Long-term care homes (LTCHs) were disproportionately affected by the coronavirus disease (COVID-19) pandemic, creating stressful circumstances for LTCH employees, residents, and their care partners. Team huddles may improve staff outcomes and enable a supportive climate. Nurse practitioners (NPs) have a multifaceted role in LTCHs, including facilitating implementation of new practices. Informed by a community-based participatory approach to research, this mixed-methods study aimed to develop and evaluate a toolkit for implementing NP-led huddles in an LTCH. The toolkit consists of two sections. Section one describes the huddles’ purpose and implementation strategies. Section two contains six scripts to guide huddle discussions. Acceptability of the intervention was evaluated using a quantitative measure (Treatment Acceptability Questionnaire) and through qualitative interviews with huddle participants. Descriptive statistics and manifest content analysis were used to analyse quantitative and qualitative data. The project team rated the toolkit as acceptable. Qualitative findings provided evidence on design quality, limitations, and recommendations for future huddles.

What are the consequences of nationalist unrest? This paper utilizes two original datasets, which cover 377 city-level anti-Japanese protests during the 2012 Senkaku/Diaoyu Island crisis and the careers of municipal leaders, to analyse the downstream effects of nationalist unrest at the subnational level. We find both political and economic consequences of China's 2012 protest demonstrations against Japan. Specifically, top Party leaders in cities that saw relatively spontaneous, early protests were less likely to be promoted to higher office, a finding that is consistent with the widely held but rarely tested expectation that social instability is punished in the Chinese Communist Party's cadre evaluation system. We also see a negative effect of nationalist protest on foreign direct investment (FDI) growth at the city level. However, the lower promotion rates associated with relatively spontaneous protests appear to arise through political rather than economic channels. By taking into account data on social unrest in addition to economic performance, these results add to existing evidence that systematic evaluation of leaders’ performance plays a major role in the Chinese political system. These findings also illuminate the dilemma that local leaders face in managing popular nationalism amid shifting national priorities.

Ontario has the highest proportion of for-profit nursing homes in Canada. These facilities, which are known in Ontario as long-term care (LTC) homes, offer 24-hour custodial as well as nursing care to individuals who cannot live independently. Increasingly, they are also operating as members of multi-facility chains. Using longitudinal data (1996–2011) from the Residential Care Facilities Survey (n = 627), our analysis revealed discernible differences in staffing levels by profit status and chain affiliation. We found for-profit LTC homes – especially those owned by a chain organization – provided significantly fewer hours of care, after adjusting for variation in the residents’ care needs. Findings from this study offer new information on the impact of organizational structure on staffing levels in Ontario’s LTC homes and have implications for other jurisdictions where a growing presence of private, chain-affiliated operators has been observed.

Effective hospital surge response in disaster depends largely on an adequate number of personnel to provide care. Studies appearing since 1991 indicate health care personnel may not be willing to work in all disaster situations—and if so, this could degrade surge response. A systematic review of the literature was conducted to determine the state of the evidence concerning the willingness of health care personnel to work in disaster. The aims of this review are to collate and assess the literature concerning willingness of health care personnel to work during a disaster, to identify gaps in the literature as areas for future investigation, and to facilitate evidence-based disaster planning. Twenty-seven studies met inclusion criteria (25 quantitative and 2 qualitative studies). The current evidence indicates there may be certain factors related to willingness to work (or lack of willingness) in disaster including the type of disaster, concern for family, and concerns about personal safety. Barriers to willingness to work have been identified including pet care needs and the lack of personal protective equipment. This review describes the state of an emerging area of science. These findings have significant implications for community and organizational emergency planning and policymaking in an environment defined by limited resources. (Disaster Med Public Health Preparedness. 2009;3:42–56)

Objectives: An influenza pandemic, as with any disaster involving contagion or contamination, has the potential to influence the number of health care employees who will report for duty. Our project assessed the uptake of proposed interventions to mitigate absenteeism in hospital workers during a pandemic.

Methods: Focus groups were followed by an Internet-based survey of a convenience sample frame of 17,000 hospital workers across 5 large urban facilities. Employees were asked to select their top barrier to reporting for duty and to score their willingness to work before and after a series of interventions were offered to mitigate it.

Results: Overall, 2864 responses were analyzed. Safety concerns were the most frequently cited top barrier to reporting for work, followed by issues of dependent care and transportation. Significant increases in employee willingness to work scores were observed from mitigation strategies that included preferential access to antiviral medication or personal protective equipment for the employee as well as their immediate family.

Conclusions: The knowledge base on workforce absenteeism during disasters is growing, although in general this issue is underrepresented in emergency planning efforts. Our data suggest that a mitigation strategy that includes options for preferential access to either antiviral therapy, protective equipment, or both for the employee as well as his or her immediate family will have the greatest impact. These findings likely have import for other disasters involving contamination or contagion, and in critical infrastructure sectors beyond health care. (Disaster Med Public Health Preparedness. 2009;3(Suppl 2):S141–S147)

Hospital plans often vary when it comes to the specific functional roles that are included in emergency and incident management positions.Bioterrorism coordinators and emergency managers for 31 hospitals in a seven-county region outside of a major metropolitan area, with urban, suburban, and rural demographics were surveyed to determine which specific functional roles were considered “essential” to their hospital's emergency operations plans. Furthermore, they were asked to estimate the percentage of their “essential” staff trained to perform the functional roles delineated in the hospital's plan. Responses were entered into a database and descriptive statistical computations were performed. Only three categories of hospital personnel were reported to be “essential” by all hospitals to their emergency preparedness plans: emergency department physicians, nurse, and support staff. Training for overall “essential” staff ranged by hospital 73.6–83.3%. Some hospitals reported that these staff members have received no training in their anticipated role based on the hospital emergency response plan. Allied health professionals and emergency medical technicians/paramedics (that are employed by hospitals) had the least amount of training on their role in the hospital preparedness and response plan, 33.3% and 22.2% respectively.Without improved guidance on benchmarks for preparedness from regulators and professional organizations, hospitals will continue to lack the capacity to effectively respond to disasters and public health emergencies.

The 10th european ALARA network (EAN) workshop took place in Prague (Czech Republic) in September 2006. This was the 10-year anniversary of the EAN, and unlike the previous workshops that addressed a particular ALARA topic, the aim of this workshop was to consider the implementation of the optimisation principle in all domains of activities (nuclear and conventional industry, medical sector, NORM industry). This principle is fundamental to radiation protection, and the workshop drew together key stakeholders to discuss its past, present and future status. The workshop was asked to consider the practical implementation of ALARA, and how this might be improved in the next 10 years. The objectives of the 10th EAN workshop were to review the past evolution of the ALARA concept, internationally, within the EU, and nationally, in terms of the practical impact on radiation protection; to examine the current status of the implementation of the ALARA principle; and to identify needs for future developments in the concept and implementation of optimisation. As with previous workshops, half the programme time was devoted to invited presentations, and half to working group discussions and report backs. After discussion, the output of these working groups was collated by the EAN co-ordinators, to produce seven formal recommendations to international organizations (IAEA, International Labour Organisation, European Commission), to EAN itself and to national authorities. These recommendations deal with justification of practices, holistic approach, ALARA culture, ALARA training, especially in the medical sector, ALARA focus through inspection and control, and stakeholder involvement. Individual presentations (papers and slides) are available to download from the EAN website (http://www.eu-alara.net).