Research demonstrates that information sharing is facilitated by familiarity, and having a common understanding of problems, use of lexicon, and semantic meaning. These factors can be difficult to develop within extreme environments such as disasters as members of the multi‐agency system that responds often have limited experience of working together. Public inquiries repeatedly highlight the impact of information sharing difficulties on public safety, but limited academic research has focused on identifying concrete behaviours that facilitate interteam information sharing within such environments. This paper presents a case study of a national disaster response exercise involving 1,000 emergency responders. Data consist of structured observations, recordings of interteam meetings, and interviews with emergency responders. Results of mixed‐method analysis indicate that interteam information sharing is delayed by limited situation awareness and poor articulation. Conversely, adopting behaviours that promote common frames for understanding interteam capabilities and information requirements improves information sharing and potentially reduces cognitive effort required to process information. Findings contribute to interteam communication theory by highlighting that in complex, time‐constrained environments, having a shared understanding of responsibilities and information requirement is important for minimizing redundant deliberation and improving relevance and speed.Practitioner points Facilitating the exchange and interpretation of relevant information is important for improving situation assessment, decision‐making, and the implementation of appropriate actions for addressing risks.Interteam information sharing can be particularly challenging when teams are comprised of members from across different organizations with different language and cultures that must form ad hoc to rapidly respond to problems in extreme environments.Adopting communication strategies that develop common frames‐of‐reference can facilitate information sharing and interteam responses to disasters.
Introduction Maintaining skeletal muscle function throughout life is a crucial component of successful aging. Disadvantaged socioeconomic position (SEP) is associated with adverse health outcomes, but has not been extensively studied for the muscle disease sarcopenia. We aimed to determine the prevalence of probable sarcopenia, a precursor to sarcopenia diagnosis, based on the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) guidelines overall, and according to SEP. Methods This cross-sectional study comprised 3342 community-dwelling older adults [mean age (SD) 68.9 ± 6.3 years] from Wave 1 of the Irish Longitudinal Study on Ageing. Probable sarcopenia was identified using gender-specific cut-off values for handgrip strength as recommended by EWGSOP2. SEP was defined by educational attainment. Multivariate regression analysis was employed to determine associations between probable sarcopenia and pre-defined risk factors. Results Overall, 23.4% of the population had probable sarcopenia and was significantly higher in the subset with low compared with high SEP (28.9% vs 18.1%, p<0.001). Consistent with this, multivariate logistic regression analysis showed that disadvantaged SEP was a significant determinant of probable sarcopenia [OR, CI 1.48 (1.17, 1.87) p<0.001]. Other known risk factors, namely, increased age, low physical activity, comorbidity, and osteoarthritis were significantly associated with an increased likelihood of probable sarcopenia, while overweight/obesity appeared to be protective. Conclusion Disadvantaged SEP was an independent determinant of probable sarcopenia in community-dwelling older adults. These findings highlight that SEP and health inequality should be considered in prevention and treatment policy for sarcopenia in the community.
Individuals responsible for decision-making during critical incidents must wrestle with uncertainty, complexity, time pressure, and accountability. Critical incidents are defined as rare events where demand outstrips resources and where there are high stakes, uncertainty, and dynamic and ever-shifting elements that frustrate clear predictions. This paper argues that critical-incident decision-making is highly complex because many critical incidents have no such analogue, and thus there is no prior experience to draw upon. Further, while prescriptive models argue for a selection of a "best" outcome, rarely in critical incidents is there a "best" outcome and, instead, more likely a "least-worst" one. Most options are high risk, most will carry negative consequences, and many will be immutable and irreversible once committed to. This paper analyzes data collected from critical decision method interviews with members of the United States Armed Forces to explore the psychological processes of making (or not making) least-worst decisions in high-consequence situations. Specifically, and based on thematic analysis of interviews with those who have made least-worst decisions while serving as part of the Armed Forces, we identify a host of exogenous (external to the incident such as resources, political agendas) and endogenous factors (features of the incident itself-size, scale, duration) that affect the decision-making process. These factors have, to date, not been factored into theoretical models of how high-stakes decisions are made under conditions of uncertainty.Keyword Decision-making . Decision inertia . Choice . Uncertainty . Least-worst decisions When the Camp fire barreled toward this Sierra foothill town last Thursday morning, officials had a crucial choice to make right away: How much of Paradise should be evacuated? . . . So, this time, they decided not to immediately undergo a full-scale evacuation, hoping to get residents out of neighborhoods closest to the fires first before the roads became gridlocked. . . . But it soon became clear that the fire was moving too fast for that plan, and that the whole town was in jeopardy. A full-scale evacuation order was issued at 9:17 a.m., but by then the fire was already consuming the town.
BACKGROUND: Sarcopenia is characterized by the accelerated loss of muscle strength, mass, and function in aging. The disease is a major public health issue with emerging evidence of a disproportionate burden in areas of socioeconomic disadvantage. OBJECTIVES: To estimate the prevalence of probable sarcopenia overall, and according to Socioeconomic Position (SEP). To explore the association between markers of SEP and probable sarcopenia. DESIGN: Cross-sectional analysis of the English Longitudinal Study of Ageing data. SETTING: England, United Kingdom (UK). PARTICIPANTS: This study comprised 6,052 older adult participants from Wave 6 of the English Longitudinal Study of Ageing (ELSA) aged 60 years and older. MEASUREMENTS: Probable sarcopenia was identified by the EWGSOP2 guidelines as low hand grip strength (females <16kg and males <27kg) or poor chair rise test performance (completion of 5 chair rises >15 seconds). Socioeconomic position was defined by educational attainment and subjective social status (SSS). Weighted multivariable regression analysis was employed to identify determinants of probable sarcopenia. RESULTS: Over one-third of older adults met the criteria for probable sarcopenia (33.7%; weighted, 36.1%) in the study population of mean age 70.7 (SD 7.7) years. When examined by SEP, the prevalence of probable sarcopenia was over 2-fold higher in adults in the most vs the least disadvantaged SEP groups (47.0% vs 20.6%, respectively, p<0.001). Multivariable regression analysis identified disadvantaged SEP, as measured by educational attainment and SSS, as independent predictors of probable sarcopenia, along with older age, physical inactivity, underweight BMI, chronic conditions, osteoarthritis, and minority group ethnicity. CONCLUSIONS: Disadvantaged SEP was associated with an increased likelihood of probable sarcopenia when controlled for other known risk factors. The findings suggest a need and opportunity for sarcopenia prevention and treatment strategies to address socioeconomic disadvantage in policies and practice.
Ireland 65 will reach 1.4 m by 2046 1. Specifically, the Economic and Social Research Institute (ESRI) project a 94.0% increase in the number of people aged 80 years and older nationally between 2015-2030 2. This marked increase will be relevant in areas such as Dublin North City where the population aged 80 years and over currently remains higher than the national average at 3.2% 3 .
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