8 research outputs found
Organizational Learning from Prescribed Fire Escapes: a Review of Developments Over the Last 10 Years in the USA and Australia
- Author
- A Edmondson
- A Edmondson
- A Edmondson
- A English
- A English
- AE Black
- AFAC
- AFAC
- AFAC
- AFAC
- AFAC
- AFAC
- AFAC
- AFAC
- AFAC
- B Gammage
- B Teague
- BA Hamiliton
- BA Turner
- BD Duncan
- C Argyris
- C Johnson
- C Lucas
- C Owen
- CM Fiol
- CSIRO
- D Bowman
- D Gregory
- D Megginson
- D Sparkes
- D Sparkes
- DA Driscoll
- DELWP
- DELWP
- DI Castaneda
- E Antonacopoulou
- F Lepine
- G Klein
- G McDonald
- HA Simon
- IGEM
- IGEM
- IGEM
- J Hong
- J Maupin
- J Maupin
- J Piñol
- JA Ziegler
- JLS Jahn
- JR Weir
- K Moriarty
- KC Ryan
- KE Weick
- KE Weick
- L Argote
- L Argote
- LN Kobziar
- LN Quinn-Davidson
- M Barton
- M Carter
- M Christianson
- MA Glynn
- MJ Keelty
- MP Thompson
- N Burrows
- NM Dixon
- NSW RFS
- OBRM
- Office of Environment and Heritage
- P Constantinides
- P Hayes
- PM Fernandes
- R Flin
- R Seidl
- RB Hammer
- RE Keane
- RH Luke
- S Ghili
- S Stack
- S Stack
- SJ Pyne
- SJ Pyne
- T Savolainen
- TD Penman
- V Butsic
- Z Gedalof
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/03/2020
- Field of study
Purpose of Review: Prescribed fire escapes continue to challenge most fire and land management agencies and many communities. This article considers the issue from knowledge management (KM) and organizational learning (OL) perspectives. We review organizational initiatives and the literature that have developed over the last 10 years to support learning from escaped prescribed fires, then use this to evaluate current learning practices and identify potential next frontiers for improving performance. Due to the difficulty obtaining statistics for non-federal entities, this review focuses primarily on developments in the US Department of Agriculture, Forest Service, but also captures reviews from the US Department of Interior, and the State of Victoria, Australia.
Recent Findings: The recurring issue of prescribed fire escapes may in part be explained by the increasing challenges and expectations fire and land management agencies and prescribed fire managers face. Agencies are being asked to burn more area and suitably contain prescribed fires with fewer resources. In many jurisdictions, this challenge is heightened by increasingly tough climate conditions, shifting demographics internal and external to their agencies, changing patterns of land use, and requirements to meet increasing fuel reduction targets. A range of interventions has been developed and implemented by state and federal land and fire management agencies to support improved performance through KM and OL. However, prescribed fires continue to escape, often for the same reasons they always have, leading us to ask: is there a next frontier or level for improving performance though learning?
Summary: This paper reviews recent developments in KM and OL to develop a model of organizational learning for prescribed fire. We then use this lens to review learning from prescribed burn escapes in Australia and the USA, highlighting the opportunities and challenges that agencies continue to face. Four areas of concentration to further strengthen OL are proposed, namely (i) strengthening the organizational learning culture, (ii) greater use of communities of practice to enhance lesson sharing, (iii) addressing the slow build time for prescribed burning expertise to replace pending retirements, and (iv) improving non-technical skills and human factors training
Safety of Nonsteroidal Anti-inflammatory Drugs in Major Gastrointestinal Surgery: A Prospective, Multicenter Cohort Study
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- Abbas Z
- Abburu S
- Abdelhadi M
- Abdikadir HR
- Abdulmajid A
- Abid A
- Abid H
- Abuhussein N
- Abul MH
- Acquaah F
- Acres M
- Adams R
- Adams RD
- Adebayo AA
- Adeleja I
- Adjei H
- Afzal Z
- Agarwal V
- Ahern N
- Ahmad K
- Ahmad S
- Ahmed F
- Ahmed H
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- Ahmed N
- Ahmed S
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- Ahn JS
- Aidoo-Micah GE
- Aildasani L
- Aithie JM
- Akhtar S
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- Warwick HL
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- Wells M
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- Ziff O
- Ziprin P
- Zuhair M
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2017
- Field of study
Background
Significant safety concerns remain surrounding the use of nonsteroidal anti-inflammatory drugs (NSAIDs) following gastrointestinal surgery, leading to wide variation in their use. This study aimed to determine the safety profile of NSAIDs after major gastrointestinal surgery.
Methods
Consecutive patients undergoing elective or emergency abdominal surgery with a minimum one-night stay during a 3-month study period were eligible for inclusion. The administration of any NSAID within 3 days following surgery was the main independent variable. The primary outcome measure was the 30-day postoperative major complication rate, as defined by the Clavien–Dindo classification (Clavien–Dindo III–V). Propensity matching with multivariable logistic regression was used to produce odds ratios (OR) and 95 % confidence intervals.
Results
From 9264 patients, 23.9 % (n = 2212) received postoperative NSAIDs. The overall major complication rate was 11.5 % (n = 1067). Following propensity matching and adjustment, use of NSAIDs were not significantly associated with any increase in major complications (OR 0.90, 0.60–1.34, p = 0.560).
Conclusions
Early use of postoperative NSAIDs was not associated with an increase in major complications following gastrointestinal surgery
Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study
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- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2019
- Field of study
Background
Patient selection for critical care admission must balance patient safety with optimal resource allocation. This study aimed to determine the relationship between critical care admission, and postoperative mortality after abdominal surgery.
Methods
This prespecified secondary analysis of a multicentre, prospective, observational study included consecutive patients enrolled in the DISCOVER study from UK and Republic of Ireland undergoing major gastrointestinal and liver surgery between October and December 2014. The primary outcome was 30-day mortality. Multivariate logistic regression was used to explore associations between critical care admission (planned and unplanned) and mortality, and inter-centre variation in critical care admission after emergency laparotomy.
Results
Of 4529 patients included, 37.8% (n=1713) underwent planned critical care admissions from theatre. Some 3.1% (n=86/2816) admitted to ward-level care subsequently underwent unplanned critical care admission. Overall 30-day mortality was 2.9% (n=133/4519), and the risk-adjusted association between 30-day mortality and critical care admission was higher in unplanned [odds ratio (OR): 8.65, 95% confidence interval (CI): 3.51–19.97) than planned admissions (OR: 2.32, 95% CI: 1.43–3.85). Some 26.7% of patients (n=1210/4529) underwent emergency laparotomies. After adjustment, 49.3% (95% CI: 46.8–51.9%, P<0.001) were predicted to have planned critical care admissions, with 7% (n=10/145) of centres outside the 95% CI.
Conclusions
After risk adjustment, no 30-day survival benefit was identified for either planned or unplanned postoperative admissions to critical care within this cohort. This likely represents appropriate admission of the highest-risk patients. Planned admissions in selected, intermediate-risk patients may present a strategy to mitigate the risk of unplanned admission. Substantial inter-centre variation exists in planned critical care admissions after emergency laparotomies
Body mass index and complications following major gastrointestinal surgery: a prospective, international cohort study and meta-analysis.
- Author
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- Kasar P
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- Keane P
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- Ko\ue7 M
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- Lee J
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- Mahesh S
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- Mirdavoudi V
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- Nachiappan R
- Nadanakumaran K
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- Palyzov\ue1 H
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- Schulzov\ue1 M
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- Sena-Ruiz F
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- Yilmaz M
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- Yilmaz T
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- Yong N
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- Yuen R
- Yuksek B
- Yuksek Ma
- Yuksel A
- Yurdaor Ss
- Yurekli Am
- Zaidi R
- Zegeye Mi
- Zengin T
- Zhang Aa
- Zhao J
- Ziff O
- Zigiotto D
- Zijlmans Jl
- Zimmerman D
- Ziprin P
- Zope S
- Zuhair M
- Publication venue
- 'Wiley'
- Publication date
- 01/01/2018
- Field of study
AIM:
Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a meta-analysis of all available prospective data.
METHODS:
This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien-Dindo Grades III-V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results.
RESULTS:
This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery for malignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49-2.96, P < 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46-0.75, P < 0.001) compared to normal weight patients.
CONCLUSIONS:
In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease
Body mass index and complications following major gastrointestinal surgery: A prospective, international cohort study and meta-analysis
- Author
- Aarts E
- Abbas Z
- Abburu S
- Abd Ghaffar Mk
- Abdelgalil R
- Abdelhadi M
- Abdikadir Hr
- Abdulmajid A
- Abdulrahman N
- Abid A
- Abid H
- Abrisqueta Carrion J
- Abuhussein N
- Abul Mh
- Acar S
- Acherman Yiz
- Acquaah F
- Acres M
- Adams R
- Adams Rd
- Adebayo Aa
- Adeleja I
- Adiyaman C
- Adjei H
- Adlan A
- Afzal Z
- Agalar C
- Agarwal V
- Agrawal M
- Ahern N
- Ahmad A
- Ahmad K
- Ahmad S
- Ahmed F
- Ahmed H
- Ahmed M
- Ahmed N
- Ahmed S
- Ahn Js
- Aidoo-Micah Ge
- Aildasani L
- Aithie Jm
- Akbulut F
- Akcaoglu T
- Akdogan A
- Akhtar S
- Akkaya E
- Akkucuk S
- Akpunarli B
- Aksoy K
- Aktas Mk
- Aktekin H
- Al-Mousawi A
- Al-Nasser A
- Al-Nasser Z
- Al-Obaedi O
- Al-Robeye A
- Albayrak D
- Alberdi San Roman I
- Alberti Delgado P
- Alcazar Montero Ja
- Alcocer Bp
- Alconchel-Gago F
- Aldrey I
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- Aliseda-Jover D
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- Yıgman S
- Yildirim N
- Yildirim R
- Yildiz S
- Yildiz Ss
- Yildiz T
- Yilmaz I
- Yilmaz M
- Yilmaz S
- Yilmaz T
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- Yoganathan S
- Yong Cs
- Yong N
- Yoruk I
- Yousif A
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- Özkan Bb
- Šimáčková B
- Široká M
- Žebrák R
- Publication venue
- 'Wiley'
- Publication date
- 01/01/2018
- Field of study
Aim Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a metaanalysis of all available prospective data. Methods This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien\u2013Dindo Grades III\u2013V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results. Results This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery formalignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49\u20132.96, P < 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46\u20130.75, P < 0.001) compared to normal weight patients. Conclusions In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease
Body mass index and complications following major gastrointestinal surgery: A prospective, international cohort study and meta-analysis
- Author
- Aarts E.
- Abbas Z.
- Abburu S.
- Abd Ghaffar M.K.
- Abdelgalil R.
- Abdelhadi M.
- Abdikadir H.R.
- Abdulmajid A.
- Abdulrahman N.
- Abid A.
- Abid H.
- Abrisqueta Carrion J.
- Abuhussein N.
- Abul M.H.
- Acar S.
- Acherman Y.I.Z.
- Acquaah F.
- Acres M.
- Adams R.
- Adams R.D.
- Adebayo A.A.
- Adeleja I.
- Adiyaman C.
- Adjei H.
- Adlan A.
- Afzal Z.
- Agalar C.
- Agarwal V.
- Agrawal M.
- Ahern N.
- Ahmad A.
- Ahmad K.
- Ahmad S.
- Ahmed F.
- Ahmed H.
- Ahmed M.
- Ahmed N.
- Ahmed S.
- Ahn J.S.
- Aidoo-Micah G.E.
- Aildasani L.
- Aithie J.M.
- Akbulut F.
- Akcaoglu T.
- Akdogan A.
- Akhtar S.
- Akkaya E.
- Akkucuk S.
- Akpunarli B.
- Aksoy K.
- Aktas M.K.
- Aktekin H.
- Al-Mousawi A.
- Al-Nasser A.
- Al-Nasser Z.
- Al-Obaedi O.
- Al-Robeye A.
- Albayrak D.
- Alberdi San Roman I.
- Alberti Delgado P.
- Alcazar Montero J.A.
- Alcocer B.P.
- Alconchel-Gago F.
- Aldrey I.
- Ali A.
- Ali B.
- Ali H.
- Ali M.
- Ali S.
- Alim Y.E.
- Aliseda-Jover D.
- Alizadeh M.
- Aljbour A.
- Aljbour I.
- Allan C.
- Allen J.L.Y.
- Allot R.
- Alonso Gonçalves S.
- Alonso Hernandez N.
- Altintas O.
- Altomare D.F.
- Alvarez Reyes I.
- Amajuoyi A.
- Amarelo Garcia M.
- Ambrona-Zafra D.
- Amelung F.J.
- Amin H.
- Amin O.
- Amphlett A.H.
- Anabitarte O.
- Anakwenze V.
- Anandarajah C.
- Anania G.
- Anconelli D.
- Anderson L.
- Anderson L.B.
- Anderson R.G.J.
- Anderson S.M.
- Ang A.
- Angelov S.
- Anilkumar A.
- Anim-Addo N.
- Ankarali T.
- Ansari N.
- Antoniou I.
- Anyan-Brown J.
- Aonzo P.
- Apicella M.
- Aquilino F.
- Aray E.
- Archer C.H.
- Archer M.
- Arcudi C.
- Arenal J.J.
- Arezzo A.
- Argenti F.
- Arif T.
- Arora E.
- Arrigo A.
- Arslan E.
- Arslan U.
- Arthurs B.
- Arukan C.
- Arun C.
- Asbjoernsen C.A.
- Ashfaq U.
- Ashken L.
- Ashraf S.
- Ashraf S.F.
- Ashton A.J.
- Ashwood J.
- Asik M.
- Aslan L.
- Aslanyan A.
- Asma A.
- Asmadi A.
- Assadullah S.
- Atalay H.
- Atasoy H.
- Atayi A.
- Atesavci S.N.
- Atif M.
- Atraszkiewicz B.A.
- Attalla M.
- Austreng L.
- Auyoung E.
- Avery P.
- Axelson T.
- Ayaz B.
- Aydar S.E.Y.I.
- Aytekin A.
- Aziz H.
- Aziz N.
- Babaoglu H.
- Bach S.
- Badia J.M.
- Badii B.
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- Publication date
- 01/08/2018
- Field of study
Aim Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a metaanalysis of all available prospective data. Methods This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien–Dindo Grades III–V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results. Results This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery formalignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49–2.96, P < 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46–0.75, P < 0.001) compared to normal weight patients. Conclusions In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease
Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study
- Author
- A. Abdulmajid
- A. Abid
- A. Al-Mousawi
- A. Al-Robeye
- A. Ali
- A. Amajuoyi
- A. Ang
- A. Anilkumar
- A. Aslanyan
- A. Asmadi
- A. Atayi
- A. Bakhsh
- A. Batho
- A. Bell
- A. Bhangu
- A. Borakati
- A. Broyd
- A. Burgess
- A. Charania
- A. Chhabra
- A. Chung
- A. Coates
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- Author
- Aashay Vaidya
- Abbas Palkhi
- Abdul Badran
- Abdulmajid Ali
- Abdurrahman Islim
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- Xue Wang
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- Zhi Min Soh
- Zhubene Mesbah
- Zoe Johnston
- Zong Lee
- Publication venue
- 'Elsevier BV'
- Publication date
- 04/02/2017
- Field of study
Letter to the editor