Indiana study profiles local pandemic planning problems

first_img “This is aggravated by federal communication efforts that confuse the two,” the researchers write. Rivalry between hospital systems that impaired coordination (though it was found that a mediator could reduce this problem) Vagueness regarding the roles and responsibilities of local public health, emergency management, and healthcare officials In addition, “Several counties with nursing schools operating within their borders have explored the idea of utilizing nursing students as care extenders, but the efficacy of this will depend in part on school decisions on how to respond to a pandemic event and whether to continue operations,” the report says. Also, it was not known whether any of the counties had checked whether students were willing to serve. The study was part of an effort by researchers at Purdue University to develop a planning template for ways to provide surge capacity to care for a flood of patients during a pandemic. The researchers interviewed public health, emergency preparedness, and hospital officials in 11 representative Indiana counties between November 2006 and August 2007; questionnaires were tested in two other counties. Interviews were conducted by telephone and on-site. In line with these plans, nearly all counties had a basic communication plan to inform the public about the disease and the local response and to direct patients to the most appropriate source of care. However, many county planners focused only on media services located within the county, rather than the sources most used by the local citizenry. For example, one surburban county planned to use the only radio station based in the county, a college station with a weak signal, instead of higher-rated TV and radio stations in the next county. In the face of this reality, “Almost all counties were giving consideration to altered standards of care to stretch resources, but were wary of this option due to liability concerns and lack of statutory protection from malpractice claims, a concern heightened by lack of guidance from state and federal governments,” the report states. Unrealistic expectations for outside help, such as material support from the National Guard or the governor’s office—a misperception grounded in experience with localized disasters such as floods In addition, planning and coordination were hindered by blurry agency roles and mismatches between political boundaries and local healthcare market boundaries. The study also showed that most hospitals were hoping to deal with the influx of pandemic flu patients largely by reducing demand for services, mainly through triage systems. Hospital officials expressed concern about making ends meet during the pressures of a pandemic, the study says. One hospital thought it would have to shut down, while others suggested they would have to rely on federal and state disaster assistance funds to get by. “Few considered the fact that most patients would be insured and that they could use usual mechanism to seek reimbursement for care which might provide a revenue stream,” the authors write. “With few exceptions, planners failed to look beyond their borders, whether to identify resources to support their population or to identify additional demand for resources in their jurisdiction,” the researchers write. “Because planning responsibilities are defined by local political jurisdictions, most focused only on those jurisdictions, with efforts to initiate intercounty cooperation rarely noted.” Managing demandMost of the counties chose to deal with hospital capacity problems during a pandemic at least partly by reducing the demand for hospital services, usually by means of a triage system to save hospital beds for those in greatest medical need, the researchers found. Because of concern about spreading flu, officials were discussing plans to separate flu patients from other patients or to locate triage functions outside the hospital, such as in tent clinics or school gyms. Interviews with health officials in 11 Indiana counties showed recent progress in pandemic planning, but also pointed up many difficulties, according to the report in the Journal of Homeland Security and Emergency Management. On the logistical and financial front, the leading concern was possible shortages of medical supplies, especially drugs and personal protective equipment, the researchers found. The economic pressure to run lean operations was cited as an obstacle to the stockpiling of supplies for emergency use. The authors suggest that, given the differences between political units and healthcare service areas, planning for providing surge capacity would be better done at the regional level than the local level. Among misunderstandings, some planners thought a pandemic would involve such high rates of illness and death that planning would be useless, and many officials had unrealistic expectations about getting help from outside sources such as the National Guard or the state governor. Jul 9, 2008 (CIDRAP News) – A study from Indiana reveals a long list of problems hampering county-level planning for pandemic influenza, ranging from misunderstanding of the threat and lack of coordination and resources to rivalry between hospital systems.center_img The researchers, with George H. Avery as first author, found that planners generally had made progress but had a long way to go. Misperception of the threatIn some counties, officials’ view of the likely impact of a pandemic amounted to “a synthesis of misinformation, resulting in a perception of impact which exceeds the worst cases historically observed,” the article states. Using retired physicians, student nursesConcerning staffing, the counties generally had tried to follow guidance in the federal pandemic flu plan, but they ran into some problems with it. For example, most counties had begun to develop a reserve list of retired or inactive physicians and nurses who could help in a pandemic. But local officials complained of a lack of state guidance on licensing and credentials, and few had addressed the problem of malpractice insurance for those workers. “While planners, for the most part, were committing a significant effort in trying to develop a pandemic influenza plan, and in fact had made large strides over the previous year, the plans developed were still crude and required much more work,” the report says. They also note other researchers’ observation that the idea of using alternative sites to provide surge capacity in a pandemic is widespread, but it is not clear just how these sites would work or even if they would be feasible. They write, “Significant barriers exist to the use of alternative care sites for building hospital surge capacity, and any attempt to develop such capacity should focus on how alternative care arrangements fit into the overall local emergency management and healthcare systems. More important than the alternative care site is the strategy for an alternative care system.” In the realm of planning and coordination, one major problem was that political boundaries “bear little resemblance to the geography of local healthcare markets, resulting in a mismatch between the way resources are used and the plans formulated for using them to meet the demands of a pandemic.” The researchers also found various other problems in planning and coordination, including: “This confusion resulted in a sense of helplessness among some planning teams, resulting from a belief that any planning would be rendered useless by the magnitude of the problem,” the report states. “This indicates a need for more care in risk communication by federal, state, international, and academic public health experts.” Local officials were also looking at other tools to limit demand for hospital services, including “public information efforts to convince those with the disease to utilize self-care when possible, creation of dedicated outpatient flu and fever clinics, and public education programs to prevent exposure by encouraging social distancing,” the report states. One county hospital that looked into insurance reimbursement during a pandemic learned that care would be covered only if it was provided in the hospital’s own facility, a restriction that would limit options for expanding capacity, the report notes. Other hospital officials assumed that the pressures of a pandemic would drive insurers into bankruptcy. A message the researchers heard from all the counties was that flu patients would not be the only demand on healthcare organizations during a pandemic. Officials said other healthcare needs would continue, such as trauma, childbirth, and medical emergencies. Consequently, not all beds could be allocated to flu patients, and hospitals will need to take steps to prevent flu from spreading to other patients. For example, several counties expected illness attack rates greater than 50% and a case-fatality rate of 50%. The researchers determined that officials derived this view by linking the high case-fatality rate in the (rare) human cases of H5N1 influenza with the high attack rate in the 1918 pandemic. The scientists grouped their findings into six categories: impact perception, planning and coordination, staffing, logistical and financial barriers, demand management, and dealing with other healthcare needs during a pandemic. Among lessons drawn from their findings, the authors say that legal and institutional barriers may limit planning in ways that are not obvious and that planners may not have the authority to address such problems. “Issues such as insurance reimbursement, malpractice and liability insurance, and scope of practice rules constrain the solution set for local planners, and require policy action at a state or federal level to solve,” they state. Avery GH, Lawley M, Garret S, et al. Planning for pandemic influenza: lessons from the experiences of thirteen Indiana counties. J Homeland Secur Emerg Manage 2008;5(1):29 [Abstract]last_img read more

After spinal injury to Norton, Luther College community bonds

first_img No. 17 Arkansas at No. 18 South Carolina Prediction: South Carolina 23, Arkansas 14 In a battle of conference foes, the Gamecocks will come out best in this fight. South Carolina’s road ahead will start at home against the Razorbacks. Published on November 3, 2010 at 12:00 pm Comments The play happened so fast, many of Chris Norton’s teammates missed it. It started when Norton, a freshman special teams player, took the field for a kickoff. He lined up while his team, Division III Luther College, was losing to Central College. The play ended with a call for an ambulance and Norton staying on the field. Jordan Grimm, a senior and the Norse’s linebacker and placekicker, didn’t even notice Norton was down at first. But then to Grimm, it quickly became clear that something felt wrong. It took a long time to get Norton off the field. After that, the team felt distracted, Grimm said. ‘It was kind of just really tough,’ Grimm said. ‘We were supposed to go out and play right after that. It kind of went downhill from there.’ Luther lost that Oct. 16 game to No. 15 Central, 45-26. The ambulance that carried Norton went to Decorah Medical Center in Decorah, Iowa. Doctors diagnosed him with a neck and spinal cord injury. Because of the injury’s severity, a helicopter took Norton to the Mayo Clinic in Rochester, Minn., where he required a three-hour surgery. Since Norton’s injury, the team and local community around Luther have responded to his loss, as Norton began the road to recovery. Right after the game, head coach Mike Durnin addressed the team. He told them the news and told them they would have to keep going.AdvertisementThis is placeholder text ‘Keep your prayers and thoughts with Chris and his family,’ Durnin told the team. In the weeks that followed, a local Decorah church held a service for Norton. Another service took place in his hometown. Luther established a fund for parents to donate to his recovery fund. ‘This has definitely been a case of the greatest of human nature standing up and supporting each other,’ Durnin said this week. As the Luther community tried to rally, so did Norton, with the help of a few others. Durnin and his wife went to the Mayo Clinic, as did Luther President Richard Torgerson and his wife. When Norton’s family finally arrived, they spotted a man wearing Luther gear, who was neither Durnin nor Torgerson. Just a Luther alumnus who went to the Oct. 16 game, saw Norton’s injury and wanted to offer his family a place to stay. A neurosurgeon called the Norton family into a small, dim room and told them to expect a long surgery, probably eight to 10 hours, said Norton’s sister, Alex. ‘The other thing is, do not expect he will have any movement from the neck down,’ the surgeon told the family, Alex said. The surgery took just three hours. After that, Alex began a blog about him and his road to recovery. She linked a donation fund to the blog so readers could contribute after they read about Norton. ‘It was a way everyone could see the information,’ she said. ‘That day of the accident and the day after, we couldn’t keep up. We were getting phone calls, texts. It was overwhelming. We kind of set up the site so people could keep up.’ Soon after the site went live, Norton wiggled his shoulders. As the team moves forward, the squad continues to feel Norton’s spirit. The team receives updates on his condition often. Luther (4-4) will face two more opponents before the end of the season. And while keeping the game in perspective, Luther’s players want to win for Norton.   ‘We’ve got a renewed sense of passion for the game, passion for life, knowing that every play could be our last,’ Grimm said. ‘Every day could be our last, you never know what life is going to throw at you.’ Grimm admits he thinks about Norton’s accident often. He tries to put it out of his mind when he approaches a kickoff. ‘It’s scary, it’s definitely scary,’ Grimm said. He tells himself that the odds are too small. That Norton just suffered a strike of bad luck. ‘It’s given us inspiration to play for Chris and to give yourself to something bigger than yourself,’ Grimm said. As for Norton, he continues to defy the first prognosis. Sensation continues to return to his body. Hopefully he can make a recovery and return to campus as a student next semester, his sister said. Each day, Norton undergoes physical therapy. His father has taken over blogging duties. On Tuesday, while in a wheelchair, therapists attached Chris’ legs to a stationary bike. The bike is powered by electricity and the motion helps rebuild Norton’s leg muscles. His father wrote, ‘I know the look he had on his face, it was his game face. He was ready to go.’ Games of the Week Louisville at Syracuse Prediction: Syracuse 30, Louisville 24 Last time the Cardinals came to the Carrier Dome in 2008, Syracuse came out on top 28-21. With the Orange winning five of its last six games, this year should be much the same. Syracuse gets its seventh win of the season and becomes bowl-eligible. No. 4 TCU at No. 6 Utah Prediction: Utah 32, TCU 28 In the week’s best matchup, the unbeaten Horned Frogs will journey to Salt Lake City to take on the unbeaten Utes. Last season, the Frogs demolished Utah 55-28. But the Frogs have lost the last two games at Salt Lake City. Look for Utah to continue the trend this week. No. 13 Arizona at No. 10 Stanford Prediction: Stanford 20, Arizona 17 Look for offense to topple defense. Stanford brings in a great offensive package, led by quarterback Andrew Luck. The Wildcats boast a No. 10-ranked defense, but luck should hold out for Stanford. No. 5 Alabama at No. 12 LSU Prediction: Alabama 30, LSU 14 Alabama rules over this series, 45-23-5. Expect that again this week. Alabama brings quarterback Greg McElroy to try and beat the Tigers. Even at home, LSU will not last past the Tide.center_img Facebook Twitter Google+last_img read more

‘Mookie should be a household name’: MLB must seize opportunity to make its players famous

first_imgMORE: Watch live MLB games all season long on fuboTV (7-day free trial)Hence the “Harper-Trout 2020” campaign-style T-shirts made by BreakingT and other companies. Of course, a couple of weeks later, Trout signed a $430 million extension with the Angels and those dreams died. After I finished with the explanation, he just smiled and said, “Ah. I saw the Trout on there and thought maybe it was a fishing shirt.”Nope, just the two biggest names in baseball, guys who had — within the past few months — signed contracts worth $760 million. Names and numbers that should have been part of America’s conscious, both because of their outstanding talent and performance and because of the shock value of ALL THAT MONEY, but neither registered with him.The lack of player recognition is an issue for baseball. From a BBC Sport article earlier this month  with the headline “Mike Trout: The brilliant $426.5m MLB star most Americans don’t know” …According to the market research firm Q Scores, 22% of the US general public is familiar with Trout. Basketball star Curry and NFL quarterback Drew Brees, on the other hand, are over 50%.Among sport fans, Trout reaches the 50% mark. But Tom Brady and LeBron James, for instance, have near universal recognition.Yikes, right? No wonder the pressure-washer guy thought my shirt was about a fish. The lack-of-recognition topic was addressed by both MLB commissioner Rob Manfred and MLB Players Association executive director Tony Clark during their separate meetings with BBWAA members in Cleveland the morning of the All-Star Game. Those two don’t share similar views on many subjects, but they seemed at least relatively aligned on this one, about what’s necessary going forward.Clark was asked specifically about Mookie Betts, a star who won last year’s AL MVP and plays in a big market (Boston), but still doesn’t have nearly the cache of NBA or NFL players.  “Mookie should be a household name. Mookie should be a one-name guy,” Clark said. “You say Ronaldo, you say Messi, you say Mookie. You should know who Mookie is. And outside of the baseball world, I don’t know how many do. So I agree with you, 100 percent, 100-plus percent, in the grand scheme of things, with respect to players who should be at the forefront of every conversation, even in conversations with non-baseball fans. No doubt about it.”At last year’s BBWAA meeting, you might recall, Manfred was asked about the marketing of Trout, and his reply raised plenty of eyebrows . “If he wants to engage and be more active in that area, I think we can help him make his brand really, really big. But he needs to make that decision that he’s prepared to engage in that area. It takes time and effort.” Even though Manfred said this year that he wouldn’t talk about baseball’s specific marketing relationship with any one player, it’s probably not a coincidence that MLB used this year’s All-Star stage to debut a powerful Mike Trout commercial. Mike Trout is exactly who he’s always been.— MLB (@MLB) July 8, 2019“I will say the last 12 months, everything that we have done from a marketing perspective, from ‘Let the Kids Play’ to the postseason one, to the three new ads that were debuted yesterday … I mean, walk around Cleveland and there is no baseball signage that is not player-focused. It has been a really broad initiative out of the commissioner’s office.”Manfred wasn’t exaggerating. The faces of baseball — even some, like Harper, who didn’t make this year’s NL All-Star team — were everywhere during the All-Star events, including this massive sign spanning the intersection of Ontario and Prospect, a couple of blocks from Progressive Field. that’s a lot of all-stars— Ryan Fagan (@ryanfagan) July 9, 2019“This special event, the All-Star Game, and the marketing around it, has been tremendous,” Clark said. “I think we can do more. I think there’s an opportunity to move our players into the forefront of the conversation by connecting them with companies that are engaged and involved in our game in ways that we haven’t before.”It’s quite the change from past approaches, as Clark pointed out by telling a story from an All-Star event “five years ago or so.”“I was asked whether I thought the industry did a good job of marketing and promoting its players,” he said. “My response was that I think we could do more, particularly on the national level, that I looked forward to a day when I turn on the TV and I see our guys plastered all over every ad, with every sponsor that’s out there, when I’m not watching a baseball game. … About an hour or so after that, the league was asked the same question. And the league response was, while respecting my concerns, that the most important thing is the jersey and the logo. And it was a moment, as a retired player, that resonated for me.”And here’s the thing: Past mistakes don’t determine baseball’s future in this area. The sport has an opportunity, right now. We all watched the thrilling Home Run Derby, with rookies Vlad Guerrero Jr. and Pete Alonso vying for the title in the final round. Ronald Acuña Jr., who’s just 21, was amazing in that event, too. Add in youngsters like Fernando Tatis Jr. (20), Juan Soto (20), Gleyber Torres (22) and others, and you have a potential marketing bonanza. MORE: MLB trade deadline predictions, rumorsI asked current young superstar Francisco Lindor about the next young wave. “It’s fun because they bring a lot of excitement to the game,” Lindor said. “There are some strong boys in this year’s rookie class, those guys can hit home runs. Tatis is a special player. Vladdy is, Alonso as well, and a couple other guys. It’s fun to watch them. I like to see the different guys have success.”Clark agrees, and sees big potential.“We have a time, particularly now, where the talent level of our players is off the charts, top to bottom. There is truly an opportunity now to push our cards across and make a difference there in a way that does engage the next generation in a way that we haven’t before.”Baseball has a long way to go in terms of being more social-media-sharing friendly, but steps are being taken, at least in regard to the players. “Another piece that I would mention to you is the social media program that, I think, about 36 percent of our players have opted into,” Manfred said at the BBWAA meeting. “We make highlights available to them, easy to get to, so they can use those highlights, add their own commentary and post very quickly. They don’t pay for anything. It’s there, ready to use.” Chatting on my front walkway, the nice gentleman we hired to pressure-wash our driveway asked a question: “What’s your shirt mean?”I was wearing my “Harper-Trout 2020” T-shirt, so I launched into a quick version of the story that was a thing this spring. For roughly five minutes after the Phillies signed Bryce Harper to a 13-year, $330 million free-agent contract, you’ll recall, Philly fans had dreams of their favorite franchise signing Mike Trout — the best player in baseball who happens to be from nearby New Jersey and is a huge Eagles football fan — when he became a free agent after the 2020 season.  He paused. “All those efforts are directed at marketing our players.”That’s a step in the right direction.last_img read more

GOP lawmakers seek to ban some actions taken for last week’s Primary

first_imgDES MOINES — Senate Republicans are proposing new restrictions on state and local election officials after changes made for last week’s primary elections led to record turnout, primarily from early voting with absentee ballots.Democrats like Senator Pam Jochum of Dubuque call the GOP moves voter suppression.“What are you afraid of, that more people in this state might engage in a constitutional right to cast a vote?” Jochum asked rhetorically late Friday night. “If this last primary showed us anything, it’s that it worked.”Secretary of State Paul Pate sent absentee ballot request forms to every registered voter in the state, urging early voting through the mail during the pandemic rather than in-person voting on Primary Day. The bill that passed the Senate Judiciary Committee late Friday night would forbid Pate and county auditors from mailing out absentee ballot request forms in the future. Senator Roby Smith, a Republican from Davenport, said he has certified letters outlining instances of voter fraud.“I welcome the debate. I can defend this until the cow’s come home…because I want to protect the ballot box,” Smith said.Republican Senator Marinnette Miller-Meek of Ottumwa won last week’s second congressional district primary and she disputed the idea Pate’s mailing of absentee ballot request forms spurred turnout.“Perhaps on the Republican side…there was a record Republican turnout because you had congressional candidates who were in very spirited primaries and who were directing people and in video and in direct mail to vote by mail,” Miller-Meeks said, ” instructed how to vote by mail, reached out to them to vote by mail.”Senator Tony Bisignano, a Democrat from Des Moines, said Republicans had devised “a potpourri” of voter limitations.“Now our president thinks this country is riddled with crooks and cheats and naves,” Bisignano said. “…You’re picking up his theme. Let’s just choke down these absentees.”The bill also stipulates that no more than 35 percent of precincts may be closed on Election Day. Last Tuesday many county auditors dramatically reduced and consolidated voting sites for the primary. Republicans say that was unfair to Iowans who had to travel great distances to vote last Tuesday.The bill’s next stop is debate in the full Senate. County auditors issued a joint statement, saying they are “baffled” legislators would want to cripple actions taken for last Tuesday’s election that “led to such success.”last_img read more

Cignal HD gets other outright semis berth

first_img787 earthquakes recorded in 24 hours due to restive Taal Volcano Playmaker Pamboy Raymundo also shone with 11 points and nine assists for Cignal.Sports Related Videospowered by AdSparcRead Next View comments MOST READ Trending Articles PLAY LIST 00:50Trending Articles03:13SEA Games 2019: PH’s Carlo Paalam boxing light flyweight semi final (HIGHLIGHTS)03:11SEA Games 2019: PH’s Ian Bautista boxing bantamweight semi final (HIGHLIGHTS)01:40Filipinos turn Taal Volcano ash, plastic trash into bricks01:32Taal Volcano watch: Island fissures steaming, lake water receding02:14Carpio hits red carpet treatment for China Coast Guard02:56NCRPO pledges to donate P3.5 million to victims of Taal eruption00:56Heavy rain brings some relief in Australia02:37Calm moments allow Taal folks some respite LATEST STORIES Indian national gunned down in Camarines Sur ‘I’m out!’: PewDiePie releases last video before taking break from YouTube Kawhi Leonard, Clippers rally to beat Pelicans “I guess we were fortunate because we had a very long preparation. We had a lot of time scouting them, but it was still a struggle against them. But the boys delivered and we got the win,” said deputy Jude Roque, who coached in Boyet Fernandez’ stead. The Hawkeyes shot the lights out from downtown, going 15-of-33 from that area.FEATURED STORIESSPORTSEnd of his agony? SC rules in favor of Espinosa, orders promoter heirs to pay boxing legendSPORTSRedemption is sweet for Ginebra, Scottie ThompsonSPORTSMayweather beats Pacquiao, Canelo for ‘Fighter of the Decade’Guard Aaron Jeruta and big man Rod Ebondo led the Scorpions, who shot 51% from the field.Top seed Flying V, which rose to 9-0 with a blowout win over Zark’s Burgers earlier, is the first team to earn an automatic semis slot.center_img PBA IMAGESCignal HD booked the last outright semifinals ticket after turning back a scrappy Centro Escolar University side, 96-89, in the 2017 PBA D-League Foundation Cup Tuesday at Ynares Sports Arena in Pasig City.Jason Perkins notched a double-double with 18 points and 10 rebounds while John Villarias gave Cignal a big lift off the bench with a team-high 19 points built on five 3-pointers.ADVERTISEMENT Pesky defense from Marcelino twins throws Salado off his game End of his agony? SC rules in favor of Espinosa, orders promoter heirs to pay boxing legend OSG plea to revoke ABS-CBN franchise ‘a duplicitous move’ – Lacson Don’t miss out on the latest news and information. McGregor blasts Cerrone in 40 seconds in UFC return Marcosian mode: Duterte threatens to arrest water execs ‘one night’ LeBron James scores 31 points, Lakers beat Rocketslast_img read more

When to Start Coding

first_imgI attended a talk by Dave Hussman at an Agile Bazaar event a few weeks ago at IBM’s offices. In attendance were developers from expansion stage software companies, big established companies, and members of senior management teams.It was sponsored by a number of software vendors, including VersionOne, an OpenView Venture Partners portfolio company, and the leading tool for Agile software development teams.His talk was entitled, “Products and People over Process and Dogma.”The people part I addressed in last week’s post, In Agile, People Come First!.Dave spent a good deal of time speaking about the right time to start coding. Dave remarked that many teams that were focused on following best practices process of Agile Product Development were not necessarily focused on the right things.The mentality was: Give us a story, we’ll code it in a short iteration, show it to you, and go from there.Well, that’s all good, but perhaps the team shouldn’t start coding just yet. Does everyone on the team understand the story? I mean, really get it? The ‘why’ and the ‘for whom’? How it fits into the bigger picture of the interface, the use case, the product, the user’s life? Has the team done analysis to think through the different ways in which the functionality could flow? The edge cases? What could go wrong?Has the team thought through the different approaches to implementing the story? How it touches other code and the architecture?I have seen first hand what happens when Scrum teams, following all the prescriptions of the Scrum methodology, fail to do the above multiple times.The result?Software that may meet the acceptance criteria of a story and definition of ‘done’ at a superficial level, but ultimately has quality issues, behaves in unpredictable ways, and is often not delivered on time.So if you’re a software developer, the next time you’re about to start writing code, ask yourself: Am I really ready?AddThis Sharing ButtonsShare to FacebookFacebookShare to TwitterTwitterShare to PrintPrintShare to EmailEmailShare to MoreAddThislast_img read more