Global policies on disaster risk reduction have highlighted individual and community responsibilities and roles in reducing risk and promoting coping capacity. Strengthening local preparedness is viewed as an essential element in effective response and recovery. This paper presents a synthesis of available literature on household preparedness published over the past 15 years. It emphasizes the complexity of preparedness, involving personal and contextual factors such as health status, self-efficacy, community support, and the nature of the emergency. In addition, people require sufficient knowledge, motivation and resources to engage in preparedness activities. Social networks have been identified as one such resource which contributes to resilience. A predominant gap in the literature is the need for evidence-informed strategies to overcome the identified challenges to household preparedness. In particular, the construct of social capital and how it can be used to foster individual and community capacity in emergency situations requires further study.
This article presents findings from a qualitative study of six occupational therapists in the first year of their career, with a focus on the experience of transition and how beginning practitioners learn about doing practice. An initial interview was conducted with each participant in the third to fifth months of practice. The participants then maintained a journal for one month. A second interview was held with each participant in the eighth to tenth months of practice, which explored the learning experiences documented in the journals and changes in knowledge and skills since beginning practice. The transitional experiences of the participants revealed that they were challenged by their limited practical experience, the responsibilities of client care, system issues and role uncertainty. The support of colleagues and peers was critical to their learning and eased their adjustment from student to occupational therapist. The relationship with clients was particularly valuable to the participants' learning and professional identity. Recommendations to bridge academic and clinical settings and ease the transition from student to therapist are proposed.
Complexity is a useful frame of reference for disaster management and understanding population health. An important means to unraveling the complexities of disaster management is to recognize the interdependencies between health care and broader social systems and how they intersect to promote health and resilience before, during and after a crisis. While recent literature has expanded our understanding of the complexity of disasters at the macro level, few studies have examined empirically how dynamic elements of critical social infrastructure at the micro level influence community capacity. The purpose of this study was to explore empirically the complexity of disasters, to determine levers for action where interventions can be used to facilitate collaborative action and promote health among high risk populations. A second purpose was to build a framework for critical social infrastructure and develop a model to identify potential points of intervention to promote population health and resilience. A community-based participatory research design was used in nine focus group consultations (n = 143) held in five communities in Canada, between October 2010 and March 2011, using the Structured Interview Matrix facilitation technique. The findings underscore the importance of interconnectedness of hard and soft systems at the micro level, with culture providing the backdrop for the social fabric of each community. Open coding drawing upon the tenets of complexity theory was used to develop four core themes that provide structure for the framework that evolved; they relate to dynamic context, situational awareness and connectedness, flexible planning, and collaboration, which are needed to foster adaptive responses to disasters. Seven action recommendations are presented, to promote community resilience and population health.
The EnRiCH Project was formed to address challenges with disaster management for high risk populations. The theoretical foundation is based on salutogenesis, systems theory and community resilience, with emphasis on community assets, social capital, citizen participation, and collaborative practice, which support adaptive capacity to respond and recover from adverse events. We present results from the process evaluation of the use of the structured interview matrix (SIM) facilitation technique as a first step in asset-mapping for a community resilience intervention. Nine SIM sessions were conducted across five geographic communities (n = 143) with professionals and volunteers from emergency management, health and social services, community organisations and citizens who represent high risk populations. Open-ended questionnaires were completed by (n = 139) participants to document experiences of partaking in the session. Content analysis suggests that the SIM is an effective technique to enhance connectedness, common ground, collaborative action, and awareness of existing services and supports in each community.
The SQ with shortened prognostication periods may be useful in nursing homes and provides a mechanism to facilitate discussions on palliative care. However, a better understanding of palliative care and increasing staff's comfort with prognostication is essential to a palliative care approach.
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