Purpose -This paper primarily aims to address the following research question: Are techniques and practices developed for uninterrupted, for-profit supply chains adaptable to the not-for-profit (NFP), interrupted context? In other words, can the managerial tools of business logistics be used in humanitarian relief logistics? Design/methodology/approach -A combination of grounded research and case-based research methods is used. Grounded research methods involve coding interview data to enable constant comparison of the data with emerging categories. Three managerial representatives of a single case organisation, the Mennonite Central Committee (MCC), are interviewed. Findings -MCC is a small NFP organisation operating in interrupted environments. As a matter of strategy, it pursues economic and social objectives. Strategic partnerships with ''like-minded'' organisations are critical to achieve these objectives. To assess its achievements, MCC needs a wide range of performance measures. Research limitations/implications -Since the paper is based on a single case, it is difficult to generalise the results beyond MCC, a small, faith-based NFP providing humanitarian assistance. There are future research opportunities to study more cases and search for additional themes. Practical implications -Partnerships and performance measurement are important elements of supply chain management (SCM) in humanitarian relief, characterised by NFP operations in interrupted environments. SCM tools and techniques created in the for-profit or business context, for partnership formation (e.g. ''how to commit'') and performance measurement (e.g. balanced scorecard), should be adapted for the humanitarian context. Originality/value -There is a growing literature on supply chain interruptions, but very little research on NFP sector supply chains, despite pressing needs for effective SCM within the NFP context. Also, there are relatively few studies on adapting business logistics practices for the humanitarian logistics context. The paper addresses these issues.
In this population-based study, the occurrence of rheumatoid arthritis (RA, incidence, prevalence, age of onset) was examined in the entire population of Manitoba, Canada, which was then divided into First Nations (FN, indigenous to Canada) and non-FN. FN had a higher prevalence and incidence of RA and were younger at disease onset than the non-FN. In addition FN patients had fewer rheumatology visits which probably adds to the burden this disease represents for them. Supplemental digital content is available in the text.
Limited research exists examining long-term mental and physical health outcomes in adult survivors of pediatric burns. The authors examine the postinjury lifetime prevalence of common mental and physical disorders in a large pediatric burn cohort and compare the results with matched controls. Seven hundred and forty five survivors of childhood burns identified in the Burn Registry (<18 years old and total BSA >1% between April 1, 1988 and March 31, 2010) were matched 1:5 to the general population based on age at time of injury (index date), sex, and geographic residence. Postinjury rate ratio (RR) was used to compare burn cases and control cohorts for common mental and physical illnesses through physician billings, and hospital claims. RR was adjusted for sex, rural residence, and income. Compared with matched controls, postburn cases had significantly higher RR of all mental disorders, which remained significant (P < .05) after adjustment (major depression RR = 1.5 [confidence limit {CL}: 1.2-1.8], anxiety disorder RR = 1.5 [CL: 1.3-1.8), substance abuse RR = 2.3 [CL: 1.7-3.2], suicide attempt RR = 4.3 [CL: 1.6-12.1], or any mental disorder RR = 1.5 [CL: 1.3-1.8]). The relative rate of some physical illnesses was also significantly increased in burn survivors: arthritis RR = 1.2 (CL: 1.1-1.4), fractures RR = 1.4 (CL: 1.2-1.6), total respiratory morbidity RR = 1.1 (CL: 1.02-1.3), and any physical illness RR = 1.2 (CL: 1.1-1.3). Adult survivors of childhood burn injury have significantly increased rates of postburn mental and physical illnesses. Screening and appropriate management of these illnesses is essential when caring for this population.
Epidemiologic study, level IV.
Background: Self-inflicted trauma (SIT) is a public health issue ranking 4th as leading cause of death and disability in young adults. Methods: Retrospective descriptive analysis of patients admitted to a level 1 trauma centre with self-inflicted injuries, 2008-2013. Results: Over a 5-year period, 268 patients with SIT presented to our hospital, 177 (66%) male, average age 39.4 years (SD 16). The most common mechanism of injury was stabbing, (47%), followed by jumping (26.86%). Jumpers had higher ISS (22 v. 9). Seasonal variation showed summer with highest incidence (34%), winter having the lowest (17%). Patients from rural areas accounted for 28%, these were younger (30 v. 42 years, p = 0.002), had lower ISS (9 v. 14, p = 0.007), presented with more firearm injuries (18.6% vs. 2.3%). Overall, 63 (23%) patients had pre-existing psychiatric disease; these patients had longer LOS (20 v. 7 days, p = 0.002), and had jumping from height as predominant mechanism (p = 0.01). Mortality was 13.8%. Patients that died were older (42 v. 30 years, p = 0.002), had higher ISS (14 v. 9, p = 0.007), longer LOS (13.5 v. 6 days, p = 0.004), with fall being the predominant mechanism associated with mortality (p < 0.0001). Conclusion:Our study defines and characterizes the population at risk for SIT in an attempt to implement appropriate prevention strategies and improve the existing post-injury care pathway.Abdominal compartment syndrome in the child. Gilgamesh Eamer,* Ioana Bratu.
phone diaries to capture contextual features of STI/HIV-risk that could impact disease acquisition among female sex workers (FSW). Methods Women engaging in transactional sex in the prior 90 days were recruited utilising incentivized snowball sampling. Participants completed STI testing and baseline/exit surveys. Over 4-weeks, they completed twice-daily electronic diaries assessing event-level sexual behaviour, condom use, and drug use. Weekly inperson interviews used open-ended questions to explore geographical characteristics of sexual encounter locations as well as acceptability of event-level monitoring. Results 25/26 participants (median age 43.5 years) completed the 4-week study. At baseline, 27% tested positive for a STI. Participants completed 84.5% of 1,518 expected surveys and 95% of 106 expected interviews. Patterns of diary compliance were stable over time. Partnered sexual activity was captured in 21.4% of diaries. At the participant-level, most reported giving oral sex (84.7%) or vaginal sex (96.1%); fewer (19.2%) reported engaging in anal sex. Among women reporting partnered sexual behaviour with any partner type (i.e., new/regular customers, romantic partners), using condoms was reported 39.2%, 45.5% and 83.3% of the time for giving oral sex, vaginal sex, and anal sex respectively. At the event-level, the frequency of giving oral sex, vaginal sex or anal sex did not significantly change over time. Conclusions It is feasible to engage and retain FSW in a technologically-advanced study to characterise risk contexts of sexual events. Adherence to study protocol was high indicating event-level monitoring using cell phone based diaries is acceptable. These data can be utilised to improve our understanding of the individual, relational and environmental factors that influence STI/HIV acquisition among FSW. An EnvironmEntAl And PoliticAl Economic Zigong Center for Disease Control and Prevention, Zigong, ChinaBackground In Sichuan province, the criminalised status of female sex work, coupled with the mobility of female sex workers (FSWs), poses major challenges to gathering information about the organisation of the sex trade. Objectives This study has 2 main objectives: (1) To document the environmental risk factors in sex work venues; (2) To describe the sex trade industry in relation to political economic factors, including broader economic transformations. Methods We trained 3 FSWs to conduct participant observation and ethnographic field note writing, including "thick descriptions" (the pealing back of multiple layers of meaning during observations of social scenes). These observations were conducted in 9 sex work venues representing previously mapped FSW venues. Findings were contextualised with secondary historical sources. Findings Participant observation revealed that FSWs were independent when choosing where they worked and when they shifted to another work site. However, gender power inequalities between sex workers and their clients were also described. These power relationships are tied to s...
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