Responsibility Of Team Research Articles

Gender diversity in top management team and corporate social responsibility performance: examining the moderating nature of TMT international experience

Purpose This study is based on the role congruity theory that examines the association between top management team (TMT) gender diversity and corporate social responsibility (CSR) performance. Design/methodology/approach This study uses data from the Taiwan Economic Journal database and the Market Observation Post System provided by the Taiwan Stock Exchange. The sample consists of 4,140 annual observations of Taiwanese-listed companies in the electronics industry from 2016–2020. Findings The results revealed that TMT gender diversity is positively associated with CSR performance, and TMT international experience strengthens the positive association between TMT gender diversity and CSR performance. Practical implications CSR is imperative. The TMT’s gender diversity aligns with current environmental trends and social expectations, driven for CSR implementation essential. This diverse configuration enables the TMTs to address corporate adaptability and maintain global competitiveness. Originality/value The findings contribute significantly to the literature on TMT gender diversity by extending the application of role congruity theory beyond individual to team-level contexts and across gender boundaries. By incorporating diverse capabilities such as international experience within TMTs, the authors identify key boundary conditions that foster CSR. This expansion not only aligns with practical realities but also opens new avenues for research into the dynamics of diverse management teams.

Manajemen Badan Usaha Milik Desa ( BUMDes) “Berkah Banyu Makmur” Di Desa Pancasan Kecamatan Ajibarang Kabupaten Banyumas

This research examines the Management of Village-Owned Enterprises (BUMDes) "Berkah Banyu Makmur" in Pancasan Village, Ajibarang District, Banyumas Regency. The research method used is qualitative with descriptive analysis. Using primary and secondary data collected through observation, interviews and documentation. The management theory used is the George R. Terry, Leslie W. Rue, G. A. Ticolau model, with its 4 aspects, namely: Planning, Organizing, Actuating, and Controlling. The research results show that BUMDes "Berkah Banyu Makmur" has succeeded in implementing management functions well. The planning aspect involves village deliberations and regulations for business development as well as efforts to make Pancasan an Edutourism Village. The organizational aspects are clear and structured, as well as the development of BUMDes using the hexahelix model. Aspects of implementing BUMDes' daily operational activities have been regulated and structured with individual and team duties and responsibilities. Routine monitoring and evaluation aspects to ensure goals are achieved, with monthly and daily monitoring. With continuous efforts and strong commitment to the vision of becoming an Edutourism Village, it is hoped that this BUMDes can continue to develop and provide greater benefits for the people of Pancasan Village, as well as becoming an inspiring example for BUMDes in the surrounding area.

Diseño y análisis de las propiedades psicométricas del instrumento de competencias de trabajo interprofesional para su uso en la población mexicana (CIP-Mx)

IntroductionInterprofessional education includes diverse strategies in order to promote competencies such as communication, ethics, critic reflection and quality processes. It is characterized by simultaneously including diverse discipline participants in the educative process. The assessment of these competencies is essential. AimTo design an assessment instrument for interprofessional health workers competencies and to measure its psychometric properties. MethodAn assessment instrument was designed, it included four competencies (communication, learning and critical reflection, quality and health processes, and ethics and values); in three dimensions (leadership and team work, roles and responsibilities, patient centered care). For content validity assessment, an expert judgement was made. Due to the fact that this instrument can be used as seven separate instruments, or, as well, as the combination of several of them due to intersection of the items between dimensions and competencies; seven exploratory factorial analysis were performed, four by competencies, and three by dimensions. The exploratory factorial analysis used varimax rotation, Bartlett test and KMO.For reliability assessment Cronbach´s Alpha was performed for each dimension, for each competency and two general ones (one for dimension assessment and another one for competencies). ResultsPsychometric properties of the instrument are described. It shows adequate properties to be used in Mexican population. ConclusionsThe instrument is suitable for measuring interprofessional work competencies from different dimensions.

An action plan to improve organizational health literacy in hospitals in the Czech Republic

Abstract Background The National Institute for Health Literacy conducted in 2023 as part of the M-POHL network and in close collaboration with the team of the Klaudian Hospital a survey on the level of organizational health literacy using the OHL-Hos tool. The OHL-Hos tool was proven by the project implementation team as suitable for initiating and monitoring organizational change. Methods Based on the self-assessment and the results of the consensus workshop, the project implementation team identified development priorities that were submitted and approved by the hospital management. To keep the sustainability of the implementation, the hospital management decided to formulate an action plan, with the time horizon 2025. Results The proposed action plan, approved by hospital management, focuses on feasible measures within a given time horizon. For each development goal, responsible teams, time frames, and expected results were formulated. The implementation project team evaluated as the most innovative standard the standard dealing with internal communication with patients and their family after discharge and thus to ensure the continuity in supporting personal health literacy of patients and relatives. In addition, as further important standards, easy navigation and access to documents, materials, and services for patients and healthcare professionals were recognized. Interventions focusing on public education, especially for children and students of all school levels, have been proposed to enhance external communication and increase health knowledge in the region. Conclusions The process of regular OHL assessment of set up measures has been considered as a way how to ensure the long-term fulfilment of the newly adopted action plan by the hospital.

Missing Medical Data in Neurological Emergency Care Compromise Patient Safety and Healthcare Resources

Background: Acute care of patients in the emergency department (ED) can be very challenging when patients attend EDs without their important medical information. This is especially problematic for multimorbid patients under polypharmacy. The aim of this study was to assess systematically the frequency and clinical relevance of incomplete medical data upon ED admission. Methods: The study was conducted in the neurological ED of a German tertiary hospital. The availability and accuracy of medical data of all neurological patients in the ED were assessed upon arrival. Treating ED physicians were asked about the acute care of the patients to clarify whether missing data resulted in delays or complications in the emergency treatment. Additionally, doctors responsible for the inpatient care of patients who were admitted to a ward via the ED were questioned about the course of the inpatient stay to monitor how initially missing data might have influenced the hospital stay. Results: Medical data of 27% of the 272 included patients were missing or incomplete upon admission in the ED. The ED physicians had to make additional phone calls to gather information in 57% of these cases (vs. 22% in patients with complete data, p < 0.0001). Delays between 5 and 240 min were documented due to initially missing data. Unnecessary diagnostic procedures (e.g., lumbar puncture) were performed in 5% of these patients, thus compromising patient safety. Even the inpatient stay was complicated by initially missing data, as doctors still had to spend time (between 10 and 180 min) to gain relevant information. Retrospectively, 5% of hospitalizations could have been avoided if all medical information had been available upon ED admission. Conclusions: Missing medical data caused complications and delays in acute as well as inpatient care of patients admitted to the neurological ED. This compromised patient safety and led to a waste of medical resources and valuable time of the responsible medical team. Therefore, a comprehensive, digital data management system is urgently needed to improve patient safety and facilitate efficient patient care in the ED and beyond.

The Influence of Shared Leadership on the Innovative Behavior of New Generation Faculty

This quantitative study examined the influence of shared leadership on the innovative behavior of the new generation faculty within the context of Chinese higher education institutions. Conducted across various universities in Guangdong Province, China, the research engaged a sample of 340 new generation faculty members. Utilizing a survey method, the study evaluated the faculty’s perceptions of shared leadership, encompassing dimensions such as team progress, authority and responsibility sharing, team expectations, and team contract. Additionally, the survey captured data on the innovative behaviors of faculty, including innovation discovery, innovation proclivity, innovation reinforcement, and innovation cooperation. The findings indicated that the new generation faculty placed significant value on shared leadership aspects, particularly team progress and team expectations. The study revealed that the faculty demonstrated a commendable level of innovative behavior, yet there was room for further enhancement in both shared leadership practices and innovative actions. The research established that a combination of career values related to shared leadership significantly predicts the professional development of faculty in terms of innovation. The study’s implications are vital for educational administrators and policymakers, emphasizing the necessity to foster shared leadership environments conducive to nurturing faculty innovation. By recognizing the predictive role of shared leadership in shaping innovative behaviors, educational institutions can strategize more effectively to promote academic excellence and drive educational reforms.

COMMON MENTAL DISORDERS IN PERSONS WITH CHRONIC CONDITION: Carthografic analysis of a case in the primary care service

The psychological consequences of chronic diseases still poorly explored, but there are data, pointing to their importance. The study aims analyze the presence of common mental disorders in users with chronic conditions in Primary Care services in a city in the metropolitan region of Porto Alegre, RS, Brazil. The research used cartography as a methodology. Interviews were conducted with users of the Network and focus groups with the responsible teams. From the interviews, a case was highlighted for discussing. Two results are pointed out: the relationship between emotional factors and the chronic condition perceived by the user and the care centered on physical health performed by the responsible professionals. The association between anxiety / depression and chronic condition is discussed based on the concepts of catastrophist thoughts and internalized stigma and presents their respective coping strategies, aided by person-centered care.

A-192 Effectiveness in Communicating Critical Results: impact of technology and consultive actions on improving performance indicators in a laboratory in Northeast Brazil

Abstract Background Critical results consist of laboratory test results that require immediate intervention or decision-making by the responsible medical team, as they pose a risk to the patient's life. To manage the process of communicating critical results, it is also necessary to define the indicators, goals and systematic comparability through benchmarking. Methods The performance of the indicators measuring the critical results process for the year 2023 was analyzed. Performance indicators such as resolution time, success and failure rate in communication, delay rate in communication and the rate of open incidents related to the communication of critical results were monitored using a Business Intelligence tool. Results In the first two months of 2023 the results reflected the absence of parameters in the LIS for effective communication of critical results. September and October there was a high turnover rate in the laboratory in addition to the change in the hospital care profile in which the laboratory medicine service was inserted. These causes culminated in a number of 122 (1.48%) communication failures, representing an increase of 1,120% compared to the first two months of the year. On the other hand, there was a significant improvement in the average communication time for critical results, decreasing from approximately 736 hours to 184 hours(reduction of around 75%). There was also a reduction in communication delay of approximately 67%. These numbers corroborate the parameterization actions in the system aimed at speeding up the process. As a continuation of the improvement actions, the laboratory implemented goal setting for the resolution time indicator and also the periodic meeting for critical analysis of the results.In addition to these actions, the laboratory approached the hospital's clinical staff, making it possible to provide clarity on the difference between compulsory notification and critical results. This clarification allowed for the establishment of a list of exams considered critical, in order to meet the hospital profile, as well as to define the communication flow. For the success indicator in communicating critical results, there was a 22% improvement when comparing the last two months of 2023 with the first two months of the same year. In the last two months of the year, this indicator performed at 99.4%, corroborating the study published by Noronha et al., (2016), where the effectiveness rate in critical results communication was 96.1%. Comparing with the study by Noronha et al., (2016), where the biochemistry sector had the highest rate of critical results communication failures (73.8%), followed by the Emergency Room (78.6% ) and ICU (16.7%), the findings of this study highlighted the top 3 detracting sectors: Biochemistry (68%), “UPA” - Emergency Care Unit (42.1%) and ICU (21.4%), making data superimposable. Conclusions The communication of critical results has challenges related to its effectiveness, especially in hospital contexts. As a critical and high-impact activity, constant actions are necessary to continuously improve the process. Actions should take into account: interactions with attending physicians, the development and training of the internal team, and constant checks of the LIS, as technology can support the process management.

Stjórnun og fagleg forysta í grunnskólum

Samfara aukinni valddreifingu í íslensku skólastarfi hefur umfang starfs skólastjóra grunnskóla aukist verulega. Í skólastjórn felst bæði stjórnun og fagleg forysta en skólastjóra er fengið það hlutverk samkvæmt lögum að móta stjórnskipan síns skóla og skipta verkum á milli kennara og stjórnenda. Sjónir fræðimanna hafa í vaxandi mæli beinst að hlut skólastjóra í að bæta námsárangur en sýnt hefur verið fram á að skýr tengsl eru á milli faglegrar forystu skólastjóra og árangurs nemenda. Með kjarasamningum 2001 var samið um störf aðstoðarskólastjóra og deildarstjóra í þeim tilgangi að efla kennslufræðilega forystu í grunnskólunum og fjölgaði stjórnendunum talsvert fram til ársins 2008. Markmið þessarar rannsóknar var að kanna hverjar væru starfsaðstæður og bakgrunnur skólastjóra og hvaða viðfangsefni hann kysi sjálfur að axla í stjórnkerfi skólans. Gagna var aflað með rafrænni spurningakönnun sem send var öllum stjórnendum í grunnskólum með meira en 100 nemendur. Niðurstöður sýna að skólastjórar grunnskóla hafa umtalsverða starfsreynslu og mikill meirihluti þeirra hefur lokið framhaldsnámi í stjórnun. Þrátt fyrir viðleitni til að binda skólana saman sem faglegar stofnanir virðast þeir enn vera talsvert laustengdir. Tilhögun stjórnkerfis skólanna er óljós og hefur í för með sér ákveðin einkenni óreiðu fremur en fagveldis. Hlutverk aðstoðarskólastjóra og deildarstjóra eru óljóst skilgreind en algengast er að skólastjóri gegni sjálfur hlutverkum stjórnenda. Hinum mikilvægu faglegu forystuhlutverkum er skipt með óljósum hætti milli stjórnenda og oftar en ekki er vísað til ábyrgðar stjórnendateymis. Benda niðurstöður til þess að áform kjarasamnings árið 2001 um að efla kennslufræðilega forystu í grunnskólum hafi ekki gengið eftir.

Abstract P406: Transforming Clinical Practices for Blood Pressure Management in Community Health Centers through Timely Data and Technical Support

Introduction: Blood pressure (BP) control can prevent major adverse cardiac events and is monitored through various means, including the Centers for Medicare and Medicaid Services 165 metric for BP control - an annual reporting metric for community health centers (CHCs) within the Uniform Data System framework that becomes accessible 6 months after the conclusion of the reporting period. In pursuit of more immediate indicators related to BP management, the National Hypertension Control Initiative (NHCI) initiated collaboration with a population health platform to support select CHCs with rapidly available data on 19 BP-related metrics. Hypothesis: With technical support and regular access to data, CHCs can implement timely clinical practice and process changes. Methods: To support CHCs in using the population health platform, NHCI staff provided technical assistance in a rapid cycle performance improvement (RCPI) to 10 interested CHCs. This opportunity allowed CHCs to partner with NHCI staff to review BP related metrics in the population health platform and to identify opportunities for clinical process and practice changes. Over an 8-week period from October to December 2023, 7 CHCs were actively involved in a series of 5-6 structured 30–60-minute meetings with both NHCI registered nurse and quality improvement staff. These meetings reviewed BP metrics, mapped clinical workflows for improvement, and supported data analytics. CHCs often chose 1-2 BP metrics for focus, concentrating on incremental change and short-term improvement. Results: Among participating CHCs that reported, they revealed successful or anticipated adjustments in team responsibilities and clinical processes, including leadership involvement and new methods. Limitations included CHC staff engagement, time, concerns with data reliability, and familiarity with the population health platform. Most reporting CHCs shared that their goals were greatly impacted by access to readily available performance data and that they plan to continue using the population health platform to affect performance moving forward. Conclusions: For participating CHCs, individualized guidance based on timely data may have been helpful in analyzing workflows and procedures, assessing clinical care practices, and implementing quality improvement plans. Frequent data may allow CHCs to make clinical practice and process changes to efficiently measure impact and more quickly improve BP control than standard methods.

Developing Self-Management in Type 1 Diabetes at Secondary Schools: Who Is Responsible? A Qualitative Study.

Occupational therapists have the proven capacity to improve outcomes for young adults who are self-managing Type 1 diabetes (T1D). There is insufficient understanding of adolescents' experiences of developing responsibility for diabetes self-management (DSM). To investigate adolescents' perceptions of sharing responsibility for T1D management at school. This study had a descriptive qualitative design and used semistructured interviews and thematic analysis. It is the second phase of a mixed-methods study with a sequential explanatory design that investigated mechanisms of responsibility-sharing at school. Secondary school in Australia. Purposive sample of adolescents (age 15-16 yr) with T1D (N = 11). Adolescents approached the complex occupation of school-based DSM primarily in partnership with their parents, with each adolescent having unique responsibilities while sharing others. Health care professionals and teachers reportedly had minimal involvement. Adolescents described owning most DSM tasks, with their perceptions of building independence limiting the sharing of this responsibility. A heightened sense of risk meant that adolescents were likely to communicate with others in cases of errant blood glucose readings. Current processes commonly resulted in reduced school participation. Adolescents valued working responsively and interdependently with their parents to manage T1D at school, which aligns with the occupational therapy model of co-occupation. Effective responsibility-sharing depends on clear, frequent, autonomy-supportive, team-based communications. Our results showed that patterns of communication for determining school-based DSM processes were fragmented and risk focused, with limited adolescent involvement, resulting in strategies that led to students at times being excluded from school activities. Plain-Language Summary: This is the first study to use an occupational lens to examine the way in which adolescents share their responsibility for diabetes care at school. Diabetes self-management in secondary schools occurs more often when adolescents work interdependently with their parents to manage their diabetes. Adolescent involvement in formal school processes and a clearer allocation of team roles and responsibilities would better support health-promoting habits and school participation.

Visual Mapping of Operating Theater Team Dynamics and Communication for Reflexive Feedback and Surgical Practice Optimization.

Effective operating theater (OT) communication and teamwork are essential to optimal surgical outcomes. We mapped the OT team dynamics and infection control practices using visual methods to guide reflexive feedback and optimize perioperative practices. Data were gathered from adult gastrointestinal surgical teams at a tertiary hospital in India using observations, sociograms (communication mapping tool), and focus group discussions (FGDs). Our methods aimed to map team communication, roles and responsibilities in infection-related practices, and door openings. Qualitative data were thematically analyzed. Quantitative data were analyzed using descriptive statistics. Data were gathered from 10 surgical procedures (over 51 hours) using 16 sociograms, 15 traffic flow maps, and 3 FGDs. Senior surgeons directly influence team hierarchies, dynamics, and communication. While the surgeons, anesthetic residents, and technicians lead most tasks during procedures, the scrub nurse acts as a mediator coordinating activity among role players across hierarchies. Failing to provide the scrub nurse with complete details of the planned surgery leads to multiple door openings to fetch equipment and disposables. Traffic flow observed in 15-minute intervals corresponds to a mean frequency of 56 door openings per hour (min: 16; max: 108), with implications for infection control. Implementing the World Health Organization surgical safety checklist was inconsistent across pathways and does not match reported compliance data. Human factors research is important in optimizing surgical teamwork. Using visual methods to provide feedback to perioperative teams on their communication patterns and behaviors, provided an opportunity for contextualized enhancement of infection prevention and control practices.

“Not me!” a qualitative, vignette-based study of nurses’ and physicians’ reactions to spiritual distress on neuro-oncological units

PurposePeople with primary malignant brain tumors experience serious health-related suffering caused by limited prognosis and high symptom burden. Consequently, neuro-oncological healthcare workers can be affected emotionally in a negative way. The aim of this study was to analyze the attitudes and behavior of nurses and physicians when confronted with spiritual distress in these patients.MethodsNeurospirit-DE is a qualitative vignette–based, multicenter, cross-sectional online survey that was conducted in Bavaria, Germany. Reflexive thematic analysis was used for data analysis.ResultsA total of 143 nurses and physicians working in neurological and neurosurgical wards in 46 hospitals participated in the survey. The participants questioned if the ability to provide spiritual care can be learned or is a natural skill. Spiritual care as a responsibility of the whole team was highlighted, and the staff reflected on the appropriate way of involving spiritual care experts. The main limitations to spiritual care were a lack of time and not viewing spiritual engagement as part of the professional role. Some were able to personally benefit from spiritual conversations with patients, but many participants criticized the perceived emotional burden while expressing the imminent need for specific training and team reflection.ConclusionsMost neuro-oncological nurses and physicians perceive spiritual care as part of their duty and know how to alleviate the patient’s spiritual distress. Nonetheless, validation of spiritual assessment tools for neuro-oncology and standardized documentation of patients’ distress, shared interprofessional training, and reflection on the professional and personal challenges faced when confronted with spiritual care in neuro-oncology require further improvement and training.

Drug survival and risk factors for ADHD medication discontinuation in adults: A Danish Nationwide Registry-based cohort study.

Attention deficit hyperactivity disorder (ADHD) medication has proven effective for treating ADHD in adults, nonetheless previous studies have shown high rates of medication discontinuation. To assess drug survival and identify risk factors associated with discontinuation of ADHD medication. A nationwide registry-based cohort study in Danish adults who redeemed a prescription for ADHD medication for the first time between 2010 and 2015. All patients were followed for 5 years from the first redeemed prescription. Discontinuation was defined as a gap of 12 months between redemptions. Logistic regression analysis with odds ratio (OR) and Kaplan Meier analysis were used to examine risk factors (sex, age, socioeconomic status, substance use disorders, and comorbidities) associated with discontinuation. Twenty three thousand nine-hundred and sixteen patients with ADHD were identified. The 5-year overall drug survival was 29% in women vs. 23.5% in men. The risk of medication discontinuation was significantly higher in men compared to women, OR 1.26 (95% CI 1.19-1.34, p < 0.001). Adults aged 31-50 years had a significantly decreased risk of medication discontinuation compared to adults aged 18-30 years, OR 0.57 (95% CI 0.53-0.61, p < 0.001). Switching ADHD medication two times or three times or more significantly decreased the risk of discontinuation; OR 0.53 (95% CI 0.49-0.56, p < 0.001) and OR 0.26 (95% CI 0.23-0.30, p < 0.001), respectively. Substance use disorders and certain comorbidities were associated with medication discontinuation. Eating disorders, OR 0.71 (95% CI 0.64-0.78, p < 0.001), intellectual disabilities, OR 0.65 (95% CI 0.59-0.73, p < 0.001) and sleep disorders, OR 0.42 (95% CI 0.37-0.49, p < 0.001) were associated with continuation of ADHD medication. The 5-year overall drug survival was longer in women compared to men. Women with ADHD; adults aged 31-50; and patients with comorbid eating disorder; intellectual disability; sleep disorder and medication switching were individually associated with continuation of ADHD medication. Various factors were associated with medication discontinuation. Discontinuation should be acknowledged as a common phenomenon in patients with ADHD and calls for increased attention from the treatment responsible prescriber or team. Moreover, our findings suggest that timely, frequent medication switching, or temporary regimens may indeed represent optimal management strategies for a significant proportion of the ADHD population.

Barriers to Embrace Multidisciplinary Learning Experience in Interior Architecture Design Module

A multidisciplinary learning experience is an approach to curriculum integration which values the ideas of collaboration across multiple disciplines in response to the Fourth Industrial Revolution (4IR). The 4IR has effectively widened the division between fields in which graduates are expected to perform desired skill and knowledge. This paper aims to determine the barriers encountered by the Interior Architecture Students embracing the multidisciplinary learning experience with students from other discipline. Through an explanatory case study approach, the emergence of approach curriculum comprised of three programmes in the built environment at a private university will be presented. The paper concludes with reflective writing addressing the barriers faced by the Interior Architecture students during the multilearning experience. Findings of the study revealed the majority of students identify communication, time-management, responsibility, attitude, and teamwork as the most significant barriers encountered by Interior Architecture students in the implementation of the MLE approach in the Design Studio module. Developing strong communication skills, allocation in managing the time, team player roles and responsibility are essential trait that must be constantly fostered. These findings help to assist interior architecture educators in developing courses that integrate various disciplines and provide academics with a deeper understanding of the conceptualisations and practices of the multidisciplinary learning experience concept approach by identifying the barriers that hinder its implementation.

Evaluasi Implementasi Sistem Aplikasi Keuangan Tingkat Instansi (SAKTI) Dengan Metode Design-Reality Gap

The Agency Level Financial Application System (SAKTI) is one of the e-government implementations that has a systemic and significant impact. Several previous studies have shown the unsuccessful implementation of SAKTI related to the implementation of the system.This research aims to evaluate the gap between design and reality in the implementation of SAKTI to obtain recommendations in order to mitigate the risk of failure of future system implementations. The research was conducted to the organizers of the SAKTI system, namely the developers and managers of the SAKTI modules. The resource persons were selected to represent the organization as structural leaders and responsible teams based on their involvement and active participation in the development and management of the SAKTI application. The research used a case study research strategy with a qualitative approach. Data/information collection from this research used techniques consisting of: observation, interviews, and literature review. The model used is the design-reality gap model supported by the concept of critical success factors/csfs in each checklist Information, Technology, Process, Objectives and Values, Staffing and Skills, Management and Structure, and Other Resources (ITPOSMO). The results show that the design-reality gap is 52.0 which falls into the category of e-government projects may fail unless there are actions to close the design-reality gap. The largest gap occurs in the staffing and skills dimension followed by the information, technology, management and structure, process, and goals, values and motivation dimensions. This suggests that the dominant factor of failure in SAKTI is socio-technical not just technical.

Development and implementation of a rehabilitation triage algorithm for disasters in the subacute phase: an experience from the 2024 Noto peninsula earthquake

Early rehabilitation during disasters such as earthquakes is an important but often undervalued responsibility of medical teams. Both the development of simple tools for assessing the life functioning of evacuees and the standardization of intervention methods are urgent issues in disaster rehabilitation. The Japanese Rehabilitation Assistance Team (JRAT), an officially recognized organization consisting of 10 suborganisations, was established after gaining important experience with disaster rehabilitation in the aftermath of the Great East Japan Earthquake. We, the Hiroshima JRAT, were dispatched to the Monzen area of Wajima City to support disaster recovery after the 2024 Noto Peninsula Earthquake. Since disaster rehabilitation assistance was not well established in the Monzen area of Wajima City, the medical team consulted JRAT for guidance on triaging evacuees based on their life functioning. We developed a rehabilitation triage algorithm that classifies evacuees into four triage tags based on their ability to perform three simple movements: sitting up, standing up from the floor, and one-leg standing. In our triage algorithm, an inability to sit up is classified as a red tag (difficulty living in a shelter without assistance), an inability to stand up from the floor is classified as a yellow tag (individual intervention: introduction of beds and handrails), one-leg standing for &amp;lt; 2 s is classified as a green tag (group intervention: installation of toilets and bath rails and use of walkers to prevent falls), and standing on one leg for more than 2 s is classified as a white tag (independent in ADLs). We worked with medical teams to triage 922 evacuees in 27 evacuation centers, resulting in the extraction of four red and eight yellow evacuees in 1 day. Our rehabilitation triage system has the potential to be a simple assessment tool for classifying the life functioning of disaster victims and linking them to appropriate supports.

Clinical Trials Radiographers identifying priority challenges associated with implementing a national programme of clinical trials in the United Kingdom's first proton beam therapy centre.

This article is an evaluation of the current trial processes within a national proton beam therapy (PBT) clinical trial service in the United Kingdom. The work within the article identifies priority challenges associated with the implementation of PBT trials with a view to improving patient trial processes. The nominal group technique (NGT) was used. Five Clinical Trials Radiographers were asked the target question "what are the major challenges when implementing PBT clinical trials and facilitating PBT trial-related activities?" Participants individually and silently listed their challenges to the target question. Following this, group discussion clarified and refined responses. Participants then individually selected five challenges that they deemed most pertinent to the target question, giving a weighted score (out of 10). Individual scores were combined to provide a ranked, weighted order of challenges. Further group discussion identified improvement strategies to the highest scored challenges. After combining lists generated by participants, 59 challenges were identified. Group discussion eliminated 27 responses. Eighteen were merged, resulting in 14 challenges. The two challenges that ranked highest were: (i) lack of initial understanding of the responsibilities of teams and who the relevant stakeholders were, and (ii) that a national PBT service requires the provision of shared care across multi-disciplinary teams and sites. Improvement areas include the development of shared protocols, clarifying stakeholder responsibilities and improving communication between centres to streamline PBT trial processes. This work has identified priority areas requiring development to improve the conduct of a national PBT clinical trials programme. This is the first publication to evaluate current clinical trial processes for the United Kingdom's PBT service.

Rapid detection of the source of a Listeria monocytogenes outbreak in Switzerland through routine interviewing of patients and whole-genome sequencing.

Listeriosis is a notifiable disease in Switzerland. In summer 2022, the Swiss Federal Office of Public Health noticed an increase in reports of listeriosis cases, indicating a possible ongoing outbreak. Here we present the approaches applied for rapidly confirming the outbreak, detecting the underlying source of infection and the measures put in place to eliminate it and contain the outbreak. For close surveillance and early detection of outbreak situations with their possible sources, listeriosis patients in Switzerland are systematically interviewed about risk behaviours and foods consumed prior to the infection.Listeria monocytogenesisolates derived from patients in medical laboratories are sent to the National Reference Laboratory for Enteropathogenic Bacteria and Listeria, where they routinely undergo whole-genome sequencing. Interview and whole-genome sequencing data are continuously linked for comparison and analysis. In summer 2022, 20 patient-derivedL. monocytogenesserotype 4b sequence type 388 strains were found to belong to an outbreak cluster (≤10 different alleles between neighbouring isolates) based on core genome multilocus sequence typing analysis. Geographically, 18 of 20 outbreak cases occurred in northeastern Switzerland. The median age of patients was 77.4 years (range: 58.1-89.7), with both sexes equally affected. Rolling analysis of the interview data revealed smoked trout from a local producer as a suspected infection source, triggering an on-site investigation of the production facility and sampling of the suspected products by the responsible cantonal food inspection team on 15 July 2022. Seven of ten samples tested positive forL. monocytogenesand the respective cantonal authority ordered a ban on production and distribution as well as a product recall. The Federal Food Safety and Veterinary Office released a nationwide public alert covering the smoked fish products concerned. Whole-genome sequencing analysis confirmed the interrelatedness of theL. monocytogenessmoked trout product isolates and the patient-derived isolates. Following the ban on production and distribution and the product recall, reporting of new outbreak-related cases rapidly dropped to zero. This listeriosis outbreak could be contained within a relatively short time thanks to identification of the source of contamination through the established combined approach of timely interviewing of every listeriosis patient or a representative and continuous molecular analysis of the patient- and food-derivedL. monocytogenesisolates. These findings highlight the effectiveness of this well-established, joint approach involving the federal and cantonal authorities and the research institutions mandated to contain listeriosis outbreaks in Switzerland.

Disaster management with cloud-based geographic information systems: site selection of landfill areas after Kahramanmaraş, Türkiye earthquake sequence

On February 6, 2023, the earthquakes centered on Kahramanmaraş-Pazarcık and Kahramanmaraş-Elbistan affected several provinces in the region and generated a vast amount of demolition waste. This study aims to develop a site selection model for the most suitable landfill areas after the earthquake using open-source Geographic Information Systems (GIS) software and the Best-Worst Method (BWM). First, the study identifies decision criteria with a Delphi expert panel. Next, it determines the weights using the BWM based on pairwise comparison. Spatial data of the determinants were obtained from open data portals, and proximity, overlay, and slope analyses were carried out for the disaster region. Combining the output data layer of each criterion, a suitability map of the landfills was produced. As a result, 36,2% (29,826 kms square) of the study area was classified as suitable and very suitable. In this study, a cloud GIS-based decision support platform was developed to act quickly and initiate recovery processes within the scope of disaster management of the destructive earthquake. The suitability map and potential sites were shared with the responsible teams in the disaster area so that the potential sites could be displayed on the map and the suitable areas could be navigated on appropriate routes. The findings of the study revealed that the use of open data and cloud GIS framework in the disaster management process enables quick, reliable, and cost-effective actions in the immediate aftermath of disasters.