Comparative Advantage in Disaster Response

This paper introduces a framework for a systematic analysis of the comparative advantages of various types of emergency responders. Our hypothesis is that one can define and then test comparative advantages across categories of actors and that a policy-making framework can help prepare better disaster responses in the future. We present an analytic framework that categorizes NGOs, governments, militaries and private responders at various levels. This initial theoretical framework provides a structure to begin to analyze comparative advantage. It suggests that there might be better combinations and sequences of responders in given situations. With the basic theory set forth, the framework is tested against data from two cases: 1) the disaster response following the 2004 Tsunami in Sri Lanka and 2) the response in Honduras after Hurricane Mitch in 1998. Ultimately, this work is intended to inspire other researchers interested in questions of disaster response to employ this methodology to develop and publish cases as well, creating a body of analysis that could then be further refined into policy recommendations to improve humanitarian emergency efforts.This publication is Hauser Center Working Paper No. 38. The Hauser Center Working Paper Series was launched during the summer of 2000. The Series enables the Hauser Center to share with a broad audience important works-in-progress written by Hauser Center scholars and researchers

Psychosocial impact of undergoing prostate cancer screening for men with BRCA1 or BRCA2 mutations.

OBJECTIVES: To report the baseline results of a longitudinal psychosocial study that forms part of the IMPACT study, a multi-national investigation of targeted prostate cancer (PCa) screening among men with a known pathogenic germline mutation in the BRCA1 or BRCA2 genes. PARTICPANTS AND METHODS: Men enrolled in the IMPACT study were invited to complete a questionnaire at collaborating sites prior to each annual screening visit. The questionnaire included sociodemographic characteristics and the following measures: the Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale (IES), 36-item short-form health survey (SF-36), Memorial Anxiety Scale for Prostate Cancer, Cancer Worry Scale-Revised, risk perception and knowledge. The results of the baseline questionnaire are presented. RESULTS: A total of 432 men completed questionnaires: 98 and 160 had mutations in BRCA1 and BRCA2 genes, respectively, and 174 were controls (familial mutation negative). Participants' perception of PCa risk was influenced by genetic status. Knowledge levels were high and unrelated to genetic status. Mean scores for the HADS and SF-36 were within reported general population norms and mean IES scores were within normal range. IES mean intrusion and avoidance scores were significantly higher in BRCA1/BRCA2 carriers than in controls and were higher in men with increased PCa risk perception. At the multivariate level, risk perception contributed more significantly to variance in IES scores than genetic status. CONCLUSION: This is the first study to report the psychosocial profile of men with BRCA1/BRCA2 mutations undergoing PCa screening. No clinically concerning levels of general or cancer-specific distress or poor quality of life were detected in the cohort as a whole. A small subset of participants reported higher levels of distress, suggesting the need for healthcare professionals offering PCa screening to identify these risk factors and offer additional information and support to men seeking PCa screening