Community response in disasters: an ecological learning framework

Natural disasters are frequently exacerbated by anthropogenic mechanisms and have social and political consequences for communities. The role of community learning in disasters is seen to be increasingly important. However, the ways in which such learning unfolds in a disaster can differ substantially from case to case. This article uses a comparative case study methodology to examine catastrophes and major disasters from five countries (Japan, New Zealand, the UK, the USA and Germany) to consider how community learning and adaptation occurs. An ecological model of learning is considered, where community learning is of small loop (adaptive, incremental, experimental) type or large loop (paradigm changing) type. Using this model, we consider that there are three types of community learning that occur in disasters (navigation, organization, reframing). The type of community learning that actually develops in a disaster depends upon a range of social factors such as stress and trauma, civic innovation and coercion

Standardized Definitions for Cardiogenic Shock Research and Mechanical Circulatory Support Devices:Scientific Expert Panel From the Shock Academic Research Consortium (SHARC)

The Shock Academic Research Consortium is a multi-stakeholder group, including representatives from the US Food and Drug Administration and other government agencies, industry, and payers, convened to develop pragmatic consensus definitions useful for the evaluation of clinical trials enrolling patients with cardiogenic shock, including trials evaluating mechanical circulatory support devices. Several in-person and virtual meetings were convened between 2020 and 2022 to discuss the need for developing the standardized definitions required for evaluation of mechanical circulatory support devices in clinical trials for cardiogenic shock patients. The expert panel identified key concepts and topics by performing literature reviews, including previous clinical trials, while recognizing current challenges and the need to advance evidence-based practice and statistical analysis to support future clinical trials. For each category, a lead (primary) author was assigned to perform a literature search and draft a proposed definition, which was presented to the subgroup. These definitions were further modified after feedback from the expert panel meetings until a consensus was reached. This manuscript summarizes the expert panel recommendations focused on outcome definitions, including efficacy and safety.</p