug reimbursement for terminal illness...... was retrieved from the Danish Health and Medicines Authority on a weekly basis during 2012. All newly registered patients were requested by letter to pass on an enclosed baseline questionnaire to their closest relative. Responding caregivers bereaved within six months received a follow-up questionnaire six...

  4. Assessing the Performance Management of National Preparedness - A Conceptual Model

    Science.gov (United States)

    2015-12-01

    biased outcomes with “ambiguous and uncertain preparedness goals, a lack of agreement about what the measures should aim at and how they should be...there may also be undue influence, either intentionally or subconsciously , on how the data is presented. These influences are caused by the...ensure that data are free of systematic error or bias , and that what is intended to be measured is actually measured.”349 This step is critical to

  5. Emergency preparedness and response in transport of radioactive material

    International Nuclear Information System (INIS)

    Takani, Michio

    2008-01-01

    Nuclear power has been providing clean, affordable electricity in many parts of the world for nearly half a century. The national and international transport of nuclear fuel cycle materials is essential to support this activity. To sustain the nuclear power industry, fuel cycle materials have to be transported safely and efficiently. The nature of the industry is such that most countries with large-scale nuclear power industries cannot provide all the necessary fuel services themselves and consequently nuclear fuel cycle transport activities are international. The radioactive material transport industry has an outstanding safety record spanning over 45 years; however the transport of radioactive materials cannot and most not be taken for granted. Efficient emergency preparedness and response in the transport of radioactive material is an important element to ensure the maximum safety in accident conditions. The World Nuclear Transport Institute (WNTI), founded by International Nuclear Services (INS) of the United Kingdom, AREVA of France an the Federation of Electric Power Companies (FEPC) of Japan, represents the collective interest of the radioactive material transport sector, and those who rely on safe, effective and reliable transport. As part of its activities, WNTI has conducted two surveys through its members on emergency preparedness and response in the transport of radioactive material and emergency exercises. After recalling the International Atomic Energy Agency approach on emergency response, this paper will be discussing the main conclusion of surveys, in particular the national variations in emergency response and preparedness on the national and local levels of regulations, the emergency preparedness in place, the emergency response organisation (who and how), communication and exercises. (author)

  6. State-level emergency preparedness and response capabilities.

    Science.gov (United States)

    Watkins, Sharon M; Perrotta, Dennis M; Stanbury, Martha; Heumann, Michael; Anderson, Henry; Simms, Erin; Huang, Monica

    2011-03-01

    Prior assessments of public health readiness had identified gaps in radiation preparedness. In recent years, preparedness planning has involved an "all-hazards" approach. Current assessment of the national status related to radiation public health emergency preparedness capabilities at the state and local health department levels was needed. A survey of state health departments related to radiation readiness was undertaken in 2010 by the Council of State and Territorial Epidemiologists (CSTE). States with nuclear power plants were instructed to consider their responses exclusive of capabilities and resources related to the plants given that the emergency response plans for nuclear power plants are specific and unique. Thirty-eight (76%) state health departments responded to the survey, including 26 of the 31 states with nuclear power plants. Specific strengths noted at the state level included that the majority of states had a written radiation response plan and most plans include a detailed section for communications issues during a radiation emergency. In addition, more than half of the states indicated that their relationship with federal partners is sufficient to provide resources for radiation emergencies, indicating the importance states placed on federal resources and expertise. Specific weaknesses are discussed and include that most states had completed little to no planning for public health surveillance to assess potential human health impacts of a radiation event; less than half had written plans to address exposure assessment, environmental sampling, human specimen collection and analysis, and human health assessment. Few reported having sufficient resources to do public health surveillance, radiation exposure assessment, laboratory functions and other capabilities. Levels of planning, resources and partnerships varied among states, those with nuclear power plants were better prepared. Gaps were evident in all states; however and additional training and

  7. Emergency Preparedness for Disasters and Crises in the Hotel Industry

    OpenAIRE

    Ahmad Rasmi AlBattat; Ahmad Puad Mat Som

    2013-01-01

    Safety and security are the most important issues to tourist while traveling and the first aspect they consider is to be protected from hazards. Emergency planning and preparedness for a crisis are the most significant components of dealing with disasters. Hospitality practitioners noticed a rising number of natural and man-made crises that harm the hospitality industry, regarding its vulnerability to crisis and intern...

  8. Guidelines to improve airport preparedness against chemical and biological terrorism.

    Energy Technology Data Exchange (ETDEWEB)

    Edwards, Donna M.; Price, Phillip N. (Lawrence Berkeley National Laboratory, Berkeley, CA); Gordon, Susanna P.; Gadgil, Ashok (Lawrence Berkeley National Laboratory, Berkeley, CA)

    2005-05-01

    Guidelines to Improve Airport Preparedness Against Chemical and Biological Terrorism is a 100-page document that makes concrete recommendations on improving security and assessing vulnerable areas and helps its readers understand the nature of chemical and biological attacks. The report has been turned over to Airports Council International (ACI) and the American Association of Airport Executives (AAAE), two organizations that together represent the interests of thousands of airport personnel and facilities in the U.S. and around the world.

  9. Implementation Aspects of Flood Warning and Preparedness Planning Alternatives

    Science.gov (United States)

    1981-08-01

    preparedness planning, establish- ment of la -d use controls and expanded use of other techniques.? In 1974, Congress mandated the full consideration...construction in progressj or wear and tear that has not yet been repaired. It is also familia -r law that property owners are liable for injury to persons...1971. U.S. Department of Defense, Office of Civil Defense. In Time of Emergency, A Citizen’s Handbook on Nuclear Attack, Natural Disasters. March 1968

  10. Radiological emergency preparedness arrangements in the European Commission

    International Nuclear Information System (INIS)

    Tanner, V.

    2002-01-01

    The purpose of this paper is to give an overview of the different procedures established within the European Commission, which are relevant to radiological emergency planning and response. Although emergency preparedness is a national responsibility within the European Union, the Commission has clearly defined operational tasks in terms of emergency information exchange and community foodstuff regulations. In addition the Commission promotes research programmes and training courses in the field

  11. Integration of multi-technology on oil spill emergency preparedness.

    Science.gov (United States)

    Liao, Zhenliang; Hannam, Phillip M; Xia, Xiaowei; Zhao, Tingting

    2012-10-01

    This paper focuses on the integration of technologies including Case-Based Reasoning (CBR), Genetic Algorithm (GA) and Artificial Neural Network (ANN) for establishing emergency preparedness for oil spill accidents. In CBR, the Frame method is used to define case representation, and the HEOM (Heterogeneous Euclidean-Overlap Metric) is improved to define the similarity of case properties. In GA, we introduce an Improved Genetic Algorithm (IGA) that achieves case adaptation, in which technologies include the Multi-Parameter Cascade Code method, the Small Section method for generation of an initial population, the Multi-Factor Integrated Fitness Function, and Niche technology for genetic operations including selection, crossover, and mutation. In ANN, a modified back-propagation algorithm is employed to train the algorithm to quickly improve system preparedness. Through the analysis of 32 fabricated oil spill cases, an oil spill emergency preparedness system based on the integration of CBR, GA and ANN is introduced. In particular, the development of ANN is presented and analyzed. The paper also discusses the efficacy of our integration approach. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. Task Force on oil spill preparedness: Offshore implementation progress

    International Nuclear Information System (INIS)

    Devenis, P.K.

    1992-01-01

    Industry members of the Canadian Petroleum Association (CPA) and the Independent Petroleum Association of Canada (IPAC) undertook a review of oil spill preparedness and response capabilities in 1989. The resulting report summarized the current state of readiness, focusing on oil spills resulting from exploration and production activities in Canada. The report recommended expenditures in research and development, equipment acquisition, and training to prevent and control offshore and onshore oil spills more effectively. The release of an implementation plan for the Task Force on Oil Spill Preparedness (TFOSP) in 1990 provided the impetus for a 5-year plan to improve this state of preparedness. The plan outlined the mechanisms for implementing the 45 recommendations developed by TFOSP. It also recommended how to incorporate them into the daily business activities of the CPA member companies. It identified the appropriate groups within industry to carry out the implementation of each recommendation. It also indicated the government interfaces, the implementation schedule, and cost estimates for putting each recommendation into place. It also recommended a vigorous monitoring program to follow and report on the status of implementation. Based on the TFOSP implementation plan recommendations, work plans were developed, specific work projects identified, and a budget approved for 1991 programs. The first year of implementation of recommendations is now complete and work plans have been developed for continuation in 1992. 2 refs

  13. Public health and terrorism preparedness: cross-border issues.

    Science.gov (United States)

    Olson, Debra; Leitheiser, Aggie; Atchison, Christopher; Larson, Susan; Homzik, Cassandra

    2005-01-01

    On December 15, 2003, the Centers for Public Health Preparedness at the University of Minnesota and the University of Iowa convened the "Public Health and Terrorism Preparedness: Cross-Border Issues Roundtable." The purpose of the roundtable was to gather public health professionals and government agency representatives at the state, provincial, and local levels to identify unmet cross-border emergency preparedness and response needs and develop strategies for addressing these needs. Representatives from six state and local public health departments and three provincial governments were invited to identify cross-border needs and issues using a nominal group process. The result of the roundtable was identification of the needs considered most important and most doable across all the focus groups. The need to collaborate on and exchange plans and protocols among agencies was identified as most important and most doable across all groups. Development of contact protocols and creation and maintenance of a contact database was also considered important and doable for a majority of groups. Other needs ranked important across the majority of groups included specific isolation and quarantine protocols for multi-state responses; a system for rapid and secure exchange of information; specific protocols for sharing human resources across borders, including emergency credentials for physicians and health care workers; and a specific protocol to coordinate Strategic National Stockpile mechanisms across border communities.

  14. The MARS simulation of the nuclear weapons preparedness LOTTA scenario

    International Nuclear Information System (INIS)

    Tovedal, H.

    2001-03-01

    The simulation method MARS, Mathematical Radiac Simulation, is primarily intended for preparedness exercises in nuclear fallout areas and simulates the ionizing radiation dose rates from fission products deposited on the ground, i.e. fallout from a nuclear weapons explosion or from a release of radioactive material from a nuclear reactor. MARS gives at any time after the fictitious explosion or reactor release the dose rates at any position in the fallout area. MARS has been used for simulation of an exercise scenario called LOTTA, designed for training and test of a radiac preparedness group in the Dept. of Nuclear Protection at FOI. The group is a member of a national preparedness organisation under the Swedish Radiation Protection Institute, SSI. This MARS application was a simulation of the entire course of events following a fictitious nuclear weapons explosion, including the fission product deposition process and the ultimate activity and dose rate distribution in the fallout area. The simulation was based on deposition and fallout prognoses worked out by FOI, using the prognosis model PELLO. This report presents a short description of the simulation of the LOTTA scenario. A more detailed presentation of the general MARS method can be found in the report 'Mathematical Radiac Simulation, MARS'

  15. Preparedness for remote possibility of a nuclear emergency

    International Nuclear Information System (INIS)

    Fujishiro, Toshio

    2001-01-01

    Nuclear disaster prevention is fundamentally preparedness for emergency with extremely lower forming probability. In order to establish allowance of nuclear energy application from society, it is essential that it brings relief feelings with preparedness and without anxiety among everything. At a time when use of nuclear energy was begun, a consciousness that a nuclear facility was one highly considered on its safety faster than that in the other industries was large and intense, and then recognition of necessity for nuclear disaster prevention was extremely minute. However, the nuclear emergency of critical accident at the JCO fuel processing facility in Tokai-mura formed on September 30, 1999 gave Japanese extremely large impact so as fundamentally to change actual feelings against conventional nuclear disaster prevention. Here was introduced on efforts onto reinforcement of nuclear disaster prevention together with establishment of the special measure rule nuclear disaster prevention countermeasure as well as its advantages and progress, to investigate on a subject to do it for a preparedness with effectiveness for obtaining real safe feelings. (G.K.)

  16. Preparedness for emerging infectious diseases: pathways from anticipation to action.

    Science.gov (United States)

    Brookes, V J; Hernández-Jover, M; Black, P F; Ward, M P

    2015-07-01

    Emerging and re-emerging infectious disease (EID) events can have devastating human, animal and environmental health impacts. The emergence of EIDs has been associated with interconnected economic, social and environmental changes. Understanding these changes is crucial for EID preparedness and subsequent prevention and control of EID events. The aim of this review is to describe tools currently available for identification, prioritization and investigation of EIDs impacting human and animal health, and how these might be integrated into a systematic approach for directing EID preparedness. Environmental scanning, foresight programmes, horizon scanning and surveillance are used to collect and assess information for rapidly responding to EIDs and to anticipate drivers of emergence for mitigating future EID impacts. Prioritization of EIDs - using transparent and repeatable methods - based on disease impacts and the importance of those impacts to decision-makers can then be used for more efficient resource allocation for prevention and control. Risk assessment and simulation modelling methods assess the likelihood of EIDs occurring, define impact and identify mitigation strategies. Each of these tools has a role to play individually; however, we propose integration of these tools into a framework that enhances the development of tactical and strategic plans for emerging risk preparedness.

  17. Fire preparedness measures in buildings with hot laboratories

    International Nuclear Information System (INIS)

    Oberlaender, B.C.

    2003-01-01

    Important hot laboratory safety issues are the general design/construction of the building with respect to fire, fire prevention, fire protection, administrative controls, and risk assessment. Within the network of the European Working Group Hot Laboratories and Remote Handling items concerning 'fire preparedness measures in hot laboratories' were screened and studied. Two questionnaires were sent to European hot laboratories; the first in November 2002 on 'fire preparedness measures, fire detection and fire suppression/extinguishing in lead shielded cells, concrete shielded cells' and the second in June 2003 on 'Fire preparedness measures in buildings with hot laboratories'. The questionnaires were filled in by a total of ten hot laboratories in seven European countries. On request of participants the answers were evaluated and 'anonymised' for presentation and discussion at the plenary meeting. The answers showed that many European hot laboratories are implementing improvements to their fire protection programmes to comply with more stringent requirements of the national authorities. The recommendations ('International guidelines for the fire protection of Nuclear Power Plants') given by the insurance pools are followed up with national variations. An ISO standard (ISO 17873) is in progress giving criteria for the design and the operation of ventilation systems as well as fire hazard management in nuclear installations others than reactors

  18. Integrating authorities and disciplines into the preparedness-planning process: a study of mental health, public health, and emergency management.

    Science.gov (United States)

    Robertson, Madeline; Pfefferbaum, Betty; Codispoti, Catherine R; Montgomery, Juliann M

    2007-01-01

    The process of integrating all necessary authorities and disciplines into an organized preparedness plan is complex, and the inclusion of disaster mental health poses specific challenges. The goals of this project were (1) to identify whether state mental health preparedness was included in state public health and emergency management preparedness plans, (2) to document barriers to entry and strategies reportedly used by state authorities in efforts to incorporate reasonable mental health preparedness into existing public health and emergency management preparedness planning, (3) to employ a theory for organizational change to organize and synthesize this information, and (4) to stimulate further discussion and research supporting coordinated preparedness efforts at the state level, particularly those inclusive of mental health. To accomplish these goals we (1) counted the number of state public health preparedness and emergency management plans that either included, mentioned, or omitted a mental health preparedness plan; (2) interviewed key officials from nine representative states for their reports on strategies used in seeking greater inclusion of mental health preparedness in public health and emergency management preparedness planning; and (3) synthesized these results to contribute to the national dialogue on coordinating disaster preparedness, particularly with respect to mental health preparedness. We found that 15 out of 29 publicly available public health preparedness plans (52 percent) included mental health preparedness, and eight of 43 publicly available emergency management plans (18 percent) incorporated mental health. Interviewees reported numerous barriers and strategies, which we cataloged according to a well-accepted eight-step plan for transforming organizations.

  19. Theory-based approaches to understanding public emergency preparedness: implications for effective health and risk communication.

    Science.gov (United States)

    Paek, Hye-Jin; Hilyard, Karen; Freimuth, Vicki; Barge, J Kevin; Mindlin, Michele

    2010-06-01

    Recent natural and human-caused disasters have awakened public health officials to the importance of emergency preparedness. Guided by health behavior and media effects theories, the analysis of a statewide survey in Georgia reveals that self-efficacy, subjective norm, and emergency news exposure are positively associated with the respondents' possession of emergency items and their stages of emergency preparedness. Practical implications suggest less focus on demographics as the sole predictor of emergency preparedness and more comprehensive measures of preparedness, including both a person's cognitive stage of preparedness and checklists of emergency items on hand. We highlight the utility of theory-based approaches for understanding and predicting public emergency preparedness as a way to enable more effective health and risk communication.

  20. Terrorism and emergency preparedness in state and territorial public health departments--United States, 2004.

    Science.gov (United States)

    2005-05-13

    After the events of September 11, 2001, federal funding for state public health preparedness programs increased from $67 million in fiscal year (FY) 2001 to approximately $1 billion in FY 2002. These funds were intended to support preparedness for and response to terrorism, infectious disease outbreaks, and other public health threats and emergencies. The Council of State and Territorial Epidemiologists (CSTE) assessed the impact of funding on epidemiologic capacity, including terrorism preparedness and response, in state health departments in November 2001 and again in May 2004, after distribution of an additional $1 billion in FY 2003. This report describes the results of those assessments, which indicated that increased funding for terrorism preparedness and emergency response has rapidly increased the number of epidemiologists and increased capacity for preparedness at the state level. However, despite the increase in epidemiologists, state public health officials estimate that 192 additional epidemiologists, an increase of 45.3%, are needed nationwide to fully staff terrorism preparedness programs.

  1. Preparedness for eHealth: Health Sciences Students’ Knowledge, Skills, and Confidence

    Directory of Open Access Journals (Sweden)

    Mary Lam

    2016-07-01

    Full Text Available There is increasing recognition of the role eHealth will play in the effective and efficient delivery of healthcare. This research challenges the assumption that students enter university as digital natives, able to confidently and competently adapt their use of information and communication technology (ICT to new contexts. This study explored health sciences students’ preparedness for working, and leading change, in eHealth-enabled environments. Using a cross-sectional study design, 420 undergraduate and postgraduate students participated in an online survey investigating their understanding of and attitude towards eHealth, frequency of online activities and software usage, confidence learning and using ICTs, and perceived learning needs. Although students reported that they regularly engaged with a wide range of online activities and software and were confident learning new ICT skills especially where they have sufficient time or support, their understanding of eHealth was uncertain or limited. Poor understanding of and difficulty translating skills learned in personal contexts to the professional context may impair graduates ability to con-fidently engage in the eHealth-enabled workplace. These results suggest educators need to scaffold the learning experience to ensure students build on their ICT knowledge to transfer this to their future workplaces.

  2. Extending injury prevention methodology to chemical terrorism preparedness: the Haddon Matrix and sarin.

    Science.gov (United States)

    Varney, Shawn; Hirshon, Jon Mark; Dischinger, Patricia; Mackenzie, Colin

    2006-01-01

    The Haddon Matrix offers a classic epidemiological model for studying injury prevention. This methodology places the public health concepts of agent, host, and environment within the three sequential phases of an injury-producing incident-pre-event, event, and postevent. This study uses this methodology to illustrate how it could be applied in systematically preparing for a mass casualty disaster such as an unconventional sarin attack in a major urban setting. Nineteen city, state, federal, and military agencies responded to the Haddon Matrix chemical terrorism preparedness exercise and offered feedback in the data review session. Four injury prevention strategies (education, engineering, enforcement, and economics) were applied to the individual factors and event phases of the Haddon Matrix. The majority of factors identified in all phases were modifiable, primarily through educational interventions focused on individual healthcare providers and first responders. The Haddon Matrix provides a viable means of studying an unconventional problem, allowing for the identification of modifiable factors to decrease the type and severity of injuries following a mass casualty disaster such as a sarin release. This strategy could be successfully incorporated into disaster planning for other weapons attacks that could potentially cause mass casualties.

  3. Strategies for healthcare information systems

    NARCIS (Netherlands)

    Stegwee, R.A.; Spil, Antonius A.M.

    2001-01-01

    Information technologies of the past two decades have created significant fundamental changes in the delivery of healthcare services by healthcare provider organizations. Many healthcare organizations have been in search of ways and strategies to keep up with continuously emerging information

  4. Recommended Vaccines for Healthcare Workers

    Science.gov (United States)

    ... Vaccination Resources for Healthcare Professionals Recommended Vaccines for Healthcare Workers Recommend on Facebook Tweet Share Compartir On ... for More Information Resources for Those Vaccinating HCWs Healthcare workers (HCWs) are at risk for exposure to ...

  5. Nurses' perceptions of mental healthcare in primary-care settings in Kenya.

    Science.gov (United States)

    Mendenhall, Emily; Isaiah, Gitonga; Nelson, Bernadette; Musau, Abednego; Koon, Adam D; Smith, Lahra; Mutiso, Victoria; Ndetei, David

    2018-04-01

    Kenya maintains an extraordinary treatment gap for mental health services because the need for and availability of mental health services are extraordinarily misaligned. One way to narrow the treatment gap is task-sharing, where specialists rationally distribute tasks across the health system, with many responsibilities falling upon frontline health workers, including nurses. Yet, little is known about how nurses perceive task-sharing mental health services. This article investigates nurses' perceptions of mental healthcare delivery within primary-care settings in Kenya. We conducted a cross-sectional study of 60 nurses from a public urban (n = 20), private urban (n = 20), and public rural (n = 20) hospitals. Nurses participated in a one-hour interview about their perceptions of mental healthcare delivery. Nurses viewed mental health services as a priority and believed integrating it into a basic package of primary care would protect it from competing health priorities, financial barriers, stigma, and social problems. Many nurses believed that integrating mental healthcare into primary care was acceptable and feasible, but low levels of knowledge of healthcare providers, especially in rural areas, and few specialists, would be barriers. These data underscore the need for task-sharing mental health services into existing primary healthcare in Kenya.

  6. Preparation, conduct and evaluation of exercises to test preparedness for a nuclear or radiological emergency. Emergency preparedness and response

    International Nuclear Information System (INIS)

    2005-04-01

    The aim of this publication is to serve as a practical tool for the preparation, conduct and evaluation of exercises to test preparedness for response to a nuclear or radiological emergency. It fulfils in part the functions assigned to the IAEA under Article 5.a(ii) of the Convention on Assistance in Case of a Nuclear Accident or Radiological Emergency (Assistance Convention), namely, to collect and disseminate to States Parties and Member States information concerning the methodologies, techniques and available results of research on such emergencies. To ensure effective response to radiation emergencies when needed, provisions should be made for regular training of emergency response personnel. As stated in Preparedness and Response for a Nuclear or Radiological Emergency (Safety Requirements, Safety Standard Series No. GS-R-2), 'The operator and the response organizations shall make arrangements for the selection of personnel and training to ensure that the personnel have the requisite knowledge, skills, abilities, equipment, procedures and other arrangements to perform their assigned response functions'. A further requirement is that 'Exercise programmes shall be conducted to ensure that all specified functions required to be performed for emergency response and all organizational interfaces for facilities in threat category I, II or III and the national level programmes for threat category IV or V are tested at suitable intervals'. In 2004 the IAEA General Conference, in resolution GC(48)/RES/10 encouraged Member States to 'implement the Safety Requirements for Preparedness and Response to a Nuclear or Radiological Emergency'. This document is published as part of the IAEA Emergency Preparedness and Response Series to assist in meeting these requirements and to fulfil Article 5 of the Assistance Convention. It was developed based on a number of assumptions about national and local capabilities. Therefore, the exercise structure, terms and scenarios must be

  7. What is Going to Move the Needle on Citizen Preparedness? Can America Create a Culture of Preparedness?

    Science.gov (United States)

    2008-03-01

    their findings applied to citizen preparedness. Messaging, sociology, psychology, marketing principles , and public health expertise in behavior...use of marketing principles and techniques to influence a target audience to voluntarily accept, reject, modify, or abandon a behavior for the...benefit of individuals, groups, or society as a whole. (Philip Kotler , Ned Roberto, Nancy Lee, 2002) Social marketing is “…A process for influencing human

  8. Innovative Strategies for Building Community Resilience: Lessons from the Frontlines of Climate Change Capacity-Building

    Science.gov (United States)

    Abrash Walton, A.

    2017-12-01

    There is broad scientific consensus that climate change is occurring; however, there is limited implementation of measures to create resilient local communities (Abrash Walton, Simpson, Rhoades, & Daniels, 2016; Adger, Arnell, & Tompkins, 2005; Glavovic & Smith, 2014; Moser & Ekstrom, 2010; Picketts, Déry, & Curry, 2014). Communities that are considered climate leaders in the United States may have adopted climate change plans, yet few have actually implemented the policies, projects and recommendations in those plans. A range of innovative, education strategies have proven effective in building the capacity of local decision makers to strengthen community resilience. This presentation draws on the results of two years of original research regarding the information and support local decision makers require for effective action. Findings are based on information from four datasets, with more than 600 respondents from 48 U.S. states and 19 other countries working on local adaptation in a range of capacities. These research results can inform priority setting for public policy, budget setting, and action as well as private sector funding and investment. The presentation will focus, in particular, on methods and results of a pioneering Facilitated Community of Practice model (FCoP) for building climate preparedness and community resilience capacity, among local-level decision makers. The FCoP process includes group formation and shared capacity building experience. The process can also support collective objective setting and creation of structures and processes for ongoing sustainable collaboration. Results from two FCoPs - one fully online and the other hybrid - suggest that participants viewed the interpersonal and technical assistance elements of the FCoP as highly valuable. These findings suggest that there is an important need for facilitated networking and other relational aspects of building capacity among those advancing resilience at the local level.

  9. Standardization of GIS datasets for emergency preparedness of NPPs

    International Nuclear Information System (INIS)

    Saindane, Shashank S.; Suri, M.M.K.; Otari, Anil; Pradeepkumar, K.S.

    2012-01-01

    Probability of a major nuclear accident which can lead to large scale release of radioactivity into environment is extremely small by the incorporation of safety systems and defence-in-depth philosophy. Nevertheless emergency preparedness for implementation of counter measures to reduce the consequences are required for all major nuclear facilities. Iodine prophylaxis, Sheltering, evacuation etc. are protective measures to be implemented for members of public in the unlikely event of any significant releases from nuclear facilities. Bhabha Atomic Research Centre has developed a GIS supported Nuclear Emergency Preparedness Program. Preparedness for Response to Nuclear emergencies needs geographical details of the affected locations specially Nuclear Power Plant Sites and nearby public domain. Geographical information system data sets which the planners are looking for will have appropriate details in order to take decision and mobilize the resources in time and follow the Standard Operating Procedures. Maps are 2-dimensional representations of our real world and GIS makes it possible to manipulate large amounts of geo-spatially referenced data and convert it into information. This has become an integral part of the nuclear emergency preparedness and response planning. This GIS datasets consisting of layers such as village settlements, roads, hospitals, police stations, shelters etc. is standardized and effectively used during the emergency. The paper focuses on the need of standardization of GIS datasets which in turn can be used as a tool to display and evaluate the impact of standoff distances and selected zones in community planning. It will also highlight the database specifications which will help in fast processing of data and analysis to derive useful and helpful information. GIS has the capability to store, manipulate, analyze and display the large amount of required spatial and tabular data. This study intends to carry out a proper response and preparedness

  10. The process of learning from emergency preparedness cooperation in international schools

    OpenAIRE

    Pham, Hanh

    2014-01-01

    Master's thesis in Risk management and societal safety The cooperation between schools and organizations can encourage schools to learn about safety procedures and preparation for emergencies to improve the school emergency preparedness. In the international schools in Stavanger, learning from emergency preparedness cooperation can be optimized when knowledge creation contributes to improve the school capability and update or change the school emergency preparedness activities. However, de...

  11. A survey of front-line paramedics examining the professional relationship between paramedics and physician medical oversight.

    Science.gov (United States)

    Foerster, Christopher R; Tavares, Walter; Virkkunen, Ilkka; Kämäräinen, Antti

    2018-03-01

    Paramedicine is often dependent on physician medical directors and their associated programs for direction and oversight. A positive relationship between paramedics and their oversight physicians promotes safety and quality care while a strained or ineffective one may threaten these goals. The objective of this study was to explore and understand the professional relationship between paramedics and physician medical oversight as viewed by front-line paramedics. All active front-line paramedics from four municipal paramedic services involving three medical oversight groups in Ontario were invited to complete an online survey. Five hundred and four paramedics were invited to participate in the study, with 242 completing the survey (48% response rate); 66% male, 76% primary care paramedics with an average of 13 (SD=9) years of experience. Paramedics had neutral or positive perceptions regarding their autonomy, opportunities to interact with their medical director, and medical director understanding of the prehospital setting. Paramedics perceived medical directives as rigid and ambiguous. A significant amount of respondents reported a perception of having provided suboptimal patient care due to fear of legal or disciplinary consequences. Issues of a lack of support for critical thinking and a lack of trust between paramedics and medical oversight groups were often raised. Paramedic perceptions of physician medical oversight were mixed. Concerning areas identified were perceptions of ambiguous written directives and concerns related to the level of trust and support for critical thinking. These perceptions may have implications for the system of care and should be explored further.

  12. Molecular diagnosis of Legionella infections--Clinical utility of front-line screening as part of a pneumonia diagnostic algorithm.

    Science.gov (United States)

    Gadsby, Naomi J; Helgason, Kristjan O; Dickson, Elizabeth M; Mills, Jonathan M; Lindsay, Diane S J; Edwards, Giles F; Hanson, Mary F; Templeton, Kate E

    2016-02-01

    Urinary antigen testing for Legionella pneumophila serogroup 1 is the leading rapid diagnostic test for Legionnaires' Disease (LD); however other Legionella species and serogroups can also cause LD. The aim was to determine the utility of front-line L. pneumophila and Legionella species PCR in a severe respiratory infection algorithm. L. pneumophila and Legionella species duplex real-time PCR was carried out on 1944 specimens from hospitalised patients over a 4 year period in Edinburgh, UK. L. pneumophila was detected by PCR in 49 (2.7%) specimens from 36 patients. During a LD outbreak, combined L. pneumophila respiratory PCR and urinary antigen testing had optimal sensitivity and specificity (92.6% and 98.3% respectively) for the detection of confirmed cases. Legionella species was detected by PCR in 16 (0.9%) specimens from 10 patients. The 5 confirmed and 1 probable cases of Legionella longbeachae LD were both PCR and antibody positive. Front-line L. pneumophila and Legionella species PCR is a valuable addition to urinary antigen testing as part of a well-defined algorithm. Cases of LD due to L. longbeachae might be considered laboratory-confirmed when there is a positive Legionella species PCR result and detection of L. longbeachae specific antibody response. Copyright © 2015 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  13. Five-year outcomes for frontline brentuximab vedotin with CHP for CD30-expressing peripheral T-cell lymphomas.

    Science.gov (United States)

    Fanale, Michelle A; Horwitz, Steven M; Forero-Torres, Andres; Bartlett, Nancy L; Advani, Ranjana H; Pro, Barbara; Chen, Robert W; Davies, Andrew; Illidge, Tim; Uttarwar, Mayur; Lee, Shih-Yuan; Ren, Hong; Kennedy, Dana A; Shustov, Andrei R

    2018-05-10

    This phase 1 study evaluated frontline brentuximab vedotin in combination with cyclophosphamide, doxorubicin, and prednisone (BV+CHP; 6 cycles, then up to 10 cycles of brentuximab vedotin monotherapy) in 26 patients with CD30 + peripheral T-cell lymphoma, including 19 with systemic anaplastic large cell lymphoma. All patients (100%) achieved an objective response, with a complete remission (CR) rate of 92%; none received a consolidative stem cell transplant. After a median observation period of 59.6 months (range, 4.6-66.0) from first dose, neither the median progression-free survival (PFS) nor the median overall survival (OS) was reached. No progression or death was observed beyond 35 months. The estimated 5-year PFS and OS rates were 52% and 80%, respectively. Eighteen of 19 patients (95%) with treatment-emergent peripheral neuropathy (PN) reported resolution or improvement of symptoms. Thirteen patients (50%) remained in remission at the end of the study, with PFS ranging from 37.8+ to 66.0+ months. Eight of these 13 patients received the maximum 16 cycles of study treatment. These final results demonstrate durable remissions in 50% of patients treated with frontline BV+CHP, suggesting a potentially curative treatment option for some patients. This trial was registered at www.clinicaltrials.gov as #NCT01309789. © 2018 by The American Society of Hematology.

  14. Turnover among healthcare professionals.

    Science.gov (United States)

    Wood, Ben D

    2009-01-01

    Turnover among healthcare professionals is a costly consequence. The existing body of knowledge on healthcare professional turnover is correlated with job satisfaction levels. A landmark study differentiated 2 areas of job satisfaction categories: satisfiers and dissatisfiers (intrinsic and extrinsic motivators). The aim of this article is to examine existing research on precursors of turnover, such as burnout behaviors experienced by healthcare professionals, job satisfaction levels, employee organizational commitment, health complications which precede turnover, some current strategies to reduce turnover, and some effects CEO turnover has on employee turnover intentions.

  15. 'Your health our concern, our health whose concern?': perceptions of injustice in organizational relationships and processes and frontline health worker motivation in Ghana.

    Science.gov (United States)

    Aberese-Ako, Matilda; van Dijk, Han; Gerrits, Trudie; Arhinful, Daniel Kojo; Agyepong, Irene Akua

    2014-09-01

    Taking a perspective of frontline health workers as internal clients within health systems, this study explored how perceived injustice in policy and organizational matters influence frontline health worker motivation and the consequent effect on workers' attitudes and performance in delivering maternal and neonatal health care in public hospitals. It consisted of an ethnographic study in two public hospitals in Southern Ghana. Participant observation, conversation and in-depth interviews were conducted over a 16-month period. Ethical approval and consent were obtained from relevant persons and authorities. Qualitative analysis software Nvivo 8 was used for coding and analysis of data. Main themes identified in the analysis form the basis for interpreting and reporting study findings. Findings showed that most workers perceived injustice in distributive, procedural and interactional dimensions at various levels in the health system. At the national policy level this included poor conditions of service. At the hospital level, it included perceived inequity in distribution of incentives, lack of protection and respect for workers. These influenced frontline worker motivation negatively and sometimes led to poor response to client needs. However, intrinsically motivated workers overcame these challenges and responded positively to clients' health care needs. It is important to recognize and conceptualize frontline workers in health systems as internal clients of the facilities and organizations within which they work. Their quality needs must be adequately met if they are to be highly motivated and supported to provide quality and responsive care to their clients. Meeting these quality needs of internal clients and creating a sense of fairness in governance arrangements between frontline workers, facilities and health system managers is crucial. Consequently, intervention measures such as creating more open door policies, involving frontline workers in decision making

  16. ‘Your health our concern, our health whose concern?’: perceptions of injustice in organizational relationships and processes and frontline health worker motivation in Ghana

    Science.gov (United States)

    van Dijk, Han; Gerrits, Trudie; Arhinful, Daniel Kojo; Agyepong, Irene Akua

    2014-01-01

    Taking a perspective of frontline health workers as internal clients within health systems, this study explored how perceived injustice in policy and organizational matters influence frontline health worker motivation and the consequent effect on workers’ attitudes and performance in delivering maternal and neonatal health care in public hospitals. It consisted of an ethnographic study in two public hospitals in Southern Ghana. Participant observation, conversation and in-depth interviews were conducted over a 16-month period. Ethical approval and consent were obtained from relevant persons and authorities. Qualitative analysis software Nvivo 8 was used for coding and analysis of data. Main themes identified in the analysis form the basis for interpreting and reporting study findings. Findings showed that most workers perceived injustice in distributive, procedural and interactional dimensions at various levels in the health system. At the national policy level this included poor conditions of service. At the hospital level, it included perceived inequity in distribution of incentives, lack of protection and respect for workers. These influenced frontline worker motivation negatively and sometimes led to poor response to client needs. However, intrinsically motivated workers overcame these challenges and responded positively to clients’ health care needs. It is important to recognize and conceptualize frontline workers in health systems as internal clients of the facilities and organizations within which they work. Their quality needs must be adequately met if they are to be highly motivated and supported to provide quality and responsive care to their clients. Meeting these quality needs of internal clients and creating a sense of fairness in governance arrangements between frontline workers, facilities and health system managers is crucial. Consequently, intervention measures such as creating more open door policies, involving frontline workers in decision

  17. Some issues on nuclear and radiological emergency preparedness and response in China

    International Nuclear Information System (INIS)

    Pan Ziqiang

    1999-01-01

    The nuclear emergency preparedness and response have comprehensively been developed over ten years in China. In order to promote the sound development of emergency preparedness and response, it is useful to retrospect the process of emergency preparedness and response, to summarize the experiences and absorb the experiences from foreign countries. The main issues are as follows: 1) The preparedness and response to nuclear and radiological accident is basically the same as the response to any accident involving hazardous material. 2) The classification of emergency planning, not only for nuclear facilities, but also irradiation installation, etc. 3) The hazard assessment-- a top priority. 4) The emergency planning zones. 5) Psychological impact

  18. U.S. Strategy for Bioterrorism Emergency Medical Preparedness and Response

    National Research Council Canada - National Science Library

    Lugo, Angel

    2003-01-01

    ... diseases and mass casualty dangers. The 2002 National Strategy for Homeland Security includes numerous emergency preparedness and response initiatives as part of the overall homeland security strategy...

  19. Healthcare Associated Infections - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Healthcare-Associated Infections (HAI) measures - national data. These measures are developed by Centers for Disease Control and Prevention (CDC) and collected...

  20. Healthcare Associated Infections - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Healthcare-Associated Infection (HAI) measures - provider data. These measures are developed by Centers for Disease Control and Prevention (CDC) and collected...

  1. Healthcare Associated Infections - State

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Healthcare-Associated Infections (HAI) measures - state data. These measures are developed by Centers for Disease Control and Prevention (CDC) and collected...

  2. Healthcare leadership's diversity paradox.

    Science.gov (United States)

    Silver, Reginald

    2017-02-06

    Purpose The purpose of this research study was to obtain healthcare executives' perspectives on diversity in executive healthcare leadership. The study focused on identifying perspectives about diversity and its potential impact on the access of healthcare services by people of color. The study also identified perspectives about factors that influence the attainment of executive healthcare roles by people of color. Design/methodology/approach A convenience sample of healthcare executives was obtained. The executives identified themselves as belonging to one of two subgroups, White healthcare executives or executives of color. Participants were interviewed telephonically in a semi-structured format. The interviews were transcribed and entered into a qualitative software application. The data were codified and important themes were identified. Findings The majority of the study participants perceive that diversity of the executive healthcare leadership team is important. There were differences in perspective among the subgroups as it relates to solutions to improve access to healthcare by people of color. There were also differences in perspective among the subgroups, as it relates to explaining the underrepresentation of people of color in executive healthcare leadership roles. Research limitations/implications This research effort benefited from the subject matter expertise of 24 healthcare executives from two states. Expansion of the number of survey participants and broadening the geographical spread of where participants were located may have yielded more convergence and/or more divergence in perspectives about key topics. Practical implications The findings from this research study serve to add to the existing body of literature on diversity in executive healthcare leadership. The findings expand on the importance of key elements in contemporary literature such as diversity, cultural competency and perspectives about the need for representation of people of

  3. Jeopardizing quality at the frontline of healthcare: prevalence and risk factors for disrespect and abuse during facility-based childbirth in Ethiopia

    Science.gov (United States)

    Karim, Ali M; Ratcliffe, Hannah L; Betemariam, Wuleta; Langer, Ana

    2018-01-01

    Abstract Disrespect and abuse (D&A) experienced by women during facility-based childbirth has gained global recognition as a threat to eliminating preventable maternal mortality and morbidity. This study explored the frequency and associated factors of D&A in four rural health centres in Ethiopia. Experiences of women who delivered in these facilities were captured by direct observation of client-provider interaction (N = 193) and exit interview at time of discharge (N = 204). Incidence of D&A was observed in each facility, with failure to ask woman for preferred birth position most commonly observed [n = 162, 83.9%, 95% confidence interval (95% CI) 78.0–88.5%]. During exit interviews, 21.1% (n = 43, 95% CI 15.4–26.7%) of respondents reported at least one occurrence of D&A. Bivariate models using client characteristics and index birth experience showed that women’s reporting of D&A was significantly associated with childbirth complications [odds ratio (OR) = 7.98, 95% CI 3.70, 17.22], weekend delivery (OR = 0.17, 95% CI 0.05, 0.63) and no previous delivery at the facility (OR = 3.20, 95% CI 1.27, 8.05). Facility-level fixed-effect models found that experience of complications (OR = 15.51, 95% CI 4.38, 54.94) and weekend delivery (OR = 0.05, 95% CI 0.01–0.32) remained significantly and most strongly associated with self-reported D&A. These data suggest that addressing D&A in health centres in Ethiopia will require a sustained effort to improve infrastructure, support the health workforce in rural settings, enforce professional standards and target interventions to improve women’s experiences as part of quality of care initiatives. PMID:29309598

  4. Physicians' accounts of frontline tensions when implementing pilot projects to improve primary care.

    Science.gov (United States)

    Mansfield, Elizabeth; Bhattacharyya, Onil; Christian, Jennifer; Naglie, Gary; Steriopoulos, Vicky; Webster, Fiona

    2018-03-19

    Purpose Canada's primary care system has been described as "a culture of pilot projects" with little evidence of converting successful initiatives into funded, permanent programs or sharing project outcomes and insights across jurisdictions. Health services pilot projects are advocated as an effective strategy for identifying promising models of care and building integrated care partnerships in local settings. In the qualitative study reported here, the purpose of this paper is to investigate the strengths and challenges of this approach. Design/methodology/approach Semi-structured interviews were conducted with 34 primary care physicians who discussed their experiences as pilot project leads. Following thematic analysis methods, broad system issues were captured as well as individual project information. Findings While participants often portrayed themselves as advocates for vulnerable patients, mobilizing healthcare organizations and providers to support new models of care was discussed as challenging. Competition between local healthcare providers and initiatives could impact pilot project success. Participants also reported tensions between their clinical, project management and research roles with additional time demands and skill requirements interfering with the work of implementing and evaluating service innovations. Originality/value Study findings highlight the complexity of pilot project implementation, which encompasses physician commitment to addressing care for vulnerable populations through to the need for additional skill set requirements and the impact of local project environments. The current pilot project approach could be strengthened by including more multidisciplinary collaboration and providing infrastructure supports to enhance the design, implementation and evaluation of health services improvement initiatives.

  5. Emergency preparedness to nuclear accidents in the Czech Republic

    International Nuclear Information System (INIS)

    Starostova, V.; Prouza, Z.; Koldus, F.; Rutova, H.

    2003-01-01

    Full text: Emergency preparedness to nuclear accidents (radiation emergency preparedness) is a part of general emergency preparedness and crisis management in the Czech Republic. The bases for it were given in 1997 when radiation emergency preparedness was defined and requirements to it were given in Act No. 18/1997 Coll., so called the Atomic Act, which entered into force in July 1997. In 2000, the bases for general emergency preparedness and crisis management in the Czech Republic were given namely in two acts - in Act No. 239/2000 Coll., an integrated rescue system, and in Act No. 240/2000 Coll., on crisis management. Both these acts entered into force on 1 January 2001. The Atomic Act determines duties of licensees in the field of preparedness. One of them is obligation to prepare and submit to SUJB the on-site emergency plan as one of attachments to his application for the licence. (The licence can be issued if defined documents, including this plan, are approved.) The licensee is obliged, under conditions given in detail in one of implementing regulation, to prepare a proposal of the emergency planning zone and submit it to SUJB. In the Act, there are also given the requirements for licensee's actions in case of a radiation emergency occurrence. On the other hand the Atomic Act names what are SUJB competencies and also what are these ones from the point of view of radiation emergency. Among others SUJB establishes the emergency planning zone, controls the activity of the National Radiation Monitoring Network, provides for the activities of an Emergency Response Centre and ensures the availability of background information necessary to take decisions aimed at reducing or averting exposure in the case of a radiation accident. SUJB has its own crisis staff; it has 4 shifts, which change regularly weekly. About 50 SUJB employees divided into 12 different functions are members of this staff. The Emergency Response Centre (ERC) of SUJB organizes work of this staff

  6. Time motion study using mixed methods to assess service delivery by frontline health workers from South India: methods.

    Science.gov (United States)

    Singh, Samiksha; Upadhyaya, Sanjeev; Deshmukh, Pradeep; Dongre, Amol; Dwivedi, Neha; Dey, Deepak; Kumar, Vijay

    2018-04-02

    In India, amidst the increasing number of health programmes, there are concerns about the performance of frontline health workers (FLHW). We assessed the time utilisation and factors affecting the work of frontline health workers from South India. This is a mixed methods study using time and motion (TAM) direct observations and qualitative enquiry among frontline/community health workers. These included 43 female and 6 male multipurpose health workers (namely, auxiliary nurse midwives (ANMs) and male-MPHWs), 12 nutrition and health workers (Anganwadi workers, AWWs) and 53 incentive-based community health workers (accredited social health activists, ASHAs). We conducted the study in two phases. In the formative phase, we conducted an in-depth inductive investigation to develop observation checklists and qualitative tools. The main study involved deductive approach for TAM observations. This enabled us to observe a larger sample to capture variations across non-tribal and tribal regions and different health cadres. For the main study, we developed GPRS-enabled android-based application to precisely record time, multi-tasking and field movement. We conducted non-participatory direct observations (home to home) for consecutively 6 days for each participant. We conducted in-depth interviews with all the participants and 33 of their supervisors and relevant officials. We conducted six focus group discussions (FGDs) with ASHAs and one FGD with ANMs to validate preliminary findings. We established a mechanism for quality assurance of data collection and analysis. We analysed the data separately for each cadre and stratified for non-tribal and tribal regions. On any working day, the ANMs spent median 7:04 h, male-MPHWs spent median 5:44 h and AWWs spent median 6:50 h on the job. The time spent on the job was less among the FLHWs from tribal areas as compared to those from non-tribal areas. ANMs and AWWs prioritised maternal and child health, while male-MPHWs were

  7. Emergency preparedness for nuclear power plants in the USA

    International Nuclear Information System (INIS)

    Schwartz, S.A.

    1986-01-01

    In the case of an operating reactor, if it is determined that there are such deficiencies that a favourable NRC finding is not warranted and if the deficiencies are not corrected within four months of that determination, the Commission will determine whether the reactor should be shut down or whether some other enforcement action is appropriate. In any case, where the Commission believes that the public health, safety, or interest so requires, the plant will be required to shut down immediately. Emergency planning considerations must be extended to emergency planning zones, and these shall consist of an area of about 10 miles in radius for exposure to the radioactive plume that might result from an accident in a nuclear power reactor and an area of about 50 miles in radius for food that might become contaminated. To evaluate the effectiveness of the licensee programme to implement their emergency plan, a 'management oversight and risk tree' (MORT) approach was developed and used by NRC appraisal teams at all operating facilities and those close to licensing. Since April 1981, over 250 emergency preparedness exercises have been observed and annual inspections conducted at US commercial nuclear power generating facilities. As a result of this experience, licensees have generally progressed from a basic ability to implement their plan to a systematic demonstration of their emergency preparedness capabilities. Almost five years have elapsed since the inception of the upgraded emergency preparedness regulatory programme, and the NRC is evaluating the resources committed to the programme to determine if modifications are appropriate. Our goal is to ensure continued adequate readiness capability to protect the public health and safety in the event of an accident

  8. Feasibility study for a computerized emergency preparedness simulation facility

    International Nuclear Information System (INIS)

    Gerhardstein, L.H.; Schroeder, J.O.; Sandusky, W.F.

    1979-11-01

    This report details the feasibility of a computerized Emergency Preparedness Simulation Facility (EPSF) for use by the Nuclear Regulatory Commission (NRC). The proposed facility would be designed to provide the NRC and other federal, state, and local government agencies with a capability to formulate, test, and evaluate the Emergency Preparedness Plans (EPP) which local and state agencies have/will establish for use during nuclear emergencies. In cases of any state emergency (including a nuclear emergency), high level state government officials will direct emergency procedures and insure that state and local emergency teams carry out tasks which have been established in their EPP. When an emergency exists, rapid mobilization of emergency teams, efficient communication, and effective coordination of individual team efforts is essential to safety, preservation of property, and overall public welfare. Current EPP evaluation procedures are qualitative in nature and while they do compare emergency drill performance with the EPP, the nature of the drills often does not provide enough realism to actual emergency conditions. Automated simulation of real emergency conditions using modern computer equipment and programming techniques will provide the NRC emergency evaluation teams a simulated environment which closely approximates conditions which would actually exist during a real emergency. In addition, the computer can be used to collect and log performance and event data which will aid the evaluation team in making assessments of the state or local area's EPP and their Emergency Preparedness Teams performance during emergency drills. Overall, a computerized EPSF can improve drill testing and evaluation efficiency, provide approximate emergency condition realism, and improve public awareness of local emergency procedures

  9. Radiation emergency medical preparedness and assistance network in China

    International Nuclear Information System (INIS)

    Su, Xu

    2008-01-01

    Full text: Rapid economic growth in demand has given rise to power shortage in China. The installed capacity of nuclear power has been scheduled to reach 36-40 GW in preliminary plans, which is about 4% of China's energy supply by 2020. On the other hand, the number of radiation facilities rises 7% annually, while this figure for medical accelerators and CT is 15%. With the application of radiation sources increasing, the possibility of accidents exposure is growing. The radiation emergency medical preparedness is increasingly practically challenging. CCMRRE (Chinese Center for Medical Response to Radiation Emergency), which functions as a national and professional institute with departments for clinic, monitoring and evaluating and technical supporting, was established in 1992. Clinic departments of haematological and surgical centres, and specialists in the radiation diagnosis and therapy, is responsible for the medical assistance in radiation accidents. The monitoring and evaluating department with bio-dosimetry, physical dosimetry and radiation monitoring laboratory, concentrates in radiation monitoring, dose estimating of accident exposure. Technical support department with advisors and experts in exposure dose estimating, radiation protecting and injury treating, provides technical instruction in case of nuclear and radiological accidents. In addition, around whole country, local organization providing first assistance, regional clinic treatment and radiation protection in nuclear accidents has been established. To strengthen the capability of radiation emergency medical response and to improve the cooperation with local organization, the managers and involved staffs were trained in skill frequently. The medical preparedness exercise, which mimics the nuclear accidents condition, was organized by CCMRRE and performed in 2007. The performances demonstrated that the radiation emergency medical preparedness and assistance system is prompt, functional and

  10. Mass-casualty events at schools: a national preparedness survey.

    Science.gov (United States)

    Graham, James; Shirm, Steve; Liggin, Rebecca; Aitken, Mary E; Dick, Rhonda

    2006-01-01

    Recent school shootings and terrorist events have demonstrated the need for well-coordinated planning for school-based mass-casualty events. The objective of this study was to document the preparedness of public schools in the United States for the prevention of and the response to a mass-casualty event. A survey was mailed to 3670 school superintendents of public school districts that were chosen at random from a list of school districts from the National Center for Education Statistics of the US Department of Education in January 2004. A second mailing was sent to nonresponders in May 2004. Descriptive statistics were used for survey variables, and the chi2 test was used to compare urban versus rural preparedness. The response rate was 58.2% (2137 usable surveys returned). Most (86.3%) school superintendents reported having a response plan, but fewer (57.2%) have a plan for prevention. Most (95.6%) have an evacuation plan, but almost one third (30%) had never conducted a drill. Almost one quarter (22.1%) have no disaster plan provisions for children with special health care needs, and one quarter reported having no plans for postdisaster counseling. Almost half (42.8%) had never met with local ambulance officials to discuss emergency planning. Urban school districts were better prepared than rural districts on almost all measures in the survey. There are important deficiencies in school emergency/disaster planning. Rural districts are less well prepared than urban districts. Disaster/mass-casualty preparedness of schools should be improved through coordination of school officials and local medical and emergency officials.

  11. Emergency Preparedness for Disasters and Crises in the Hotel Industry

    Directory of Open Access Journals (Sweden)

    Ahmad Rasmi AlBattat

    2013-09-01

    Full Text Available Safety and security are the most important issues to tourist while traveling and the first aspect they consider is to be protected from hazards. Emergency planning and preparedness for a crisis are the most significant components of dealing with disasters. Hospitality practitioners noticed a rising number of natural and man-made crises that harm the hospitality industry, regarding its vulnerability to crisis and internal and external hazards. By using secondary data, this study aims to shed some light on this issue, contributing to knowledge and awareness on emergency preparedness for the hospitality industry. Moreover, the study aims to explain the management’s commitment to adopt, develop, and update emergency plans. The results of this study explain that tourism as an international mobile industry must respond to internal and external hazards such as disease movement and terrorist attacks. Marketing safety is important to promote hotels and tourist destinations to the guests and holiday advisors. Hotels have a long history of being a soft target for terrorist attacks, as can be seen in several accidents that have shaken the hotel industry in the past few decades. Hotels invest a lot to install protective techniques, but terrorists are becoming more organized. Practitioners propose disaster management frameworks using several measurements. Recovery from crisis and learning help business retention that minimizes negative impacts and prevent losses. Finally, evaluation and feedback are very important to overcome the hazards and return to normal, as well as adopting new ideas to deal with emergencies. Single- and double-loop organizational learning should benefit proactive preparedness.

  12. Research on evacuation planning as nuclear emergency preparedness

    International Nuclear Information System (INIS)

    Yamamoto, Kazuya

    2007-10-01

    The International Atomic Energy Agency (IAEA) has introduced new concepts of precautionary action zone (PAZ) and urgent protective action planning zone (UPZ) in 'Preparedness and Response for a Nuclear or Radiological Emergency' (GS-R-2 (2002)), in order to reduce substantially the risk of severe deterministic health effects. Open literature based research was made to reveal problems on evacuation planning and the preparedness for nuclear emergency arising from introduction of PAZ into Japan that has applied the emergency planning zone (EPZ) concept currently. In regard to application of PAZ, it should be noted that the requirements for preparedness and response for a nuclear or radiological emergency are not only dimensional but also timely. The principal issue is implementation of evacuation of precautionary decided area within several hours. The logic of evacuation planning for a nuclear emergency and the methods of advance public education and information in the U.S. is effective for even prompt evacuation to the outside of the EPZ. As concerns evacuation planning for a nuclear emergency in Japan, several important issues to be considered were found, that is, selection of public reception centers which are outside area of the EPZ, an unique reception center assigned to each emergency response planning area, public education and information of practical details about the evacuation plan in advance, and necessity of the evacuation time estimates. To establish a practical evacuation planning guide for nuclear emergencies, further researches on application of traffic simulation technology to evacuation time estimates and on knowledge of actual evacuation experience in natural disasters and chemical plant accidents are required. (author)

  13. Continuous Vigilance - Evaluating Preparedness for a Biological Event

    Directory of Open Access Journals (Sweden)

    Bruria eAdini

    2014-04-01

    Full Text Available Objective: Effective response to biological events necessitates ongoing evaluation of preparedness. This study was a bilateral German-Israeli collaboration aimed at developing an evaluation tool for assessing preparedness of medical facilities for biological events.Methods: Measurable parameters were identified through a literature review for inclusion in the evaluation tool and disseminated to 228 content experts in 2 modified Delphi cycles. Focus groups were conducted to identify psychosocial needs of the medical teams. Table top and functional exercises were implemented to review applicability of the tool. Results: 117 experts from Germany and Israel participated in the modified Delphi. Out of 188 parameters that were identified, 183 achieved a consensus of >75% of the content experts. Following comments recommended in the Delphi cycles, and feedback from focus groups and hospital exercises, the final tool consisted of 172 parameters. Median level of importance of each parameter was calculated based on ranking recommended in the Delphi process. Computerized web-based software was developed to calculate scores of preparedness for biological events.Conclusions: Ongoing evaluation means, such as the tool developed in the study, can facilitate the need for a valid and reliable mechanism that may be widely adopted and implemented as quality assurance measures. The tool is based on measurable parameters and indicators that can effectively present strengths and weaknesses in managing a response to a public health threat, and accordingly, steps can be implemented to improve readiness. Adoption of such a tool is an important component of assuring public health and effective emergency management.Contact person regarding the evaluation tool: adinib@bgu.ac.ilLink to the computerized tool: http://www.be-prep.com/us

  14. Resident cross-cultural training, satisfaction, and preparedness.

    Science.gov (United States)

    Frintner, Mary Pat; Mendoza, Fernando S; Dreyer, Benard P; Cull, William L; Laraque, Danielle

    2013-01-01

    To describe the diversity of pediatric residents and examine relationships of cross-cultural training experiences with training satisfaction, perceived preparedness for providing culturally effective care, and attitudes surrounding care for underserved populations. A cross-sectional survey was conducted of a national random sample of graduating pediatric residents and an additional sample of minority residents. Using weighted analysis, we used multivariate regression to test for differences in satisfaction, preparedness, and attitudes between residents with more and less cross-cultural experiences during residency, controlling for residents' characteristics and experiences before training. The survey response rate was 57%. Eleven percent were Hispanic, 61% white, 21% Asian, 9% African American, 9% other racial/ethnic groups; 34% grew up in a bi- or multilingual family. Ninety-three percent of residents were satisfied with their residency training, 81% with the instruction they received on health and health care disparities, and 54% on global health issues. Ninety-six percent of residents felt they were prepared to care for patients from diverse backgrounds, but fewer felt prepared to care for families with beliefs at odds with Western medicine (49%) and families who receive alternative or complementary care (37%). Residents with more cross-cultural experiences during residency reported being better prepared than those with less experience to care for families with limited English proficiency (adjusted odds ratio [aOR] 2.11; 95% confidence interval [CI] 1.40-3.17), new immigrants (aOR 1.91; 95% CI 1.32-2.75), and with religious beliefs that might affect clinical care (aOR 1.62; 95% CI 1.13-2.32). Pediatric residents begin their training with diverse cross-cultural backgrounds and experiences. Residency experiences in cross-cultural care contribute to feelings of preparedness to care for diverse US children. Copyright © 2013 Academic Pediatric Association. Published

  15. Ebola virus disease surveillance and response preparedness in northern Ghana

    Directory of Open Access Journals (Sweden)

    Martin N. Adokiya

    2016-05-01

    Full Text Available Background: The recent Ebola virus disease (EVD outbreak has been described as unprecedented in terms of morbidity, mortality, and geographical extension. It also revealed many weaknesses and inadequacies for disease surveillance and response systems in Africa due to underqualified staff, cultural beliefs, and lack of trust for the formal health care sector. In 2014, Ghana had high risk of importation of EVD cases. Objective: The objective of this study was to assess the EVD surveillance and response system in northern Ghana. Design: This was an observational study conducted among 47 health workers (district directors, medical, disease control, and laboratory officers in all 13 districts of the Upper East Region representing public, mission, and private health services. A semi-structured questionnaire with focus on core and support functions (e.g. detection, confirmation was administered to the informants. Their responses were recorded according to specific themes. In addition, 34 weekly Integrated Disease Surveillance and Response reports (August 2014 to March 2015 were collated from each district. Results: In 2014 and 2015, a total of 10 suspected Ebola cases were clinically diagnosed from four districts. Out of the suspected cases, eight died and the cause of death was unexplained. All the 10 suspected cases were reported, none was confirmed. The informants had knowledge on EVD surveillance and data reporting. However, there were gaps such as delayed reporting, low quality protective equipment (e.g. gloves, aprons, inadequate staff, and lack of laboratory capacity. The majority (38/47 of the respondents were not satisfied with EVD surveillance system and response preparedness due to lack of infrared thermometers, ineffective screening, and lack of isolation centres. Conclusion: EVD surveillance and response preparedness is insufficient and the epidemic is a wake-up call for early detection and response preparedness. Ebola surveillance remains

  16. Preparedness for ongoing Ebola virus infection: how to welcome it?

    Directory of Open Access Journals (Sweden)

    Sora Yasri

    2015-06-01

    Full Text Available The problem of Ebola virus infection is the big global concern. Preparedness for ongoing Ebola virus infection is the topic that should be discussed. In fact, it is necessary to set up a biosecurity system to protect against the present Ebola outbreak. The medical personnel have to prepare for fighting the problem. The management of the present outbreak requires international collaboration and control of cross-border disease transmission is also the big challenge. The good case study is the Hajj scenario.

  17. 1993 International oil spill conference: Prevention, preparedness, response

    International Nuclear Information System (INIS)

    Anon.

    1993-01-01

    This book contains the proceedings of the 1993 International Oil Spill Conference which took place March 29 - April 1 in Tampa, Florida. It was jointly sponsored by the American Petroleum Institute, the US Coast Guard, and the US Environmental Protection Agency. Topics discussed included all aspects of spill prevention and preparedness, including planning, training, and research and development. Response issues, including fate and effects of spilled oil, cleanup, bioremediation, and in situ burning were also discussed. Legal and economic issues were also analyzed in the form of case studies

  18. Research on environmental impacts of nuclear power and emergency preparedness

    International Nuclear Information System (INIS)

    Vuori, S.

    1994-01-01

    The future needs of nuclear energy research in Finland have been recently reviewed by an expert group. Concerning the research on environmental impacts and emergency preparedness, the group recommended the establishment of a common coordination group for the different projects in this field. The main objectives in this field include efficient accident management and mitigation of off-site consequences with appropriate countermeasures and more reliable real time prediction tools for atmospheric dispersion and radiation dose evaluations as well as efficient and fast real time surveillance and measurement systems. (orig.)

  19. Flood disaster preparedness: a retrospect from Grand Forks, North Dakota.

    Science.gov (United States)

    Siders, C; Jacobson, R

    1998-01-01

    Natural disasters often come without warning. The clinical, financial, and business risks can be enormous. Grand Forks' (ND) healthcare systems experienced a flooding disaster of unprecedented proportions in April of 1997. Planned and practiced disaster and evacuation procedures can significantly reduce a healthcare facilities' risk to life, health, and safety. This article retrospectively analyzes disaster preparation and the complete evacuation of the facilities' patients.

  20. Intentions to Participate in Counselling among Front-Line, At-Risk Irish Government Employees: An Application of the Theory of Planned Behaviour

    Science.gov (United States)

    Hyland, Philip E.; McLaughlin, Christopher G.; Boduszek, Daniel; Prentice, Garry R.

    2012-01-01

    The study set out to examine intentions to engage in counselling among at-risk Irish government employees and the differential utility of two alternative theory of planned behaviour (TPB) models of behaviour to explain intentions to participate in counselling. Individuals (N = 259) employed in a front-line, at-risk occupation for the Irish…

  1. Successful Implementation of Patient Self-Check-In Kiosks from a Frontline Service Employee Perspective: A Qualitative Study of Best Practices

    Science.gov (United States)

    Mandato, Kathleen

    2010-01-01

    This research study examined the best practices for a successful rollout of check-in kiosks from the perspectives of frontline service employees (FLSEs) in an outpatient medical setting, the benefits and positive experiences of the kiosks, and those factors that helped to motivate the FLSEs to perform their role in promoting the use of the kiosks.…

  2. Implementing UK Autism Policy & National Institute for Health and Care Excellence Guidance--Assessing the Impact of Autism Training for Frontline Staff in Community Learning Disabilities Teams

    Science.gov (United States)

    Clark, Alex; Browne, Sarah; Boardman, Liz; Hewitt, Lealah; Light, Sophie

    2016-01-01

    UK National Autism Strategy (Department of Health, 2010 and National Institute for Health and Care Excellence guidance (NICE, 2012) states that frontline staff should have a good understanding of Autism. Fifty-six clinical and administrative staff from a multidisciplinary community Learning Disability service completed an electronic questionnaire…

  3. Patient safety climate (PSC) perceptions of frontline staff in acute care hospitals: examining the role of ease of reporting, unit norms of openness, and participative leadership.

    Science.gov (United States)

    Zaheer, Shahram; Ginsburg, Liane; Chuang, You-Ta; Grace, Sherry L

    2015-01-01

    Increased awareness regarding the importance of patient safety issues has led to the proliferation of theoretical conceptualizations, frameworks, and articles that apply safety experiences from high-reliability industries to medical settings. However, empirical research on patient safety and patient safety climate in medical settings still lags far behind the theoretical literature on these topics. The broader organizational literature suggests that ease of reporting, unit norms of openness, and participative leadership might be important variables for improving patient safety. The aim of this empirical study is to examine in detail how these three variables influence frontline staff perceptions of patient safety climate within health care organizations. A cross-sectional study design was used. Data were collected using a questionnaire composed of previously validated scales. The results of the study show that ease of reporting, unit norms of openness, and participative leadership are positively related to staff perceptions of patient safety climate. Health care management needs to involve frontline staff during the development and implementation stages of an error reporting system to ensure staff perceive error reporting to be easy and efficient. Senior and supervisory leaders at health care organizations must be provided with learning opportunities to improve their participative leadership skills so they can better integrate frontline staff ideas and concerns while making safety-related decisions. Finally, health care management must ensure that frontline staff are able to freely communicate safety concerns without fear of being punished or ridiculed by others.

  4. Healthcare is primary

    Directory of Open Access Journals (Sweden)

    Raman Kumar

    2015-01-01

    Full Text Available India is undergoing a rapid transformation in terms of governance, administrative reforms, newer policy develoment, and social movements. India is also considered one of the most vibrant economies in the world. The current discourse in public space is dominated by issues such as economic development, security, corruption free governance, gender equity, and women safety. Healthcare though remains a pressing need of population; seems to have taken a backseat. In the era of decreasing subsidies and cautious investment in social sectors, the 2 nd National Conference on Family Medicine and Primary Care 2015 (FMPC brought a focus on "healthcare" in India. The theme of this conference was "Healthcare is Primary." The conference participants discussed on the theme of why healthcare should be a national priority and why strong primary care should remain at the center of healthcare delivery system. The experts recommended that India needs to strengthen the "general health system" instead of focusing on disease based vertical programs. Public health system should have capacity and skill pool to be able to deliver person centered comprehensive health services to the community. Proactive implementation of policies towards human resource in health is the need of the hour. As the draft National Health Policy 2015 is being debated, "family medicine" (academic primary care, the unfinished agenda of National Health Policy 2002, remains a priority area of implementation.

  5. REP Executive Education focuses on Midwest plant off-site emergency preparedness

    OpenAIRE

    Center for Homeland Defense and Security

    2015-01-01

    Center for Homeland Defense and Security News and Stories, PRESS RELEASES The Center for Homeland Defense and Security burgeoning Radiological Emergency Preparedness (REP) Executive Education Program convened June 8-12 with a special focus on emergency preparedness policy and strategic issues for...

  6. Terrorism threats and preparedness in Canada: the perspective of the Canadian public.

    Science.gov (United States)

    Gibson, Stacey; Lemyre, Louise; Clément, Mélanie; Markon, Marie-Pierre L; Lee, Jennifer E C

    2007-06-01

    Although Canada has not experienced a major terrorist attack, an increased global pending threat has put preparedness at the top of the Canadian government's agenda. Given its strong multicultural community and close proximity to the recently targeted United States, the Canadian experience is unique. However, minimal research exists on the public's reactions to terrorism threats and related preparedness strategies. In order for response initiatives to be optimally effective, it is important that the public's opinions regarding terrorism and preparedness be considered. This qualitative study examined perceptions of terrorism threats among Canadians living in Central and Eastern Canada (N = 75) in the fall of 2004. Conceptualizations of terrorism threat, psychosocial impacts, and sense of preparedness were explored in a series of qualitative interviews. Findings revealed that the majority of Canadians did not feel overly threatened by terrorist attacks, due in part to a perception of terrorist threats as related to global sociopolitical events and a positive Canadian identity. In addition, while most respondents did not feel they were individually affected by the threat of terrorism, there was some concern regarding larger societal impacts, such as increased paranoia, discrimination, and threats to civil liberties. Participants' views on preparedness focused largely on the utility of emergency preparedness strategies and the factors that could mitigate or inhibit preparedness at the individual and institutional levels, with a specific focus on education. Finally, the significant relevance of these findings in shaping terrorism preparedness, both in Canada and generally, is discussed.

  7. 75 FR 35035 - Office of the Assistant Secretary for Preparedness and Response; Statement of Organization...

    Science.gov (United States)

    2010-06-21

    ... organizational change is to retitle the OPHEP as the Office of the Assistant Secretary for Preparedness and... health and medical preparedness, including Emergency Support Function 8 (ESF 8). Furthermore, the ASPR... Center (SOC), Centers for Disease Control and Prevention (CDC) Headquarters staff, the Director's...

  8. 75 FR 18214 - Board of Scientific Counselors, Coordinating Office for Terrorism Preparedness and Emergency...

    Science.gov (United States)

    2010-04-09

    ... Scientific Counselors, Coordinating Office for Terrorism Preparedness and Emergency Response (BSC, COTPER) \\1\\ \\1\\ The Coordinating Office for Terrorism Preparedness and Emergency Response has been renamed and is..., NE., Global Communications Center, Building 19, Auditorium B3, Atlanta, Georgia 30333. This meeting...

  9. 78 FR 79081 - Medicare and Medicaid Programs; Emergency Preparedness Requirements for Medicare and Medicaid...

    Science.gov (United States)

    2013-12-27

    ... Conditions for Coverage CHAP Community Health Accreditation Program CMHC Community Mental Health Center COI... Pathology Services (Sec. 485.727) N. Emergency Preparedness Regulations for Community Mental Health Centers... Preparedness for Community Mental Health Centers (CMHCs)--Training and Testing (Sec. 485.920(d)) R. Conditions...

  10. Community Mental Health Preparedness in Disasters: A Qualitative Content Analysis in an Iranian Context

    Directory of Open Access Journals (Sweden)

    Juliet Roudini

    2017-07-01

    Conclusion: Mental health preparedness is a multifactorial phenomenon that requires a clear understanding and definition of perceived threats, public trust on social structure and formal and informal supportive organization. This preparedness involves proportional, mental, social, familial, religious beliefs, and cultural sensitivity along with the ability to handle mentally disastrous situation, which can be measured after concept analysis and tool development process.

  11. Ready for University? A Cross-National Study of Students' Perceived Preparedness for University

    Science.gov (United States)

    Jansen, Ellen P. W. A.; van der Meer, Jacques

    2012-01-01

    Students' preparedness for higher education is seen as one of the main factors affecting first-year attrition or study success. In this paper we report on a cross-national study in which students' preparedness for university was measured "before" students commenced their study at a university in New Zealand or in the Netherlands. This…

  12. Does Classroom Management Coursework Influence Pre-service Teachers' Perceived Preparedness or Confidence?

    Science.gov (United States)

    O'Neill, Sue; Stephenson, Jennifer

    2012-01-01

    There has been conjecture that completing focused coursework units on classroom management during pre-service teacher preparation might lead to increased feelings of preparedness and confidence. This study reports the preparedness in managing specific problem behaviours, familiarity, and confidence in using management strategies and models of…

  13. Emergency preparedness 1995 site support plan WBS 6.7.2.3

    International Nuclear Information System (INIS)

    Faulk, S.M.

    1994-09-01

    The Emergency Preparedness Program provides an emergency management system including occurrence notification; development, coordination, and direction of planning, preparedness, and readiness assurance for response to emergency events on the Hanford Site; and emergency management support to Department of Energy, Richland Operations Office (RL)

  14. Ready for university? A cross national study on students' perceived preparedness for university

    NARCIS (Netherlands)

    Jansen, E.P.W.A.; van der Meer, J.

    Students' preparedness for higher education is seen as one of the main factors affecting first-year attrition or study success. In this paper we report on a cross-national study in which students' preparedness for university was measured before students commenced their study at a university in New

  15. 47 CFR 0.387 - Other national security and emergency preparedness delegations; cross reference.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Other national security and emergency... COMMISSION GENERAL COMMISSION ORGANIZATION Delegations of Authority National Security and Emergency Preparedness Delegations § 0.387 Other national security and emergency preparedness delegations; cross...

  16. Natural Hazard Preparedness in an Auckland Community: Child and Community Perceptions

    Science.gov (United States)

    Bolton, Patricia; Dirks, Kim; Neuwelt, Pat

    2014-01-01

    Community engagement in natural hazard preparedness is crucial to ensure sustainable initiatives. Children are important members of communities, and can actively contribute to community preparedness. This article presents research undertaken with 11- to 12-year-old students from a school in Auckland, New Zealand, and leaders associated with the…

  17. Transition to Work: Effects of Preparedness and Goal Construction on Employment and Depressive Symptoms

    Science.gov (United States)

    Koivisto, Petri; Vuori, Jukka; Vinokur, Amiram D.

    2010-01-01

    This study examines the mediating role of employment preparedness in improving employment, mental health, and construction of work-life goals among young vocational school graduates who participated in the School-to-Work effectiveness trial. The trial included a 1-week intervention program that focused on enhancing employment preparedness. In this…

  18. Corporate preparedness for pandemic influenza: a survey of pharmaceutical and biotechnology companies in Montgomery County, Maryland.

    Science.gov (United States)

    Watkins, Rissah J; Barnett, Daniel J; Links, Jonathan M

    2008-09-01

    We conducted a survey of corporate preparedness for pandemic influenza among biotechnology and pharmaceutical companies in Montgomery County, Maryland, to determine the level of preparedness for this industry and geographic region. The survey, based on the HHS Business Pandemic Influenza Planning Checklist, established whether a company had a preparedness plan specific to pandemic influenza, the contents of its plan, or its reasons for a lack of a plan. A total of 50 companies participated in the survey. Of these, 40 did not have any type of preparedness plan, 3 were drafting plans, 6 had general preparedness plans that could be applied to an influenza pandemic, and only 1 company had a preparedness plan specifically designed to address pandemic influenza. Biotechnology and pharmaceutical companies in this geographic region are currently not well prepared for pandemic influenza. Public health officials should offer more help, possibly in the form of a model small business preparedness plan, and collaboration between companies should be encouraged to foster sharing of preparedness plans.

  19. Managing a front-line field hospital in Libya: Description of case mix and lessons learned for future humanitarian emergencies

    Directory of Open Access Journals (Sweden)

    Adam C. Levine

    2012-06-01

    Full Text Available Between June and August 2011, International Medical Corps deployed a field hospital near the front-line of the fighting between government troops and opposition fighters in Western Libya. The field hospital cared for over 1300 combatants and non-combatants from both sides of the conflict during that time period, the vast majority of them presenting with war-related injuries. Over 60% of battle-related injuries were due to shrapnel wounds and blast injuries from exploding small mortars, with smaller percentages due to battle-related motor vehicle accidents, gun shot wounds, burns, and other causes. The most pertinent lessons learned from our experience were the importance of dedicating significant resources to logistics and supply chain management, the rewards garnered from building strong ties with the local community early in the deployment of the field hospital, and the need to pay careful attention to basic principles of humanitarian ethics.

  20. How 'healthy' are healthcare organizations? Exploring employee healthcare utilization rates among Dutch healthcare organizations.

    Science.gov (United States)

    Bronkhorst, Babette

    2017-08-01

    Occupational health and safety research rarely makes use of data on employee healthcare utilization to gain insight into the physical and mental health of healthcare staff. This paper aims to fill this gap by examining the prevalence of two relevant types of healthcare utilization among staff working in healthcare organizations: physical therapy and mental healthcare utilization. The paper furthermore explores what role employee and organizational characteristics play in explaining differences in healthcare utilization between organizations. A Dutch healthcare insurance company provided healthcare utilization records for a sample of 417 organizations employing 136,804 healthcare workers in the Netherlands. The results showed that there are large differences between and within healthcare industries when it comes to employee healthcare utilization. Multivariate regression analyses revealed that employee characteristics such as age and gender distributions, and healthcare industry, explain some of the variance between healthcare organizations. Nevertheless, the results of the analyses showed that for all healthcare utilization indicators there is still a large amount of unexplained variance. Further research into the subject of organizational differences in employee healthcare utilization is needed, as finding possibilities to influence employee health and subsequent healthcare utilization is beneficial to employees, employers and society as a whole.

  1. The Cuban National Healthcare System: Characterization of primary healthcare services.

    Directory of Open Access Journals (Sweden)

    Keli Regina DAL PRÁ

    2015-10-01

    Full Text Available This article presents a report on the experience of healthcare professionals in Florianópolis, who took the course La Atención Primaria de Salud y la Medicina Familiar en Cuba [Primary Healthcare and Family Medicine in Cuba], in 2014. The purpose of the study is to characterize the healthcare units and services provided by the Cuban National Healthcare System (SNS and to reflect on this experience/immersion, particularly on Cuba’s Primary Healthcare Service. The results found that in comparison with Brazil’s Single Healthcare System (SUS Cuba’s SNS Family Healthcare (SF service is the central organizing element of the Primary Healthcare Service. The number of SF teams per inhabitant is different than in Brazil; the programs given priority in the APS are similar to those in Brazil and the intersectorial nature and scope of the services prove to be effective in the resolution of healthcare problems.

  2. Youth Delinquency or Everyday Racism? Front-line Professionals’ Perspectives on Preventing Racism and Intolerance in Sweden

    Directory of Open Access Journals (Sweden)

    Alida Skiple

    2018-03-01

    Full Text Available In this article, I ask which problematizations of racism and intolerance that substantiate a local implementation of a targeted educational program in Sweden, called the Tolerance Project. By participating in municipality-level meetings and conversations with front-line professionals concerning the recent implementation of the program in one specific region, I have found several motivations for the continuing work to reduce racism and intolerance at schools. To emphasize this point, I have divided the problematizations into four ideal types and applied a ‘what’s the problem represented to be’ analysis to each of them. The four problematizations can be described in the following terms: generational racism, growth of the Sweden Democrats, normalization of racist language, and general ‘at-risk’ youths. The first three problematizations are context dependent, in terms of both time (during the so-called refugee crisis and space (in a region with a long history of National Socialism. Problematizing generational racism, growth of the Sweden Democrats and normalization of racist language indicate that what is mainly to be prevented is anti-immigrant sentiments in the young as well as the adult population. This implies a limitation to the role of schools in prevention, as adults cannot be directly targeted by the school. The fourth ideal type, at-risk youth, emphasizes that there are certain risk factors that might cause young people to later radicalize or deviate in one way or another. This corresponds to the general discourse of radicalization, but, in line with other studies of front-line professionals’ perspectives, there is no clear distinction between preventing radicalization and fostering democratic citizens. Furthermore, the conglomeration of problematizations might decrease the stigmatizing effect that a targeted initiative can have, as opposed to initiatives that operate with one specific target group. The Tolerance Project might

  3. Associating Factors With Public Preparedness Behavior Against Earthquake: A Review of Iranian Research Literature

    Directory of Open Access Journals (Sweden)

    Maryam Ranjbar

    2018-01-01

    Full Text Available Local preparedness against earthquakes has been recently highlighted in research and policies on disaster management and risk reduction promotion in Iran. To advance the understanding of public preparedness and how it can be applied in diverse localities, further information is required about the predictors of people’s adoption of mitigation activities and earthquake preparedness. A synthesis of the available published research results on earthquake preparedness and the influencing factors in Iran are presented in this literature review. It emphasizes the complexity of both the concept of preparedness and the contextual factors that mediate its adoption. The predominant roles of public awareness, trusted information resources, social capital and community collaboration as predictors are discussed. 

  4. Improving Healthcare Logistics Processes

    DEFF Research Database (Denmark)

    Feibert, Diana Cordes

    logistics processes in hospitals and aims to provide theoretically and empirically based evidence for improving these processes to both expand the knowledge base of healthcare logistics and provide a decision tool for hospital logistics managers to improve their processes. Case studies were conducted...... processes. Furthermore, a method for benchmarking healthcare logistics processes was developed. Finally, a theoretically and empirically founded framework was developed to support managers in making an informed decision on how to improve healthcare logistics processes. This study contributes to the limited...... literature concerned with the improvement of logistics processes in hospitals. Furthermore, the developed framework provides guidance for logistics managers in hospitals on how to improve their processes given the circumstances in which they operate....

  5. Competing Logics and Healthcare

    Science.gov (United States)

    Saks, Mike

    2018-01-01

    This paper offers a short commentary on the editorial by Mannion and Exworthy. The paper highlights the positive insights offered by their analysis into the tensions between the competing institutional logics of standardization and customization in healthcare, in part manifested in the conflict between managers and professionals, and endorses the plea of the authors for further research in this field. However, the editorial is criticized for its lack of a strong societal reference point, the comparative absence of focus on hybridization, and its failure to highlight structural factors impinging on the opposing logics in a broader neo-institutional framework. With reference to the Procrustean metaphor, it is argued that greater stress should be placed on the healthcare user in future health policy. Finally, the case of complementary and alternative medicine is set out which – while not explicitly mentioned in the editorial – most effectively concretizes the tensions at the heart of this analysis of healthcare. PMID:29626406

  6. Conization and healthcare use

    DEFF Research Database (Denmark)

    Frederiksen, Maria E.; Vázquez-Prada Baillet, Miguel; Jensen, Pernille T.

    2017-01-01

    The aim of this study was to assess whether negative psychological consequences of conization reported in questionnaire studies translated into increased use of the healthcare services that could relieve such symptoms. This was a population-based register study comparing women undergoing conization......, healthcare use increased significantly from the 'before' to the 'after' period. For contacts with GPs and hospitals, the increase was significantly larger for the conization group than for the control group, but this could be attributed to the standard postconization follow-up process. In the 'before' period......, women who later had a conization used fewer drugs than women of the control-group, but their drug use increased similarly over time. The conization event did not result in an increased use of the healthcare services that could relieve potential negative side effects. However, women who underwent...

  7. Queueing for healthcare.

    Science.gov (United States)

    Palvannan, R Kannapiran; Teow, Kiok Liang

    2012-04-01

    Patient queues are prevalent in healthcare and wait time is one measure of access to care. We illustrate Queueing Theory-an analytical tool that has provided many insights to service providers when designing new service systems and managing existing ones. This established theory helps us to quantify the appropriate service capacity to meet the patient demand, balancing system utilization and the patient's wait time. It considers four key factors that affect the patient's wait time: average patient demand, average service rate and the variation in both. We illustrate four basic insights that will be useful for managers and doctors who manage healthcare delivery systems, at hospital or department level. Two examples from local hospitals are shown where we have used queueing models to estimate the service capacity and analyze the impact of capacity configurations, while considering the inherent variation in healthcare.

  8. Assessing hospital disaster preparedness: a comparison of an on-site survey, directly observed drill performance, and video analysis of teamwork.

    Science.gov (United States)

    Kaji, Amy H; Langford, Vinette; Lewis, Roger J

    2008-09-01

    There is currently no validated method for assessing hospital disaster preparedness. We determine the degree of correlation between the results of 3 methods for assessing hospital disaster preparedness: administration of an on-site survey, drill observation using a structured evaluation tool, and video analysis of team performance in the hospital incident command center. This was a prospective, observational study conducted during a regional disaster drill, comparing the results from an on-site survey, a structured disaster drill evaluation tool, and a video analysis of teamwork, performed at 6 911-receiving hospitals in Los Angeles County, CA. The on-site survey was conducted separately from the drill and assessed hospital disaster plan structure, vendor agreements, modes of communication, medical and surgical supplies, involvement of law enforcement, mutual aid agreements with other facilities, drills and training, surge capacity, decontamination capability, and pharmaceutical stockpiles. The drill evaluation tool, developed by Johns Hopkins University under contract from the Agency for Healthcare Research and Quality, was used to assess various aspects of drill performance, such as the availability of the hospital disaster plan, the geographic configuration of the incident command center, whether drill participants were identifiable, whether the noise level interfered with effective communication, and how often key information (eg, number of available staffed floor, intensive care, and isolation beds; number of arriving victims; expected triage level of victims; number of potential discharges) was received by the incident command center. Teamwork behaviors in the incident command center were quantitatively assessed, using the MedTeams analysis of the video recordings obtained during the disaster drill. Spearman rank correlations of the results between pair-wise groupings of the 3 assessment methods were calculated. The 3 evaluation methods demonstrated

  9. Characteristics of healthcare wastes

    International Nuclear Information System (INIS)

    Diaz, L.F.; Eggerth, L.L.; Enkhtsetseg, Sh.; Savage, G.M.

    2008-01-01

    A comprehensive understanding of the quantities and characteristics of the material that needs to be managed is one of the most basic steps in the development of a plan for solid waste management. In this case, the material under consideration is the solid waste generated in healthcare facilities, also known as healthcare waste. Unfortunately, limited reliable information is available in the open literature on the quantities and characteristics of the various types of wastes that are generated in healthcare facilities. Thus, sound management of these wastes, particularly in developing countries, often is problematic. This article provides information on the quantities and properties of healthcare wastes in various types of facilities located in developing countries, as well as in some industrialized countries. Most of the information has been obtained from the open literature, although some information has been collected by the authors and from reports available to the authors. Only data collected within approximately the last 15 years and using prescribed methodologies are presented. The range of hospital waste generation (both infectious and mixed solid waste fractions) varies from 0.016 to 3.23 kg/bed-day. The relatively wide variation is due to the fact that some of the facilities surveyed in Ulaanbaatar include out-patient services and district health clinics; these facilities essentially provide very basic services and thus the quantities of waste generated are relatively small. On the other hand, the reported amount of infectious (clinical, yellow bag) waste varied from 0.01 to 0.65 kg/bed-day. The characteristics of the components of healthcare wastes, such as the bulk density and the calorific value, have substantial variability. This literature review and the associated attempt at a comparative analysis point to the need for worldwide consensus on the terms and characteristics that describe wastes from healthcare facilities. Such a consensus would greatly

  10. Emergency response preparedness: the French experience of large scale exercises

    International Nuclear Information System (INIS)

    Chanson, D.; Desnoyers, B.; Chabane, J.M.

    2004-01-01

    In compliance with the IAEA regulations for the transport of radioactive material in the event of accidents during transport of radioactive material, emergency provisions to protect persons, property and environment have to be established and developed by the relevant national organisations. In France, the prefect of the department where the accident occurs is responsible for decisions and measures required to ensure the protection of both population and property at risk owing to the accident. During an accident, the ministers concerned provide the prefect with recommendations and information, in order to help him take the requisite decisions. On their side, the nuclear industry and transport companies also have to be prepared to intervene and to support the authorities at their request, depending on their capacities and their specialities. To prepare the emergency teams properly and acquire effective emergency plans, training exercises have to be conducted regularly with every ministerial department involved, the nuclear industry and transport companies, members of the public and the media. Then, the feedback from such exercises shall be taken into account to improve the emergency procedures. This paper will introduce: - emergency response preparedness: what is required by the relevant regulations? - emergency response preparedness: how is France organised? - the French experience of conducting large training exercises simulating accidents involving the transport of radioactive material; - the main difficulties and lessons learned; - the perspectives

  11. Social Network Types and Acute Stroke Preparedness Behavior

    Directory of Open Access Journals (Sweden)

    Bernadette Boden-Albala

    2011-08-01

    Full Text Available Objectives: Presence of informal social networks has been associated with favorable health and behaviors, but whether different types of social networks impact on different health outcomes remains largely unknown. We examined the associations of different social network types (marital dyad, household, friendship, and informal community networks with acute stroke preparedness behavior. We hypothesized that marital dyad best matched the required tasks and is the most effective network type for this behavior. Methods: We collected in-person interview and medical record data for 1,077 adults diagnosed with stroke and transient ischemic attack. We used logistic regression analyses to examine the association of each social network with arrival at the emergency department (ED within 3 h of stroke symptoms. Results: Adjusting for age, race-ethnicity, education, gender, transportation type to ED and vascular diagnosis, being married or living with a partner was significantly associated with early arrival at the ED (odds ratio = 2.0, 95% confidence interval: 1.2–3.1, but no significant univariate or multivariate associations were observed for household, friendship, and community networks. Conclusions: The marital/partnership dyad is the most influential type of social network for stroke preparedness behavior.

  12. Severe accidents risk assessment as a basis for emergency preparedness

    International Nuclear Information System (INIS)

    Sinka, D.; Mikulicic, V.

    2000-01-01

    The paper demonstrates, by example of the Republic of Croatia, the possibilities of implementing risk assessment as basis for nuclear accident emergency preparedness development. Individual risks of severe accidents for citizens of the biggest Croatian population centers, as well as collective risk for entire population have been assessed using the PRONEL method. The assessment covered 90 power reactors located at a distance up to 1.000 km. The conducted assessment shows the risks for various regions of the Republic of Croatia, and comparison between them. If risk would be taken as basic criterion in nuclear emergency planning, the results of assessment would directly indicate the necessary preparation level for each region. Furthermore, the assessment of risks from individual power plants and power plant types indicates to which facilities the greatest attention should be paid in nuclear accidents preparedness development. Risks from groups of power plants formed in accordance with their respective distance from exposure location shows what kind of tools for determining consequences and protective actions during a nuclear accident should be made available. (author)

  13. Preventing intentional food contamination: a survey to assess restaurant preparedness.

    Science.gov (United States)

    Xirasagar, Sudha; Kanwat, C P; Qu, Haiyan; Smith, Lillian U; Patterson, Nathaniel J; Shewchuk, Richard M

    2010-01-01

    In the age of preparedness, public health agencies are concerned with intentional acts of food contamination in restaurants, in addition to food safety. Food safety consists of applying standard norms of practice and infrastructure, which, if violated, cause food-borne illness. In contrast, food defense requires an institutionalized mindset of informed alertness to unusual variations from the norms, combined with preemptive practices best suited to each restaurant. Therefore, while food safety lends itself to regulation to ensure standard practices, food defense is best served by advisory guidelines for autonomous application, preserving the restaurant industry's core values of hospitality and customer service. To address this challenge, public health agencies need survey tools that can yield action-relevant data on the knowledge and practice gaps in food defense preparedness and on educational messages and support services to be developed for maximum impact potential. This article presents a mail survey instrument, developed using qualitative research to ensure content and face validity. Instrument development involved drafting the survey on the basis of expert consultations, validating its content by using focus groups (representing all restaurant categories and geographic regions), and ensuring face validity through cognitive interviews. The resulting survey remains sensitive to the hospitality industry while encompassing all vulnerable points.

  14. Perceptions of disaster preparedness among older people in South Korea.

    Science.gov (United States)

    Yoo, Myoungran; Lee, Mijung; Tullmann, Dorothy

    2016-03-01

    Older people are a major vulnerable population. During disasters, given their physical frailty, lower social status, loss of medications and medical care, the vulnerability of older people increases. The purpose of this study was to examine the perceptions of older people in Korea on various aspects of disaster preparedness to better understand their special needs and to facilitate appropriate disaster planning. The study was qualitative and used focus group interviews with 12 older people in one major city and one rural area of South Korea. Four themes were identified by the analysis of the interviews: defenceless state, reality of accepting limitations, strong will to live, importance of disaster preparedness governmental efforts for the older people. Findings indicated that preparation of shelters and transportation was critical to help older people survive in times of disasters and suggested that there should be active involvement of the government in terms of disaster planning, managing and preparing older people for disasters. In addition, healthy older people can be assets to disaster relief efforts by providing practical and emotional support for the most fragile older people. Older people can also provide knowledge of their special needs to the government to improve their disaster response policy. © 2015 John Wiley & Sons Ltd.

  15. Barriers to disaster preparedness among medical special needs populations

    Directory of Open Access Journals (Sweden)

    Leslie eMeyer

    2015-09-01

    Full Text Available A medical special needs (MSN assessment was conducted among 3088 respondents in a hurricane prone area. The sample was female (51.7%, Hispanic (92.9%, aged > 45 years (51%, not insured for health (59.2%, and with an MSN (33.2%. Barriers to preparedness were characterized for all households, including those with inhabitants reporting MSN ranging from level 0 (mild to level 4 (most severe. Multivariable logistic regression tested associations between hurricane preparedness and barriers to evacuation by level of MSN. A significant interaction effect between number of evacuation barriers and MSN was found. Among households that reported individuals with level 0 MSN, the odds of being unprepared increased 18% for each additional evacuation barrier [OR=1.18, 95% CI (1.08, 1.30]. Among households that reported individuals with level 1 MSN, the odds of being unprepared increased 29% for each additional evacuation barrier [OR=1.29, 95% CI (1.11, 1.51]. Among households that reported individuals with level 3 MSN, the odds of being unprepared increased 68% for each additional evacuation barrier [OR=1.68, 95% CI (1.21, 1.32]. MSN alone did not explain the probability of unpreparedness, but rather MSN in the presence of barriers helped explain unpreparedness.

  16. The zombie thermographer apocalypse preparedness 101: zombie thermographer pandemic

    Science.gov (United States)

    Colbert, Fred

    2013-05-01

    Fact: The U.S Government Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response, rather remarkably has dedicated part of their web site to" Zombie Preparedness". See: http://www.cdc.gov/phpr/zombies.htm for more information. This is a tongue-incheek campaign with messages to engage audiences with the hazards of unpreparedness. The CDC director, U.S. Assistant Surgeon General Ali S. Khan (RET), MD, MPH notes, "If you are generally well equipped to deal with a zombie apocalypse you will be prepared for a hurricane, pandemic, earthquake, or terrorist attack. Make a plan, and be prepared!" (CDC Website, April 26th, 2013). Today we can make an easy comparison between the humor that the CDC is bringing to light, and what is actually happening in the Thermographic Industry. It must be acknowledge there are "Zombie Thermographers" out there. At times, it can be observed from the sidelines as a pandemic apocalypse attacking the credibility and legitimacy of the science and the industry that so many have been working to advance for over 30 years. This paper outlines and explores the trends currently taking place, the very real risks to facility plant, property, and human life as a result, and the strategies to overcome these problems.

  17. DGNB certified Healthcare Centres

    DEFF Research Database (Denmark)

    Brunsgaard, Camilla; Larsen, Tine Steen

    2015-01-01

    for sustainability and wants a certification. This research investigates the decision‐making and design process (DMaDP) behind four DGNB certified Healthcare Centres (HCC) in Northern Jutland in Denmark. In general, knowledge about the DMaDP is important. However it is important to know what part DGNB plays...... a dialog about DGNB and energy concept is important even before anyone start sketching. Experiences with the different approaches will be further outlined in the paper.Future research has the intention to collect further knowledge about DGNB and DMaDP in practise. This project was limited to Healthcare...

  18. Costing Practices in Healthcare

    DEFF Research Database (Denmark)

    Chapman, Christopher; Kern, Anja; Laguecir, Aziza

    2014-01-01

    .e., Diagnosis Related Group (DRG) systems, and costing practices. DRG-based payment systems strongly influence costing practices in multiple ways. In particular, setting DRG tariffs requires highly standardized costing practices linked with specific skill sets from management accountants and brings other...... jurisdictions (e.g., clinical coding) to bear on costing practice. These factors contribute to the fragmentation of the jurisdiction of management accounting.......The rising cost of healthcare is a globally pressing concern. This makes detailed attention to the way in which costing is carried out of central importance. This article offers a framework for considering the interdependencies between a dominant element of the contemporary healthcare context, i...

  19. The health of healthcare, Part II: patient healthcare has cancer.

    Science.gov (United States)

    Waldman, Deane

    2013-01-01

    In this article, we make the etiologic diagnosis for a sick patient named Healthcare: the cancer of greed. When we explore the two forms of this cancer--corporate and bureaucratic--we find the latter is the greater danger to We the Patients. The "treatments" applied to patient Healthcare by the Congressional "doctors" have consistently made the patient worse, not better. At the core of healthcare's woes is the government's diversion of money from healthcare services to healthcare bureaucracy. As this is the root cause, it is what we must address in order to cure, not sedate or palliate, patient Healthcare.

  20. It Takes Two to Tango: Customization and Standardization as Colluding Logics in Healthcare Comment on "(Re) Making the Procrustean Bed Standardization and Customization as Competing Logics in Healthcare".

    Science.gov (United States)

    Greenfield, David; Eljiz, Kathy; Butler-Henderson, Kerryn

    2017-06-28

    The healthcare context is characterized with new developments, technologies, ideas and expectations that are continually reshaping the frontline of care delivery. Mannion and Exworthy identify two key factors driving this complexity, 'standardization' and 'customization,' and their apparent resulting paradox to be negotiated by healthcare professionals, managers and policy makers. However, while they present a compelling argument an alternative viewpoint exists. An analysis is presented that shows instead of being 'competing' logics in healthcare, standardization and customization are long standing 'colluding' logics. Mannion and Exworthy's call for further sustained work to understand this complex, contested space is endorsed, noting that it is critical to inform future debates and service decisions. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  1. Social marketing in healthcare

    Directory of Open Access Journals (Sweden)

    Radha Aras

    2011-08-01

    Full Text Available BackgroundSocial marketing is an important tool in the delivery ofhealthcare services. For any healthcare programme orproject to be successful, community/consumer participationis required. The four principles of social marketing can guidepolicymakers and healthcare providers to successfully planand implement health programmes.AimTo review the existing literature in order to project thebenefits of social marketing in healthcare.MethodA search of periodical literature by the author involvingsocial marketing and marketing concepts in health wascarried out. Items were identified initially through healthorientedindexing services such as Medline, Health STARand Cinahl, using the identifiers “social marketing“ and“marketing in health”. An extensive search was also carriedout on educational database ERIC.ResultsA literature review of various studies on social marketingindicated that the selection of the right product (accordingto the community need at the right place, with the rightstrategy for promotion and at the right price yields goodresults. However, along with technical sustainability(product, price, promotion and place, financialsustainability, institutional sustainability and marketsustainability are conducive factors for the success of socialmarketing.ConclusionThe purpose of this literature review was to ascertain thelikely effectiveness of social marketing principles andapproaches and behaviour change communication towardshealth promotion.It is important for all healthcare workers to understand andrespond to the public’s desires and needs and routinely useconsumer research to determine how best to help thepublic to solve problems and realise aspirations. Socialmarketing can optimise public health by facilitatingrelationship-building with consumers and making their liveshealthier.

  2. Organizational excellence in healthcare

    NARCIS (Netherlands)

    Does, R.J.M.M.; van den Heuvel, J.; Foley, K.J.; Hermel, P.

    2008-01-01

    Healthcare, as any other service operation, requires systematic innovation efforts to remain competitive, cost efficient and up to date. In this paper, we outline a methodology and present how principles of two improvement programs, i.e., Lean Thinking and Six Sigma, can be combined to provide an

  3. Coproduction of healthcare service.

    Science.gov (United States)

    Batalden, Maren; Batalden, Paul; Margolis, Peter; Seid, Michael; Armstrong, Gail; Opipari-Arrigan, Lisa; Hartung, Hans

    2016-07-01

    Efforts to ensure effective participation of patients in healthcare are called by many names-patient centredness, patient engagement, patient experience. Improvement initiatives in this domain often resemble the efforts of manufacturers to engage consumers in designing and marketing products. Services, however, are fundamentally different than products; unlike goods, services are always 'coproduced'. Failure to recognise this unique character of a service and its implications may limit our success in partnering with patients to improve health care. We trace a partial history of the coproduction concept, present a model of healthcare service coproduction and explore its application as a design principle in three healthcare service delivery innovations. We use the principle to examine the roles, relationships and aims of this interdependent work. We explore the principle's implications and challenges for health professional development, for service delivery system design and for understanding and measuring benefit in healthcare services. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  4. Healthcare liquid waste management.

    Science.gov (United States)

    Sharma, D R; Pradhan, B; Pathak, R P; Shrestha, S C

    2010-04-01

    The management of healthcare liquid waste is an overlooked problem in Nepal with stern repercussions in terms of damaging the environment and affecting the health of people. This study was carried out to explore the healthcare liquid waste management practices in Kathmandu based central hospitals of Nepal. A descriptive prospective study was conducted in 10 central hospitals of Kathmandu during the period of May to December 2008. Primary data were collected through interview, observation and microbiology laboratory works and secondary data were collected by records review. For microbiological laboratory works,waste water specimens cultured for the enumeration of total viable counts using standard protocols. Evidence of waste management guidelines and committees for the management of healthcare liquid wastes could not be found in any of the studied hospitals. Similarly, total viable counts heavily exceeded the standard heterotrophic plate count (p=0.000) with no significant difference in such counts in hospitals with and without treatment plants (p=0.232). Healthcare liquid waste management practice was not found to be satisfactory. Installation of effluent treatment plants and the development of standards for environmental indicators with effective monitoring, evaluation and strict control via relevant legal frameworks were realized.

  5. Building National Healthcare Infrastructure

    DEFF Research Database (Denmark)

    Jensen, Tina Blegind; Thorseng, Anne

    2017-01-01

    This case chapter is about the evolution of the Danish national e-health portal, sundhed.dk, which provides patient-oriented digital services. We present how the organization behind sundhed.dk succeeded in establishing a national healthcare infrastructure by (1) collating and assembling existing...

  6. Infrastructures for healthcare

    DEFF Research Database (Denmark)

    Langhoff, Tue Odd; Amstrup, Mikkel Hvid; Mørck, Peter

    2018-01-01

    The Danish General Practitioners Database has over more than a decade developed into a large-scale successful information infrastructure supporting medical research in Denmark. Danish general practitioners produce the data, by coding all patient consultations according to a certain set of classif...... synergy into account, if not to risk breaking down the fragile nature of otherwise successful information infrastructures supporting research on healthcare....

  7. Improving water, sanitation and hygiene in health-care facilities, Liberia.

    Science.gov (United States)

    Abrampah, Nana Mensah; Montgomery, Maggie; Baller, April; Ndivo, Francis; Gasasira, Alex; Cooper, Catherine; Frescas, Ruben; Gordon, Bruce; Syed, Shamsuzzoha Babar

    2017-07-01

    The lack of proper water and sanitation infrastructures and poor hygiene practices in health-care facilities reduces facilities' preparedness and response to disease outbreaks and decreases the communities' trust in the health services provided. To improve water and sanitation infrastructures and hygiene practices, the Liberian health ministry held multistakeholder meetings to develop a national water, sanitation and hygiene and environmental health package. A national train-the-trainer course was held for county environmental health technicians, which included infection prevention and control focal persons; the focal persons acted as change agents. In Liberia, only 45% of 701 surveyed health-care facilities had an improved water source in 2015, and only 27% of these health-care facilities had proper disposal for infectious waste. Local ownership, through engagement of local health workers, was introduced to ensure development and refinement of the package. In-county collaborations between health-care facilities, along with multisectoral collaboration, informed national level direction, which led to increased focus on water and sanitation infrastructures and uptake of hygiene practices to improve the overall quality of service delivery. National level leadership was important to identify a vision and create an enabling environment for changing the perception of water, sanitation and hygiene in health-care provision. The involvement of health workers was central to address basic infrastructure and hygiene practices in health-care facilities and they also worked as stimulators for sustainable change. Further, developing a long-term implementation plan for national level initiatives is important to ensure sustainability.

  8. Healthcare waste management: current practices in selected healthcare facilities, Botswana.

    Science.gov (United States)

    Mbongwe, Bontle; Mmereki, Baagi T; Magashula, Andrew

    2008-01-01

    Healthcare waste management continues to present an array of challenges for developing countries, and Botswana is no exception. The possible impact of healthcare waste on public health and the environment has received a lot of attention such that Waste Management dedicated a special issue to the management of healthcare waste (Healthcare Wastes Management, 2005. Waste Management 25(6) 567-665). As the demand for more healthcare facilities increases, there is also an increase on waste generation from these facilities. This situation requires an organised system of healthcare waste management to curb public health risks as well as occupational hazards among healthcare workers as a result of poor waste management. This paper reviews current waste management practices at the healthcare facility level and proposes possible options for improvement in Botswana.

  9. Social marketing in healthcare.

    Science.gov (United States)

    Aras, Radha

    2011-01-01

    Social marketing is an important tool in the delivery of healthcare services. For any healthcare programme or project to be successful, community/consumer participation is required. The four principles of social marketing can guide policymakers and healthcare providers to successfully plan and implement health programmes. To review the existing literature in order to project the benefits of social marketing in healthcare. A search of periodical literature by the author involving social marketing and marketing concepts in health was carried out. Items were identified initially through health-oriented indexing services such as Medline, Health STAR and Cinahl, using the identifiers "social marketing" and "marketing in health". An extensive search was also carried out on educational database ERIC. A literature review of various studies on social marketing indicated that the selection of the right product (according to the community need) at the right place, with the right strategy for promotion and at the right price yields good results. However, along with technical sustainability (product, price, promotion and place), financial sustainability, institutional sustainability and market sustainability are conducive factors for the success of social marketing. The purpose of this literature review was to ascertain the likely effectiveness of social marketing principles and approaches and behaviour change communication towards health promotion. It is important for all healthcare workers to understand and respond to the public's desires and needs and routinely use consumer research to determine how best to help the public to solve problems and realise aspirations. Social marketing can optimise public health by facilitating relationship-building with consumers and making their lives healthier.

  10. Factors Influencing Healthcare Service Quality

    Directory of Open Access Journals (Sweden)

    Ali Mohammad Mosadeghrad

    2014-07-01

    Full Text Available Background The main purpose of this study was to identify factors that influence healthcare quality in the Iranian context. Methods Exploratory in-depth individual and focus group interviews were conducted with 222 healthcare stakeholders including healthcare providers, managers, policy-makers, and payers to identify factors affecting the quality of healthcare services provided in Iranian healthcare organisations. Results Quality in healthcare is a production of cooperation between the patient and the healthcare provider in a supportive environment. Personal factors of the provider and the patient, and factors pertaining to the healthcare organisation, healthcare system, and the broader environment affect healthcare service quality. Healthcare quality can be improved by supportive visionary leadership, proper planning, education and training, availability of resources, effective management of resources, employees and processes, and collaboration and cooperation among providers. Conclusion This article contributes to healthcare theory and practice by developing a conceptual framework that provides policy-makers and managers a practical understanding of factors that affect healthcare service quality.

  11. Architecture of personal healthcare information system in ubiquitous healthcare

    NARCIS (Netherlands)

    Bhardwaj, S.; Sain, M.; Lee, H.-J.; Chung, W.Y.; Slezak, D.; et al., xx

    2009-01-01

    Due to recent development in Ubiquitous Healthcare now it’s time to build such application which can work independently and with less interference of Physician. In this paper we are try to build the whole architecture of personal Healthcare information system for ubiquitous healthcare which also

  12. Malicious acts involving radioactive sources: prevention and preparedness for response

    International Nuclear Information System (INIS)

    Pradeepkumar, K.S.

    2008-01-01

    Full text: The increasing concern over the malevolent use of radioactive sources and radiological terrorism demands strengthening the preparedness for response to radiological emergencies. In spite of various security measures adopted internationally, availability of orphan sources cannot be completely ruled out. The trends in terrorism also indicates the possibility of various means which may be adopted by terrorists especially if they are aware of the challenges of radioactive contamination in public domain and the capability of 'denial of area' and the fear factor which can be injected during such radiological emergencies. It is to be well understood that whatever measures are taken by some countries in preventing the sources from getting stolen or smuggled in/out of their country are not adequate to eliminate radiological terrorism in a global level unless all nations collectively address and ensure the security of radioactive sources, hence preventing the generation of any orphan sources. While preparedness for response to various radiological emergency scenario have many common factors, the challenges involved in responding to radiological terrorism involves understanding the fear factor due to the presence of radioactive contamination after the blast and thermal effects on the victims and issues like handling of contaminated and seriously injured persons, restriction on the movement of responders and forensic teams in a contaminated field etc. Hence an understanding and anticipation of all possible means of radiological terrorism is very essential to prevent and to reduce the consequences. There are many deterrents, which are to be developed and maintained by all nations collectively which should include intelligence, wide usage of radiation monitors by customs, police and other security agencies, installation of state of the art high sensitive radiation monitors and systems etc to prevent and deter stealing and illicit trafficking of radioactive sources

  13. The Study to Improve Tsunami Preparedness Education in Turkey

    Science.gov (United States)

    Sakamoto, Mayumi; Tanırcan, Gülüm; Kaneda, Yoshiyuki; Puskulcu, Seyhun; Kumamoto, Kunihiko

    2016-04-01

    Compared to its long history on disastrous earthquakes, disaster education history in Turkey is rather short. It has just started with an initiative of Disaster Preparedness Education Unit of Bogazici University (BU/DPEU) after 1999 Kocaeli Earthquake. Training modules and materials on disaster preparedness were prepared both for students, teachers and community. Regarding to the school education, the Ministry of National Education (MoNE) reformed their education plan in 2003, and disaster education became one of eight focused components for primary-middle education. In 2011-2014 MoNE had conducted "School-based Disaster Education Project" in collaboration with Japan International Cooperation Agency (JICA). The majority of the school education materials focus more on earthquake and there are very few education programs on tsunami. Within the MarDiM (Earthquake and Tsunami Disaster Mitigation in the Marmara Region and Disaster Education in Turkey) project between Turkey and Japan a multidisciplinary engineering research as well as development of disaster education, tsunami education booklet and video were newly developed in 2015. In order to investigate students' knowledge natural disasters and disaster preparedness with focus on tsunami, a questionnaire based survey was conducted. The survey aims to clarify following questions: 1) how students obtain natural disaster information, 2) how students prepare for natural disaster, 3) knowledge on tsunami (hazard mechanism, evacuation behavior, historical disaster). The study was conducted by BU/DPEU in 2015 and 375 students answered the questionnaire. Results showed that students have more interest on earthquake, flood, tsunami and landslide followed it. Most students have heard about tsunami and the school is a key resource of their information. They know relatively well about tsunami mechanism, however, they have less knowledge on tsunami evacuation behavior and tsunami history in Turkey. In order to let students have

  14. Emergency preparedness and response: achievements, future needs and opportunities

    International Nuclear Information System (INIS)

    Kelly, G.N.

    2000-01-01

    The Chernobyl accident had a profound effect on emergency preparedness and response world-wide and particularly within Europe. Deficiencies in arrangements for dealing with such a large accident, at both national and international levels (eg, world trade in foodstuffs), led to many problems of both a practical and political nature. Many lessons were learnt and considerable resources have since been committed to improve emergency preparedness and avoid similar problems in future. Improvements have been made at national, regional and international levels and have been diverse in nature. Some of the more notable at an international level are the convention on early notification, limits for the contamination of foodstuffs in international trade and broad agreement on the principles of intervention (albeit less so on their practical interpretation). At a regional level, many bi and multi-lateral agreements have been brought into to force for the timely exchange of information and the efficacy of these arrangements is increasingly being demonstrated by regional exercises. At a national level, the improvements have been diverse, ranging from the installation of extensive networks of gamma monitors to provide early warning of an accident to more robust and effective arrangements between the many organisations with a role or responsibility in an emergency. More than a decade after Chernobyl, it is timely to reflect on what has been achieved in practice and, in particular, whether there is a need for further improvement and, if so, where these aspects will be addressed in the context of the likelihood the decreasing resources will be allocated to this area in future as memories fade post Chernobyl. Particular attention will be given to: the potential for advances in informatics, communications and decision support to provide better emergency preparedness and response at reduced cost; the adequacy of guidance on intervention for the long tern management of containment areas

  15. A review of competencies developed for disaster healthcare providers: limitations of current processes and applicability.

    Science.gov (United States)

    Daily, Elaine; Padjen, Patricia; Birnbaum, Marvin

    2010-01-01

    In order to prepare the healthcare system and healthcare personnel to meet the health needs of populations affected by disasters, educational programs have been developed by numerous academic institutions, hospitals, professional organizations, governments, and non-government organizations. Lacking standards for best practices as a foundation, many organizations and institutions have developed "core competencies" that they consider essential knowledge and skills for disaster healthcare personnel. The Nursing Section of the World Association for Disaster and Emergency Medicine (WADEM) considered the possibility of endorsing an existing set of competencies that could be used to prepare nurses universally to participate in disaster health activities. This study was undertaken for the purpose of reviewing published disaster health competencies to determine commonalities and universal applicability for disaster preparedness. In 2007, a review of the electronic literature databases was conducted using the major keywords: disaster response competencies; disaster preparedness competencies; emergency response competencies; disaster planning competencies; emergency planning competencies; public health emergency preparedness competencies; disaster nursing competencies; and disaster nursing education competencies. A manual search of references and selected literature from public and private sources also was conducted. Inclusion criteria included: English language; competencies listed or specifically referred to; competencies relevant to disaster, mass-casualty incident (MCI), or public health emergency; and competencies relevant to healthcare. Eighty-six articles were identified; 20 articles failed to meet the initial inclusion criteria; 27 articles did not meet the additional criteria, leaving 39 articles for analysis. Twenty-eight articles described competencies targeted to a specific profession/discipline, while 10 articles described competencies targeted to a defined role

  16. Progress in Public Health Emergency Preparedness-United States, 2001-2016.

    Science.gov (United States)

    Murthy, Bhavini Patel; Molinari, Noelle-Angelique M; LeBlanc, Tanya T; Vagi, Sara J; Avchen, Rachel N

    2017-09-01

    To evaluate the Public Health Emergency Preparedness (PHEP) program's progress toward meeting public health preparedness capability standards in state, local, and territorial health departments. All 62 PHEP awardees completed the Centers for Disease Control and Prevention's self-administered PHEP Impact Assessment as part of program review measuring public health preparedness capability before September 11, 2001 (9/11), and in 2014. We collected additional self-reported capability self-assessments from 2016. We analyzed trends in congressional funding for public health preparedness from 2001 to 2016. Before 9/11, most PHEP awardees reported limited preparedness capabilities, but considerable progress was reported by 2016. The number of jurisdictions reporting established capability functions within the countermeasures and mitigation domain had the largest increase, almost 200%, by 2014. However, more than 20% of jurisdictions still reported underdeveloped coordination between the health system and public health agencies in 2016. Challenges and barriers to building PHEP capabilities included lack of trained personnel, plans, and sustained resources. Considerable progress in public health preparedness capability was observed from before 9/11 to 2016. Support, sustainment, and advancement of public health preparedness capability is critical to ensure a strong public health infrastructure.

  17. Public Health Preparedness Funding: Key Programs and Trends From 2001 to 2017.

    Science.gov (United States)

    Watson, Crystal R; Watson, Matthew; Sell, Tara Kirk

    2017-09-01

    To evaluate trends in funding over the past 16 years for key federal public health preparedness and response programs at the US Department of Health and Human Services, to improve understanding of federal funding history in this area, and to provide context for future resource allocation decisions for public health preparedness. In this 2017 analysis, we examined the funding history of key federal programs critical to public health preparedness by reviewing program budget data collected for our annual examination of federal funding for biodefense and health security programs since fiscal year (FY) 2001. State and local preparedness at the Centers for Disease Control and Prevention initially received $940 million in FY2002 and resulted in significant preparedness gains, but funding levels have since decreased by 31%. Similarly, the Hospital Preparedness Program within the Office of the Assistant Secretary for Preparedness and Response was funded at a high of $515 million in FY2003, but funding was reduced by 50%. Investments in medical countermeasure development and stockpiling remained relatively stable. The United States has made significant progress in preparing for disasters and advancing public health infrastructure. To enable continued advancement, federal funding commitments must be sustained.

  18. centred healthcare in South Africa

    African Journals Online (AJOL)

    2016-07-15

    Puchalski) was one of the editors of the Oxford textbook on spirituality in ..... and in some cases provide up to 70% of all healthcare services. A hallmark of ..... including the business world, education, healthcare, the arts, ecology ...

  19. Art of disaster preparedness in European union: a survey on the health systems.

    Science.gov (United States)

    Djalali, Ahmadreza; Della Corte, Francesco; Foletti, Marco; Ragazzoni, Luca; Ripoll Gallardo, Alba; Lupescu, Olivera; Arculeo, Chris; von Arnim, Götz; Friedl, Tom; Ashkenazi, Michael; Fischer, Philipp; Hreckovski, Boris; Khorram-Manesh, Amir; Komadina, Radko; Lechner, Konstanze; Patru, Cristina; Burkle, Frederick M; Ingrassia, Pier Luigi

    2014-12-17

    Naturally occurring and man-made disasters have been increasing in the world, including Europe, over the past several decades. Health systems are a key part of any community disaster management system. The success of preparedness and prevention depends on the success of activities such as disaster planning, organization and training. The aim of this study is to evaluate health system preparedness for disasters in the 27 European Union member countries. A cross-sectional analysis study was completed between June-September 2012. The checklist used for this survey was a modified from the World Health Organization toolkit for assessing health-system capacity for crisis management. Three specialists from each of the 27 European Union countries were included in the survey. Responses to each survey question were scored and the range of preparedness level was defined as 0-100%, categorized in three levels as follows: Acceptable; Transitional; or Insufficient. Response rate was 79.1%. The average level of disaster management preparedness in the health systems of 27 European Union member states was 68% (Acceptable). The highest level of preparedness was seen in the United Kingdom, Luxemburg, and Lithuania. Considering the elements of disaster management system, the highest level of preparedness score was at health information elements (86%), and the lowest level was for hospitals, and educational elements (54%). This survey study suggests that preparedness level of European Union countries in 2012 is at an acceptable level but could be improved. Elements such as hospitals and education and training suffer from insufficient levels of preparedness. The European Union health systems need a collective strategic plan, as well as enough resources, to establish a comprehensive and standardized disaster management strategy plan. A competency based training curriculum for managers and first responders is basic to accomplishing this goal. Disaster medicine; Disaster preparedness

  20. Disaster preparedness in an Australian urban trauma center: staff knowledge and perceptions.

    Science.gov (United States)

    Corrigan, Ellen; Samrasinghe, Iromi

    2012-10-01

    A substantial barrier to improving disaster preparedness in Australia is a lack of prescriptive national guidelines based on individual hospital capabilities. A recent literature review revealed that only one Australian hospital has published data regarding its current preparedness level. To establish baseline levels of disaster knowledge, preparedness, and willingness to respond to a disaster among one hospital's staff, and thus enable the implementation of national disaster preparedness guidelines based on realistic capabilities of individual hospitals. An anonymous questionnaire was distributed to individuals and departments that play key roles in the hospital's external disaster response. Questions concerned prior education and experience specific to disasters, general preparedness knowledge, perceived preparedness of themselves and their department, and willingness to respond to a disaster from a conventional and/or chemical, biological, or radiological incident. Responses were received from 140 individuals representing nine hospital departments. Eighty-three participants (59.3%) had previously received disaster education; 53 (37.9%) had attended a disaster simulation drill, and 18 (12.9%) had responded to an actual disaster. The average disaster preparedness knowledge score was 3.57 out of 10. The majority of respondents rated themselves as "not really" prepared and were "unsure" of their respective departments' level of preparedness. Most respondents indicated a willingness to participate in both a conventional incident involving burns and/or physical trauma, and an incident involving chemical, biological or radiological (CBR) weapons. Australian hospital staff are under-prepared to respond to a disaster because of a lack of education, insufficient simulation exercises, and limited disaster experience. The absence of specific national standards and guidelines through which individual hospitals can develop their capabilities further compounds the poverty in