scholarly journals Adapting to change: Clalit's response to the COVID-19 pandemic

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Gil Lavie ◽  
Orly Weinstein ◽  
Yoram Segal ◽  
Ehud Davidson
Keyword(s):  
Large Scale ◽  
Healthcare Personnel ◽  
Past Century ◽  
Healthcare Organizations ◽  
Crisis Planning ◽  
Level Of Functioning ◽  
Best Response ◽  
Home Based ◽  
Health Event

AbstractThe COVID-19 pandemic is the most significant global health event of the past century. The profound and unexpected changes that it brought about have forced healthcare organizations to make far-reaching adjustments to accommodate the new reality. With the outbreak of the pandemic in Israel and the understanding of its consequences, Clalit Health Services (Clalit), the largest healthcare organization in Israel, rapidly mobilized in order to provide the best response possible from the perspective of both its patients and its employees. In the short term, four designated workgroups were established just days into the pandemic. Their task was to prepare operational work plans to achieve the following goals: providing the best possible treatment for COVID patients; maintaining the level of care for non-COVID patients; protecting healthcare personnel without compromising their competence and level of functioning; and beginning the process of post-crisis planning. In the context of the long term, and with the understanding that the changes in healthcare brought about by the COVID-19 pandemic would be long-lasting and irreversible, and would act as a catalyst in Clalit’s preparations for the future, Clalit has carried out the called-for modifications in its organizational strategy. This was based on the need to shift service and treatment foci from the hospitals to the community and the patient’s home and his cellular device, by means of strengthening Clalit’s strategic abilities to become more proactive, more digital and more home-based. In this article, we present a survey of Clalit’s preparations for the new reality in the short and medium terms, as well as the leveraging of insights gained during the first wave of the pandemic, with goal of revising Clalit’s long-term strategic plan. We conclude and point out the organizational abilities required for optimal response to future large-scale emergencies: The ability to quickly identify the need for change, respond quickly while harnessing the various parts of the organization in order to provide an agile and adaptive response, and facilitate long-term planning activity in parallel to providing an operational response in the short and medium terms.

scholarly journals A century of genetic homogenization in Baltic salmon—evidence from archival DNA

2021 ◽  
Vol 288 (1949) ◽  
Author(s):  
Johan Östergren ◽  
Stefan Palm ◽  
John Gilbey ◽  
Göran Spong ◽  
Johan Dannewitz ◽  
...  
Keyword(s):  
Baltic Sea ◽  
Large Scale ◽  
Isolation By Distance ◽  
Anthropogenic Impacts ◽  
Genetic Change ◽  
Past Century ◽  
The Baltic Sea ◽  
The Baltic ◽  
Archival Dna

Intra-species genetic homogenization arising from anthropogenic impacts is a major threat to biodiversity. However, few taxa have sufficient historical material to systematically quantify long-term genetic changes. Using archival DNA collected over approximately 100 years, we assessed spatio-temporal genetic change in Atlantic salmon populations across the Baltic Sea, an area heavily impacted by hydropower exploitation and associated with large-scale mitigation stocking. Analysis was carried out by screening 82 SNPs in 1680 individuals from 13 Swedish rivers. We found an overall decrease in genetic divergence and diminished isolation by distance among populations, strongly indicating genetic homogenization over the past century. We further observed an increase in genetic diversity within populations consistent with increased gene flow. The temporal genetic change was lower in larger wild populations than in smaller wild and hatchery-reared ones, indicating that larger populations have been able to support a high number of native spawners in relation to immigrants. Our results demonstrate that stocking practices of salmon in the Baltic Sea have led to the homogenization of populations over the last century, potentially compromising their ability to adapt to environmental change. Stocking of reared fish is common worldwide, and our study is a cautionary example of the potentially long-term negative effects of such activities.

Similar Holocene glaciation histories in tropical South America and Africa

Geology ◽  
2020 ◽  
Author(s):  
Anthony C. Vickers ◽  
Jeremy D. Shakun ◽  
Brent M. Goehring ◽  
Andrew Gorin, ◽  
Meredith A. Kelly ◽  
...  
Keyword(s):  
South America ◽  
Large Scale ◽  
Past Century ◽  
Tropical Glaciers ◽  
The Past ◽  
Ice Cap ◽  
Ice Retreat ◽  
Quelccaya Ice Cap ◽  
The Tropics

Tropical glaciers have retreated alongside warming temperatures over the past century, yet the way in which these trends fit into a long-term geological context is largely unclear. Here, we present reconstructions of Holocene glacier extents relative to today from the Quelccaya ice cap (Peru) and the Rwenzori Mountains (Uganda) based on measurements of in situ14C and 10Be from recently exposed bedrock. Ice-extent histories are similar at both sites and suggest that ice was generally smaller than today during the first half of the Holocene and larger than today for most, if not all, of the past several millennia. The similar glaciation history in South America and Africa suggests that large-scale warming followed by cooling of the tropics during the late Holocene primarily drove ice extent, rather than regional changes in precipitation. Our results also imply that recent tropical ice retreat is anomalous in a multimillennial context.

Estimating the hazard from extreme hail events across regional to local scales

2021 ◽  
Author(s):  
Katharina Schroeer ◽  
Cornelia Schwierz ◽  
Simona Trefalt ◽  
Alessandro Hering ◽  
Urs Germann
Keyword(s):  
Large Scale ◽  
Past Century ◽  
Worst Case ◽  
The Past ◽  
Weather Radars ◽  
Data Archives ◽  
Damage Claims ◽  
Definition Of ◽  
Convective Weather

<p>Hailstorms and associated hail stone sizes are a tricky atmospheric hazard to assess, because the processes leading to severe convective weather are complex and the spatiotemporal scales of the impacts are often small. The high natural variability of hail requires expensive high-resolution, area-covering measurements to establish robust statics. Weather radars help to achieve this, but despite growing data archives, records usually do not yet extend to climatological time scales (≥30y), and reference ground observations to calibrate hail algorithms are still fragmentary. Consequentially, there remain substantial uncertainties regarding the long-term hazard of hail. Nevertheless, stakeholders require estimates of return periods for preventive regulations or as input to downstream impact models, e.g., in the insurance and engineering sector.</p><p>In the project “Hail climatology Switzerland” MeteoSwiss partnered up with three federal offices, the insurance and engineering sectors to establish a common national reference of the occurrence of hail in Switzerland. The deliverables include developing return period maps of extreme hail events. However, the definition of such extremes varies across sectors. For example, stakeholders from damage prevention require impact probabilities of the largest hailstorm onto an average rooftop, whereas reinsurance stakeholders are interested in nation-wide worst-case events. Here we report on the approaches we took in deriving the frequencies of severe hail considering the different stakeholder demands and the challenges and uncertainties we thereby encountered.</p><p>Using newly reprocessed gridded radar hail data, we assess frequencies of observed hail occurrence in Switzerland over 19 years (2002-2020). We further developed a probabilistic hazard model using stochastic resampling of hailstorms, driven by large-scale environmental boundary conditions. In order to take a storm-object perspective on extremes, we isolate more than 40’000 individual hailstorm footprints. This allows us to consider local storm properties such as the distributions of hail stone sizes by storm area and duration. In addition, we identify region-dependent extreme storm properties, which is specifically relevant in the Alpine region, where high and complex topography creates sharp climatic gradients and results from other regions are often not easily transferable.</p><p>Results show that observed storm tracks vary strongly between years, and hail footprints vary substantially by storm type. Comparing our results obtained from the longest radar-based hail record so far, we find that the spatial patterns of hail agree well with existing hazard maps derived, i.a., from damage claims. However, we also find that frequencies of local extreme hail stone sizes may have been underestimated in the past. This is further corroborated by a regionally aggregated comparative analysis of the radar record to historical records of very large hail in Switzerland over the past century.</p>

Evolution of Large-Scale Coronal Structures

1994 ◽  
Vol 144 ◽  
pp. 29-33
Author(s):  
P. Ambrož
Keyword(s):  
Magnetic Field ◽  
Field Line ◽  
Large Scale ◽  
Coronal Magnetic Field ◽  
Source Surface ◽  
Solar Cycles ◽  
Characteristic Relationship ◽  
The Magnetic Field ◽  
Coronal Structures

AbstractThe large-scale coronal structures observed during the sporadically visible solar eclipses were compared with the numerically extrapolated field-line structures of coronal magnetic field. A characteristic relationship between the observed structures of coronal plasma and the magnetic field line configurations was determined. The long-term evolution of large scale coronal structures inferred from photospheric magnetic observations in the course of 11- and 22-year solar cycles is described.Some known parameters, such as the source surface radius, or coronal rotation rate are discussed and actually interpreted. A relation between the large-scale photospheric magnetic field evolution and the coronal structure rearrangement is demonstrated.

Computer Analyses in Preventive Health Research

1967 ◽  
Vol 06 (01) ◽  
pp. 8-14 ◽  
Author(s):  
M. F. Collen
Keyword(s):  
Medical Research ◽  
Preventive Medicine ◽  
Health Research ◽  
Large Scale ◽  
Preventive Health ◽  
New Era ◽  
Large Numbers ◽  
Normal Test ◽  
Computer Analyses

The utilization of an automated multitest laboratory as a data acquisition center and of a computer for trie data processing and analysis permits large scale preventive medical research previously not feasible. Normal test values are easily generated for the particular population studied. Long-term epidemiological research on large numbers of persons becomes practical. It is our belief that the advent of automation and computers has introduced a new era of preventive medicine.

A Case of Duodenal Neuroendocrine Carcinoma Treated with Amrubicin as Second-line Chemotherapy

2015 ◽  
Vol 24 (3) ◽  
pp. 379-382
Author(s):  
Tadahisa Inoue ◽  
Hitoshi Sano ◽  
Takashi Mizushima ◽  
Hirotada Nishie ◽  
Hiroyasu Iwasaki ◽  
...  
Keyword(s):  
Neuroendocrine Carcinoma ◽  
Distant Metastases ◽  
Salvage Chemotherapy ◽  
Second Line ◽  
Effective Treatment Option ◽  
Second Line Chemotherapy ◽  
Best Response ◽  
Long Term Effect ◽  
Line Chemotherapy

We present the case of a Japanese man in his 60s with duodenal neuroendocrine carcinoma with distant metastases. Chemotherapy with irinotecan plus cisplatin was initiated as a first-line regimen. However, disease progression was observed after only two cycles. Therefore, amrubicin was administered as a second-line chemotherapy. The patient showed a long-term effect of amrubicin therapy, and the best response was a partial response after seven cycles. For duodenal neuroendocrine carcinoma, amrubicin therapy can be considered an effective treatment option as salvage chemotherapy.

(A review) Atlas of especially protected natural areas of Saint Petersburg / Ed. in chief V. N. Khramtsov, T. V. Kovaleva, N. Yu. Natsvaladze. St. Petersburg, 2013. 176 p.

2014 ◽  
pp. 124-129
Author(s):  
Z. V. Karamysheva
Keyword(s):  
Protected Areas ◽  
Large Scale ◽  
Natural Areas ◽  
Natural Protected Areas ◽  
Saint Petersburg ◽  
Natural Processes ◽  
Original Illustrations ◽  
Vegetation Maps ◽  
Protected Natural Areas

The review contains detailed description of the «Atlas of especially protected natural areas of Saint Petersburg» published in 2013. This publication presents the results of long-term studies of 12 natural protected areas made by a large research team in the years from 2002 to 2013 (see References). The Atlas contains a large number of the historical maps, new satellite images, the original illustrations, detailed texts on the nature of protected areas, summary tables of rare species of vascular plants, fungi and vertebrates recorded in these areas. Special attention is paid to the principles of thematic large-scale mapping. The landscape maps, the vegetation maps as well as the maps of natural processes in landscapes are included. Reviewed Atlas deserves the highest praise.

Etude de l'aménagement d'une forêt classée au Mali avec la participation des populations riveraines - Données du problème et éléments de méthodologie | A Study of the Management of a State-Owned Forest in Mali with the Participation of the Population Living nearby - Issue under Investigation and Elements of Methodology

2000 ◽  
Vol 151 (3) ◽  
pp. 80-83
Author(s):  
Pascal Schneider ◽  
Jean-Pierre Sorg
Keyword(s):  
Natural Resources ◽  
Research Methodology ◽  
Large Scale ◽  
Environmental Context ◽  
Forest Resources ◽  
The State ◽  
Commercial Use ◽  
Economic Context ◽  
The People

In and around the state-owned forest of Farako in the region of Sikasso, Mali, a large-scale study focused on finding a compromise allowing the existential and legitimate needs of the population to be met and at the same time conserving the forest resources in the long term. The first step in research was to sketch out the rural socio-economic context and determine the needs for natural resources for autoconsumption and commercial use as well as the demand for non-material forest services. Simultaneously, the environmental context of the forest and the resources available were evaluated by means of inventories with regard to quality and quantity. According to an in-depth comparison between demand and potential, there is a differentiated view of the suitability of the forest to meet the needs of the people living nearby. Propositions for a multipurpose management of the forest were drawn up. This contribution deals with some basic elements of research methodology as well as with results of the study.

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