Context Of Emergence Research Articles

Rapid evaluation of COVID-19 related service and practice changes in health and human services using tailored methods.

The COVID-19 pandemic required substantive delivery and practice changes for government services under tight timeframes and high public scrutiny. These urgently implemented service changes provided the opportunity for evaluators to support decision-makers to understand the impact of adaptations for those delivering and receiving health and human services. Tailored rapid evaluation methods (REM) provide a pragmatic approach to generating timely information for evidence-based policy and decision-making under these conditions. Drawing from features of a range of existing rapid evaluation models, as well as developmental and utilization-focussed evaluation theory, this article outlines the design and implementation of a novel REM approach and considers the benefits of both tailoring and standardizing rapid evaluation approaches to meet end-user needs. The tailored REM approach and mixed methods are contextualized and compared to other documented rapid evaluation models to demonstrate the purpose and value of customization. This article builds on previous descriptions of the implementation of a novel REM approach to provide a comparative account of tailored rapid evaluation methods. The article outlines the drivers that led to the selected tailoring of the REM approach, and shares lessons learned in the context of the COVID-19 pandemic by a large internal government evaluation unit (Department of Health and Human Services) in Victoria, Australia. The customized features of REM ensure that it can consider the experiences of those delivering and receiving services, and inform near-term decision-making on programme and policy design in emergency and fast-paced contexts. The article shares a case study of a rapid evaluation of telehealth in pediatric care to demonstrate insights from tailoring the REM approach in practice. The REM method was utilized with the aim of delivering findings in a time-sensitive manner to rapidly inform decision making for policy-makers. Key enablers for the tailored REM protocol include the use of multi-disciplinary teams, flexible evaluation design, and a participatory approach that facilitates stakeholder involvement throughout delivery. Insights from the case study and methods presented seek to inform practice for evaluators who intend to or may want to tailor their own rapid evaluation model in resource and time-limited settings.

The Emergency of Prosociality: A Developmental Perspective on Altruism and Other Prosocial Behavior in the Face of Disaster

No two emergency situations are alike. A combination of human and contextual factors makes each emergency and disaster unique in its time line, its aftermath, and especially its impact on affected populations. In all of these situations, however, people engage in prosocial behavior that benefits others. We provide an overview of altruistic and other prosocial behavior in typical human development and of developmental distinctions between helping, sharing, and comforting. We focus on the expression of these behaviors in emergency situations, using the COVID-19 pandemic to illustrate how prosociality shifts and adapts in a specific context. Finally, we suggest that a developmental framework may help researchers and professionals in the field achieve a more comprehensive understanding of the many facets and underlying mechanisms of prosociality in emergency contexts.

Human preparedness: Relational infrastructures and medical countermeasures in Sierra Leone

ABSTRACT This paper examines health worker experiences in two areas of post-epidemic preparedness in Sierra Leone – vaccine trials and laboratory strengthening – to reflect on the place of people in current models of epidemic response. Drawing on ethnographic research and interviews with health workers in the aftermath of Ebola, it explores the hopes and expectations that interventions foster for frontline workers in under-resourced health systems, and describes the unseen work involved in sustaining robust response infrastructures. Our analysis focuses on what it means for the people who sustain health systems in an emergency to be ‘prepared’ for an epidemic. Human preparedness entails more than the presence of a labour force; it involves building and maintaining ‘relational infrastructures’, often fragile social and moral relationships between health workers, publics, governments, and international organisations. The COVID-19 pandemic has underscored the value of rethinking human resources from an anthropological perspective, and investing in the safety and support of people at the forefront of response. In describing the labour, personal losses, and social risks undertaken by frontline workers for protocols and practicality to meet in an emergency context, we describe the social process of preparedness; that is, the contextual engineering and investment that make response systems work.

What is conservative and revolutionary about the “conservative revolution”? Argument-level evidence from three thinkers

This article reassesses the concept of “conservative revolution” by textual and argumentative analysis of the work of Arthur Moeller van den Bruck, Ernst Jünger, and Hans Freyer – three prominent thinkers of the “conservative revolution” in interwar Germany. Rather than problematically conflating conservative and revolutionary elements into abstract ideological positions, which produces the “paradox” of conservative revolution observed by several scholars, I propose we must take seriously the argumentative context. What, exactly, did they mean by the apparently contradictory idea? This, I posit, can only be comprehended by analyzing the elements of conservatism and revolution in the original sources and with regard to the broader argumentative framework in which the notion of “conservative revolution” emerged. First, the article analyzes the three thinkers' idea of a future-oriented, politically creative, and genuinely historical conservatism in opposition to mere backward-looking unhistorical reactionism. Second, it addresses the question of revolution as a destructive political means for conservative ends and shows how Moeller, Jünger, and Freyer linguistically constructed a continuity between the failed revolution of 1918 and the anticipated conservative revolution. The three authors spoke of continuous movement, the conservation of energy, and volcanic forces to argue for a seamless continuity between the two revolutions, thereby using the proximity of the ideologically opposing revolt for their own argumentative ends. This situatedness gives rise to doubts about the generalizability of the conservative revolution idea beyond its context of emergence: although similar ideas emerged elsewhere in the era and have been revived lately among the New Right, the particular historical dynamics of the concept of conservative revolution hinders its applicability and popular appeal in later settings that lack comparable widely shared experiences of revolutionary events.

Use of Digital Resources in Higher Education during COVID-19: A Literature Review

The sudden transition from face-to-face education to remote education under the international-level restrictions imposed as a result of the COVID-19 pandemic—a transition made in the spirit of achieving and developing accessible education—involved the application of methodologically diverse resources and strategies. The objective of this article is to investigate the digital resources that have been applied in higher education institutions, paying special attention to the type and frequency of use of resources. A literature review was carried out on a total of 44 articles. The main results show that the primary resources applied in higher education institutions were videoconferencing tools, educational videos, and virtual platforms. Most higher education institutions made use of free and open access resources. Our primary conclusions posit our observation that the use of digital resources for teaching in an emergency context has not enabled reflection on their use. Such reflection would equip institutions for the optimization of these resources toward their efficient pedagogical application in teaching–learning processes.

Student Evaluation of Distance Learning during the COVID-19 Pandemic: A Cross-Sectional Survey on Medical, Dental, and Healthcare Students at Sapienza University of Rome.

The COVID-19 pandemic has had a deep impact on university education, necessitating an abrupt shift from face-to-face learning to distance learning (DL). This has created new challenges, especially for those courses in which practical activities and internships are integral parts of the education program. The aim of this study was to assess the impact of DL on the study progress of a population of pregraduate students of medicine, dentistry, and healthcare professions. The survey was administered through an anonymous questionnaire by sharing a Google Forms link. Demographic data and educational background information were collected to obtain a profile of the participants. Different aspects of DL were investigated, including availability of digital devices, quality of connection, and environmental conditions; other questions focused on the effects of DL on students’ progress and professional maturation. Measures of association were also calculated using the chi-squared test, Cramer V, and Somers D. Among the 372 who participated, the results showed that students had a positive attitude toward online classroom and that DL did not substantially affect their progress. Most of the associations were statistically significant, also highlighting the effect of the degree course on the responses. Some critical issues clearly emerged, however, including the lack of adequate devices and environmental conditions due to economic disparity, poor relationships, suspension of internship programs, and clinical training. The results suggest that DL cannot be considered as a substitute for classroom-based medical education outside an emergency context.

Shared Situational Awareness within the Hospital Emergency Context: A Scoping Review.

Background. Shared Situation Awareness (SSA) has been applied in many fields such as sport, the military and aviation with promising outcomes on team performance. The application of SSA within the hospital emergency healthcare context has not been explored yet. The aim of this scoping review is to explore and map literature related to shared situational awareness within the hospital emergency healthcare context. Methods. The Arksey and O’Malley (2005) framework was used in which three electronic databases were searched for evidence investigating SSA within a hospital emergency healthcare context. Results. A review of the literature showed a clear lack of evidence that directly investigates SSA within the context of hospital emergency care. In the emergency medical field, the term SSA is seldom used and ‘team situation awareness’ is the most frequently used term. The most common framework was the three-level framework. Two techniques were reported in the selected studies to investigate SSA (1) freeze probe technique and (2) observer-based rating technique. The freeze probe technique mandates a simulation or artificial environment, while the observer-based rating technique could be applied in an ecological as well as an artificial environment. There is no standardized technique to calculate the score of the SSA. Finally, there was a significant impact of SSA on clinical team performance as well as some related skills such as leadership, task management, mindfulness and task prioritization. Conclusions. Reviewing the literature revealed a lack of studies investigating the use of SSA within the context of hospital emergency care. There is also a lack of agreement on how a SSA score should be calculated. Further studies are required to overcome these issues.

Conducting rapid qualitative interview research during the COVID-19 pandemic-Reflections on methodological choices.

As the COVID-19 pandemic has shown, setting up studies in time to gather relevant, real-world data enables researchers to capture current views and experiences, focus on practicalities on the ground, and deliver actionable results. Delivering high quality rapid studies in healthcare poses several challenges even in non-emergency situations. There is an expanding literature discussing benefits and challenges of conducting rapid research, yet there are relatively few examples related to methodological dilemmas and decisions that researchers may face when conducting rapid studies. In rapidly-changing emergency contexts, some of these challenges may be more easily overcome, while others may be unique to the emergency, magnified, or emerge in different ways. In this manuscript, we discuss our reflections and lessons learnt across the research process when conducting rapid qualitative interview studies in the context of a healthcare emergency, focusing on methodological issues. By this we mean the challenging considerations and pragmatic choices we made, and their downstream impacts, that shaped our studies. We draw on our extensive combined experience of delivering several projects during the COVID-19 pandemic in both single and multi-country settings, where we implemented rapid studies, or rapidly adapted an existing study. In the context of these studies, we discuss two main considerations, with a particular focus on the complexities, multiple facets, and trade-offs involved in: (i) team-based approaches to qualitative studies; and (ii) timely and rapid data collection, analysis and dissemination. We contribute a transparent discussion of these issues, describing them, what helped us to deal with them, and which issues have been difficult to overcome. We situate our discussion of arising issues in relation to existing literature, to offer broader recommendations while also identifying gaps in current understandings of how to deal with these methodological challenges. We thus identify key considerations, lessons, and possibilities for researchers implementing rapid studies in healthcare emergencies and beyond. We aim to promote transparency in reporting, assist other researchers in making informed choices, and consequently contribute to the development of the rapid qualitative research.

Basic education in emergency contexts: what does research say about the reality of COVID-19?

The health seriousness due to the Covid-19 virus pandemic that has been installed worldwide since 2019 has brought news in all areas of social life. In Brazil, the federal government has little to do with public policies aimed at social areas. While science, in addition to numerous assumptions and being the object of government denialist discourses, has sought to contribute to the clarification of the phenomenon of the pandemic and its impacts on society. Therefore, the present study sought to analyze the panorama of research, in the period 2020 and 2021, on basic education in times of a pandemic. For that, from a qualitative approach, a bibliographic research was carried out in which 11 works were selected. The investigations demonstrate that the option for distance teaching has proved to be the main alternative for the educational offer in this scenario, but its implementation accentuates the educational inequalities that exist in the country.

When timing is key: How autocratic and democratic leadership relate to follower trust in emergency contexts.

In emergency contexts, leaders’ ability to develop others’ trust in them is critical to leadership effectiveness. By integrating functional leadership and team process theories, we argue that democratic and autocratic leadership can create trust in the leader depending on the performance phase of the action team. We further argue that action and transition phases produce different task demands for leadership behavior to enhance trust in the leader, and different leader characteristics (i.e., leader benevolence and leader ability) mediate these effects. The results of a scenario experiment (N = 125) and field survey (N = 165) among firefighters revealed that autocratic rather than democratic leadership elevates trust in the leader during the action phase by increasing leader ability. In contrast, democratic rather than autocratic leadership enhances trust in the leader during the transition phase by elevating leader benevolence. These findings highlight the importance of leader characteristics in emergencies, demonstrating the value of mixing autocratic and democratic leadership behaviors across different team performance phases to build trust in the leader.

Taming a Flow of Contamination: A Constitutive Approach to Flows in an Emergency Context

This article explores flows as a key feature of emergency contexts and how various actors manage them. Based on a single-case study of the Papa Giovanni XXIII hospital in Bergamo, Northern Italy, this article shows how actors manage a flow of contamination during the COVID-19 pandemic by shifting and sharing authority, manipulating space, and developing and coordinating a flow of treatment and safety protocols. This study contributes to the literature on emergency contexts and organizational flows by highlighting their importance in emergency contexts and challenging widely shared assumptions about flows and how they are managed. We elaborate a constitutive approach to study organizational flows that can be utilized in other areas of management and organization research, and propose future avenues for emergency context research that focuses on flows.

Beneficial effects of a program of Mindfulness by remote during COVID-19 lockdown.

In the emergency context of COVID-19 pandemic and lockdown, mindfulness relaxation techniques can provide a safe and effective strategy to obtain in a reasonably short time some degree of relief from suffering and to guarantee a greater confidence with emotional reactions in the general population. The Mindfulness-Based Stress Reduction program for coping with COVID-19 emergency was designed as an 8-week program during the early phase of lockdown consisting in practice meditation exercises at least once a day guided and structured by certified instructors entered on a free online platform. At the end of the program all participants completed a survey. A total of 108 surveys were completed (67.6% male; 32.4% female). Despite the difficult moment of lockdown and the fear linked to the pandemic, 61.9% of interviewed subjects declared a state of general well-being from fair to good linked to the practice of mindfulness. Female subjects (p=0.001), married subjects (p=0.05) and people taking pharmacologic therapy demonstrated (p=0.009) significant improvement in daily management of emotions and practical requests during the early phase of the COVID-19 outbreak. Mindfulness meditation may be effective in helping people to regulate emotions and to support their mental health during this period of worry and uncertainty.

Discursive construction in multilingual crisis risk communication: An analysis of ‘A letter to foreign nationals’ messages in China’s COVID-19 fight

This article examines the discursive construction of a specific letter-style multilingual crisis message released by local governmental institutions during China’s battle against the COVID-19 pandemic. Based on a sociocognitive analysis of a collection of 33 English-language messages, the analysis revealed the structural features of the message and the discursive strategies in constructing and negotiating the identities of the message’s addresser and the addressee. It was found that the discursive relationship between the addresser and the addressee was established on an ingroup-outgroup distinction mediated by neutralising strategies to reduce authoritative imposition and image-enhancing strategies to promote a responsible government. The findings suggest that multilingual crisis communication is a multivocal, complex social practice shaped by genre, textual, media and contextual factors. These findings will provide insights into the crisis discourse as an emerging topic of interest and help inform multilingual communication strategies in and beyond the context of a public health emergency.

Reduction of urea test ordering in the emergency department: multicomponent intervention including education, electronic ordering, and data feedback.

IntroductionIn the emergency department (ED), laboratory testing accounts for a significant portion of the medical assessment. Although excess laboratory test ordering has been proven to be prevalent, different types of interventions have been used to encourage a behavioural change in how physicians order tests. In one western Canadian hospital medicine program, a quality improvement project aimed to reduce the total monthly blood urea nitrogen (BUN) test ordered by physicians was found to be successful. The objective of this project was to evaluate a similar multicomponent intervention aimed at ED physician ordering, with the primary goal of reducing the number of monthly BUN tests ordered per ED visit.MethodsA pre post intervention design was conducted over 12-months. The first intervention component was an educational presentation conducted by physician leaders. Second, a regularly used order panel within the ED electronic order system was modified, removing the BUN test. The third component involved audit and feedback; the total monthly BUN test ordered for the ED department post intervention start was shared with all ED physicians twice (at 5 and 12 months).An interrupted time series analysis was completed to evaluate the multicomponent intervention effect.ResultsThe total monthly ordered BUN test declined from an average of 1905 pre-intervention to 448 post-intervention, and the total monthly BUN test to total ED visit ratio declined from 0.46 to 0.1. These results were a statistically significant reduction in physician BUN test ordering.ConclusionsTargeted education, order panel design and data feedback interventions can impact physician ordering behaviour in the emergent healthcare context, where diagnostic tests are often over used.Supplementary InformationThe online version contains supplementary material available at 10.1007/s43678-022-00333-w.

Assessment of perceived support in the context of emergency: Development and validation of the psycho-social support scale

In research and clinical contexts, it is important to briefly evaluate perceived Psychological and Social Support (PSS) to plan psychological interventions and allocate efforts and resources. However, an appropriate brief assessment tool for PSS was lacking. This study aimed at developing a brief and accurate scale to specifically measure PSS in clinical and emergency contexts, with specific, relevant, targeted, and irredundant items. Experienced clinicians developed the perceived Psycho-Social Support Scale (PSSS) and administered it to a clinical sample (N = 112) seeking psychological help during the COVID-19 emergency. A Confirmatory Factor Analysis examined the PSSS internal structure, and a Multiple Indicator and Multiple Causes model investigated its association with the number of sessions and emotional symptoms. The PSSS showed good psychometric properties and the Confirmatory Factor Analysis provided acceptable fit indexes for a unidimensional structure. The Multiple Indicators and Multiple Causes revealed that more sessions and emotional symptoms were associated with lower PSSS scores. The PSSS is a reliable brief tool to measure PS and could be useful to individualize treatments (i.e., number of sessions) to efficiently allocate efforts and resources in clinical contexts and emergencies (e.g., earthquake, COVID-19 pandemic).

Development of Multi-epitope Based Subunit Vaccine Against Crimean-Congo Hemorrhagic Fever Virus Using Reverse Vaccinology Approach.

Crimean-Congo hemorrhagic fever (CCHF) is a viral disease caused by the Crimean-Congo hemorrhagic fever virus (CCHFV) of the Nairovirus genus. CCHF has occurred endemically in several regions of Africa, Southern Europe, and Central and Southeast Asia, with a case fatality rate of 5 to 80%. The World health organization enlisted CCHF as one of the top prioritized diseases for research and development in emergency contexts that making it a public health concern as no effective vaccine is available till date. Therefore, the present study aims to develop an effective multi-epitope subunit vaccine using immunoinformatics and reverse vaccinology approach against this virus. The B-cell and T-cell epitopes were predicted from structural and non-structural proteins, and filtered by immunogenicity, allergenicity, toxicity, conservancy, and cross-reactivity. The computational analysis revealed that the epitopes could induce an adequate immune response and had strong associations with their respective human leukocyte antigen (HLA) alleles with 98.94% of total world population coverage. Finally, the vaccine with 427 amino acids was constructed by connecting 8 cytotoxic T-lymphocytes, 4 helper T-lymphocytes, and 10 B-cell epitopes with appropriate linkers and β-defensin as an adjuvant. The antigenicity, allergenicity, solubility, and physiochemical properties of the vaccine were evaluated, followed by structural modelling, refinement, and validation. In addition, molecular docking and molecular dynamic simulations revealed a robust binding affinity and stability of the vaccine-immune receptor complex. Moreover, the codons were optimized for its higher expression in Escherichia coli (E. coli) K12 strain followed by in silico cloning. The proposed subunit vaccine developed in this study could be a potential candidate against CCHFV. However, further experimental validation is required to ensure the immunogenicity and safety profile of the proposed vaccine for combating and eradicating CCHFV.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10989-022-10430-0.

Navigating hope and despair in sustainability education: A reflexive roadmap for being with eco-anxiety in the classroom

In this article, we reflect on our experiences of teaching sustainability in management education in an emergent context of increasing and pervasive eco-anxiety. Our collaborative autoethnographic enquiry stemmed from the tensions we experienced in our desire to present a realistic view of the future to students, while still maintaining their (and our) sense of hope and agency. While sustainability in management education has long acknowledged the need to engage learners’ hearts and hands as well as their heads, the challenges of effectively integrating the emotional (heart) dimension in the classroom have remained under-explored in the literature. We develop the findings of our collaborative autoethnography into a framework that provides insights for educators navigating the range of emotional responses evoked in the sustainability in management education classroom. This framework acts as a roadmap, based around five spheres of practice, that will aid sustainability in management education educators in making more conscious and deliberate choices about their teaching practice within the complex context of eco-anxiety.

Factors influencing severity of recurrent malaria in a conflict-affected state of South Sudan: an unmatched case-control study

BackgroundThe burden of malaria remains the highest in sub-Saharan Africa and South Sudan is not an exception. The country has borne the brunt of years of chronic warfare and remains endemic of malaria, with increasing mortality and morbidity. Limited data still exists on factors influencing the recurrence of severe malaria, especially in emergency contexts such as South Sudan, affected by various conflicts and humanitarian situations. This study therefore aimed to investigate factors influencing severity of occurrence malaria in selected primary healthcare centres in South Sudan. This would assist and guide in malaria prevention, treatment, and eradication efforts.MethodsWe conducted an unmatched case-control study using routinely collected clinic data for individuals aged 1 year and above who received a diagnosis of severe malaria at 3 primary healthcare centres (PHCC); Malual Bab PHCC, Matangai PHCC and Malek PHCC between September 15, 2019 to December 15, 2019 in South Sudan. Patient characteristics were analyzed using simple descriptive statistics. Inferential statistics were also conducted to identify the associated factors influencing recurrence of severe malaria. All analyses were conducted using R Version 3.6.2.ResultsA total of 289 recurrent malaria cases were included in this study. More than half of the participants were female. Overall, the prevalence of severe recurrent malaria was 66.1% (191) while 74.4% (215) did not complete malaria treatment. Among those who did not complete malaria treatment, 76.7% (165) had severe recurrent malaria, while among those who completed malaria treatment 35.1% (26) had severe recurrent malaria (p < 0.001). There is a significant association between marital status (OR 0.33, 95% CI 0.19–0.56, p < 0.001), employment status (OR 0.35, 95% CI 0.14–0.87, p = 0.024), the use of preventive measures (OR 3.82, 95% CI 1.81–8.43, p < 0.001) and nutrition status (OR 0.22, 95% CI 0.13–0.37, p < 0.001). When adjusted for employment, marital status, nutritional and prevention measures in turns using Mantel–Haenszel test of association, this effect remained statistically significant.ConclusionsOur study showed that there is a high prevalence of severe recurrent malaria in South Sudan and that a significant relationship exists between severe recurrent malaria and antimalarial treatment dosage completion influenced by certain personal and social factors such as marital status, employment status, the use of preventive measures and nutrition status. Findings from our study would be useful for effective response to control and prevent malaria in endemic areas of South Sudan.

The Eudemonic Wellbeing of Volunteers in a Public Health Emergency: COVID-19 in China.

With improvements in the public awareness regarding volunteer opportunities, more people are participating in social work, particularly during emergency events. The mental health of volunteers has been attracting more academic attention due to its increasing social significance. Drawing on the Theory of Planned Behavior, a qualitative interview was conducted to identify important attitudes, subjective norms, and perceived control factors guiding people’s volunteering behaviors in an emergency context. Then, a sequential quantitative survey was implemented based on the results of the qualitative study to explore the impact of the aforementioned factors and job involvement on eudemonic well-being. The moderating role of empathy in these relationships was also investigated in this nested design. The results indicate that behavioral attitudes, perceived control, and job involvement have significant positive effects on volunteers’ eudemonic well-being. A high perspective taking (cognitive empathy) of volunteers positively moderates the relationship between job involvement and eudemonic well-being, while high personal distress (affective empathy) buffers this relationship. The theoretical and practical implications of these findings are discussed in relation to emergency volunteer activities.

Difficultés diagnostiques du trouble de conversion à l’adolescence : étude mixte qualitative et clinique autour du parcours de soin d’une jeune fille de 15 ans

IntroductionThe diagnosis of conversion disorder causes many difficulties in children and adolescents. As a diagnosis of exclusion, it implies diagnostic procedures that are often long and costly. The objective is to describe the difficulties encountered by health professionals in the diagnostic process when faced with an atypical neurological symptom. MethodA mixed study combining a case study and a thematic qualitative study based on semi-directed interviews with the physicians who managed the patient of the case study. ResultsThe case study highlighted the difficulties of articulation with psychiatry. The thematic analysis revealed four main difficulties: 1) specific patients with a complex picture that lead to diagnostic difficulties in emergency; 2) specific parents with a strong demand for a precise diagnosis despite an ambivalence towards psychiatric illness; 3) a specific physio-psycho-pathology that can be difficult to explain to patients and families due to a lack of knowledge among somatic physicians; 4) a feeling of failure and doubt with regard to these complex pictures leading to difficulties in positioning the patients. ConclusionPatients with conversion disorders require time, listening and reflection. This temporality is not compatible with the emergency context, often reinforced by the pressure of worried parents. The lack of specialized training in mental health and interdisciplinarity and the stigmatization of psychiatric diagnostic hypotheses hinder care and can lead to serious consequences in the short and long term.