scholarly journals An ethical approach to considering family presence during COVID-19

2020 ◽  
pp. 084047042098065
Author(s):  
Elizabeth Bardon
Keyword(s):  
Decision Making ◽  
Risk Mitigation ◽  
Tertiary Care ◽  
Mitigation Strategies ◽  
Ethical Framework ◽  
Care Hospital ◽  
Healthcare Organizations ◽  
Family Presence ◽  
The Public ◽  
Risk Mitigation Strategies

The COVID-19 pandemic has required healthcare organizations to introduce risk mitigation strategies that challenge usual family presence (visitor) policies. Policies within healthcare must be viewed from an ethical lens, which includes ensuring that the patient voice helps guide decision-making. In considering pandemic-specific family presence policies, Kingston Health Sciences Centre, an academic tertiary care hospital in Southeastern Ontario, applied an ethical framework for decision-making. The various tensions between the values of duty to provide care, protection of the public from harm, transparency, proportionality, and patient-centred care are highlighted in a discussion of how patient partners contributed to decision-making about family presence in the first 9 months of the COVID-19 pandemic.

scholarly journals Hydroxychloroquine: does prophylaxis work?

2021 ◽  
Vol 8 (12) ◽  
pp. 5805
Author(s):  
Atul Jha ◽  
Manish Bhartiya ◽  
Vijay R. Kumar ◽  
Vimal Upreti ◽  
Parag Deshmukh ◽  
...  
Keyword(s):  
Risk Mitigation ◽  
Tertiary Care ◽  
Mitigation Strategies ◽  
Care Hospital ◽  
The North ◽  
Group I ◽  
Risk Mitigation Strategies ◽  
Front Line Workers ◽  
Group Ii ◽  
Exposure Prophylaxis

Background: Healthcare workers are front line workers in management of SARS-CoV-2 pandemic. The higher risk of acquiring the infection due to increased contact and exposures has prompted multiple risk mitigation strategies. To assess the role of hydroxychloroquine pre-exposure prophylaxis in prevention of SARS-CoV-2 infection amongst HCWs.Methods: This retrospective cohort study assessed the effect of HCQS prophylaxis amongst HCWs in a tertiary care hospital in the north-eastern part of India. All HCWs, involved in management of SARS-CoV-2 were enrolled. The subjects were retrospectively divided in two groups on HCQ prophylaxis. Group I (51.8%, n=116) taking HCQ prophylaxis and group II (48.2%, n=108) not taking the prophylaxis. The demographic characteristics, use of PPE, HCQ prophylaxis and side effect profile were noted. Results: Of the whole cohort, 22.8% (n=51) subjects tested positive. In group I (n=116), 24 subjects (20.7%) tested positive, whereas in Group II (n=108), 27 subjects (25.0%) tested positive. Further analysis of the incidence of SARS-CoV-2 infection amongst the two groups demonstrated that the although the rate of infection was lower (20.7% vs 25%) in Group I as compared to group II [X2 (1, N=224)=0.371, p=0.5] but it was statistically insignificant.Conclusions: Our study involving HCWs, does not show a statistically significant reduction in the incidence of infection with pre-exposure prophylaxis. Based on our findings and published literature, a prophylaxis of HCQS against the SARS-CoV-2 infection cannot be recommended.

scholarly journals Management of Cardiac Implantable Electrical Devices in Patients Undergoing Radiofrequency Ablation for Spine Pain: Physician Survey and Review of Guidelines

2020 ◽  
Vol 4;23 (7;4) ◽  
pp. E335-E342
Author(s):  
Jason Friedrich
Keyword(s):  
Decision Making ◽  
Chronic Pain ◽  
Radiofrequency Ablation ◽  
Joint Pain ◽  
Risk Mitigation ◽  
Narrative Review ◽  
Mitigation Strategies ◽  
Web Based ◽  
Electrical Devices ◽  
Risk Mitigation Strategies

Background: More patients with cardiac implantable electrical devices (CIEDs) are presenting to spine and pain practices for radiofrequency ablation (RFA) procedures for chronic pain. Although the potential for electromagnetic interference (EMI) affecting CIED function is known with RFA procedures, available guidelines do not specifically address CIED management for percutaneous RFA for zygapophyseal (z-joint) joint pain, and thus physician practice may vary. Objectives: To better understand current practices of physicians who perform RFA for chronic z-joint pain with respect to management of CIEDs. Perioperative CIED management guidelines are also reviewed to specifically address risk mitigation strategies for potential EMI created by ambulatory percutaneous spine RFA procedures. Study Design: Web-based provider survey and narrative review. Setting: Multispecialty pain clinic, academic medical center. Methods: A web-based survey was created using Research Electronic Data Capture (REDCap). A survey link was provided via e-mail to active members of the Spine Intervention Society (SIS), American Society of Regional Anesthesia and Pain Medicine, as well as distributed freely to community Pain Physicians and any receptive academic departments of PM&R or Anesthesiology. The narrative review summarizes pertinent case series, review articles, a SIS recommendation statement, and multi-specialty peri-operative guidelines as they relate specifically to spine RFA procedures. Results: A total of 197 clinicians participated in the survey from diverse clinical backgrounds, including anesthesiology, physical medicine and rehabilitation, radiology, neurosurgery, and neurology, with 81% reporting fellowship training. Survey responses indicate wide variability in provider management of CIEDs before, during, and after RFA for z-joint pain. Respondents indicated they would like more specific guidelines to aid in management and decision-making around CIEDs and spine RFA procedures. Literature review yielded several practice guidelines related to perioperative management of CIEDs, but no specific guideline for percutaneous spine RFA procedures. However, combining the risk mitigation strategies provided in these guidelines, with interventional pain physician clinical experience allows for reasonable management recommendations to aid in decision-making. Limitations: Although this manuscript can serve as a review of CIEDs and aid in management decisions in patients with CIEDs, it is not a clinical practice guideline. Conclusions: Practice patterns vary regarding CIED management in ambulatory spine RFA procedures. CIED presence is not a contraindication for spine RFA but does increase the complexity of a spine RFA procedure and necessitates some added precautions. Key words: Radiofrequency ablation, neurotomy, cardiac implantable electrical device, zygapophyseal joint, spondylosis, neck pain, low back pain, chronic pain

scholarly journals Experiential account of risk mitigation strategies in a tertiary care psychiatric setting during COVID-19 pandemic

2021 ◽  
Vol 56 ◽  
pp. 102556
Author(s):  
Sundarnag Ganjekar ◽  
Guru S. Gowda ◽  
Damodharan Dinakaran ◽  
Sharad Philip ◽  
Nellai K. Chithra ◽  
...  
Keyword(s):  
Risk Mitigation ◽  
Tertiary Care ◽  
Mitigation Strategies ◽  
Psychiatric Setting ◽  
Risk Mitigation Strategies

scholarly journals Coronavirus Disease 2019: Community Risk Mitigation Strategies in China

2020 ◽  
Vol 01 (01) ◽  
pp. 73-87
Author(s):  
Benran Jiang ◽  
Wei Li ◽  
Ting Yuan
Keyword(s):  
Risk Mitigation ◽  
Mitigation Strategies ◽  
Contact Tracing ◽  
Targeted Prevention ◽  
Risk Levels ◽  
The Public ◽  
Effective Contact ◽  
Community Risk ◽  
Risk Mitigation Strategies ◽  
And Control

The COVID-19 pandemic has been a global health emergency. In the absence of effective pharmaceutical interventions and vaccine, long-term community risk mitigation strategies are crucial to prevent and control the resurgence of the epidemic in China. A multi-level, region-specific and dynamic approach has been applied to ensure early detection, quick response, effective contact tracing and management, and targeted prevention and control on the basis of risk levels. Science popularization of the public health measures in the community is also an important strategy to curb the risk of pandemic.

Social media use in the legal profession

2018 ◽  
Vol 43 (2) ◽  
pp. 120-125
Author(s):  
Alyce Zawacki
Keyword(s):  
Social Media ◽  
Media Use ◽  
Risk Mitigation ◽  
Mitigation Strategies ◽  
Ethical Challenges ◽  
Social Media Use ◽  
Legal Professionals ◽  
The Public ◽  
Risk Mitigation Strategies ◽  
Important Evidence

There has been a large uptake of social media use by legal professionals over recent years, but with the embrace of the 21st-century lawyer comes an obligation to not only use social media but to do so ethically. Undoubtedly, social media presents a number of ethical challenges for the profession. However, with risk mitigation strategies, Web 2.0 can be used to gain clients through advertising, gather important evidence, serve court documents, network with others in the field and, most importantly, educate the public.

scholarly journals 307 A systems approach to understanding biosecurity decision-making

2020 ◽  
Vol 98 (Supplement_4) ◽  
pp. 43-43
Author(s):  
Scott C Merrill ◽  
Christopher Koliba ◽  
Gabriela Bucini ◽  
Eric Clark ◽  
Luke Trinity ◽  
...  
Keyword(s):  
Decision Making ◽  
Negative Impact ◽  
Risk Mitigation ◽  
African Swine Fever Virus ◽  
The United States ◽  
Mitigation Strategies ◽  
Communication Strategy ◽  
Livestock Industry ◽  
Diarrhea Virus ◽  
Operational Level

Abstract Disease and its consequences result in social and economic impacts to the US animal livestock industry, ranging from losses in human capital to economic costs in excess of a billion dollars annually. Impacts would dramatically escalate if a devastating disease like Foot and Mouth Disease or African Swine Fever virus were to emerge in the United States. Investing in preventative biosecurity can reduce the likelihood of disease incursions and their negative impact on our livestock industry, yet uncertainty persists with regards to developing an effective biosecurity structure and culture. Here we show the implications of human behavior and decision making for biosecurity effectiveness, from the operational level to the owner/managerial level and finally to the systems level. For example, adjustments to risk messaging strategies could double worker compliance with biosecurity practices at the operational level. The improvement of our risk communication strategy may increase willingness to invest in biosecurity. Furthermore, the adaptation of policies could nudge behavior so that we observe a short disease outbreak followed by a quick eradication instead of a pandemic. Our research shows how the emergence of now-endemic diseases, such as Porcine Epidemic Diarrhea virus, cannot be adequately modeled without the use of a human behavioral component. Focusing solely on any one sector or level of the livestock system is not sufficient to predict emergent disease patterns and their social and economic impact on livestock industries. These results provide insight toward developing more effective risk mitigation strategies and ways to nudge behavior toward more disease resilient systems.

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