Resilience and Coping for the Healthcare Community: A Post-disaster Group Work Intervention for Healthcare and Social Service Providers

Healthcare and social service providers play a critical role in supporting children, families and communities immediately after a disaster and throughout the recovery process. These providers, who may have also experienced the disaster and related losses, are among the least likely to receive mental health or psychological support which can result in burnout, secondary traumatic stress, depression and anxiety. Accessible psychosocial interventions designed for healthcare and social service providers in the aftermath of a disaster are therefore critical to recovery and to ensure providers are available to support families after future disasters. The purpose of this article is to describe Resilience and Coping for the Healthcare Community (RCHC), a manualized group work intervention for social service and health care providers who have provided care to children, families, and communities after a natural disaster. RCHC is currently being delivered in response to Hurricanes Harvey and Maria, storms that struck the gulf coast of the United States and the island of Puerto Rico in 2017. RCHC has also been used in the areas affected by Hurricane Sandy (New York and New Jersey), in Shreveport, Louisiana following severe flooding and in Saipan after a Typhoon devastated the island. Healthcare and social service providers who have received RCHC include the staff of Federally Qualified Health Centers and other community clinics, Disaster Case Managers, Child Care Providers, Mental Health Providers and First Responders. The health and wellbeing of these providers directly impacts their ability to provide quality care to families in their communities. This article presents the theoretical foundations of the RCHC intervention, describes the intervention in detail, provides a description of early and ongoing evaluation studies, and discusses the conditions for both implementation of RCHC and training of RCHC providers. The RCHC psychoeducational intervention provides education on, and strategies for, acute, chronic and post-traumatic stress, coping, and resilience, tailored for the needs of the helping professions. Through the use of individual and collective processing, healthcare and social service providers participating in RCHC develop both individual and collective coping plans. Considering the short and long-term impacts of disasters on communities’ essential healthcare and social service workforce, interventions like RCHC stand to provide essential benefits, including retention and wellbeing of providers of family services

Testing the Underlying Chemical Principles of the Biotic Ligand Model (BLM) to Marine Copper Systems: Measuring Copper Speciation Using Fluorescence Quenching

Speciation of copper in marine systems strongly influences the ability of copper to cause toxicity. Natural organic matter (NOM) contains many binding sites which provides a protective effect on copper toxicity. The purpose of this study was to characterize copper binding with NOM using fluorescence quenching techniques. Fluorescence quenching of NOM with copper was performed on nine sea water samples. The resulting stability con- stants and binding capacities were consistent with literature values of marine NOM, show- ing strong binding with log K values from 7.64 to 10.2 and binding capacities ranging from 15 to 3110 nmole mg C −1 . Free copper concentrations estimated at total dissolved copper concentrations corresponding to previously published rotifer effect concentrations, in the same nine samples, were statistically the same as the range of free copper calculated for the effect concentration in NOM-free artificial seawater. These data confirms the applicability of fluorescence spectroscopy techniques for NOM and copper speciation characterization in sea water and demonstrates that such measured speciation is consistent with the chemical principles underlying the Biotic Ligand Model (BLM) approach for bioavailability-based metals risk assessment

Framing Collaboration: Archives, IRs, and General Collections

Collaborative collecting highlights the opportunity for liaison librarians and archivists in academic libraries to develop an integrated and holistic approach to the successful collection of library materials. Yet as academic libraries become the central location for general collections, institutional repositories, university archives, manuscript collections, and other special collections, the world of collecting in academic libraries becomes more siloed. The profession stands to benefit from a stronger realization of shared collecting practices. Liaison librarians have the potential to provide critical information to archivists in support of faculty collecting and research. Archivists have the opportunity to provide liaison librarians with context about university units and the organization’s broader history. Shared information can result in more robust collecting policies and practices across the library

Accounting for undesirable outputs in productivity measurements: Application to the California-Oregon drift gillnet fishery

Many production activities typically produce undesirable outputs, e.g., the production of the pollutant sulfur dioxide in the generation of electricity. Traditional economic metrics may overstate the efficiency and productivity of these production activities by failing to account for the undesirable outputs. These omissions can lead to conclusions that are biased against resource conservation and protection. Many fisheries capture their target species concomitantly with undesirable outputs such as bycatch of juvenile fish, marine mammals, sea birds, and sea turtles. One such fishery is the California-Oregon (CA/OR) drift gillnet fishery (DGNF), which incidentally takes protected species, such as sea turtles and marine mammals while harvesting swordfish and thresher shark. Beginning in August of 2001, regulatory measures to reduce the take of endangered species (e.g., leatherback sea turtles) have required the annual closure of an area located between Point Conception and 45?? N. latitude, for the time period August 15 to November 15. This regulatory closure acts as a natural experiment for assessing the impact of the time-area closure on the productivity of the CA/OR DGNF. The three primary purposes of this research were to measure the impact of the 2001 time-area closure on the productivity of the CA/OR DGNF, and to estimate the opportunity cost or shadow price of undesirable outputs. These shadow prices provide lower bound estimates of the social costs of conservation regulations intended to protect endangered leatherback sea turtles and other bycatch species. An alternative method which models the joint production of both desirable and undesirable outputs, the directional output distance function approach, was used to estimate the efficiency and productivity of drift gillnet fishing trips, thus crediting trips with reductions in undesirable harvest and increases in desirable outputs for the time period 1996-2008. By incorporating undesirable harvest into the production process, a more appropriate measure of total factor productivity was calculated than what is provided by traditional productivity measures. The new productivity measure can be used to develop more effective policies designed to maintain or improve a fishery\u27s economic performance. The results indicate that efficiency and productivity measures which ignore undesirable outputs substantially misinterpret the economic performance of economic trips. The model that incorporates undesirable outputs indicates that productivity per trip has been growing by 788 pounds of swordfish over the research period relative to the base year. This is considerably lower than the average growth of 964 pounds when undesirable outputs are ignored and 878 pounds when undesirable outputs are allowed to expand. However, post-closure averages suggest that conventional estimates understate the economic performance of the observed trips. Post-closure productivity growth resulted in an increase of 334 pounds of swordfish harvest when adjusted for undesirable outputs. Average trip shadow prices (per animal captured) revealed a conservation opportunity cost for the reduction of undesirable outputs of &2,500 for marketable discards, &6,600 for unmarketable discards, &28,800 for sea turtles, and &9,800 for marine mammals in forgone composite swordfish and thresher shark revenue

Three- versus four-factor prothrombin complex concentrate for the reversal of warfarin-induced bleeding

Objective: The objective of this study was to evaluate the effectiveness of 3-factor prothrombin complex concentrate (3F-PCC) compared to 4-factor PCC (4F-PCC) in warfarin-associated bleeding. Methods: This multicenter, retrospective, cohort study analyzed data from patients admitted between May 2011 and October 2014 who received PCC for warfarin-associated bleeding. The primary outcome was the rate of international normalized ratio (INR) normalization, defined as an INR ≤1.3, after administration of 3F-PCC compared to 4F-PCC. Other variables of interest included the incidence of additional reversal agents, new thromboembolic events, and mortality. Results: A total of 134 patients were included in the analysis. The average dose of PCC administered was 24.6 ± 9.3 units/kg versus 36.3 ± 12.8 units/kg in the 3F-PCC and 4F-PCC groups, respectively, P < 0.001. Baseline INR in the 3F-PCC and 4F-PCC groups was 3.61 ± 2.3 and 6.87 ± 2.3, respectively P < 0.001. 4F-PCC had a higher rate of INR normalization at first INR check post-PCC administration compared to 3F-PCC (84.2% vs. 51.9%, P = 0.0001). Thromboembolic events, intensive care unit and hospital length of stay, and mortality were similar among both groups. Conclusion: The use of 4F-PCC leads to a more significant reduction in INR compared to 3F-PCC though no difference in mortality or length of stay was observed. Thromboembolism rates were similar among both groups