Governing the Humanitarian Knowledge Commons

Humanitarians and bureaucrats who are mandated to work together in complex emergencies face many challenges, especially in settings marked by conflict and displacement. High on the list of challenges are barriers to sharing knowledge freely. These barriers include (self)censorship, contested framings and priorities, deliberate ICT black-outs, and the withholding (or not collecting) of mission-critical information. These barriers exacerbate the gaps in knowledge sharing that occur as a result of a lack of time or capacity. This article conceptualises crisis knowledge as a ‘commons’: a shared resource that is subject to social dilemmas. The enclosure of the knowledge commons—brought about by the barriers outlined above—hampers daily operations as well as efforts to improve the situation in the long term. Trust is key to effective commons governance, as actors need to sacrifice personal benefits (e.g., control over information) for a collective good (e.g., shared learning). Knowledge and trust are deeply interlinked, as shared ways of knowing (alignment) foster trust, and trust fosters the sharing of knowledge. Given the hierarchical nature of humanitarian relationships, this article explores how power and networks shape this dynamic. It focuses on the humanitarian response to the 2018 Guji-Gedeo displacement crisis in the south of Ethiopia. It presents a qualitative analysis of how the governance arrangements that marked this response shaped emergency operations centres’ ability to manage the local knowledge commons effectively. It shows how in Guji-Gedeo, these arrangements resulted in a clustering of trust that strengthened barriers to knowledge sharing, resulting in a partial enclosure of the knowledge commons

Facilities management and earthquake risk reduction: The TURNkey project

Reducing vulnerability and improving resilience of the existing built environment to disaster events is a complex multidisciplinary challenge in which facilities managers need to contribute an understanding of the impact that a disaster event could have on both their hard and soft facilities. Facilities managers also need to identify potential operational, physical and corporate adaptations/mitigations that can support continued business function during and after a disaster event. This paper describes work in progress to develop an earthquake forecasting, early warning and rapid response system that business and critical infrastructure organisations can use as part disaster risk reduction and business continuity planning. Focusing on theory and methods, the paper considers the different aspects of resilience from a facilities management perspective and presents findings from a participatory action research programme that developed a series of use-cases to explore the potential impact of earthquake forecasting, early warning and rapid response on an organisation's vulnerability and resilience to an earthquake; and identifying physical, operational and organisational mitigation interventions that can reduce an organisation's disaster risk. The paper concludes the need for facilities managers to understand the different aspects of resilience and to apply the most appropriate to their hard and soft facilities management system

Mental health professionals’ knowledge, skills and attitudes on domestic violence and abuse in the Netherlands:Cross-sectional study

Background Despite the high prevalence of domestic violence and abuse (DVA) among patients with psychiatric conditions, detection rates are low. Limited knowledge and skills on DVA in mental healthcare (MHC) professionals might contribute to poor identification.AimsTo assess the level of, and factors associated with, DVA knowledge and skills among MHC professionals. Method A total of 278 professionals in Dutch MHC institutions completed a survey assessing factual knowledge, perceived knowledge, perceived skills and attitudes about DVA. Results On average, low scores were reported for perceived skills and knowledge. MHC professionals in primary care scored higher than those working with individuals with severe mental illness (P<0.005). Levels of factual knowledge were higher; levels of attitudes moderate. Previous training was positively associated with skills (odds ratios (OR) = 3.0) and attitudes (OR = 2.7). Years of work was negatively associated with factual knowledge (OR = 0.97). Larger case-loads predicted higher scores on skills (OR = 2.1). Conclusions Training is needed, particularly for clinicians working with patients with severe mental illness

Fighting misinformation in seismology: Expert opinion on earthquake facts vs. fiction

Misinformation carries the potential for immense damage to public understanding of science and for evidence-based decision making at an individual and policy level. Our research explores the following questions within seismology: which claims can be considered misinformation, which are supported by a consensus, and which are still under scientific debate? Consensus and debate are important to quantify, because where levels of scientific consensus on an issue are high, communication of this fact may itself serve as a useful tool in combating misinformation. This is a challenge for earthquake science, where certain theories and facts in seismology are still being established. The present study collates a list of common public statements about earthquakes and provides–to the best of our knowledge–the first elicitation of the opinions of 164 earth scientists on the degree of verity of these statements. The results provide important insights for the state of knowledge in the field, helping identify those areas where consensus messaging may aid in the fight against earthquake related misinformation and areas where there is currently lack of consensus opinion. We highlight the necessity of using clear, accessible, jargon-free statements with specified parameters and precise wording when communicating with the public about earthquakes, as well as of transparency about the uncertainties around some issues in seismology

Questioning Big Data: Crowdsourcing crisis data towards an inclusive humanitarian response

The aim of this paper is to critically explore whether crowdsourced Big Data enables an inclusive humanitarian response at times of crisis. We argue that all data, including Big Data, are socially constructed artefacts that reflect the contexts and processes of their creation. To support our argument, we qualitatively analysed the process of ‘Big Data making’ that occurred by way of crowdsourcing through open data platforms, in the context of two specific humanitarian crises, namely the 2010 earthquake in Haiti and the 2015 earthquake in Nepal. We show that the process of creating Big Data from local and global sources of knowledge entails the transformation of information as it moves from one distinct group of contributors to the next. The implication of this transformation is that locally based, affected people and often the original ‘crowd’ are excluded from the information flow, and from the interpretation process of crowdsourced crisis knowledge, as used by formal responding organizations, and are marginalized in their ability to benefit from Big Data in support of their own means. Our paper contributes a critical perspective to the debate on participatory Big Data, by explaining the process of in and exclusion during data making, towards more responsive humanitarian relief

Severe autoimmune hemolytic anemia; epidemiology, clinical management, outcomes and knowledge gaps

Autoimmune hemolytic anemia (AIHA) is an acquired hemolytic disorder, mediated by auto-antibodies, and has a variable clinical course ranging from fully compensated low grade hemolysis to severe life-threatening cases. The rarity, heterogeneity and incomplete understanding of severe AIHA complicate the recognition and management of severe cases. In this review, we describe how severe AIHA can be defined and what is currently known of the severity and outcome of AIHA. There are no validated predictors for severe clinical course, but certain risk factors for poor outcomes (hospitalisation, transfusion need and mortality) can aid in recognizing severe cases. Some serological subtypes of AIHA (warm AIHA with complement positive DAT, mixed, atypical) are associated with lower hemoglobin levels, higher transfusion need and mortality. Currently, there is no evidence-based therapeutic approach for severe AIHA. We provide a general approach for the management of severe AIHA patients, incorporating monitoring, supportive measures and therapeutic options based on expert opinion. In cases where steroids fail, there is a lack of rapidly effective therapeutic options. In this era, numerous novel therapies are emerging for AIHA, including novel complement inhibitors, such as sutimlimab. Their potential in severe AIHA is discussed. Future research efforts are needed to gain a clearer picture of severe AIHA and develop prediction models for severe disease course. It is crucial to incorporate not only clinical characteristics but also biomarkers that are associated with pathophysiological differences and severity, to enhance the accuracy of prediction models and facilitate the selection of the optimal therapeutic approach. Future clinical trials should prioritize the inclusion of severe AIHA patients, particularly in the quest for rapidly acting novel agents

Thioguanine is Effective as Maintenance Therapy for Inflammatory Bowel Disease:A Prospective Multicentre Registry Study

Background and Aims: Thioguanine is a well-tolerated and effective therapy for inflammatory bowel disease [IBD] patients. Prospective effectiveness data are needed to substantiate the role of thioguanine as a maintenance therapy for IBD.Methods: IBD patients who previously failed azathioprine or mercaptopurine and initiated thioguanine were prospectively followed for 12 months starting when corticosteroid-free clinical remission was achieved (Harvey-Bradshaw Index [HBI] ≤ 4 or Simple Clinical Colitis Activity Index [SCCAI] ≤ 2). The primary endpoint was corticosteroid-free clinical remission throughout 12 months. Loss of clinical remission was defined as SCCAI &gt; 2 or HBI &gt; 4, need of surgery, escalation of therapy, initiation of corticosteroids or study discontinuation. Additional endpoints were adverse events, drug survival, physician global assessment [PGA] and quality of life [QoL].Results: Sustained corticosteroid-free clinical remission at 3, 6 or 12 months was observed in 75 [69%], 66 [61%] and 49 [45%] of 108 patients, respectively. Thioguanine was continued in 86 patients [80%] for at least 12 months. Loss of response [55%] included escalation to biologicals in 15%, corticosteroids in 10% and surgery in 3%. According to PGA scores, 82% of patients were still in remission after 12 months and QoL scores remained stable. Adverse events leading to discontinuation were reported in 11%, infections in 10%, myelo- and hepatotoxicity each in 6%, and portal hypertension in 1% of patients.Conclusion: Sustained corticosteroid-free clinical remission over 12 months was achieved in 45% of IBD patients on monotherapy with thioguanine. A drug continuation rate of 80%, together with favourable PGA and QoL scores, underlines the tolerability and effectiveness of thioguanine for IBD.</p

Дослідження руху індексу Doing Business України

Background: Domestic Violence and Abuse (DVA) is associated with a range of psychosocial and mental health problems. Having a psychiatric illness increases likelihood of being a victim of DVA. Despite the evidence of a high risk for DVA and the serious effects of violent victimization in psychiatric patients, detection rates are low and responses are inadequate. The aim of the BRAVE (Better Reduction trough Assessment of Violence and Evaluation) study is to improve detection of and response to DVA in psychiatric patients. In this article, we present the protocol of the BRAVE study which follows the SPIRIT guidelines. Methods: The BRAVE study is a cluster randomized controlled trial. We will include 24 community mental health teams from Rotterdam and The Hague. Twelve teams will provide care as usual and 12 teams will receive the intervention. The intervention consists of 1) a knowledge and sk

Fighting misinformation in seismology: Expert opinion on earthquake facts vs. fiction

Misinformation carries the potential for immense damage to public understanding of science and for evidence-based decision making at an individual and policy level. Our research explores the following questions within seismology: which claims can be considered misinformation, which are supported by a consensus, and which are still under scientific debate? Consensus and debate are important to quantify, because where levels of scientific consensus on an issue are high, communication of this fact may itself serve as a useful tool in combating misinformation. This is a challenge for earthquake science, where certain theories and facts in seismology are still being established. The present study collates a list of common public statements about earthquakes and provides–to the best of our knowledge–the first elicitation of the opinions of 164 earth scientists on the degree of verity of these statements. The results provide important insights for the state of knowledge in the field, helping identify those areas where consensus messaging may aid in the fight against earthquake related misinformation and areas where there is currently lack of consensus opinion. We highlight the necessity of using clear, accessible, jargon-free statements with specified parameters and precise wording when communicating with the public about earthquakes, as well as of transparency about the uncertainties around some issues in seismology

Regioscan zoetwatermaatregelen : Verkennen van het perspectief van kleinschalige zoetwatermaatregelen voor de regionale zoetwateropgave

De Regioscan zoetwatermaatregelen brengt de bijdrage in beeld die lokale maatregelen kunnen leveren aan het opheffen van regionale zoetwatertekorten. Dit helpt bij de ontwikkeling van een zoetwaterstrategie. Het rapport bevat meer informatie en achtergronden over het instrument, en een handleiding voor het gebruik