Crisis Planning Research Articles

Trends in hospital acquired New Delhi metallo-beta-lactamase-producing Enterobacterales in Tuscany (Italy) from 2019 to 2021: impact of the COVID-19 pandemic

In Tuscany, Italy, New Delhi metallo-beta-lactamase-producing carbapenem-resistant Enterobacterales (NDM-CRE) in hospitalized patients has increasingly been observed since 2018, leading in 2019 to the implementation of enhanced control measures successfully reducing transmission. We describe the NDM-CRE epidemiology during the COVID-19 pandemic in Tuscany. Data on NDM-CRE patients hospitalized in five Tuscan hospitals were collected from January 2019 to December 2021. Weekly rates of NDM-CRE cases on hospital days in medical and critical-care wards were calculated. In March-December 2020, NDM-CRE rates were stratified by COVID-19 diagnosis. Multi-variate regression analysis was performed to assess outcomes' differences among two periods analysed and between COVID-19 populations. Since March 2020, an increase in NDM-CRE cases was observed, associated with COVID-19 admissions. COVID-19 patients differed significantly from non-COVID-19 ones by several variables, including patient features (age, Charlson index) and clinical history and outcomes (NDM-CRE infection/colonization, intensive care unit stay, length of stay, mortality). During the pandemic, we observed a higher rate of NDM-CRE cases per hospital day in both non-COVID-19 patients (273/100,000) and COVID-19 patients (370/100,00) when compared with pre-pandemic period cases (187/100,00). Our data suggest a resurgence in NDM-CRE spread among hospitalized patients in Tuscany during the COVID-19 pandemic, as well as a change in patients' case-mix. The observed increase in hospital transmission of NDM-CRE could be related to changes in infection prevention and control procedures, aimed mainly at COVID-19 management, leading to new challenges in hospital preparedness and crisis management planning.

도시홍수 통합관리모델 수립연구

Urban areas with high levels of impervious cover and inadequate flood-mitigation policies are becoming increasingly vulnerable to flooding compared to other areas. Despite nationwide efforts to mitigate flood damages, which primarily focus on major rivers, smaller rivers and urban catchments still experience frequent floods. This study utilized a semi-distributed hydrologic model and SWMM to consider the potential backwater effect on inland flooding. Through complementary analysis using observed rainfall and flow data from early October 2016 (Typhoon Chaba), the study was conducted on the Yugok Catchment. The results demonstrate the advantages of the semi-distributed model, which can handle spatial-temporal rainfall distribution and infiltration parameters while maintaining relatively faster calculation speed compared to a fully-distributed model. Furthermore, this study suggests that integrating the model with the SWMM can provide sufficient, accurate, and prompt information to enable effective flood crisis management plan.

Crisis plans in mental health: A scoping review.

Crisis situations are frequent among people with mental health disorders. Several interventions have been developed to act in prevention, including crisis plans recognized as particularly effective in reducing coercive measures. In the literature, several models of crisis plans are proposed with similar aims and contents. Based on the methodology proposed by the Joanna Briggs Institute, a scoping review was conducted to map the state of knowledge on crisis plans in adult mental health settings. The literature search conducted on six databases (CINAHL, PubMed, Medline, EMBASE, PsychINFO and Cochrane) yielded 2435 articles. Of these, 122 full-text articles were assessed for eligibility, and 78 met the inclusion criteria. Studies were critically appraised using the Joanna Briggs Institute appraisal tools, and data were extracted by two independent reviewers. Content analysis identified a typology of crisis plans: (1) the legal crisis plan and (2) the formal crisis plan. Five modalities were identified for its completion: the sections, the moment, the completion steps, the people involved and the training of key actors. Most identified outcomes are consistent with the main purpose of the intervention, which is crisis prevention. However, the most identified outcomes focused on the service user's recovery and indicated that crisis plans could provide an opportunity to operationalize recovery in mental healthcare, thus suggesting an evolution in the aim of the intervention. Future research should further focus on the modalities of crisis plans to guide the implementation in clinical practice.

Changes in Hotel Management During the Covid-19 Pandemic and Post-pandemic Periods in Georgia

The COVID-19 pandemic, which caused significant human loss, significantly damaged several economic sectors, primarily tourism and its significant segment, the hotel industry. In Georgia in 2019, before the pandemic, tourism reached its highest indicators since its independence. International arrivals totaled 7,7 million, with 5.1 million tourist visits; tourism accounted for 8.4% of the gross domestic product (GDP), while the number of people engaged in the industry was 11.6% of all employees in the country. By the end of the first year of the pandemic, the number of international tourist visits to Georgia decreased by 78.5% (2020), and 66.0% of hotels and food sector facilities in the country ceased operations. Several hotels were used as quarantine spaces and "Covid hotels" during the pandemic, per government decree. To overcome the crisis, targeted measures were developed, envisaging support and special activities as well as financial benefits for the subjects of the tourism industry. Nevertheless, the crisis management plan could have been better and did not foresee the alterations necessary after the pandemic, which caused significant consumer behaviour changes in the hotel industry. Now customers give priority to compliance with hygiene and safety norms. However, most hospitality industry organisations in Georgia need more resources for implementing new technologies that meet tourists' needs. The pandemic has aggravated the problem of staff outflow and redistribution to other sectors. In the post-pandemic period, an increase in demand for medical and health-improving tourist programmes and ecological and adventure tours is expected, which should be provided with appropriate accommodation facilities.

Psychiatric Advance Directives: A Call for Humanization

Psychiatric Advance Directives: A Call for Humanization

Redefining crisis in museums: Insiders perspectives on digital engagement

AbstractCOVID‐19 has highlighted the need for museums to develop policies and practices that allow them to be more responsive to audiences' during a crisis, in many cases pushing them to explore new technologies and approaches. Based on an analysis of the National Museum of Australia and its digital engagement throughout the 2019/2020 bushfire season and the COVID‐19 pandemic, this paper identifies a lack of literature to support the need for digital channels to be incorporated in institutional crisis planning. Referencing “Momentous”, a purpose‐built website, and two Facebook groups, “Fridge Door Fire Stories” and “Bridging the Distance,” we explore the content shared on these platforms by users and place this in conversation with the reflections of the cultural workers who created and maintained these online platforms. We suggest digital technologies help communities to take a more active role in negotiating how the museum represents their experiences.

The Impact of Modern Crisis Management Strategies on Crisis Management Planning

The research aims to identify modern strategies for crisis management, and their impact on planning for crisis management, where the research was applied to employees in the directorates of the university presidency and its offices, totaling (75) employees. The researcher used the descriptive approach, and a questionnaire consisting of (28) items was prepared. It included two approaches (modern strategies for crisis management, and crisis management planning). A questionnaire was distributed electronically to a research sample of (60) employees, which was determined from the Krejci and Morgan table. The researcher found that there is a statistically significant effect of modern strategies for crisis management on management planning the crisis, at the level of significance of 5%, and the most modern used strategies were the strategy of Crisis Fragmentation, followed by Changing Path strategy, then the strategy of Containing the Crisis, then the strategy of Crisis Exhausting, followed by the strategy of the Work Teams, then the strategy of the Mobilization Reserve in the last phase. The research concluded there are no statistically significant differences in modern strategies for crisis management according to the variable (gender, educational qualification, respondent’s character, age), at the level of significance of 5%, and the researcher recommended the need to form task forces to manage crises in colleges with expertise, provide the necessary material and human support.

Financial, policy, and ethical barriers to the expansion of living donor liver transplant: Meeting report from a living donor liver transplant consensus conference.

In October 2021, the American Society of Transplantation (AST) hosted a virtual consensus conference aimed at identifying and addressing barriers to the broader, safe expansion of living donor liver transplantation (LDLT) throughout the United States (US). A multidisciplinary group of LDLT experts convened to address issues related to financial implications on the donor, transplant center crisis management, regulatory and oversight policies, and ethical considerations by assessing the relative significance of issues in preventing LDLT growth, with proposed strategies to overcome barriers. Living liver donors endure multiple obstacles including financial instability, loss of job security, and potential morbidity. These concerns, along with other center, state, and federal specific policies can be perceived as significant barriers to expanding LDLT. Donor safety is of paramount importance to the transplant community; however, regulatory and oversight policies aimed at ensuring donor safety can be viewed as ambiguous and complicated leading to time-consuming evaluations that may deter donor motivation and program expansion. Transplant programs need to establish appropriate crisis management plans to mitigate potential negative donor outcomes and ensure program viability and stability. Finally, ethical aspects, including informed consent for high-risk recipients and use of non-directed donors, can be perceived as additional barriers to expanding LDLT.

Transforming challenges into opportunities – a case study of Shukan hospital during COVID-19

Learning outcomes This case analysis will make the audience aware of the sudden nature of the crisis, specifically the transboundary crisis. They will be introduced to the concepts of participative leadership and situational leadership. Majorly the audience would learn to remain composed in times of crisis and comprehend how a circumstance can transform a participatory leadership style into a situational leadership style. The case will allow the audience to brainstorm how to take innovative decisions to manage a crisis situation. The primary objectives of the case are as follows: ■ to understand a transboundary crisis and its characteristics to deal with it; ■ to visualise the application of participative and situational leadership and evaluate and analyse the most suitable leadership style during an unknown crisis; ■ to make the students aware of how to remain composed in times of crisis and, for instance, implementing the change of leadership styles per the situation's requirement; and ■ to make students learn to design innovative decision-making strategies to develop a crisis management plan for managing future crises. Case overview/synopsis The case highlights the successful management of the crises faced by a multi-specialty hospital named “Shukan-Caring Lives”, established in 2017 in Vadodara city of Gujarat, India. The case revolves around the Chief Operating Officer, his executive management body and the paramedical and medical staff of the hospital, who dealt with the grave Corona crisis. This case shows how the change in leadership style from participative to situational leadership style could manage the situation by taking brilliant initiatives and providing insightful solutions with a lot of dedication, showing how situational leadership can deal with the transboundary crisis. Complexity academic level The case is an excellent example of a transboundary crisis for any organisation and demonstrates a novel idea of transforming the participative leadership style into a situational leadership style as and when the need arises. The topics of transboundary crisis and management crisis can be taught in strategic management. At the same time, leadership styles and transformation of leadership style can be covered in organisation behaviour. Management development programmes can also include such kinds of cases to give exposure to crisis and its management. The target audience would be PG management students, management executives and senior-level managers in various courses. Supplementary material Teaching notes are available for educators only. Subject code CSS 11: Strategy.

Two-Dimensional Modelling for Dam Break Analysis and Flood Hazard Mapping: A Case Study of Papadia Dam, Northern Greece

Dams are expensive technical constructions that ensure food production, sustain farmers’ income, and cover a large percentage of urban water supply demands. However, the threat of a dam break flood, which can be extremely dangerous for the local society, should be taken into account, and proactive mitigation measures should be planned. Towards this direction, dam break modelling and flood hazard assessment are essential for developing flood crisis management and evacuation plans. In this study, a hypothetical case of failure of the Papadia dam in the Florina Regional Unit in northern Greece is examined. Two scenarios of failure were considered: overtopping and piping. A two-dimensional numerical model for the two failure scenarios was used to simulate the dam break process and flood wave routing using HEC-RAS software. A sensitivity analysis of the mesh size and breach parameters was performed to better understand their impact on the critical outputs of the simulation model. Flood hazard maps were produced in GIS environment based on water depth and velocity criteria. Furthermore, two classification approaches were adopted to assess the flood hazard using the product of water depth and velocity. The results showed that the extent of the inundated area could affect most of the study area and could cause severe damage to agricultural activities.

IMPACT OF PAK-IMF BAILOUT ARRANGEMENT ON ECONOMIC GROWTH

Government of Pakistan has been facing various macro-economic challenges due to internal and external factors. Pak economy suffers from monetary, fiscal and BOP crisis after every few years building up a near crisis scenario which needs to be managed through traditional stabilization policies most common among them is approaching to IMF. Pakistan’s policy of dependence on internal and external loans is not new and the cost of these crisis management plans has a strong reason behind slowing down socio-economic development.
 The recent economic crisis has approached after facing a significantly harsh macroeconomic imbalance during 2000-2016 while Pakistan was under an IMF Program. To bridge up the gaps in import- export, making up declining foreign reserves, satisfying FATF and support the BOP imbalance, Government was left with no alternative except to have a bailout package with IMF embracing all the attached harsh conditions.
 During the recent past Pakistan failed to enhance its portfolio, put a gauge on unnecessary and luxury exports at higher rates, a weak tax system where tax evasions increases fiscal deficit, lavish exemption and reductions in tax rates rising inflations, expanding unemployment and a weaker industrial base make Pakistan stand on the verge of serious dip. All this has a trickle down impact to the poor masses due to weaker economic policies and deepening corruption in Pakistan. These are the ideal ecological factors which held the IMF plant grow greener and healthier. The present bailout program has a list of policies to correct domestic and external factors and strengthen the economy of Pakistan as it has been doing in many other countered. This paper is an attempt to cover the impacts of previous program and of the recent one on the economy of Pakistan.

The first German evidence-based clinical guidelines on borderline personality disorder

IntroductionThough the evidence regarding the psychotherapeutic and drug treatment of borderline personality disorder (BPD) is rapidly accumulating, with more then 120 randomised controlled trial on the clinical treatment being availabe currently, no evidence-based guidelines existed as yet in Germany. This talk will present the first German evidence-based clinical guidelines for BPD.ObjectivesIn this talk the German evidence-based clinical guidelines for borderline personality disorder will be presented, and focuses and important recommendations highlighted.MethodsA diverse, multidisciplinary panel, including members with research and clinical expertise in the treatment and care of individuals with BPD as well as representatives of persons with lived experience and their relatives, has developed the first evidence-based German treatment guidelines for BPD. The Australian NHMRC and the British NICE guidelines were used as source guidelines and adapted, based on the findings of updated literature searches. All recommendations were consented in an independently moderated, formalised consensus process. Special attention was paid to the management of financial and non-financial conflicts of interest.ResultsThe guidelines support the early detection and treatment of BPD and recommend that the diagnosis be made in adolescents from the age of twelve years on. Disorder-specific psychotherapies, i.e. structured psychological therapies that are specifically designed for people with BPD, are recommended as the first-line treatment for BPD. If the primary focus is the treatment of self-harm, Dialectical Behaviour Therapy or Mentalisation-Based Treatment are recommended. Drug treatment should only be considered if in crisis psychological interventions do not suffice and should be withdrawn as early as possible. Besides, drug treatment may only have a role if required for the treatment of comorbid psychic disorders. The guidelines also recommend educating significant others of the person concerned about the disorder and including them in the development of crisis plans. It is also recommended to offer support to relatives, especially if they are children or adolescents. Also, the role of individuals with BPD who are parents is considered, and early support to foster parenting skills and attachment relationships is recommended.ConclusionsThe first evidence-based German guidelines on BPD are now available and will help to ameliorate the health care of persons with a diagnosis of BPD. The publication of an English version is impending.Disclosure of InterestNone Declared

Joint Crisis Plans and Crisis Cards in Inpatient Psychiatric Treatment—a Multicenter Randomized Controlled Trial.

Joint Crisis Plans (JCP) and crisis cards (CC) are both instruments designed to improve the management of future psychiatric crisis situations, but they differ, for example, in terms of resource use, legal validity, and aims. International research findings for JCP are inconsistent. From January 2018 to December 2020, a single-blinded, two-armed multicenter RCT was carried out, with assessments at T0 (baseline) and T1 (18 months later). The patients included had schizophrenia or schizoaffective disorder and were aged between 18 and 62 years. The primary outcome was the cumulative duration of inpatient treatment (voluntary/involuntary), and coercive measures comprised the secondary outcome. Trial registration: DRKS00013985. Of the 266 study participants, 157 completed the study. In the CC group 57.8% and in the JCP group 64.9% were admitted to psychiatric hospitals between the index treatment and T1 (p = 0.367); 8.4% of the CC group and 12.2% of the JPC group were admitted against their will (p = 0.441). The cumulative treatment duration was not significantly shorter (p = 0.631) in the JPC group (mean 42.43 days, SD = 48.60) than in the CC group (50.16 days, SD = 74.16). Thus, JPCs did not achieve the expected improvement with regard to the primary endpoint. There were also no relevant differences regarding the secondary endpoint. Major effects in favor of the JCP were observed, however, in patients' development of conficence in the treatment teams and in their active participation in the treatment procedure. Although the study showed no superiority of JCP over CC with regard to the primary and secondary outcomes, JCP should be used more frequently in routine practice as an intervention to support a participative approach to treatment.

Planned, improvised or resilience: Small business owner-managers’ perception and response to crises in crisis-prone environments

This article addresses a fundamental question concerning planning, improvisation and resilience in the context of crisis management and business continuity. We seek to explore when and how small business owner-managers respond to crisis situations and cope with associated challenges to their business operations. This question remains unresolved, despite substantial progress in the crisis management and small business literature, which still produces opposing empirical findings and theoretical arguments. While one view supports strengthening existing planned responses to crises; the other view argues and finds support for improvised responses. Drawing on inductive multiple-case study approach, we extend previous research on crisis management by focusing on its planned, improvised and resilience dimensions. The purpose is to provide empirical insights about owner-managers’ perception and response to crises in a crisis-prone environment and complement it with theoretical insights from normal accident and high reliability theories to have a balanced view of crisis management practices within small businesses. We found that crisis planning, improvisation and resilience that occurs simultaneously in the crisis management process is more valuable and enrich crisis management practices of small businesses. We conclude by proposing specific areas for future research in relation to crises and resilience in crisis-prone environment.

Exploring the impact of the COVID-19 pandemic on mental health organisations in England

Purpose This paper aims to explore the impact of the COVID-19 pandemic on mental health organisations in England. Design/methodology/approach A qualitative mixed-methods approach was applied, including a review of the academic literature, a review of the non-academic literature and a brief semi-structured survey. Respondents of the semi-structured survey included seven healthcare leaders from four different NHS Mental Health Trusts in England. This review applied thematic analysis to the data findings. Findings Mental health organisations in England have been significantly impacted by the COVID-19 pandemic. The analysis of the identified resources found four overarching areas for learning: organisational structures, approaches to practice (working and delivering care), leadership and staff support. Organisational structures refer to structural, systemic and procedural changes that have taken place. Approaches to practice relate to shifts in organisational work and delivery of care. Leadership identifies styles used to manage change and disruption. Staff support refers to measures and interventions applied to meet changing staff needs and well-being. Practical implications Mental health organisations can reduce the ongoing impact of the COVID-19 pandemic through continuous improvements in future crisis planning, innovations in clinical practice and a sustained focus on staff well-being. Originality/value A multi-dimensional exploration into the impact of the COVID-19 pandemic on mental health organisations was conducted. The review also provides insights into the experience of healthcare leadership in managing change during the COVID-19 pandemic.

Methane production from Sargassum muticum (Ochrophyta, Phaeophyceae): Modeling by experimental design methodology of the influence of size and inoculum/substrate ratio

Marine macroalgae are present in the ocean and more particularly in the coastal zone. Their distribution is related to biotic and abiotic factors. Considered as sustainable raw materials for a wide range of value-added products and energy production, they are valued in the fields of human and plant health, agriculture, food or construction (Baghel et al., 2020). Since 2011, large rafts of brown algae of the genus Sargassum have been observed, causing strandings in West Africa, throughout the Caribbean basin and the Gulf of Mexico. These include the species S. fluitans and S. natans. Faced with this recurring phenomenon of massive seaweed strandings, the French State has made a strong commitment to the fight against these phenomena: after a first crisis management plan in 2018, a second plan (2022-2025) was deployed with a view in particular to better prevention, health monitoring and the recovery of collected algae. In Guadeloupe, there are still around 116,000 m3 of sargassum stranded each year (ADEME in Guadeloupe, 2018). At present, valorization, which is very partial (90% of the algae collected is stored without use), is mainly done by composting or manufacturing biomaterials. This untapped biomass could be valorized in the energy sector by Anaerobic Digestion (AD) for the production of a gas rich in methane (anr.fr/Projet-ANR-19-SARG-0009 “Valorisation agro-énergétique des Sargasses – SAVE”). The objective of this study is to perform AD experiments with S. muticum as a substrate, a brown alga with characteristics similar to the previously mentioned stranded species, in order to assess their Bio-Methanogenic Potential (BMP), define the experimental conditions of AD, and to propose, in the long term, an energy recovery of the co-products resulting from the biorefining of seaweed stranded or harvested at sea.

ОСОБЛИВОСТІ УПРАВЛІННЯ РИЗИКАМИ В АГРАРНІЙ СФЕРІ ЕКОНОМІКИ УКРАЇНИ

The features of risk management in the agrarian sector of the Ukrainian economy are determined. The study of theoretical sources has allowed to identify the basic concepts of risk management. It is established that the risk management system in agriculture includes a set of decisions and actions aimed at reducing various risks arising in the agricultural environment. At the same time, it involves the processes of recognizing and predicting the occurrence of risks, as well as the choice of measures and means to reduce losses in the event of their occurrence. This is especially true for the agricultural sector of the economy, which, in addition to the above, is heavily dependent on natural and climatic factors. Risk management can be defined as a system of operations that links strategy, processes, people, technology and knowledge. Its purpose is to assess the level of risk associated with the fulfillment of the tasks assigned to the enterprise, as well as to take measures to eliminate the consequences of risk situations. Therefore, risk management takes into account all, not only financial threats and opportunities, and its main goal is to maximize the value created by the business entity. This approach to this problem applies to enterprises operating in various sectors of the economy, including enterprises in the field of agriculture. The process of risk management in the agrarian sector of the economy is proposed to be divided into 8 main stages, which cover the necessary measures – risk identification, risk assessment, planning of risk management strategies, implementation of risk management measures, monitoring and control, crisis plan, reporting and documentation, training and provision of information. However, it should be noted that it is important to constantly update the list of risks in agricultural production, as they may change over time. The most important risk management strategies that can be applied in agriculture have been identified. These include diversification of production, use of modern technologies and modernization of the industry, and insurance. The conducted research is of practical importance and allows to reduce the risks of the agricultural sector of the Ukrainian economy and help to restore the industry.

Crisis planning among tour operators: an evaluation of small, medium-sized and large enterprises

Crisis planning among tour operators: an evaluation of small, medium-sized and large enterprises

Цифровизация как инструмент глобального партнерства: шоки и трансформации российской сферы IT

An example of the destructive influence of dependence on partners can be called the situation in the information and telecommunications (IT) sphere of Russia. Despite the aggravation of relations, the market share of some software and hardware components reached 100% of Russian market. Accordingly, with the beginning of the acute phase of station pressure, when Western partners began to leave the Russian market, the IT sphere turned out to be seriously destabilized. Equipment prices increased, many software developers were left without strategic partners and investments, customers without digital products. IT development budgets were urgently adjusted for the purchase of hardware. Moreover, an attempt was made to “capture” Russian personnel who were employed in Western IT companies. It is obvious that such a level of global openness for the IT sphere, which provides a number of basic needs for the population and business, as well as the authorities, is a threat to national security. The growth of self-sufficiency in all areas of the IT sphere will contribute to the sustainability of both the sphere itself and the whole country and will avoid the need for such emergency measures as it were required in 2022. IT is just an example and increasing self-sufficiency is relevant for the industry of mechanical engineering and tools, the production of components, energy and transport infrastructure and a number of other sectors of the Russian economy. The article examines the role of the state in the crisis management and strategic planning of the development of the IT sphere to ensure stability and security of work in the future.

Možnosti využití konstruktivní simulace pro plánování nouzového zásobování vodou

The paper focuses on the issue of information support of emergency drinking water supply planning. Implementation of simulation into the process modeling for process verification in the field of Crisis Management provides us with an opportunity to make the preparation of a Crisis Management Plan more effective. The article presents the role of simulation in Crisis Management, the possibility of using simulations within the Crisis Management Cycle, and particularly the use of constructive simulation in the process verification of the emergency water supply. During the simulation, deficiencies in the planning processes have been identified, and possibilities of simulation tools aimed at the planning process of crisis management in the emergency water supply field have been discussed.