The use of exercises to enhance and assess interlocal collaboration in preparedness: A qualitative analysis

2016 ◽  
Vol 13 (6) ◽  
pp. 499
Author(s):  
Nicole A. Errett, PhD, MSPH, CPH, CE ◽  
Shannon Frattaroli, PhD, MPH ◽  
Daniel J. Barnett, MD, MPH ◽  
Beth A. Resnick, MPH ◽  
Lainie Rutkow, PhD, JD, MPH
Keyword(s):  
Emergency Preparedness ◽  
Policy Development ◽  
Large Scale ◽  
Best Practice ◽  
Future Research ◽  
Emergency Plan ◽  
Semistructured Interviews ◽  
Development Support ◽  
Assessment Strategies

Introduction: Interlocal collaboration, or collaboration among neighboring independent municipalities, has been generally accepted as an emergency preparedness strategy. In the absence of large-scale disasters, emergency preparedness exercises may serve to test the effectiveness of interlocal collaboration on emergency preparedness. However, the use of emergency preparedness exercises to enhance or assess interlocal collaboration, or its impact on preparedness, requires additional empirical exploration. Hypothesis/problem: This exploratory study aims to understand the perspectives of key informants (KIs) with broad knowledge of the history, goals, and implementation of the Urban Area Security Initiative (UASI) program, as well as knowledge of interlocal collaboration exercises conducted as part of the UASI program, about the role of exercises in improving and assessing interlocal collaboration for emergency preparedness.Method: In early 2014, 28 KIs were interviewed during 24 semistructured interviews. Interviews were recorded and analyzed to identify key themes related to emergency preparedness exercises and the enhancement and assessment of interlocal collaboration.Results: KIs perceived exercises to enhance interlocal collaboration in preparedness by promoting regional, interlocal: risk assessment; emergency plan testing and operationalization; relationship development; support for regional plans and operational structures; capability delivery practice; best practice sharing across interlocal collaborations; and engagement of elected or senior leadership in interlocal preparedness endeavors. Exercise participants, scenarios, administration, formats, and assessment strategies to promote interlocal collaboration were identified. Conclusions: Seven distinct mechanisms by which exercises can enhance interlocal collaboration that can be used to guide future research and policy development were identified. The format, scenario, participation, and administration of emergency preparedness exercises can be tailored to enhance collaboration.

Emergency preparedness in a sample of persons with disabilities

2013 ◽  
Vol 8 (1) ◽  
pp. 35-47 ◽  
Author(s):  
Robyn R. M. Gershon, MHS, DrPH ◽  
Lewis E. Kraus, MPH, MCP ◽  
Victoria H. Raveis, PhD ◽  
Martin F. Sherman, PhD ◽  
June I. Kailes, MSW
Keyword(s):  
Emergency Preparedness ◽  
Large Scale ◽  
Planning Process ◽  
Limited Attention ◽  
Emergency Plan ◽  
Cross Sectional ◽  
Persons With Disabilities ◽  
Personal Assistance ◽  
Effective Strategies

Objective: The objective of this study was to characterize emergency preparedness in this vulnerable population, and to ascertain the role of the personal assistant (PA) and the potential impact of prior emergency experience on preparedness efforts.Design: Cross-sectional Internet-based survey conducted in 2011.Setting: Convenience sample.Participants: Two-hundred fifty-three community residents with cognitive and/or physical disabilities, all receiving personal assistance services.Main outcome variables: Emergency preparedness, operationalized as responses to a seven-item scale.Results: The mean score for the emergency preparedness scale was 2.32 (SD = 2.74), range 0-7. Even though 62.8 percent (n = 159) of the participants had previously experienced one or more large-scale emergencies, only 47.4 percent (n = 120) of the entire sample and 55.3 percent (n = 88) of those with actual emergency experience reported preparing an emergency plan. Sixty-three percent (n = 76) of those reporting a plan had involved their PA in its development. Participants who reported such involvement were significantly more likely to have higher scores on the emergency preparedness scale (p 0.001). Participants who had experienced a prior emergency were also more likely to score higher on the emergency preparedness scale (p 0.001). In general, participants reported limited attention to other basic preparedness recommendations: only 28 percent (n = 70) had prepared a “go-bag” with necessary supplies, 29 percent (n = 74) had developed a strategy for communicating with their PA during emergencies, and 32 percent (n = 81) had stockpiled emergency supplies. Of particular importance, only 26 percent (n = 66) had made alternative back-up plans for personal assistance.Conclusions: Involving the PA in the planning process and experiencing an emergency were both significantly associated with higher emergency preparedness scores in this sample of people living with disabilities. However, critical deficiencies in preparedness were noted, such as lack of back-up plans for replacing their PA. Despite a concerted national effort to improve preparedness in the population of people living with disabilities, important preparedness gaps remain. These findings highlight the need for additional study on emergency preparedness barriers in people living with disabilities so that effective strategies to reduce vulnerabilities can be identified.

scholarly journals (P2-1) Large Civilian Jets Configured for Aeromedical Use: Implications for Disaster Health

2011 ◽  
Vol 26 (S1) ◽  
pp. s135-s135
Author(s):  
S. Curnin
Keyword(s):  
Emergency Preparedness ◽  
Large Scale ◽  
International Study ◽  
Extensive Literature ◽  
Aeromedical Evacuation ◽  
Study Tour ◽  
Health Agencies ◽  
Effective Option ◽  
The Military

BackgroundAustralia is a vast and isolated country and often the only viable option of transporting multiple casualties is using fixed wing aircraft. A number of civilian aeromedical services and the military are responsible for the evacuation of casualties, both nationally and internationally. Due to Australia's increased operational commitments, the military can no longer be expected to provide a rapid aeromedical deployment. This situation, coupled with the limited surge capacity of Australia's civilian fixed wing aeromedical services, highlights the need for Australia to improve preparation and readiness for a large scale civilian aeromedical response.Discussion and ObservationsHistorically, the use of large jets configured for aeromedical use has been exclusively the domain of the military. Yet in recent years the use of large civilian jets configured for aeromedical capability has been suggested as a solution. The purpose of this paper is to explore the role of large civilian jets configured for aeromedical use in the event of a disaster with multiple casualties. This study involved an extensive literature review and an international study tour of aeromedical services that are at the forefront of using large jets in aeromedical evacuation. The findings identified that standard civilian jets can easily be reconfigured for transporting multiple casualties. It is argued that this strategy can be an inexpensive and effective option and should be included in emergency preparedness arrangements. The aim of this paper is to prompt disaster health agencies in Australia to consider the use of a civilian jet system that can be used for a disaster requiring a large scale aeromedical response.

ON THE CHARACTERISTICS OF INNOVATIVE FIRMS IN KOREA: THE ROLE OF R&D AND INNOVATION TYPE

1999 ◽  
Vol 03 (01) ◽  
pp. 111-131 ◽  
Author(s):  
YONG-TAE PARK ◽  
CHUL-HYUN KIM ◽  
JI-HYO LEE
Keyword(s):  
Large Scale ◽  
Data Gathering ◽  
Policy Implications ◽  
Future Research ◽  
Different Types ◽  
Innovative Firms ◽  
Unexpected Findings ◽  
Innovation Type ◽  
Recent Extension

In spite of the recent extension of our knowledge on technological innovation, little inquiry has been made of the distinctive characteristics between R&D firms and non-R&D firms, as well as between product-innovative firms and process-innovative firms. To this end, the main objective of this empirical study, grounded on a large-scale innovation survey of Korean manufacturing firms, is to contrast these two types of firms. The results were mixed. Some hypotheses were confirmed while others were discordant with expectation. By and large, R&D firms and product-innovative firms seem to share a similar propensity, whereas non-R&D firms and process-innovative firms are alike in character. However, there were some unexpected findings which merit attention and are worthy of in-depth examination. Although the study is subject to limitations in terms of its research design and data gathering, the results render some important policy implications. Furthermore, comparative analyses between different types of innovations need to be addressed more extensively in future research.

scholarly journals Economic analysis of the implementation of autologous transfusion technologies throughout England

2005 ◽  
Vol 21 (2) ◽  
pp. 234-239 ◽  
Author(s):  
Simon Dixon ◽  
Virge James ◽  
Daniel Hind ◽  
Craig J. Currie
Keyword(s):  
Policy Development ◽  
Large Scale ◽  
Future Research ◽  
Cell Salvage ◽  
Autologous Transfusion ◽  
The United Kingdom ◽  
Intraoperative Cell Salvage ◽  
The Mean ◽  
The Cost ◽  
Preoperative Autologous Donation

Objectives:This study aims to provide the first estimates of the costs and effects of the large scale introduction of autologous transfusion technologies into the United Kingdom National Health Service.Methods:A model was constructed to allow disparate data sources to be combined to produce estimates of the scale, costs, and effects of introducing four interventions. The interventions considered were preparing patients for surgery (PPS) clinics, preoperative autologous donation (PAD), intraoperative cell salvage (ICS), and postoperative cell salvage (PoCS).Results:The key determinants of cost per operation are the anticipated level of reductions in blood use, the mean level of blood use, mean length of stay, and the cost of the technology. The results show the potential for considerable reductions in blood use. The greatest reductions are anticipated to be through the use of PPS and ICS. Vascular surgery, transplant surgery, and cardiothoracic surgery appear to be the specialties that will benefit most from the technologies.Conclusions:Several simplifications were used in the production of these estimates; consequently, caution should be used in their interpretation and use. Despite the drawbacks in the methods used in the study, the model shows the scale of the issue, the importance of gathering better data, and the form that data must take. Such preliminary modeling exercises are essential for rational policy development and to direct future research and discussion among stakeholders.

scholarly journals Understanding barriers to linking novel consumer and lifestyle data for health research, results from the LifeInfo Survey: a topic modelling approach (Preprint)

2020 ◽  
Author(s):  
Holly Clarke ◽  
Stephen Clark ◽  
Mark Birkin ◽  
Heather Iles-Smith ◽  
Adam Glaser ◽  
...  
Keyword(s):  
Data Sharing ◽  
Large Scale ◽  
Best Practice ◽  
Latent Dirichlet Allocation ◽  
Data Linkage ◽  
Public Attitudes ◽  
Future Research ◽  
Store Loyalty ◽  
Topic Modelling ◽  
Personal Privacy

BACKGROUND Novel consumer and lifestyle data, for example those collected by supermarket loyalty cards or mobile phone exercise tracking apps, offer numerous benefits for researchers wishing to understand diet and exercise related risk factors for diseases. Yet, limited research has addressed public attitudes towards linking these data with individual health records for research purposes. OBJECTIVE The aim of this research was to identify key barriers for data linkage and recommend safeguards and procedures that would encourage individuals to share these data for potential future research. METHODS The LifeInfo Survey consulted the public on their attitudes towards sharing consumer and lifestyle data for research purposes. Where barriers to data sharing existed, participants provided unstructured survey responses detailing what would make them more likely to share data for linkage with their health record in the future. The topic modelling technique Latent Dirichlet Allocation (LDA) was used to analyse these textual responses to uncover common thematic topics within the texts. RESULTS Participants provided responses related to sharing their store loyalty card data (n = 2,338) and health/fitness app data (n = 1,531). Key barriers to data sharing identified through topic modelling included: data safety and security, personal privacy, requirements of further information, fear of data being accessed by others, problems with data accuracy, not understanding the reason for data linkage and not using data production services. We provide recommendations for addressing these issues to establish best practice for future researchers wishing to utilise these data. CONCLUSIONS This study formulates large-scale consultation of public attitudes towards data linkage of this kind, as such, it is an important first step in understanding and addressing barriers to participation for research utilising novel consumer and lifestyle data.

The administrative state in food policymaking: a fait accompli

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Margaret Bancerz
Keyword(s):  
Policy Process ◽  
Policy Development ◽  
Food Policy ◽  
Administrative State ◽  
Nonstate Actors ◽  
Content Type ◽  
Semistructured Interviews ◽  
Elite Interviews

PurposeThis paper analyzes scholarly literature and the development of a nonstate food strategy in Canada, the Conference Board of Canada's Canadian Food Strategy, to explore the role of the administrative state in food policymaking.Design/methodology/approachThis research is based on an exploratory case study drawing data from 38 semistructured interviews, including elite interviews. It also draws on policy documents from the nonstate food strategy.FindingsThis paper shows that various nonstate actors, including large food industry players, identify a role for the state in food policy in two ways: as a “conductor,” playing a managing role in the food policy process, and as a “commander,” taking control of policy development and involving nonstate actors when necessary. The complex and wicked aspects of food policy require the administrative state's involvement in food policymaking, while tamer aspects of food policy may be less state-centric.Originality/valueThis paper fills gaps in studies exploring food policymaking processes as well as the administrative state's role in food policymaking in a governance era. It contributes to a better understanding of the state's role in complex and wicked policy domains.

Inside and Outside of Hillforts

2012 ◽  
Author(s):  
Dennis Harding
Keyword(s):  
Large Scale ◽  
Eastern Mediterranean ◽  
Public Funding ◽  
Future Research ◽  
Implicit Assumption ◽  
Social Functions ◽  
Economic Role ◽  
Surface Survey ◽  
The 1960S

By the 1960s, a greater interest in the social and economic role of hillforts demanded more extensive excavation of their interiors. Whilst fieldwork was still dependent on volunteer labour and limited research funds, the expense of large-scale stripping by hand would have been prohibitive, and only with public funding of ‘rescue’ or ‘salvage’ excavation in advance of development was it practical to contemplate large-scale area excavation. Hillforts that were extensively excavated included Balksbury (Wainwright 1969; Wainwright and Davies 1995; Ellis and Rawlings 2001) and Winklebury (Smith 1977; Robertson-Mackay 1977; Fisher 1985) in Hampshire. Whilst large-scale examination of hillfort interiors is plainly essential to an understanding of their economic and social functions, there is a high probability that ephemeral features, the foundations of which did not penetrate into subsoil or bedrock, will be destroyed by mechanical stripping, if they have not already been damaged beyond retrieval by ploughing. So the question remains: how partial and therefore potentially misleading are the surviving plans of hillfort interiors thus exposed? Hillfort exteriors, arguably equally important to an understanding of the role of the enclosure as its interior, have been even more neglected, first because of an implicit assumption that the earthworks defined the area of the ‘site’, and second, because the logistical problems of excavating outside the limits of the ramparts increased exponentially with distance from the enclosure. The possibility, indeed probability, of activity contemporary with the occupation of the hillfort having extended beyond the limits of the rampart need not necessarily imply a social division between acropolis and polis on the eastern Mediterranean model. It simply requires a redefinition of the concept of what constituted the ‘site’ in which the enclosure earthworks are not the definitive criterion. The issue was identified more than thirty years ago (Harding 1979; Hingley 1980), and excavation and survey at Battlesbury Camp, Wiltshire (Ellis and Powell 2008) and Castle Hill, Little Wittenham (Allen et al. 2011), has shown its importance for future research. There are three principal, non-intrusive ways of investigating hillfort interiors and immediate exteriors. The first is by surface survey, not in itself as simple as may appear at first sight, since detecting and meaningfully depicting the highly fugitive traces of prehistoric occupation requires an experienced eye, sensitive to the residual surface signs of constructional activity.

scholarly journals Living with severe asthma: the role of perceived competence and goal achievement

2019 ◽  
pp. 174239531988410
Author(s):  
Daniela Eassey ◽  
Helen K Reddel ◽  
Kath Ryan ◽  
Lorraine Smith
Keyword(s):  
Severe Asthma ◽  
Healthcare Providers ◽  
Perceived Competence ◽  
Goal Achievement ◽  
Self Management ◽  
Future Research ◽  
Face To Face ◽  
Management Interventions ◽  
Semistructured Interviews

Objective The overall aim of this study was to examine, among individuals living with severe asthma, the role of perceived competence in achieving their goals. Methods Qualitative research methods were used to conduct in-depth semistructured interviews. Interviews were video and/or audio recorded, transcribed and analyzed inductively and deductively, informed by the self-determination theory construct of perceived competence. Thirty-six face-to-face interviews, lasting 1.5–4 h, were conducted across Australia. Results Feeling competent to achieve asthma goals played a role in participants’ ability to achieve broader goals. Their desire to achieve their broader goals was strongly driven by their perceived ability to master managing their condition, which at times required more than medical strategies. Two main themes were discerned from the analysis: (1) learning how to look after yourself: self-care is important and (2) reaching an agreement with severe asthma: being at one with the illness. Discussion This study highlighted the influence of perceived competence on self-management and goal achievement in severe asthma. Healthcare providers could explore patients’ perceived competence to set and achieve goals, as a self-management strategy. Future research should consider these findings when developing and implementing patient-driven, self-management interventions for those living with severe asthma.

Rethinking Evaluation for Improved Health Outcomes: Implications for Remote Australia

2019 ◽  
Vol 41 (2) ◽  
pp. 234-254 ◽  
Author(s):  
Timothy A. Carey ◽  
James M. Fauth ◽  
George C. Tremblay
Keyword(s):  
Health Outcomes ◽  
Monitoring And Evaluation ◽  
Future Research ◽  
Policy And Practice ◽  
Community Partners ◽  
Service Effectiveness ◽  
Semistructured Interviews ◽  
External Evaluators ◽  
Ongoing Monitoring

Despite enduring and unacceptable disparities in health outcomes for Aboriginal and Torres Strait Islander Australians as well as people living in rural and remote locations, evidence indicates that health services are not routinely evaluated. This article describes an exploration of a context where evaluators and community partners have achieved considerable success in implementing and sustaining ongoing monitoring and evaluation for enhanced service effectiveness in rural and underserved communities of New Hampshire. The purpose of this project was to establish the principles supporting this success and to set the stage for future research investigating the applicability of these principles to the remote Australian context. Semistructured interviews were conducted with 15 people from different organizations and in different positions within those organizations. The results invite a reconsideration of the way in which evidence-based practice is conceptualized as well as the role of external evaluators. The study has important implications and recommendations for both policy and practice.

Nurses' Conceptions of Decision Making Concerning Life-Sustaining Treatment

2008 ◽  
Vol 15 (2) ◽  
pp. 160-173 ◽  
Author(s):  
Marit Silén ◽  
Mia Svantesson ◽  
Gerd Ahlström
Keyword(s):  
Decision Making ◽  
Qualitative Content Analysis ◽  
Future Research ◽  
Dialysis Patients ◽  
Next Of Kin ◽  
Test Models ◽  
Semistructured Interviews ◽  
Nurses Role ◽  
Life Sustaining Treatment

The aim of this study was to describe nurses' conceptions of decision making with regard to life-sustaining treatment for dialysis patients. Semistructured interviews were conducted with 13 nurses caring for such patients at three hospitals. The interview material was subjected to qualitative content analysis. The nurses saw decision making as being characterized by uncertainty and by lack of communication and collaboration among all concerned. They described different ways of handling decision making, as well as insufficiency of physician—nurse collaboration, lack of confidence in physicians, hindrances to patient participation, and ambivalence about the role of patients' next of kin. Future research should test models for facilitating communication and decision making so that decisions will emerge from collaboration of all concerned. Nurses' role in decision making also needs to be discussed.

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